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In this proof of concept study, 50 lesions from 15 patients with multiple seborrheic keratoses (SKs) were treated with a novel aqueous solution containing nitric acid, zinc and copper salts, and organic acids (acetic, lactic, and oxalic acid). Treatment consisted in the application of an amount of the solution sufficient to obtain a whitening/yellowish reaction. Application of the nitric-zinc solution was performed every other week until clinical and dermoscopic clearance or crust formation, for a maximum of 4 applications. Efficacy evaluation was performed at 8 weeks (T1) and 6 months (T2). All subjects, who reported no or minimal discomfort during and after the application of the solution, completed the study. At T1, a complete clinical and dermoscopic resolution was observed in 37 lesions after an average of 3 applications/lesion (range 2-4). A partial response, with minimal persistent residual spots, was detected in the remaining 13 lesions. All patients with complete clearance showed no relapses at a 6-month follow-up (T2). The positive preliminary results indicate that this novel solution may represent a promising alternative option for SKs especially in patients not keen or eligible to undergo invasive tissue-destructive procedures., (© 2017 Wiley Periodicals, Inc.)

Background and Purpose: Effective non-invasive techniques to monitor plaque psoriasis progression and treatment are desirable. The aim of the study was to evaluate changes in vascular pattern using videodermatoscopy (VD) and in skin thickness by ultrasound (US), along with clinical observation, during treatment with biologicals., Methods: Forty-two patients with moderate-to-severe plaque psoriasis treated with adalimumab, etanercept, or ustekinumab were evaluated. Following the identification of a 'target' plaque at baseline, lesion changes were monitored at 15, 30 and 60 days by clinical observation using a Target Lesion Score (TLS), and by VD and US., Results: After 60 days, a significant improvement in all three parameters was observed. In adalimumab-treated patients mean values of TLS, VD, and US were reduced by 83.9%, 73.5%, and 90%, respectively; in etanercept-treated patients by 67.9%, 49.7%, and 79.3%; in ustekinumab-treated patients by 80.9%, 66.4%, and 80.1%. Skin thickness was the first parameter to improve. Vascular improvement was slower compared to clinical and US responses., Conclusion: VD and US may be useful to monitor psoriasis treatment. Further investigations are warranted to assess if the persistence of an altered vascular pattern despite clinical and US normalization, as observed in 22% of patients, may influence disease progression and/or correlate with rate and severity degree of relapse., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Dermatoscopy (DE) is a noninvasive technique that allows a rapid and magnified in vivo observation of the skin surface with the visualization of morphologic features invisible to the naked eye. It is performed using manual devices without computer assistance, which generally allows ×10 magnifications. Videodermatoscopy (VD) represents the evolution of DE and is performed using a video camera equipped with optic fibers and lenses that currently allow magnifications ranging from ×10 to ×1000. Both DE and VD have been demonstrated to have further applications in dermatology apart from their use in differential diagnosis of pigmented skin lesions. In several disorders, they may be useful in differential diagnosis, prognostic evaluation, and in evaluating the response to treatment. This article focuses on the use of DE and VD in therapeutic follow-up. Although VD systems using high magnifications may not be cost-effective in all cases, VD represents a more reliable noninvasive and easy-to-use tool in therapeutic follow-up both for in-office dermatology as well as for clinical investigations., (© 2010 The International Society of Dermatology.)

Lentigo maligna (LM) is an in situ variant of cutaneous melanoma, which usually occurs in sun-damaged skin. Surgical treatment of LM is often difficult and not well accepted by patients, as lesions are usually quite large and located on the face. Imiquimod 5% cream is a local immune response modifier that has been used off-label to treat LM. The authors report of 2 female patients with LM on the nose (aged 39 and 48 years) treated with imiquimod 5% cream applied 5 times a week for a total duration of 4 months. Videodermatoscopy, a noninvasive diagnostic technique, was used to address the diagnosis and to monitor treatment response with imiquimod therapy and during follow-up. At the end of the treatment period, the lesions had cleared in both patients, with no evident remnants confirmed by videodermatoscopy. The patients refused to undergo a control biopsy, but complied for a 30-month followed-up period which revealed no evident changes. The authors' experience, in agreement with other clinical reports and open trials, suggests that topical imiquimod is a valuable treatment option capable of leading LM to clinical clearance.