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Background: Erythroplasia of Queyrat (EQ) is a rare squamous cell carcinoma in situ, usually occurring on the glans penis, the prepuce, or the urethral meatus. Therapy is mandatory because it can progress to invasive carcinoma in up to 30% of cases. Treatment options include 5-fluorouracil, curettage, cryotherapy, radiotherapy, laser, partial or total penectomy, and microsurgery, as also with imiquimod and photodynamic therapies., Methods: Between 2015 to 2018 we treated five patients, with histologically confirmed EQ, with ingenol mebutate (IM) 0.015% gel applied for 3 days consecutively., Results: Three patients showed complete response at one year follow up. Two patients showed partial response after two months, so they received a second course of therapy with IM. At one-year follow-up, one of them showed complete response, the other partial response., Conclusions: Our experience demonstrated that IM may be considered as an effective and safe treatment option in EQ. IM offers various advantages such as easy and fast application, rapid complete remission, better compliance, few side effects and excellent cosmetical results. The authors call for further exploitation in bigger trials.

Background: Inadequate treatment and delayed access to care represent critical issues regarding psoriasis. In Italy, patients treated with biologics are scanty and patients' misinformation could interfere with both biologics prescription and access to care. Literature provide data on disease awareness and perception about biologics in already-treated patients, but there is a lack of information concerning patients never treated with such drugs., Methods: We conducted a national survey including three academic-based psoriasis care centers at Bologna, Rome and Catania. A questionnaire named Psoriatic Patients's Awareness on Biologics (PPAB) was administered to patients naïve for biologics and accessing for the fist-time to a psoriasis care center., Results: Patients from Northern Italy referred to more reliable sources of information and awareness on biologics decreased from North to South. The increase of the Psoriasis Area Severity Index was associated to unawareness about biologics and impaired self-evaluation on the eligibility to treatment. Patients under systemic conventional /multiple therapy were more likely to be unaware about biologics., Conclusions: Our survey demonstrates that psoriatic patients' awareness is still an unmet need. For more, patients potentially eligible for biologics (severe or treated with systemic conventional/multiple therapy) were less informed. We believe that patients' misinformation could have delayed the access to a psoriasis care center, so that when patients sought help their condition was more severe and required systemic conventional/multiple therapy. Our results reiterate the importance of physicians in the information process and urge the need of a common network among office dermatologists, general practitioners and psoriasis care centers.

Erythroplasia of Queyrat (EQ) is a rare disease involving the mucosal and transitional surfaces of the penis. Effective treatment is necessary to minimize progression to squamous cell carcinoma. The standard therapy for EQ, partial or radical penectomy, is invasive; photodynamic therapy (PDT) may be an effective, non-surgical tissue-sparing option. We report the case of a 67-year-old patient with long-standing EQ who was suc-cessfully treated with methyl aminolevulinate-PDT (MAL-PDT). A complete clinical response, confirmedby incisional biopsy, was achieved af-ter fivesessions of every-other-week treatment. The patient experienced moderate edema, erythema and pain within 5-7 days after the treatment, without urination problems. Our experience and a review of the published literature suggest that MAL-PDT may represent a valuable treatment option for selected cases of histopathologically-confirmed EQ.

Background: The aim of this study is to evaluate efficacy and tolerability of a complete skin care line consisting of an oral supplement in two distinct formulations for males and females, and a topical cream device in the treatment of mild and moderate acne. Oral supplements contain biotin, probiotic, vitamin E, zinc, nicotinamide; in the formulation for males beta sitosterol and Boswellia serrata were added, the oral supplement for females contains myo-inositol and folic acid. The topical cream device is represented by the association between active plant agents (verbascoside, Ocimum gratissimum) and keratolytic molecules (salicylic acid, gluconolactone, complex alpha-hydroxy acids)., Methods: An equal number of male and female patients with mild to moderate acne were enrolled in a double-blinded clinical trial. Efficacy and tolerability evaluations were performed at week 4 (T1) and week 12 (T2) by Global acne Grading System (GAGs)., Results: Most of patients had satisfactory therapeutic response, in terms of GAGs reduction. All the four groups presented a statistically significant improvement of the mean GAGs at T2 but those assuming the oral supplement improved more, as expected., Conclusions: Our data suggest that this association can be considered a new effective option for mild and moderate acne. This therapeutic line differs from others in the gender matched oral treatment.

Introduction: The attention to the impact of gender differences in acne is needed and, at the moment, lacking. The aim of this paper was to perform a systematic review on gender differences in acne., Evidence Acquisition: A review of the literature was performed using the PubMed and Ovid literature search engines , using a variety of combined search terms including "acne", "gender", "sex", "females", "males". The search extended until July 2013., Evidence Syntesis: Gender differences in acne highlight hormonal interactions as a major target for which more research is needed to translate current findings to clinically significant diagnostic and therapeutic applications. In addition, female patients are more likely to develop anxiety and depression due to their condition, and acne improvement positively influences quality of life., Conclusions: The patient's sex should not radically alter diagnostic or therapeutic efforts, although gender differences could be necessary to set up clinical management, monitoring also the psychological aspect.

Aim: Psoriasis is a systemic inflammatory immune-mediated skin disease. Recently a relationship with metabolic syndrome in terms of psoriasis severity and response to therapy was observed., Methods: We performed an open-label randomized controlled study to evaluate the role of a nutraceutical containing Q10 coenzyme, Krill-oil, lipoic acid, resveratrol, Vitis vinifera seed oil, vitamin E and selenium in addition to etanercept therapy for patients affected by psoriasis and metabolic syndrome. Forty patients were enrolled and divided into two arms, one receiving only etanercept, one other receiving also the neutraceutical. After a period of 3 months (T1) a second evaluation of the considered parameters was performed., Results: At T1 statistically significant differences were detected in HDL cholesterol and triglycerides values both comparing the two arms and in the nutraceutical arm., Conclusion: Our results show that the dietary addiction of the nutraceutical to the etanercept therapy in patients affected by both psoriasis and metabolic syndrome could help to restore the normal lipid profile.

The original observation by de Bold et al. (1981) of a rapid, massive, and short-lasting diuretic and natriuretic effect following injection of rat atrial extracts into intact rats, led to the identification, isolation and purification of the atrial natriuretic factor (ANF). ANF is stored in atrial myocytes and released into the blood stream by atrial distension. Available data suggest that the mechanism of ANF-induced natriuresis involves either renal hemodynamic effects, such as the increase in glomerular filtration rate and reduction of medullary tonicity, or direct effect on sodium transport in the medullary collecting ducts. ANF induces relaxation of vascular smooth muscle, decreases blood pressure and cardiac output. All these effects displayed by ANF are associated to the an inhibition of aldosterone, renin and vasopressin release. Most of these actions are mediated by specific high affinity receptors, which are coupled to a particulate guanylate cyclase. Although ANF levels are increased in some disorders, such as severe heart failure, hypertension, chronic renal failure, the role of the peptide is uncertain. To better define the potential physiopathological role and the possible therapeutic implications of this new hormonal system in conditions of disturbed body fluid and sodium homeostasis, further experimental and clinical data must be awaited.

The clinical efficacy of a macrolide antibiotic, roxithromycin, was evaluated in 24 patients affected by acute odontogenic infections. Patients were treated with a first dose of 300 mg p.o. which was followed by 150 mg p.o. 12-hourly for the following two days. Total responses were evaluated by an arbitrary scale. The results showed that an excellent and good response was obtained in 99.96% of treated patients. On the basis of clinically compared data and the drug safety it may be concluded that roxithromycin can be successfully used in the treatment of odontogenic infections.