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I Dear Editor i , Naevi typically involute after the fourth decade of life and are rare in the elderly.1,2 However, the rate at which naevi disappear with age varies greatly with some individuals still having large numbers of naevi in late middle age. Melanocytic lesions fulfilled the following 4 criteria: (i) a clinical-dermoscopic diagnosis of enlarging naevus with a peripheral rim of brown clods as in accordance with Kittler4; (ii) lesions that showed a growth and maintained a growth were routinely excised; (iii) no other dermoscopic signs of melanoma, and (iv) a histopathologic diagnosis of naevus or melanoma. [Extracted from the article]

Background: Different lifestyle and dietetic factors have been linked with the onset and severity of acne. Objective: To assess the complex interconnection between dietetic variables and acne. Methods: This was a reanalysis of data from a case-control study by using a semantic connectivity map approach. 563 subjects, aged 10-24 years, involved in a case-control study of acne between March 2009 and February 2010, were considered in this study. The analysis evaluated the link between a moderate to severe acne and anthropometric variables, family history and dietetic factors. Analyses were conducted by relying on an artificial adaptive system, the Auto Semantic Connectivity Map (AutoCM). Results: The AutoCM map showed that moderate-severe acne was closely associated with family history of acne in first degree relatives, obesity (BMI ≥ 30), and high consumption of milk, in particular skim milk, cheese/yogurt, sweets/ cakes, chocolate, and a low consumption of fish, and limited intake of fruits/vegetables. Conclusion: Our analyses confirm the link between several dietetic items and acne. When providing care, dermatologists should also be aware of the complex interconnection between dietetic factors and acne. [ABSTRACT FROM AUTHOR]

It is stated that patients with vitiligo have an increased risk of developing autoimmune diseases. The aim of this study was to estimate the prevalence of autoantibodies or overt autoimmune diseases in a group of vitiligo patients examined among a sample deemed to be representative of the general population of young men living in southern Italy. A total of 60 vitiligo patients were identified among 34 740 potential conscripts visited to evaluate their fitness to compulsory service in Italian Navy, obtaining a prevalence of 0.17% (95% CI: 0.13-0.22), which was deemed the prevalence of vitiligo in the Italian general population of the same age and sex. Forty of these vitiligo patients underwent blood test including also the search of the main autoantibodies. Circulating autoantibodies were detected in 42.5% of subjects. Anti-thyroglobulin antibodies were documented in 27.5%, anti-thyroperoxidase in 22.5%, anti-smooth muscle in 17.3%, anti-nuclear, anti-mitochondrial and anti-gastric parietal cells in 2.5% respectively. Only in two cases (5%) an overt thyroid disease was diagnosed. No significant association between the extension of the skin involved/clinical course of the disease and circulating autoantibodies was detected. Circulating autoantibodies (particularly anti-thyroid antibodies) were statistically associated with a lower duration of the disease. In agreement with other studies, autoantibodies in the lack of clinical manifestations have been frequently observed in our vitiligo patients, especially during the early phase of the disease. The clinical significance of this finding seems to be limited, with the possible exception of thyroid disease, and it needs further exploration, through large cohort studies. [ABSTRACT FROM AUTHOR]

Background Few studies on the prevalence and incidence of many skin conditions in the general population are available because it is difficult to submit to dermatologic examination large samples of seemingly healthy population. Objective The aim of this study was to estimate the prevalence of several skin conditions among a sample that is deemed to be representative of the general population of young men living in southern Italy. Patients/Methods Potential conscripts resident in the coastal regions of southern Italy and called at the age of 18 to the Draft's Council Medical Unit in Taranto underwent a clinical and instrumental examination to evaluate their psycho-physical fitness to compulsory service in Italian Navy. From January 1998 to April 2004 a dermo-epidemiologic project named EpiEnlist (EPIdemiology in ENLISTed Men) project was carried out by the Department of Dermatology of the Italian Navy Hospital in Taranto under the auspices of the Italian Group for Epidemiological Research in Dermatology. All the subjects showing skin lesions evocative of neurofibromatosis (NF), congenital melanocytic nevus (CMN), Becker nevus (BN), and vitiligo were referred to the Department of Dermatology of the Italian Navy Hospital for confirming the diagnosis. The confirmed cases were recorded in a predefined patient's card, containing the main anamnestic, clinical, instrumental, and laboratory data. Results Because the recording of the various conditions started and ended in different times, the total number of examined subjects varied. NF type 1 was diagnosed in 6 of 34 740 subjects [prevalence 1:5735 or 0.017%; 95% confidence interval (95% CI), 0.0008–0.0037], CMN in 157 of 23 354 (prevalence 1:148 or 0.67%; 95% CI, 0.57–0.79). BN was observed in 70 of 27 954 young men (prevalence 1:399 or 0.25%; 95% CI, 0.15–0.35), and its mean age of appearance was 11.9 years (minimum 5–maximum 17). In 41 subjects (58.6%), the age of appearance was over 10 years. Vitiligo was recorded in 60 of 34 740 persons (prevalence 1:579 or 0.17%; 95% CI, 0.13–0.22). In 40 subjects with vitiligo, the blood test was done: in 40% of these circulating autoantibodies, mainly anti-thyroid (25.6%) and anti-smooth muscle (17.3%) autoantibodies were detected, but only in 5% of cases, a thyroid disease was diagnosed, and no other sign of autoimmune diseases was observed. Conclusions The epidemiological data of the skin conditions considered in the present study can be considered roughly in agreement with those reported in the available surveys. Because they were obtained in a large sample of Italian young males from the general population, they can be useful for therapeutic and preventive interventions by the public health organizations. [ABSTRACT FROM AUTHOR]

Background Recently, we identified and described dermoscopic aspects, present with a higher frequency in congenital melanocytic lesions with respect to acquired naevi. We also classified small- and medium-sized congenital naevi (CN) into nine subtypes according to their macroscopic and dermoscopic aspects. Objectives Because the recognition of dermoscopic features may be instrument dependent, in this study, we wanted to check whether dermoscopic patterns specific for CN can be identified in digital images acquired by means of different instruments. We also wanted to check the validity of our previously proposed classification and assess possible age- and site-dependent variations of dermoscopic patterns and naevus subtypes. Patients/methods Images corresponding to 384 small- or medium-sized CN were collected in eight different centres employing four different instruments. Lesion images were evaluated and checked for the presence of specific dermoscopic criteria, classified, and compared with a database of 350 acquired naevi. Results Specific and unspecific dermoscopic features were identifiable in images acquired by means of all four instrument types. The mean number of identified features per lesion did not vary according to the instrument employed for the acquisition of the images; however, it was lower for lesions recorded employing low magnifications. The previously proposed classification was easily applied to the whole image database. The variegated naevus type was identified as a highly specific clinical/dermoscopic pattern. Dermoscopic features varied according to age and location. The globular type prevailed in subjects under 11 years of age and on the trunk, whereas the majority of reticular lesions were located on the limbs. Conclusions Because definite clinical and histological criteria for the diagnosis of the congenital nature of naevi are lacking, the use of dermoscopy can be of great help in identifying those lesions where the presence of specific dermoscopic features makes the diagnosis of CN more likely. Moreover, dermoscopy can be useful both for the classification of lesions already identified as congenital according to definite clinical and anamnestic data and for a possible correlation of naevus phenotype and dermoscopic patterns to the risk of developing a malignant melanoma in prospective studies. [ABSTRACT FROM AUTHOR]

Abstract Background The most frequently employed diagnostic criteria of atopic dermatitis (AD) can be fulfilled in the absence of elevated total circulating IgE or specific IgE to food allergens or environmental aeroallergens and/or in the absence of personal or familial history of atopy as well. Therefore a distinction between ‘extrinsic’ or ‘allergic’ and ‘intrinsic’ or ‘non-allergic’ AD has been suggested. Recently, a patch test with environmental aeroallergens, named atopy patch test (APT), has been proposed for use in the study of AD. Objective The aim of this study was to investigate the reactivity to APT in patients with ‘extrinsic’ and ‘intrinsic’ AD. Patients, materials and methods Two groups of adult male subjects with AD were examined consecutively in our department (Department of Dermatology, Italian Navy Main Hospital, Taranto, Italy) and patch tested with whole bodies of house dust mites (HDM) at a concentration of 20% in petrolatum (Dermatophagoides pteronyssinus 50%, D. farinae 50%). The groups included: (i) 95 patients affected by the adult clinical form of ‘extrinsic’ AD; (ii) 12 patients affected by the adult clinical form of ‘intrinsic’ AD; and (iii) a control group of 49 adult healthy male subjects with a negative anamnesis for eczema and atopy and negative skin prick test to aeroallergens/food allergens and/or normal level of total circulating IgE, also patch tested with the same allergen. The statistical differences were calculated by χ2 test and 95% confidence intervals (CI) were provided. Results The APT was positive in 47.4% (CI: 37–57%) of ‘extrinsic’ AD, in 66.6% (CI: 41–93%) of ‘intrinsic’ AD and in 12.2% (CI: 3–21%) of healthy subjects. The differences between the two AD subgroups and the control group were statistically significant (P < 0.001). Conclusions... [ABSTRACT FROM AUTHOR]

Pityriasis versicolor is a superficial fungal disease with a world-wide distribution, but there are few available studies on its prevalence in the general population. To assess the prevalence of pityriasis versicolor in a representative sample of young Italian sailors, evaluating the influence of habits and risk factors in the affected individuals. Young cadets ( n = 1024: 975 men and 49 women, mean age 22 years) of the Italian Navy Petty Officers' School in Taranto were consecutively examined by the same observer. The diagnosis of pityriasis versicolor was based on clinical picture and/or Wood's lamp examination. All the subjects filled in a questionnaire about sport practice, swimming pool attendance, marching, presence of hyperhidrosis and a positive clinical history of pityriasis versicolor in the past. The affected individuals were also asked if they were aware of their skin lesions. Differences between answers of affected and unaffected subjects were tested by Fisher's exact P-value test, and odds ratios were calculated. Pityriasis versicolor was diagnosed in 22 subjects (2·1%), all men, of whom 15 (68%) were not aware of their condition. No statistical association was found between active pityriasis versicolor and sport practice, swimming pool attendance, marching or presence of hyperhidrosis. A significant association [odds ratio 8·7 (95% confidence interval 3·3–21·5); Fisher's exact P-value test P < 0·01] was documented between active pityriasis versicolor and a previous clinical history of pityriasis versicolor. The prevalence of pityriasis versicolor in this sample of young Italian sailors was not high, in agreement with the available surveys performed in the general population in temperate climates. Many affected subjects were not aware of their condition. The only important factor associated with pityriasis versicolor was a previous history of pityriasis versicolor. This observation could confirm the hypothesis that constitutional factors, e.g. seborrhoea and chemical constitution of sebum, may play a crucial role in temperate climates, leading to relapsing forms of this superficial mycosis. [ABSTRACT FROM AUTHOR]