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In this study, a detailed phytochemical investigation of compounds in the twigs of the mistletoe Loranthus europaeus Jacq., which belongs to the Loranthaceae family, is presented. Specimens were collected from the mistletoe L. europaeus growing on oak trees in the mainland of Greece. The alliance of oaks and mistletoes became a symbol of knowledge and strength for many centuries. Although numerous compounds of aerial tissues of other mistletoes, e.g., Viscum album, have been published, few studies have been conducted to investigate the metabolic and physiological traits of the hemiparasitic, deciduous Loranthus europaeus. LC-HRMS-based analysis led to a detailed characterization of ethyl acetate and dichloromethane extracts of the twigs of L. europaeus, which, to the best of our knowledge, exhibit enhanced antioxidant potential. Hence, twenty-four and twenty-six compounds were tentatively identified from the ethyl acetate and dichloromethane twigs' extracts, respectively; these compounds belong to fatty acids, flavonoids, and flavonoid glycosides. Also, chlorophyll, soluble sugar, starch, and lipid contents in the twigs of L. europaeus, which have not hitherto been published, were investigated. [ABSTRACT FROM AUTHOR]

Contact dermatitis is a frequent skin disorder related to environmental and occupational etiological factors, which could potentially affect all age groups, as well as both genders. The current study is aimed at exploring the patterns of contact sensitization with respect to the population's occupational patterns in Greece. A retrospective analysis was performed in a cohort of 1978 patients from 2014 to 2016. Patients were divided into two categories; blue collars (BlC) and white collars (WhC), as well as detailed occupation was considered. Separation was performed on the basis of their profession, i.e., labor workers and handicraftsmen were sorted to the BlC group, while office employees were sorted to the WhC group. The common allergen in all occupational subgroups was nickel sulphate. The three most prevalent allergens in both BlC and WhC were nickel sulphate 5%, fragrance mix (I) 8%, and Balsam of Peru 25%. WhC males were uniquely sensitized to colophony 20% and formaldehyde 2%, and WhC females were uniquely sensitized to 5-chloro-2-methyl-4-isothiazolin-3-one (CMIT) and neomycin sulphate 20%. Sensitization to allergens manifested occupation-specific patterns. Allergic contact dermatitis surveillance is of great importance towards the clinical and systematic understanding of the disease, especially with respect to the patient's occupational profile. [ABSTRACT FROM AUTHOR]

Background: Oxidative hair dyes are an important source of chemical exposure and a major risk factor for the development of occupational and non‐occupational allergic contact dermatitis (ACD) worldwide. Objective: To identify the frequency of common allergens associated with occupational and non‐occupational ACD to hair dyes during the last 10 years, in Greece. Methods: We retrospectively reviewed the medical records of patients with suspected ACD to hair dyes from 2010–2019. All patients with patch‐test‐confirmed ACD to hair dyes were evaluated. Results: Out of 501 patients with suspected ACD to hair dyes, 362 had at least one positive reaction to hair dye allergens (62.4% were customers and 37.6% were hairdressers). The mean age of customers and hairdressers was 43.8 years and 30.8 years, respectively. Of the customers, 58.9% were exposed to dyes for >10 years and 61% of hairdressers for <5 years. The most common site of ACD among customers was the scalp (85%) and among hairdressers the hands (90%). p‐Phenylenediamine (PPD) was the most common contact allergen (52.2%), followed by toluene‐2,5‐diamine, p‐aminophenol, m‐aminophenol, and ammonium persulfate. Conclusions: Sensitization prevalences for PPD and cross‐reacting allergens have increased in Greece during the last decade, regardless of occupational or non‐occupational exposure to hair dyes. [ABSTRACT FROM AUTHOR]

The patient characteristics according to the MOAHLFA index were as follows: 619 (31.3%) male patients, 624 (31.6%) patients with occupational dermatitis, 692 (35.0%) with atopic dermatitis, 993 (50.2%) with hand dermatitis and 481 (24.3%) with leg dermatitis. At the population level, contact allergy to fragrances was quite frequent, affecting between 1.1% and 2.3% of the general population in Europe.[7] Finally, 31.55% of our patients had occupational dermatitis, reflecting the fact that our department is a specialized referral center for occupational dermatitis. The ongoing high prevalence of nickel allergy shows the importance of complying with nickel regulation, which includes consumer products.[[8]] Fragrance mix was the second most prevalent allergen, also suggesting a need for intervention. Acceptable risk of contact allergy in the general population assessed by CE-DUR--a method to detect and categorize contact allergy epidemics based on patient data. [Extracted from the article]

The aim of the study was to evaluate the antioxidant activity of extracts of aerial tissues (i.e. flowers, leaves, stems, twigs and berries) of the mistletoe Loranthus europaeus that grow on oak trees in a natural forest, in the mainland of Greece. Total phenolic content and antioxidant potential of aerial issues of L. europaeus was evaluated by the Folin-Ciocalteu method, the Ferric reducing antioxidant power assay, the free radical DPPH scavenging and the Co(II)/EDTA induced luminol plateau chemiluminescence assay. Extracts of twigs and stems of L. europaeus exhibited higher antioxidant activity in comparison to that of fruits, leaves and flowers. [ABSTRACT FROM AUTHOR]

Patients with autoimmune urticaria (AIU) and positive autologous serum skin test (ASST) represent a more serious type of chronic urticaria that does not respond to treatment with antihistamines, but responds completely to systemic corticosteroids. Because of the chronic course of the disease, there is a risk of side-effects. Cyclosporin A (CsA) is an alternative treatment for patients with AIU. In order to determine the efficacy of CsA at the lowest possible dose in patients with chronic idiopathic urticaria and positive ASST, 30 patients were included in a 5-month study with a follow-up one year after the end of treatment. All patients had positive ASST before treatment and autoantibodies were present in 73%. Twentythree patients completed the study and responded to low-dose CsA treatment. Three patients did not respond to a dose of 2.5 mg/kg CsA, and 4 patients dropped-out due to side-effects. After the first month of treatment, an improvement of 31% was noted, reaching 88% after the fifth month of treatment. The mean dose of CsA was 2.16 mg/kg for the first month and 0.55 mg/kg for the fifth month. Three to 6 months after the end of the study, the ASST was repeated and was negative in 78.3% of patients. At the one-year follow-up, 20 patients were symptom-free (87%) and 3 had relapsed (13%). CsA, even in low-doses, can bean effective and short-term treatment with minimum side-effects in patients with AIU. [ABSTRACT FROM AUTHOR]

Background and objective: Although cutaneous warts are extremely common in children effective treatment does not exist. We combined imiquimod with a salicylic acid solution 15% (SA) on areas, with thick keratin, like palms and soles to increase its penetration through the epithelium.Methods: Patients were randomly divided into two groups. The first group was subjected to cryotherapy with liquid nitrogen every two weeks for a maximum of 3 months. The second group was subjected to treatment with imiquimod 5% daily for 6–10 h onto the warts for five consecutive days per week for a maximum of 3 months.Results: Eighty-six children were included, 35 girls and 51 boys, 49 in the cryotherapy group and 37 in the imiquimod and SA group. At the end of the third month no statistically significant difference could be noted between the imiquimod 5% and salicylic acid and cryotherapy groups (p = 0.154). Thirty (81.1%) children treated with imiquimod 5% and salicylic acid were free from their warts in comparison to 33 (67.3%) children treated with cryotherapy.Conclusions: Imiquimod 5% cream as a monotherapy or in combination with SA can be used safely in children with warts and is equally effective and more effective than cryotherapy in plantar warts.Limitations: Our study is not placebo controlled and spontaneous resolution cannot be ruled out. [ABSTRACT FROM AUTHOR]

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Background: Sensitive skin is an area of considerable research interest. Although research has been performed in people who consider their skin to be sensitive, genital skin sensitivity has not been explored. Objective: Determine whether women with prior dermatologist-assessed vulvar erythema exhibited greater irritation to sanitary pads, and whether such women considered their skin to be sensitive, based on self-reported reactions to products used on the face or genitalia. Methods: A retrospective questionnaire was administered and post-hoc analysis performed on 2 subgroups of women who had participated in a prior randomized trial of sanitary pads: ie, those who presented either with or without preexisting vulvar erythema on clinical trial enrollment. Results: Women with preexisting vulvar erythema were more likely to report facial redness induced by cosmetics J compared with women without vulvar erythema. Despite the persistence of slightly higher erythema scores among women with preexisting vulvar erythema in a prospective sanitary pad trial, no correlation to self-reported genital sensitivity was found. Conclusions: Women with preexisting vulvar erythema were no more likely to perceive their skin as sensitive. However, they might be a more sensitive population based on the persistence of slight vulvar erythema in a prospective trial and a correlation with self-reported facial erythema with cosmetics. Because vulvar erythema was assessed objectively, its correlation with self-reported facial but not genital sensitivity may reflect the fact that facial changes are more noticeable. [ABSTRACT FROM AUTHOR]

We compared the skin compatibility of two menstrual pad technologies in a single-center, parallel, randomized, examiner-blinded study involving adult women. This report presents the results of a subset of 10 participants who had a genital infection within 12 months prior to the start of the study. In a blinded fashion, participants were randomized to receive one of the two pads for use over two menstrual periods. Participants' skin erythema was graded 24–48 hours following cessation of menstrual flow and on day 14 of each menstrual cycle. Participants subjectively reported any sensory effects. Vulvar erythema scores for the mons pubis, labia majora, labia minora, perineum, buttocks, left medial thigh, and right medial thigh assessed after both menstrual cycles were not statistically different between groups or between the two different products. A low incidence of itching and burning occurred in both groups without statistical significance; none of the participants experienced a recurrent or new genital infection. These preliminary results show that participants with recent genital infections included in clinical studies do not exhibit greater vulvar erythema or sensory effects than participants without recent genital infection. The study showed that the safety profile of the products tested remained acceptable in women with recent genital infection. [ABSTRACT FROM AUTHOR]

Background : Cutaneous and sensory effects of sanitary pads with a novel “fabric-like” polyethylene film surface (topsheet) were assessed. Methods : Cutaneous erythema and subjective sensory effects of a test pad with fabric-like film topsheet (group size: 53) and a commercial pad with a conventional nonwoven fabric topsheet (group size: 55) were compared in a randomized, examiner-blind, prospective trial lasting two menstrual cycles. Only the assigned pads were used menstrually. An assigned panty liner brand was worn intermenstrually at participant discretion. Primary outcome measures were 1) the frequency and severity of erythema of the vulva, perineum, buttocks, and upper thighs, as visually scored by using a standard scale postmenstrually (16–84 hours after flow cessation) and intermenstrually (days 12–16); 2) sensory irritation frequency as reported on daily diaries; and 3) product preference ratings. Results : The frequency and severity of erythema did not differ between groups except for cycle 2, when a statistically higher mean erythema score (in the barely perceptible range) occurred postmenstrually on the right thigh (commercial pad group) and intermenstrually on the buttocks (test pad group). The frequency of rubbing, itching, or burning sensations declined from about 2% after cycle 1 to less than 1% after cycle 2, with no consistent difference between groups. The test pad was preferred overall, especially for absorbency and soiling protection. Conclusions : The test pad was well tolerated and comparable in skin compatibility to a commercial pad with a history of acceptable use. [ABSTRACT FROM AUTHOR]

Darier's disease is an autosomal dominant dermatosis. It may rarely be complicated by localized or widespread cutaneous viral infections. We describe a case of Kaposi's varicelliform eruption due to herpes simplex virus type 1 presenting in a patient with Darier's disease. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a chronic, immune-mediated inflammatory disease estimated approximately in 2% of the European population. Drug abuse is reported in 3-5% of the global population. Main observation: We present a 41-year-old, cocaine-addicted patient male with severe plaque-type psoriasis treated successfully with ustekinumab. The patient received ustekinumab at a dose of 45 mg subcutaneously at weeks 0, 4 and 16 and achieved PASI 75 at week 18. Conclusions: Although several drug-abusers experience psoriasis, literature is very poor regarding the outcome of systemic treatment in those patients. In our patient no adverse effects were seen during the administration period of ustekinumab and no interactions between cocaine and ustekinumab were noticed. Nevertheless, more individuals and further studies are needed to establish the efficacy and safety of ustekinumab in the treatment of psoriasis in drug-abusers. [ABSTRACT FROM AUTHOR]

15 patients suffering from allergic contact dermatitis verified by patch test, were investigated for intracellular activity of enzyme 5 nucleoltidase from intact and affected skin. These patients were not treated topically or per as with corticosteroids or other non-steroid anti-inflammatory drugs. 5 nucleotidase activity was measured by an enzymatic method in skin cytosol. These results show an increase of intracellular activity on enzymes, significantly higher in affected skin than in non-affected.

Chronic spontaneous urticaria (CSU, or CU) is a disease that significantly affects the quality of life of patients. The connection between the cognitive state of an individual and dermatological diseases has been previously reported, and it is known, although not thoroughly investigated, that there is a cognitive and quality of life relation to dermal pathologies. Urticaria is a chronic disease that requires a specialized approach to diagnosis and treatment but also a holistic approach with respect to the consideration of both the pathophysiology of the disease and the cognition status of the patient. The present study aims at analyzing CU score and cognitive indexes with respect to time, as a time series and their subsequent interactions. We have attempted to model the investigated time series in order to unravel possible causative relationships between cognitive/quality of life factors and urticaria. One hundred and eleven patients (29 males/82 females) admitted to our department were diagnosed with CU. CU was estimated on UAS7 score basis, which was used in order to define disease severity. Indexes used for assessing the cognitive and quality of life of patients' status included the Urticaria Control Test (UCT) and Dermatology Life Quality Index (DLQI). Significant correlations were found between UAS7 score and the UCT and DLQI scores, respectively. Interestingly, each score time series was modelled by different sets of equations, indicating the unique effect each one has on the disease, as well as that each score probably is manifested by a different pathophysiological mechanism., (© 2021. The Author(s), under exclusive license to Springer Nature Switzerland AG.)

Background: Chronic Spontaneous Urticaria (CSU) is a disease presenting typical wheals characterized by itching, angioedema or both. Although CU is, by appearance, a relatively "simple" disease, yet it has a devastating effect on those suffering due to its immense social implications., Aims: The aim of the present study was to investigate the effect of omalizumab in the treatment of CSU. In particular, gender, co-administration of drugs and comorbidities were taken into account., Materials and Methods: 108 patients (25 Males/83 Females) admitted to our department were diagnosed with CSU and were treated for 30 months. CSU was estimated on a score basis, which was used in order to define disease severity. The mean total CSU score and the mean CSU score of the first trimester, as well as the first semester, were calculated. Patients were treated with omalizumab, and in several cases, with co-administration of dapsone, cyclosporine and anti-histamines., Results: Females manifested significantly higher scores as compared to males. Further on, patients who relapsed manifested significantly higher scores during the whole time course, as well as at the end of the first semester., Conclusion: Females are more prone to CSU. Although CSU scores in patients with remission, relapse and poor response manifested no significant difference at diagnosis, relapsed patients manifested higher CSU scores in the first semester. Therefore, the first semester of treatment is probably critical for the final patient outcome. Further studies are necessary in order to understand the mechanisms of CSU for better treatment and prognosis., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Chronic spontaneous urticaria (CSU, or CU) is a disease that significantly affects the quality of life of patients. It is a chronic disease and requires a specialized approach to diagnosis and treatment. In recent years, the disease has been of great interest due to the existence of new targeted therapeutic approaches., Aim: The present study aims at analyzing CU score concerning time, as a time-series. The authors have attempted to model the investigated time-series to unravel possible causative relationships., Methods: 108 patients (25Males/83Females) admitted to our department were diagnosed with CU. CU was estimated on a score basis, which was used to define disease severity. Urticaria score was assessed on the basis of Urticaria Activity Score 7 (UAS7). The mean CU score, the mean CU score rate concerning the first month at diagnosis as well as the monthly CU score rate were calculated., Results: Gender is a factor that influences CU score with time. In addition, there was a significant finding that time-series differ with the administration of monotherapy or complementary therapy., Conclusion: We have found that females are more prone to CU, while omalizumab monotherapy has more beneficial results as compared to the application of concurrent and maintenance therapies. Further, patients with co-morbidities were more likely to interrupt treatment. Finally, and most significantly, it was shown that monthly CU score rate manifested an oscillatory pattern, which was modelled with the sum of sines functions, highlighting a relative immunological pattern., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Pimecrolimus 1% cream is an effective, non-corticosteroid, topical anti-inflammatory treatment for atopic dermatitis (AD). The aim of this article was to review published clinical data that have examined how pimecrolimus can address the medical needs of AD patients. Clinical studies have demonstrated that early treatment with pimecrolimus decreases the progression to disease flares, rapidly improves pruritus and significantly enhances quality of life. Patients find the formulation easy to apply, which may result in improved adherence with the treatment regimen. Pimecrolimus, in contrast to topical corticosteroids (TCSs), does not induce skin atrophy or epidermal barrier dysfunction and is highly effective for the treatment of AD in sensitive skin areas. Furthermore, pimecrolimus reduces the incidence of skin infections compared with TCSs and is not associated with other TCS-related side effects such as striae, telangiectasia and hypothalamic-pituitary-adrenal axis suppression. An additional benefit of pimecrolimus is its substantial steroid sparing effect. On the basis of these data, a new treatment algorithm for patients with mild-to-moderate AD is proposed in which pimecrolimus is recommended as a first line therapy for patients with established mild AD at the first signs and symptoms of disease. Pimecrolimus is also recommended for mild-to-moderate AD after initial treatment with a TCS. After resolution of lesions, maintenance treatment with pimecrolimus may effectively prevent subsequent disease flares. In conclusion, the clinical profile of pimecrolimus suggests that it may be considered the drug of choice for the treatment of mild-to-moderate AD in children as well as adults and particularly in sensitive skin areas.

Tacrolimus is a macrolide immunosuppressant that has been demonstrated to inhibit T-lymphocyte activation without the side-effects of corticosteroids. The safety profile of tacrolimus makes it a promising therapeutic option for dermatitis. To evaluate and compare the therapeutic ability of tacrolimus 0.1% ointment and mometasone furoate 0.1% ointment in patients with chronic hand eczema and positive patch tests. Thirty adults with chronic hand eczema and positive patch test reaction to relevant contact allergens were treated with tacrolimus 0.1% ointment or mometasone furoate 0.1% ointment in a single-centre, randomized comparative study. The scores of the evaluated clinical parameters (erythema, infiltration, vesiculation, desquamation, presence of cracks and itching) did not differ between Groups A and B at any of the four time points (p>0.05).On the other hand, in both groups, a significant difference was detected in all parameters between baseline and Day 90 recorded values. Tacrolimus is a promising alternative therapy for contact dermatitis patients as it is effective from the first month of treatment, well tolerated and offers similar therapeutic results to topical corticosteroid therapy.

Erythrokeratodermia variabilis (EKV) is characterized by migrating red patches resembling a geographical map, and by localized or generalized hyperkeratosis with scaling of the skin. The onset is usually at birth or during infancy, and the disease persists throughout life. EKV is mainly inherited as an autosomal dominant disease, although recessive transmission has occasionally been reported. Mutations associated with EKV have been identified in the connexin (Cx) genes GJB3 (Cx31) and GJB4 (Cx30.3), however, several cases of EKV have been tested negative for mutations in these two Cx genes. Here, we report our findings of the clinical, histological, and molecular examinations performed in two unrelated sporadic cases of EKV. The molecular screening involved bidirectional sequencing of the coding regions of the GJB3 and GJB4 genes and revealed the existence of a novel c.295G>A missense variant in the GJB4 gene found in homozygosity in one case. The substitution was found to result in a p.E99K change of the Cx30.3 protein, an alteration predicted to have a benign rather than a damaging effect on the protein function.