Search

Background: Guidelines recommend limiting melanoma screening in a population with known risk factors, but none indicates methods for efficient recruitment. The purpose of this study is to compare three different methods of recruiting subjects to be screened for melanoma to detect which, if any, is the most efficient., Methods: From 2010 to 2019, subjects were recruited as follows: (1) regular skin examinations (RS), mainly conducted through the Associazione Contro il Melanoma network; (2) occasional melanoma screening (OS), during annual public campaigns; (3) and selective screening (SS), where people were invited to undergo a skin check after filling in a risk evaluation questionnaire, in cases where the assigned outcome was intermediate/high risk. Melanoma risk factors were compared across different screening methods. Generalized Linear Mixed Models were used for multivariable analysis., Results: A total of 2238 subjects (62.7% women) were recruited, median age 44 years (2-85), and 1094 (48.9 %) records were collected through RS, 826 (36.9 %) through OS, and 318 (14.2 %) through SS. A total of 131 suspicious non-melanoma skin cancers were clinically diagnosed, 20 pathologically confirmed, and 2 melanomas detected. SS performed significantly better at selecting subjects with a family history of melanoma and I-II phototypes compared to OS., Conclusions: Prior evaluation of melanoma known risk factors allowed for effective selection of a population to screen at higher risk of developing a melanoma.

The first aids to burned patients are fundamental for the evolution of the disease and the success of the next medical care in a Burns Center. In our 30-years experience, we can reassume that they must be provided to limit the cause of thermal damage, to evaluate and correct eventual respiratory or cardiovascular disorders, to find out the possible damage to different organs and the primary care on cutaneous lesions.

The authors discuss a brief history of lasers and their use in dermatology. Although the excellent results achieved by the use of laser in dermatology, this special treatment modality is in continuous evolution. At present, new devices have been under development for the therapy of different kind of diseases, while lasers, already in use, has been changing, in order to be more secure, effective and be useful in many others disorders.

The authors describe a case report characterised by asymptomatic papules and non-tender subcutaneous nodules as the isolated manifestations of gout.

Syphilis such as the other Sexually transmitted diseases are a cultural background of physician. The authors have presented this case of nodular secondary syphilis for three main reasons. The first one is that, in the last years, syphilis has re-emerged as the problem of public health. The second one is to underline how secondary syphilis, also known as the great imitator, may present itself with numerous manifestations, mimicking different dermatological diseases. Finally, because we want to remember how syphilis and the other sexual transmitted diseases must to be in the cultural background of a dermatologist, and have to be considered in the dermatological differential diagnosis.

The "inflammatory linear verrucous epidermal nevus" is a rare disease, consisting of hyperplasia of the normal components of the epidermis. Its clinical features include erythematous and hyperkeratosic, warty, sometimes psoriasiform or lichenoid patches with a typical linear arrangement. At present, there are no effective medical therapies available. Currently, the best therapeutic results are obtained with surgical excision or the latest laser therapy. The Authors present a 9-years old girl with an inflammatory linear verrucous epidermal nevus on her neck, successfully treated with CO 2 Laser ablation.

In a recent past, the incidence of syphilis has increased in various geographical regions. The authors describe a case of secondary syphilis mimicking palmoplantar psoriasis.

For more than a century, radiotherapy has been an effective treatment for oncologic patients. The Authors report a brief history of the radiation therapy and its actual indication for the treatments of cutaneous malignant diseases.

Erythema ab igne is a localised, cutaneous condition consisting of reticulate hyperpigmentation, epidermal atrophy, and telangiectasias. It is caused by repetitive and prolonged exposure to moderate heat that is insufficient for producing burns. Currently, erythema ab igne is most commonly observed following repeated use of hot water bottles, infrared lamps and heating pads. If not properly treated, erythema ab igne can become chronic and even malignant. We report a case of erythema ab igne, successfully treated with systemic mesoglycan-based therapy, and local therapy with bioflavonoids.

To retrieve the history of venous ulcers and of skin lesions in general, we must go back to the appearance of human beings on earth. It is interesting to note that cutaneous injuries evolved parallel to human society. An essential first step in the pathogenesis of ulcers was represented by the transition of the quadruped man to Homo Erectus. This condition was characterized by a greater gravitational pressure on the lower limbs, with consequences on the peripheral venous system. Furthermore, human evolution was characterized by an increased risk of traumatic injuries, secondary to his natural need to create fire and hunt (e.g. stones, iron, fire, animal fighting). Humans then began to fight one another until they came to real wars, with increased frequency of wounds and infectious complications. The situation degraded with the introduction of horse riding, introduced by the Scites, who first tamed animals in the 7th century BC. This condition exhibited iliac veins at compression phenomena, favouring the venous stasis. With time, man continued to evolve until the modern age, which is characterized by increased risk factors for venous wounds such as poor physical activity and dietary errors (1, 2).

Stigmata are one of the most ancient and fascinating mysteries of the Christian religion. The word “stigmata” derives by the Greek “stigma”, that means sign, mark. Classically, stigmata are the sores inflicted on Jesus Christ during his passion and crucifixion. Today, the term stigmatized has been extended to designate several cases of individuals, who show skin sores similar to those of Christ. The Authors report a brief history of stigmata, trying to give an explanation to such a fascinating phenomenon.

This is the final report of a large, controlled, multicenter Italian study on immuno- and chemotherapy in adult patients with burns affecting 20 to 95% of total body surface area (mean 35%). The antibiotic treatment of burn patients consisted of topical silver sulfadiazine, short-term antimicrobial chemoprophylaxis with pefloxacin (800 mg i.v. qd) for the first 4 days and polychemotherapy with teicoplanin (800 mg i.v. qd) together with netilmicin (300 mg i.m. qd) in one or more cycles of 5-12 days. At random, half of the patients received thymostimulin, 70 mg i.m. qd for the first month and every other day thereafter. The analysis at completion of 634 valid cases showed that when the results are stratified by means of the Roi risk index, 396 of the 530 patients who contracted wound infection (84%) after chemoprophylaxis were in the first three categories and a mean of 95% survived. Of the remaining 134 patients (Roi index 4-5) only 50% survived. There was no difference in survival of the immunotherapy group in comparison with the parallel group without thymostimulin. The short-term antimicrobial prophylaxis prevented wound infection in only 104 of 634 patients (16%) and they were at low risk (84% Roi index 1). Of the bacterial pathogens involved in septic complications Staphylococcus aureus and Pseudomonas aeruginosa were prevalent (86%): eradication was achieved in 43% of patients and clinical cure or improvement were seen with combination chemotherapy in 64% of all patients, mainly with only one treatment cycle. This value increased to 79% for the 395 protocol-complying patients and went down to 20% in the 135 non-compliers. The total survival of complier and non-complier patients was 447 of the 530 valid patients (84%). The overall mortality of the 634 evaluable patients was 13.1%, ranging from less than 2% to 68%. Burn mortality was directly proportional to the percentage of burned body surface area, to increasing age and other variables of the Roi index, a 50% mortality being associated with a 72.5% total body surface area burned. Normoergic burn patients had a mortality rate of 9.1% versus 35.7% in anergic patients.

The present paper reports the results of clinical and laboratory tests carried out on two homogeneous groups of ten burn patients subjected to local therapy, either with isotonic chloroxidating solution Amuchina* or with 1% silver sulfadiazine cream at the Burns Centre of the Pisa University Dermatological Clinic. The local systemic behaviour of the patients examined was evaluated for the containment of septic complications at the burn site. In the group subjected to treatment with chloroxidating solution, sepsis appeared to have a lower incidence in the evolution of dermatitis in the phase of escharolysis, in the formation of granulation tissue, and in the attachment of cutaneous grafts. The systemic involvement (temperature curve, etc.) appeared to be more marked for some patients treated with silver sulfadiazine in response to septic aggression of the burn wounds. On the basis of data referring to the development of the wound granulation and the temperature curve, as well as the microbial presence and the subjective tolerance of the medication, the comparison was favourable, making all necessary allowances, to topical treatment with electrolytic chloroxidating solution; other comparative data were at the limit of significance.