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Introduction: Cellulite (from Italian “cellulite”) is a widely used term to indicate a common condition afflicting women (ie, fat-lobular hypertrophy, which is localized mainly on thighs and buttocks). Despite the fact that several physiopathologic factors have been proposed for localized fat-lobular hypertrophy, the arena seems to be limited to vascular damage and lobular hypertrophy. These 2 components are known as the possible target of many different plant extracts, which may play an important role in influencing and reducing vascular damage and lobular hypertrophy.Materials and Methods: This study was aimed at evaluating the efficacy of a multifunctional plant complex in the treatment of localized fat-lobular hypertrophy. The study was carried out on a group of 25 subjects with clinical evidence of cellulite and on a control group of 15 subjects that received a placebo (2 capsules per day for a period of 2 months). The instrumental investigation measured baseline, intermediate, and final values of the following biophysical parameters: weight; arterial blood pressure; circumference of hips, thighs, and ankles; cutaneous fold thickness of hips; and measurement of the superficial microcirculation. Moreover, there was also a baseline and final assessment of circulating thyroid hormones and clotting analysis. Evaluation of the antioxidant efficacy of the product was tested and proved.Results: Volunteers' weight remained relatively constant during the study. Significant variations were recorded in the measurements of other biophysical cutaneous parameters (the circumference of hips, thighs, ankles; cutaneous fold thickness; skin microcirculation; and ultrasonography) in the group that had used the nonplacebo product, whereas the group who used the placebo did not present any significant variations. The thermographic data recorded a significant increase at the end of treatment. Significant variations in arterial blood pressure measurements, already 1 month after treatment in the first group, were observed. Thyroid function remained within normal range both before and after treatment; the variation in total cholesterol, low-density lipoprotein, and triglycerides were of no significance. No significant alterations were noted in the prothrombin concentration, whereas activated partial thromboplastine time (aPTT) and fibrinogen values were significantly increased in the treated volunteers. There was a significant reduction of the lipid peroxidase count and increase in the plasma total antioxidant capacity in the subjects who were nonsmokers and smokers.Conclusions: The data collected indicate that this multifunctional plant complex can reduce the dimensions of thighs and hips; decrease the thickness of underlying fat tissue while maintaining relatively constant body weight; and in particular improve blood circulation, which leads to the improvement of heat perfusion.

Darier–White disease (DWD) is a rare autosomal dominant genodermatosis, characterized by constant and typical histopathological findings, such as hyperkeratosis, dyskeratosis with corps rondsand grainsand papillary microvilli formation with suprabasal clefting. Despite its nearly constant histopathological presentation, unusual clinical variants are reported, such as the vegetating and cornifying ones. These variants share the same histopathological features of the classic type, except for the striking hyperkeratosis and acanthosis. Here, unreported pseudoepitheliomatous features are described in an elderly male patient with a long history of vegetating and verrucous papules and nodules of DWD, associated with typical nail involvement. These unique histolopathological changes were closely in conjunction with the characteristic microscopic features of DWD. Differential diagnosis with other pseudoepitheliomatous and acantholytic conditions such as reticulated seborrheic keratosis, inverted follicular keratosis, and acantholytic squamous cell carcinoma is also considered. Pseudoepitheliomatous features, in this case of vegetating DWD, could be regarded as a reactive epidermal phenomenon because of different stimuli, i.e. maceration, bacterial superinfection, and chronic scratching.

The aim of this focus is to establish the role of methotrexate (MTX) in the treatment of psoriatic disease (PD). Despite the lack of hard evidence, MTX can be regarded as the nonbiological drug of choice for the treatment of peripheral psoriatic arthritis, although its effect on psoriatic dactylitis, enthesitis, and spondylitis needs to be further studied by means of well conducted clinical trials. MTX is effective in improving the skin involvement of PD, and can be used in moderate to severe psoriasis before starting a biological agent. Although rheumatologists consider it relatively safe in PD, dermatologists are very concerned about its toxicity and so, until more definite data are available, precautions should be taken to prevent MTX-induced liver fibrosis and cirrhosis.

• A close association was noted between palmoplantar keratoderma (PPK) and Charcot-Marie-Tooth disease (CMT) in nine members of a family in five generations. Clinical, genealogic, electroneurophysiologic, chromosome, urinary amino acid, and histopathologic studies were performed to define the two entities. Charco-Marie-Tooth disease occurred with advancing age in all of the members with PPK, but in none without PPK. Palmoplantar keratoderma and CMT appear to be genetically associated and transmitted as an autosomal dominant trait. This is the first report, to our knowledge, of an association between PPK and CMT.(Arch Dermatol 116:789-790, 1980)

IN REPLY.— We wish to thank Dr Sybert, who has given us the opportunity to clarify the discrepancies between the text and the Table of our article. We hope that the Table accompanying this letter, compiled in accordance to the text, will clarify every question.Clinical and Electroneurophysiologic Data of Family Members* Patient/Age, yr/Sex PPK CMT Electrophysiologic Abnormalities Associated Defects I-1/M ND ND I-2/F ND ND II-1/F ND ND II-2/M ND ND II-3/62/M ND ND II-4/F ND ND -1/F ND ND III-2/52/M Clubbing of fingers III-3/45/F NP III-4/42/F Clubbing of fingers III-5/F NP III-6/40/M NP IV-1/F ND ND IV-2/31/M Myofibrillatory activity Clubbing of fingers IV-3/29/M Conduction velocity decreased HyperhidroIV-4/27/M Myofibrillatory activity Hyperhidrosis IV-5/24/F NP V-1/3/M NP V-2/1/F NPPPK indicates palmoplantar keratoderma; CMT, Charcot-Marie-Tooth disease; ND, not determined; and NP, not present.Changes under the heading "Electrophysiologic Abnormalities" are as follows. For patient III-5, "ND" should be changed to a