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Background: It is believed that vitiligo has an impact on the overall patient quality of life (QoL)., Objective: To estimate QoL in a fairly large sample of Italian vitiligo patients by using the Dermatology Life Quality Index (DLQI) questionnaire., Methods: One hundred and sixty-one vitiligo patients referred to 9 dermatological centers were offered to participate by filling in the Italian version of the DLQI questionnaire., Results: The mean total DLQI score was 4.3 (SD ±4.9; range: 0-22). In multivariate analysis, DLQI >5 was associated with female gender, stability of the disease over time and involvement of the face at disease onset., Conclusions: The impairment of QoL is overall limited in Italian vitiligo patients, especially if it is compared with results from other available studies. This could be due to cultural and ethnic characteristics of the sample.

Background: Autoimmune comorbidities and circulating autoantibodies have been observed in vitiligo patients, but differences in rate are present according to countries in which the studies were performed, perhaps owing to ethnic diversities or different trigger factors., Objective: To estimate the prevalence of circulating autoantibodies and overt autoimmune diseases in a fairly large sample of Italian vitiligo patients., Methods: 175 outpatients affected by vitiligo and referred to nine dermatological centers were included in the study. Patients were offered routine blood test, serological testing for thyroid function and search for autoantibodies., Results: At least one circulating autoantibody was detected in 61 (41.8%) of 146 subjects who underwent laboratory tests. Anti-thyroperoxidase (25.6%), anti-thyroglobulin (23.4%), antinuclear antibodies (16.8%) and anti-gastric parietal cell antibodies (7.8%) were the most noticed autoantibodies. 74 (41.5%) autoimmune comorbidities, mainly autoimmune thyroiditis (37%), were reported., Conclusion: The prevalence of autoimmune comorbidities and circulating autoantibodies in this study was in agreement with other surveys conducted on Caucasian patients., (© 2014 S. Karger AG, Basel.)

Background/aims: To evaluate the association of psoriasis with selected medical conditions and a number of drugs used before diagnosis., Methods: Multicenter case-control study involving outpatient services of 20 general and teaching hospitals. Entry criteria for cases were a first diagnosis of psoriasis made by a dermatologist and a history of skin manifestations of no more than 2 years after the reported onset of the disease. Controls were the first eligible dermatological patients observed on randomly selected days in the same centers as cases. A total of 560 cases and 690 controls were recruited., Results: The odds ratio (OR) of psoriasis was 0.8 (95% confidence interval, CI, 0.5-1.3) in hypertensive subjects, 1.1 (95% CI 0.6-2.0) in diabetics and 1.1 (95% CI 0.7-1.7) in hyperlipidemic subjects. Histamine 2 receptor antagonist exposure was negatively associated with psoriasis: OR 0.3 (95% CI 0.1-0.8)., Conclusion: Our study rules out a strong association of psoriasis at its first ever diagnosis with common chronic conditions. The reported associations of psoriasis with relatively common conditions such as diabetes mellitus, hypertension and hyperlipidemia may represent a late effect of well-known risk factors for psoriasis such as smoking and overweight or reflect factors related to the long course of psoriasis itself., ((c) 2008 S. Karger AG, Basel.)

Background: The dermoscopic features of congenital melanocytic nevi (CMN) have recently been described, and some structures have been proposed as distinctive of these moles., Objective: The aim of our study was to evaluate the agreement between observers, i.e. the reproducibility, in the identification of these features., Method: Fifty-two CMN, randomly selected from 127 male subjects carrying at least 1 CMN, were examined by a 1st medium-experienced observer. The image recording was performed according to the dermoscopic patterns of the Consensus Net Meeting on Dermoscopy and to the features proposed for CMN by Seidenari et al. The presence/absence of these features was recorded in a specifically developed patient's card, and the most typical dermoscopic features of the lesions were also photographed and observed again in this form by the same investigator and by a 2nd basic-experienced observer. The reproducibility of the dermoscopic features assessed directly and on photographs by the 1st observer (intraobserver agreement) and the agreement between the 1st and the 2nd observers judging nevi on photographs (interobserver agreement) were estimated by Cohen's kappa statistics., Results: Intraobserver agreement was highly satisfactory for all the dermoscopic features, with the exception of focal thickening of network lines and follicles (satisfactory), and hyperpigmented areas and target vessels (fairly satisfactory), which were more frequently identified on Dermaphot pictures. Interobserver agreement was highly satisfactory for network, globules/dots, blotches, focal hypopigmentation, skin furrow hypopigmentation and follicles; it was satisfactory for perifollicular hypopigmentation, vessels and target vessels, and barely satisfactory for focal thickening of network lines, target globules and hyperpigmented areas; finally, it was fairly satisfactory for target network., Conclusion: The identification of dermoscopic features of CMN seems to show a good reproducibility, with a satisfactory intra- and interobserver agreement. Other studies involving a higher number of experienced and less experienced observers are requested to confirm these results., (Copyright 2008 S. Karger AG, Basel.)

Background: The prevalence of congenital melanocytic nevi (CMN) among newborns ranges between 0.2 and 6% in the worldwide literature. In the only available study from Italy the rate was 1% at birth and 1.4% at 2 years of age. Some surveys performed among samples of children and adolescents in other countries showed a prevalence which ranged from 1.4 to 4.4%. Additional data on the frequency in adults are not available., Objective: The aim of this study was to estimate the prevalence of CMN in a large sample of a young male Italian population, which is deemed to be representative of the general population of the same age and sex., Methods: The potential conscripts resident in the coastal regions of southern Italy, enlisted for the compulsory service in the Italian Navy, were called at the age of 18 to the Draft's Council Medical Unit of the Italian Navy in Taranto to evaluate their psychophysical fitness to recruitment. All the subjects examined from September 2002 to March 2004 showing skin lesions evocative of CMN were referred by general practitioners of the Draft's Council Medical Unit to the Department of Dermatology of the Italian Navy Hospital for confirming the diagnosis, which was based on the clinical features and the personal history. The confirmed cases were recorded in a predefined patient card, containing the main anamnestic and clinical data. Since the screening of small CMN in such a large sample of subjects was believed to be difficult, only CMN with a diameter >or=1.5 cm were recorded., Results: In 23,354 examined persons 157 CMN were diagnosed, with a prevalence of 0.67% (Bayesian 95% confidence interval 0.57-0.79); 126 (80.3%) CMN were medium-sized (>or=1.5 and or=20 cm in diameter). Three CMN (1.9%) were located on the face, 23 (14.6%) on the chest, 24 (15.2%) on the abdomen, 36 (22.9%) on the back, 48 (30.5%) on the lumbar area, 15 (9.5%) on the upper limb, 19 (12.1%) on the lower limb and 15 (9.5%) on the shoulder. No CMN was located on the head. In 19 cases (12.1%) >or=2 adjacent anatomical sites (shoulder/chest, shoulder/arm, etc.) were involved. In 73 moles (46.4%) terminal hairs were present. Eight CMN (5.1%) showed a zosteriform (i.e. segmental) feature. None of the examined subjects reported a personal history of malignant melanoma (MM), and no person with a history of MM was observed among all the enlisted men referred to the Department of Dermatology during the time of the study., Conclusion: The prevalence of CMN in the Italian young male general population is roughly in agreement with the rates detected in general populations from other European studies. The observations of this study also suggest that the risk of appearance of MM, at least in childhood and adolescence, is limited for medium-sized CMN., (Copyright (c) 2007 S. Karger AG, Basel.)

Background: Dermoscopic features of congenital melanocytic nevi (CMN) have been mostly assessed by high-resolution video-dermoscopy. However, optical dermoscopy with the 10-fold magnification is largely available. In some instances, the differential diagnosis between large CMN and Becker nevus (BN) may be difficult., Objective: The aims of this work were: (1) to assess by dermoscopy with the 10-fold magnification the morphological features which have been previously suggested as useful for the identification of CMN in high-resolution video-dermoscopy; (2) to search and point out the dermoscopic features of BN; (3) to explore dermoscopic differences between CMN and BN., Methods: The subjects were observed among about 23,000 consecutive young men assessed at the Draft Council's Medical Unit of the Italian Navy in Taranto for compulsory recruitment and referred to the Department of Dermatology of the Italian Navy Hospital for dermatological examination. Lesions were examined by the same observer using a dermatoscope with a 10-fold magnification, and both the dermoscopic criteria stated by the international Consensus Net Meeting on Dermoscopy and dermoscopic features previously suggested as useful for the identification of CMN by video-dermoscopy were recorded in a predisposed patient's card., Results: There were 127 male subjects, median age 19 years, with 127 CMN, measuring > or = 1.5 to < or = 19.9 cm in 78% and > or = 20 cm in 22% of cases, and 64 male subjects, median age 19 years, with 64 BN. In the sample of medium-sized and large CMN, dermoscopic features previously identified as characteristic of congenital lesions (i.e. target network, focal thickening of network lines, target globules, skin furrow hypopigmentation, focal hypopigmentation, hair follicles, perifollicular hypopigmentation, vessels and target vessels) were observed in sufficiently high rates. In the BN group, network, focal hypopigmentation, skin furrow hypopigmentation, hair follicles, perifollicular hypopigmentation and vessels were the main dermoscopic features. Focal thickening of network lines, globules, target globules, homogeneous diffuse pigmentation, hyperpigmented areas, blotches and target vessels were more frequently observed in CMN than in BN., Conclusions: (1) The same dermoscopic features observed in small and medium-sized CMN by video-dermoscopy with high magnifications are also detectable in medium-sized and large CMN, employing the dermoscopy with the 10-fold magnification. (2) Network, focal, skin furrow and perifollicular hypopigmentation, hair follicles and vessels could be considered as peculiar dermoscopic features of BN. (3) Major differences in the frequency of dermoscopic characteristics were detected between CMN and BN, and dermoscopy seems to provide some diagnostic aid in differentiating CMN from BN in equivocal cases., (2006 S. Karger AG, Basel)

Background: Limited studies on the prevalence and risk factors for superficial mycoses are available., Objective: The aim of this paper was to evaluate the prevalence and risk factors for superficial mycoses (dermatophytes and Candida spp.) in a sample of young Italian people resident at a military school., Methods: A total of 1,024 young cadets from the Italian Navy Petty Officers School in Taranto, including 975 (95.21%) males and 49 (4.79%) females, mean age 22.5 +/- 3.0 years (range 18-30), were consecutively examined by the same observer. A complete dermatological examination was performed on all the subjects, and skin scrapings for microscopy and fungal culture were obtained from suspected lesions. All the subjects completed a questionnaire providing information on sports practice, swimming-pool attendance, marching, wearing shower sandals, frequent use of 'gummed' shoes, history of severe traumas to the nails, presence of hyperhidrosis and history of superficial mycoses. The affected subjects were also asked if they were aware of their condition. Data were analysed by the Statistical Analysis System, version 8.0. The Fisher exact test and odds ratios were calculated., Results: A total of 33 subjects (3.2%) were found to suffer from a mycologically confirmed fungal infection (3% by dermatophytes and 0.2% by Candida albicans): tinea pedis/Candida intertrigo of the feet was suspected in 126 (12.1%) subjects and confirmed in 30 (2.9%), including 28 cases of tinea pedis and 2 cases of Candida intertrigo; tinea cruris/Candida intertrigo of the groin was suspected in 28 (2.7%) subjects, but confirmed in only 1 case (0.1%); onychomycosis was suspected in 64 (6.1%) subjects and confirmed in 2 cases (0.2%). The organism most frequently responsible in tinea pedis was Trichophyton mentagrophytes var. interdigitale (82.1%). The same species (50%) and T. mentagrophytes var. mentagrophytes (50%) were associated with tinea unguium, Epidermophyton floccosum was the only species detected in tinea cruris. Non-dermatophytic filamentous fungi (Penicillium spp., Fusarium spp., Aspergillus spp. and Paecilomyces spp.), not considered pathogenic, were isolated in 48 samples. None of the risk factors analysed were significantly associated with fungal infection. Only 2 subjects out of the 33 people affected were aware of their condition. They both had tinea pedis., Conclusion: The prevalence of mycoses in sailors living in an Italian military school was lower than rates detected in other military populations. This may be due to the cadets' lifestyle and environmental conditions. The most frequent infection was tinea pedis, mainly caused by T. interdigitale. None of the investigated risk factors were significantly associated with the disease, and most of the affected individuals were not aware of their condition.

Background: The atopy patch test (APT), namely the patch test with aeroallergens, is regarded as specific for patients with atopic dermatitis (AD), but small numbers of positive APT were reported in the past also in atopic subjects without dermatitis and in healthy persons., Objective: The aim of this study was to evaluate the response to the APT with house dust mites (HDM) in subjects nonaffected by AD and to compare the outcomes observed in these cases with those pointed out in AD patients, evaluating also the differences between two allergen extracts manufactured at different purifications and concentrations., Methods: Forty-seven atopic subjects without eczema (AWE), 33 nonatopic (NA) subjects and 77 adult AD patients were patch tested with an extract of purified bodies of HDM at 20% and with another extract of whole bodies of HDM at 30%, the latter corresponding to 300 microg/g of Der p 1. The reproducibility of APT was also tested in 8 AD patients, in 37 AWE subjects and in 19 NA subjects., Results: Positive responses with extract at 20% were observed in 29 (37.7%) AD, in 5 (10.6%) AWE and in 4 (12.1%) NA subjects. The APT with HDM at 30% was positive in 32 (41.6%) AD, 9 (19.1%) AWE and 4 (12.1%) NA persons. The rates of positivity and the intensity scores of responses were significantly different between AD and non-AD subjects (p < 0.01). The reproducibility of the APT in the three groups was satisfactory., Conclusion: These observations lead to conclude that the APT with HDM is positive also in non-AD subjects but it is probably more specific for AD., (Copyright (c) 2004 S. Karger AG, Basel.)

Background: No reports on the frequency of X-linked ichthyosis (XLI) in the Italian general population and few surveys on the frequency of XLI in large communities in the world are available., Objective: The aim of this study was the assessment of the frequency of XLI in a large representative sample of the Italian male population., Subjects and Methods: This study involved young men who enlisted as conscripts in the Italian Navy from January 1998 through February 2002, examined, prior to enlistment, at the Draft Council's Medical Unit of the Italian Navy in Taranto, Italy, to evaluate their psychophysical fitness. All the patients with an ichthyosiform condition were referred to the Department of Dermatology of the Navy Hospital, underwent a thorough dermatological examination and completed a questionnaire regarding their personal and familial history. Pertinent results of the other clinical investigations were recorded and the final diagnosis was formulated on the basis of all these data., Results: From January 1998 through February 2002, of 75,653 young men examined, 15 cases of XLI were diagnosed, with a frequency of 1:5,043 or 1.98 per 10,000 (95% confidence interval based on the Poisson distribution 1.01-2.90). Four out of 15 cases (26.6%) showed corneal opacities. No other significant associated pathological change was observed., Conclusions: As this study is a survey involving a large male sample, homogeneous with reference to age, race and country of origin (southern Italy), the frequency of XLI could be estimated at about 1.98 per 10,000 males. These data are roughly in agreement with estimates from other European surveys., (Copyright 2003 S. Karger AG, Basel)

Background: Epidemiological studies about atopic dermatitis (AD) almost exclusively relate to childhood disease with little mention of adult-onset disease. In clinical practice, however, patients who have AD and in whom the onset of disease occurs in adult life are sometimes seen., Objective: Because the subjects with a chronic and recalcitrant eczema are frequently patch tested, the aim of this study was to evaluate the prevalence of adult-onset AD in a patch test population and the differences existing between the early- and adult-onset subsets., Methods: This retrospective analysis was performed on 502 adults (458 males, 44 females) affected by eczematous dermatitis, consecutively examined in the Department of Dermatology of the Italian Navy Hospital in Taranto. In this department, all the eczematous subjects are routinely submitted to the following tests: standard series (GIRDCA or SIDAPA with integrative haptens), prick test with environmental aeroallergens and common food allergens and dosage of total serum IgE. If it is required, additional series of patch tests are also applied. Many patients are also submitted to the atopy patch test (APT) with whole bodies of house dust mites at a concentration of 20%. In the AD patients, diagnosed according to the criteria of Hanifin and Rajka, the ages of onset were subdivided into the following categories: infancy (0-3 years); childhood (4-11 years); adolescence (> or =12 years). We arbitrarily also used the age of 18 years as the cut-off mark to allocate the patients to the adult-onset group (AOG) and defined as early-onset group (EOG) the cases encompassed in the aforesaid categories (i.e. onset < or =17 years)., Results: 8.8% of all eczemas were adult-onset ADs. 28 (5.6% of all eczemas) adult-onset ADs were 'sole' ADs, while 22 cases (3.2% of all eczemas) were adult-onset ADs in which a contact sensitization was detected. The mean SCORAD indexes, according to the age-of-onset groups, decreased when the age of onset increased. No statistical difference was detected between the EOG and AOG with regard to true contact sensitization, clinically relevant or non-relevant contact sensitization, prevalence of 'pure' AD and 'mixed' AD, and outcome of the APT. The hands were the most frequently affected site in the AOG., Conclusion: A small but significant number of patch-test-negative eczematous cases could be adult-onset ADs and, in this instance, the other two allergological tests (i.e. prick tests and dosage of total serum IgE) and an accurate evaluation according to stated clinical criteria should be performed. However, other studies on large series of patients are required to confirm our observation., (Copyright 2003 S. Karger AG, Basel)

Background: It is difficult to carry out studies on the prevalence of tinea pedis in the community. Some studies are performed on selected groups of subjects, exposed to the same risk factors, i.e. schoolchildren, public bathers, athletes and military men., Objective: The aim of this work was to detect in a sample of military men the prevalence of tinea pedis and the awareness of their condition, and to relate the infection to risk factors of the group as well., Methods: 410 male Italian navy cadets in an Italian navy petty officers school were clinically examined and mycological cultures were performed, employing the skin scrapings obtained from suspected lesions., Results: Dermatophytes were isolated from toe clefts in 10 subjects, giving a point prevalence of 2.4% (95% confidence interval 1.3-4.4%). The isolated dermatophytes were Trichophyton mentagrophytes (70%), Trichophyton rubrum (20%) and Epidermophyton floccosum (10%). None of the subjects was aware of his disease. No significant association was observed between tinea pedis and risk factors (i.e. hyperhidrosis and habits)., Conclusion: The prevalence in our sample was lower than that observed in previous studies on military men. That can be attributed to the general amelioration of hygienic conditions and strengthening of preventive habits. Therefore the prevalence of tinea pedis in Italian sailors seems to be reduced but still rather relevant. That is important because these subjects are a reservoir of ringworm infection., (Copyright 2000 S. Karger AG, Basel)