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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.

Lichen sclerosus (LS) shows a predilection for the genital area and occurs mostly in postmenopausal women and in prepubertal girls. We conducted a retrospective review of 15 young girls whit genital LS with onset before the menarcheal age and treated with topical clobetasol propionate 0.05%. The mean duration of follow-up was 4.7 years with relapses in nine patients after approximately 1 year from the first clearing. At the end of the study we observed that (i) potent topical steroids are safe and effective in childhood, (ii) an early aggressive treatment gives the best therapeutic response, (iii) one follow-up visit a year is required to monitor for relapsing.

Melanoma is the most deadly form of skin cancer and its incidence is increasing worldwide. In 2009, the International Agency for Research on Cancer classified the entire UV spectrum as carcinogenic. In many countries, including Italy, the use of tanning equipment by minors and individuals with high risk phenotypes has been banned. This study assessed tan-seeking behaviour in a Mediterranean population with a relatively high melanoma incidence, where a considerable time is spent tanning outdoors. Subjects spending the most time in the sun were typically young single men, who use significantly less sunscreen and sunglasses. The overall prevalence of sunbed use was 22% in youth (≤35 years old) and 18% of them used sunbeds throughout the year. Sunbed use in youth was greater for phenotypes at risk. In Italy, 3.8% of melanoma cases are attributable to sunbed use, more in women (4.2% vs 3.1%, for women and men respectively) and much more in the young (17%). Of 8013 new melanoma cases in 2008 in Italy, 293 were attributable to sunbed use, with a high proportion of these in women (168) and 1045 were attributable to sun exposure. Among youth, 172 cases were attributable to sunbed use and 140 exclusively to sunbed use. This analysis reveals that a large number of cancers each year in Italy could be avoided by changing cultural attitudes to tanning. Sun avoidance and protection is generally inadequate in adults, especially young men. These results have important implications for the primary prevention of melanoma.

The eutectic mixture of local anesthetic cream, a 1 : 1 mixture of prilocaine and lidocaine, 2.5% each, is frequently used in pediatric and dermatologic practice to obtain local anesthesia. Side effects include transient skin blanching, erythema, urticaria, allergic contact dermatitis, irritant contact dermatitis, hyperpigmentation, and purpura. We report two children with a purpuric reaction after application of this mixture cream. Purpura after application of this anesthetic cream is a rare nonallergic reaction and only 17 occurrences have been reported, to our knowledge, in the literature. Patch tests could not be performed in our two patients because of lack of parental consent but we suggest that the purpuric reactions were most probably of toxic origin. The pathogenesis of purpura after application of eutectic mixture of local anesthetics cream, which resolves within 2 weeks without dermatologic sequelae and without any specific therapy, is complex. The lesions are probably caused by the direct effect of the cream components on the vessels but many other factors, such as atopic dermatitis, prematurity, subjective predisposition to purpura, trauma, and thrombocytopenia may play important pathogenetic roles.

Background The World Health Organization classified the entire ultraviolet (UV) spectrum and artificial UV tanning devices as carcinogenic to humans. Italian law has prohibited the use of tanning equipment by children under 18 years of age and by high-risk populations. Objectives The present large survey aimed to determine the prevalence of current sunbed use in Italy and to identify user characteristics. This study identifies starting points for future national interventions to reduce the health risks of exposure to artificial UV radiation. Methods In 2011 we conducted a survey of 4703 people in an area on the sunny Mediterranean coast in Italy. Through multivariate logistic models we investigated the associations of sunbed use with phenotypical factors. Results Overall prevalence of sunbed use was 20%, higher among women (22% vs. 16%; P < 0·0001), and young (22% vs. 17% for age < 35 years; P < 0·0001) and highly educated people (22% vs. 14%; P < 0·0001). Subjects at high risk of melanoma used sunbeds significantly more; i.e. people with freckles (25% vs. 18%; P < 0·0001), red hair (30% vs. 19%; P = 0·01) or fair eyes (22% vs. 19%; P = 0·006). Associations were confirmed in multivariate models. Conclusions More skin cancer monitoring is needed at tanning centres, and educational campaigns should be promoted, especially for young women and subjects at high risk of melanoma.

The term psoriasiform acral dermatitis (PAD) was coined by Zaias in 1980 (1) to describe a distinctive psoriasiform dermatitis selectively localized on the distal phalanges of the fingers and associated with a remarkable shorte-ning of the nail bed. In the last few years only 8 patients affected by this unusual chronic dermatosis have been reported in the literature (1–4). Seven of these patients were children under 10 years of age. In 1999 we descri-bed PAD in 3 children affected by psoriasis followed up until now and we concluded our report with an open question as to whether PAD was a distinctive entity or just a clinical manifestation of psoriasis in children. In the latter situation the most appropriate term to define this entity would be “psoriatic acral dermatitis”, PAD being a particular variety of acral psoriasis in childhood that can be isolated or associated with typical lesions of psoriasis in other cutaneous areas (4). Over the last 8 years we have had the opportunity to observe PAD in another 7 Caucasian children.The aim of our study is to answer the above-men-tioned question by means of a larger case study with a long-term follow-up and the possible appearance of other cutaneous diseases in the affected patients. In our department from 1993 to 2007 a diagnosis of PAD was made in 10 Caucasian children aged from 2 to 6 years (mean age 4.2 years). All 10 patients were boys and 2 were brothers. All the patients had the typical features of PAD: (

Background: Increased skin Staphylococcus aureus colonization is frequently found in atopic patients. The reduction of local overinfection decreases skin inflammation and improves the flares. Objective: To evaluate the effectiveness of the antimicrobial activity of a silk fabric (MICROAIR DermaSilk®) coated with alkoxysilane quaternary ammonium with durable antimicrobial properties (AEGIS AEM 5572/5) in children affected by atopic dermatitis (AD). Methods: Sixteen children, 12 affected by AD with symmetric eczematous lesions on the antecubital areas and 4 without any cutaneous disease, used, for 7 days, tubular arm covers made of this special silk fabric but only one of each pair was coated with AEGIS AEM 5572/5. Microbiological examinations were done with standard cultural swabs and by means of quantification of bacterial agents using agar plates at baseline, after 1 h and after 7 days. Results: After 7 days a significant improvement in the mean value of the ‘local SCORAD’ index was observed in both the covered areas compared to the values obtained at baseline. The reduction in the mean number of colony forming units per square centimetre was similar in both areas. Conclusions: Although this special silk fabric seems to be able to improve skin lesions in AD, we were unable to demonstrate that such silk fabrics coated with AEGIS AEM 5572/5 have an antibacterial activity in vivo, as shown in vitro.

ejd.2010.1239 Auteur(s) : Annalisa PATRIZI1, Matelda MEDRI1,2, Fabiola AFFOLTER ORLOWSKI3, Cosimo MISCIALI1, Carlotta BARALDI1, Iria NERI1 mateldamedri@libero.it 1 Dermatology. Department of Internal Medicine, Geriatrics and Nefrologic Diseases, University of Bologna, via Massarenti 1, CAP 40128, Bologna, Italy 2 Istituto Tumori Romagna, IRST, Meldola/Forli, Italy 3 Pontificia Universidade Catolica do Parana, Italy Myxoid neurofibroma is a benign tumor of perineural cell origin [1, 2]. [...]