Search

Background: Carnosine is a low molecular weight water soluble biological dipeptide, composed of alanine and histidine, present in a levorotatory form in mammalian tissues. Interesting activities are related to the detoxification from free radical species and byproducts of membrane lipids peroxidation. Objectives: The aim of the present study was to evaluate the photoprotective properties of carnosine and acetylated carnosine when applied to human skin. Materials and methods: Carnosine and N-acetylcarnosine at 0.5% solution in water were applied before and after UVB irradiation in twenty healthy volunteers with phototype 2 or 3. 9 patients were males and 11 females, 25 to 46 years of age. None of the patients had a positive case history for photodermatoses or had received any sun exposure. The minimal erithemal dose (MED) for UVB was determined before the study with a UVB Philips TL12 lamp with a radiance of 4 mW/cm2 and a 290 - 320 nm emission spectrum. Results: Carnosine solution obtained 3.6% reduction of erythema (compared to MED) and N-acetylcarnosine 7.3% reduction. Conclusions: An antioxidant capacity of N-acetylcarnosine and carnosine was shown, probably more significant with vehicles improving skin penetration of the substances through skin barrier. N-acetylcarnosine represents an interesting hydrophilic antioxidant for dermatological preparations.

Objective: The aim of this work was to assess whether psoriasis is associated with phenotype prevalence and altered activity of Haptoglobin (Hpt). Background: Hpt is a plasma acute phase glycoprotein, displaying in humans three phenotypes. Phenotype prevalence or structure modification of Hpt was associated with several diseases. The Hpt main function is to bind and carry to the liver free hemoglobin for degradation and iron recycling. Hpt was recently found able to bind the apolipoprotein A-I (ApoA-I), thus impairing its stimulation on the activity of the enzyme lecithin-cholesterol acyl-transferase (LCAT) Study design: Hpt was isolated from patients with psoriasis vulgaris, and its activity in hemoglobin or ApoA-I binding and LCAT inhibition was compared with that of normal protein. Methods: Two affinity chromatography steps, the first using resin-coupled hemoglobin and the second anti-Hpt antibodies, were used to purify Hpt. The protein phenotype was assessed by electrophoresis. Binding experiments were performed by ELISA with stationary hemoglobin or ApoA-I, Hpt in solution, and anti-Hpt antibodies for detection of bound Hpt. Standard LCAT assays were carried out in the presence of Hpt purified from patients or healthy subjects. Results: Phenotype prevalence of Hpt in psoriasis was not found. After affinity chromatography by hemoglobin, albumin and ApoA-I were routinely found heavily contaminating only Hpt from normal subjects. Isolated Hpt from patients had lower activity than normal protein in both hemoglobin binding and LCAT inhibition. Conclusions: In psoriasis, Hpt displays some structure modification(s) which might be associated with the protein function in the disease.

We report a study performed with 64 patients with an adverse drug reaction (ADR) history who were admitted to hospital for drug tolerance testing, and who were also patch tested with drugs currently suggested and used by the "ESCD working party on drug skin testing in cutaneous adverse drug reactions (ESCD-WPD)". Three positive patch test reactions were observed in two patients, namely a boy presenting with a maculo-papular rash and who was found to be amoxycillin and ampicillin positive and a girl with diffuse urticaria found to be erythromycin positive. The few positive patch test reactions reported confirm that such a procedure is highly sensitive, particularly in maculo-papular rashes, eczematous reactions and fixed drug eruptions, but that it has a low sensitivity in urticarioid or anaphylactic reactions.

Background: skin reactivity towards chemical or physical irritant substances is variable and subjective. The aim of the present study is to evaluate, by means of validated devices and allergologic investigations, modifications induced by a moisturizing cream containing anti-oxidant chemicals when applied to sensitive skin. Materials and methods: 16 female patients with sensitive skin, aged between 15 and 60 years (medium age: 32), were enrolled. The product, containing green tea's polyphenols, soy isoflavones, vitamins E and C, was applied twice daily for a period of 7 days. Evaluation of cutaneous sensitivity was carried out by lactic acid test (stinging test), transepidermal water loss (TEWL) measurement, use test and patch test. Results: 81.2% of the patients had a positive reaction to the lactic acid test: 46.1% of them reported moderate to intense stinging. A significant decrease of TEWL values in treated areas was demonstrated. Both the use test and patch test with the product as is were negative in all the patients. Conclusions: the test product demonstrated moisturizing properties, positive effects on the cutaneous barrier and good acceptability. The data obtained suggest that it could be recommended in treating patients with sensitive skin.

We report a study performed with 64 patients with an adverse drug reaction (ADR) history who were admitted to hospital for drug tolerance testing, and who were also patch tested with drugs currently suggested and used by the "ESCD working party on drug skin testing in cutaneous adverse drug reactions (ESCD-WPD)". Three positive patch test reactions were observed in two patients, namely a boy presenting with a maculo-papular rash and who was found to be amoxycillin and ampicillin positive and a girl with diffuse urticaria found to be erythromycin positive. The few positive patch test reactions reported confirm that such a procedure is highly sensitive, particularly in maculo-papular rashes, eczematous reactions and fixed drug eruptions, but that it has a low sensitivity in urticarioid or anaphylactic reactions.

The scientific committee of the SIDAPA (Società Italiana Dermatologia Allergologica Professionale ed Ambientale) planned a questionnaire which was sent by e-mail to 500 randomly selected Italian dermatologists. These dermatologists were working in different hospitals, university departments and private clinics in different regions of the country. The aim of the investigation was to gather information about the dermatologists' prescriptions of cosmetics, to find out which are the most prescribed cosmetics and how dermatologists face some practical problems connected with the prescription of cosmetics for conditions such as sensitive skin and allergic dermatitis. All data were entered into a data base and statistically analysed using SPSS (Statistical Package for Social Scientists) IBM version 1.1. The response rate to the questionnaire was 25.4% of the dermatologists. According to the results, 59.2% of dermatologists prescribe up to 40 cosmetics per week, while 41.8% prescribe more than 40 cosmetics per week. 93.6% of them prescribe detergents, 89.6% recommend sun blockers, 85.6% shampoos and 85.1% moisturizers. Surprisingly enough, 72% of dermatologists say they prescribe camouflage products. Other cosmetic products such as anticellulite, anti-wrinkle and anti-stretch mark products, anti-perspirants deodorants and products for hair removal, make-up and make-up removal and skin lighteners are less frequently prescribed. The prescription of liquid detergents far outweighs the prescription of other types. For the commonest dermatoses of the scalp, dermatologists usually prescribe shampoos applied twice a week; only in the case of scalp psoriasis are 3 applications per week recommended. More than half of dermatologists try out free samples of cosmetic products on their own skin, particularly moisturizers, deodorants, shampoos and sunblockers. More than 70% of the respondents consult the suppliers' data sheets, especially for anti-wrinkle products, emollients/moisturizers and sunblockers. Less than 50% of dermatologists perform an exclusive evaluation of the chemical composition of a new cosmetic product. 89.6% of dermatologists are aware of the problem of sensitive skin, a common self-diagnosed skin condition. If contact allergy to a hapten has been previously diagnosed in a patient, dermatologists say they check the composition of the cosmetic product before prescribing: 84% check "always" and 15.2% "often". In conclusion, dermatologists now prescribe a lot of cosmetics, especially those which are usually used in the treatment of skin diseases, such as moisturizers/emollients, detergents and sunblockers. Dermatologists also focus their attention on the characteristics of the cosmetic products as well as on their patients' problems.

Leptin belongs to the helical cytokine family and has structural similarity to interleukin (IL)-6, IL-12, IL-15, prolactin, and growth hormone. It is mainly secreted by adipocytes but (at lower levels) also by stomach, skeletal muscle, and placenta. Initially, leptin was considered an antiobesity hormone, but experimental evidence has also shown pleiotropic effects on hematopoiesis, angiogenesis, lymphoid organ homeostasis, and T-lymphocyte functions. Recent evidence indicates that leptin modifies T-cell immunity by promoting T helper 1 proinflammatory immune response and production of cytokines. OBJECTIVE: The aim of the present study was to evaluate leptin serum levels in patients with allergic contact dermatitis (ACD) and atopic dermatitis and to evaluate the correlation of these levels with different patterns of lymphocyte subpopulations. METHODS: Serum leptin was assayed by enzyme-linked immunosorbent assay. Immunophenotypic analysis of peripheral blood was performed by flow cytometry. RESULTS: We found that serum leptin levels were higher in ACD patients than in healthy controls (p = .02). In these patients, an inverse correlation between serum leptin and the percentage of CD4CD25 T lymphocytes was observed (p = .002). CONCLUSION: These data seem to suggest that leptin might play a role in the pathogenesis of ACD and thus have implications for the therapy for ACD.

Background: although topical antihistamines were widely prescribed in the past, their current usage is mostly limited to treating sensitive reactions. Materials and methods: 82 consecutive patients with a medical history of adverse drug reactions, of various eczematous lesions or with no drug-induced urticarias were patch tested with eight formulations containing antihistamines, which are sold in Italy. In 8 subjects with eczematous manifestations, tolerability and efficacy against itching in 3 out of the 8 formulations were evaluated. Results: 4 positive patch tests in 2 subjects were recorded, and these were mainly due to commercial formulations containing promethazine (2 cases), maleate dimethindene and chlorhydrate hysotipendile. The 8 subjects with eczematous manifestations reported the 3 products tested to be useful against itching and very tolerable too. Conclusions: although the dermatologic profession has been prescribing these topical therapeutic formulations less than the systemic ones in recent years, owing to their large commercial diffusion and the frequency with which they are self-prescribed, we think that with the exception of some drugs such as promethazine which have been shown to be sensitising, some of the ingredients used should be revaluated for wider use including the dermato-allergologic field.

Spitz nevus is an uncommon, benign melanocytic neoplasm that shares many clinical and histological features with melanoma. It presents clinical ambiguity that makes the diagnosis and management of the patient difficult. We present our experience in the management of Spitz nevus by rigorous dermoscopic long-term follow-up of 8 Spitz nevi in patients younger than 12 years. Dermoscopic images, acquired every 6 months, show evolution and modifications of these lesions. The aim of this paper is to better understand the long-term modifications of nevi with starburst pattern to avoid surgical excision of these lesions in the pediatric age group.

Phaeohyphomycoses are induced by dematiaceous or darkly pigmented fungi. Alternaria species are the most important causative agents. Factors such as immunosuppression, local wounds or systemic disease are generally present. We report a case of phaeohyphomycosis induced by Alternaria alternata in an immunocompromised patient. The main interest in this case is the rareness of the cutaneous alternariosis and of its clinical aspects and the good response to therapy. Recognition of Alternaria spp. as potential opportunistic pathogens is important for the differential diagnosis of dermatological lesions, such as granulomatous or ulcerative lesions in immunocompromised patients.

Background: Leptin belongs to the helical cytokine family and has structural similarity to interleukin (IL)-6, IL-12, IL-15, prolactin, and growth hormone. It is mainly secreted by adipocytes but (at lower levels) also by stomach, skeletal muscle, and placenta. Initially, leptin was considered an antiobesity hormone, but experimental evidence has also shown pleiotropic effects on hematopoiesis, angiogenesis, lymphoid organ homeostasis, and T-lymphocyte functions. Recent evidence indicates that leptin modifies T-cell immunity by promoting T helper 1 proinflammatory immune response and production of cytokines. Objective: The aim of the present study was to evaluate leptin serum levels in patients with allergic contact dermatitis (ACD) and atopic dermatitis and to evaluate the correlation of these levels with different patterns of lymphocyte subpopulations. Methods: Serum leptin was assayed by enzyme-linked immunosorbent assay. Immunophenotypic analysis of peripheral blood was performed by flow cytometry. Results: We found that serum leptin levels were higher in ACD patients than in healthy controls (p = .02). In these patients, an inverse correlation between serum leptin and the percentage of CD4 +CD25 + T lymphocytes was observed (p = .002). Conclusion: These data seem to suggest that leptin might play a role in the pathogenesis of ACD and thus have implications for the therapy for ACD

Background: Household cleaning products often contain potential allergens and irritants but allergic contact dermatitis from these products in general consumers is rarely reported in the literature. Objectives: The purpose of this study was to evaluate the presence of irritants and allergens as indicated on the labels or on the product information found on the website of household cleaning products marketed in Italy. Material/Methods: We examined the labels and the product information of 291 liquid household washing and cleaning products, including 43 washing-up liquids, 63 laundry detergents, 61 fabric conditioners, 47 spray detergents, and 77 hard surface cleaning products. We obtained the data from the product information found on the websites for 263 products and directly on the product packages for 28 products. For each product we specifically recorded the presence of surfactants, preservatives, and fragrances listed in Annex III of Directive 76/768/EEC. Results: The websites of two Italian brands do not respect EU regulations as they provide product information only with bar codes of the products. Preservatives and fragrances are the main allergens declared in the label of household cleaning products with methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) listed in 35.7% and limonene in 43.6% of the products. Surfactants were listed in 16.5% of the studied products. Conclusions: Our study shows that household cleaning products in Italian market contain several allergens, particularly preservatives and fragrances. For consumers, at least in Italy, it may not be easy to retrieve product information from the website for two widely sold brands. The information had to be taken from the actual package. © 2009 John Wiley & Sons A/S.

Background: Contact dermatitis (CD) is a chronic disease with a significant impact on quality of life (QoL). There have been relatively few reports in the literature on specific QoL outcomes for patients suffering from CD. Objectives: To develop a new instrument specifically designed to measure QoL in CD and to investigate which disease features could strongly influence QoL. Methods: Three hundred seventy-two patients affected by CD were administered a 20-item questionnaire, which comprised some questions taken and modified from the Dermatology Life Quality Index and the Skindex 16. Six more items were added. Univariate analysis and a chi-square test were performed. Results: Females reported lower QoL scores than males. Three aspects (itching, discomfort, and difficulty in daily activities) were strongly associated with a poor QoL; even if patients who experienced difficulty in using their hands at work had a poor QoL, the statistical significance was very low. Conclusion: A CD-specific questionnaire can be used to understand a priori the impact on psychological behaviour of the patient and can lead to specific choices, such as the appropriate therapy to be used, the evaluation of treatment efficacy, the choice of preventive devices, and the comparison with QoL of other dermatoses.

Background Obese subjects frequently show skin diseases. However, less attention has been paid to the impactof obesity on skin disorders until now.Objective The purposes of this study are: to highlight the incidence of some dermatoses in obese subjects and tostudy the water barrier function of the obese skin using transepidermal water loss (TEWL).Methods Sixty obese subjects and 20 normal weight volunteers were recruited. Obese group was further dividedinto three body mass index (BMI) classes: class I (BMI 30–34.9 kg⁄m 2 ), class II (BMI 35–39.9 kg⁄m ) and class III(BMI 40 g⁄m 2 ). All subjects attended dermatological examination for skin diseases. To assess barrier function, TEWLmeasurements were performed on the volar surface of the forearm using a tewameter.Results The results of this study showed that: (i) obese subjects show a higher incidence of some dermatosescompared with normal-weight controls; in addition the dermatoses are more, frequent as BMI increases; (ii) the rateof TEWL is lower in obese subjects, than in the normal-weight subjects, particularly in patients with intra-abdominalobesity.Conclusion Specific dermatoses as skin tags, striae distensae and plantar hyperkeratosis, could be considered asa cutaneous stigma of severe obesity. The low permeability of the skin to evaporative water loss is observed inobese subjects compared with normal weight control. Although the physiological mechanisms are still unknown, thisfinding has not been previously described and we believe that this may constitute a new field in the research onobesity.Received: 26 November 2008; Accepted: 13 February 2009

Acrokeratoelastoidosis (AKE) is a rare chronic skin disorder characterized by firm papules or plaques on the sides of the hands and feet. It appears to be a genodermatosis with an autosomal dominant inheritance pattern and a possible linkage to chromosome 2. However, many sporadic reports of acquired cases seen in older individuals with a history of both excessive sun exposure and chronic trauma of the hands have also appeared in literature. Although poorly understood, lesions may result from an abnormality in the secretion or excretion of elastic material by fibroblasts in the dermis. We describe the case of a 42-year-old woman and review the patient's clinical and histopathologic features, the causes of the disease as well as the differential diagnosis made.