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Nonostante una buona percentuale di soggetti con dermatite atopica (DA) vada incontro a remissione nella prima età scolare, un numero considerevole dei casi (10-20%) continua a presentarla in età adolescenziale. La persistenza della DA sembra essere correlata alla presenza di alcuni fattori di rischio come: sesso femminile, presenza di sensibilizzazione allergica, associazione con asma e/o rinocongiuntivite allergica e pratica di alcune attività lavorative a rischio di contattocon sostanze allergizzanti. Durante l’adolescenza il quadro clinico può essere differente rispetto alle altre fasce d’età, conlocalizzazione delle lesioni prevalentemente al collo, associate a sovrinfezione da Malassezia, alle palpebre, ai palmi delle mani e alle piante dei piedi.Infine lo stress e le difficoltà psicologiche rappresentano un problema importante nella gestione dei pazienti adolescenti, causando un significativo peggioramento della qualità di vita loro e delle loro famiglie.

Atopic dermatitis (AD) is a chronic inflammatory skin disorder that typically occurs during childhood especially in the first year of life, with a variable frequency from 10% to 30%. Recent studies have shown that in Europe among 10-20% of children with AD suffer from this disorder also in adolescence. AD is a chronic inflammatory skin disease with a typical onset in the first years of life and with a 10- 30% prevalence among young children. AD prevalence in adolescence has been estimated around 5-15% in European countries. AD persists from childhood through adolescence in around 40% of cases and some risk factors have been identified: female sex, sensitization to inhalant and food allergens, allergic asthma and/or rhinoconjunctivitis, the practice of certain jobs. During adolescence, AD mainly appears on the face and neck, often associated with overinfection by Malassezia, and on the palms and soles. AD persistence during adolescence is correlated with psychological diseases such as anxiety; moreover, adolescents affected by AD might have problems in the relationship with their peers. Stress and the psychological problems represent a serious burden for adolescents with AD and cause a significant worsening of the patients’ quality of life (QoL). The pharmacological treatment is similar to other age groups. Educational and psychological approaches should be considered in the most severe cases.

Papular mycosis fungoides: a new case expanding the spectrum of phenotypic and clinical findings.

Langerhans cell histiocytosis (LCH) may be a single-system disease or a multisystem disease with organ dysfunction. Cytotoxic drugs and corticosteroids, alone or in combination, are the treatments for multisystem LCH. We report the case of a young girl who had multiple lentigines localized in periflexural areas, arisen after chemotherapy for Letterer-Siwe disease with skin and bone involvement. The time of lesions onset induces to hypothesize that immune suppression caused by chemotherapy may favor melanocyte proliferation. We hypothesize that the unusual periflexural localization of the lentigines may be due to a greater concentration of melanocytic cells in periflexural areas or a greater concentration of the drugs in the folds due to vasodilation

The object of this article is to review the mechanisms of the allergic march from atopic dermatitis to asthma, considering the various steps from the primary skin lesion to respiratory allergy. The data sources used were PubMed databases, researching articles from the last 15 years. Most of the evidence on which the concept of the atopic march is based comes from cross-sectional population studies at different ages. Reduced filaggrin expression is implicated as a major predisposing factor for atopy. Other gene products and factors play an important role. The mechanism that triggers the atopic march is represented by defects in the epidermal barrier that predispose to primary sensitisation and consequent later sensitisation in the airways. The major predisposing factor is a primary inherited epithelial barrier defect resulting from filaggrin gene mutation, but other factors may also play a role in this complex mechanism. Further research into preventative and treatment strategies is needed.

We read with great interest the article entitled ‘Matchstick eyebrow hairs: a dermoscopic clue to the diagnosis of Netherton syndrome’ published by E. Goujon et al. in the JEADV,1 in which the authors reported a new dermoscopic morphological aspect typical of Netherton Syndrome (NS). We too have investigated hair shaft abnormalities by videodermatoscope and we would like to add some annotations. Until now, three characteristic hair alterations have been described in the literature: (i) trichorrhexis invaginata, (ii) golf-tee hairs and (iii) matchstick hairs. The pathognomonic hair feature of NS is the trichorrhexis invaginata, an invagination of distal dilated hair portion in a concave proximal hair terminal, universally known as ‘bamboo hairs’ and ‘ball-and-socket’ aspect.2

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Atopic dermatitis (AD), the most frequent chronic skin disease of early childhood, is associated with impaired barrier function. The recognition and removal of factors recognized as potential irritants may improve the symptoms of DA and reduce flares. Many types of fabrics could exacerbate AD, but others may help to control this condition. Synthetic fabrics and wool tend to produce irritant reaction and itching. Cotton is frequently recommended in AD patients, however its structure contains short fibers which expand and contract when the fabric is wet causing a rubbing that can irritate the atopic skin. Also, cotton is sensitive to the colonization of bacteria and fungi, making over-infection easier. Finally, the dyes used for dying of cotton clothes can complicate AD promoting contact sensitization. The type of silk fabric generally used for clothing is not particularly useful for the treatment and care of children with AD because it reduces transpiration; furthermore, some people may be allergic to the sericin, a protein in the silk . Several studies reported in the literature, have suggested that Microair Dermasilk®, a particular type of silk without sericin and permanently bonded to a anti-microbial agent (AEGIS AEM 5772/5) is well tolerated and has beneficial effects on atopic skin. The effectiveness of this tissue on eczema has been undoubtedly prove, while it is doubtful its ability to reduce the number of colonies of Staphylococcus aureus which often colonize eczema causing a worsening of the disease. In fact AEGIS AEM 5772/5 has shown antimicrobial properties in vitro while in vivo there are conflicting opinions. The last fiber approved by the “Federal Trade Commission” is Lyocell, a cellulosic fiber belonging to the generic” man-made fibers”: Lyocell fiber is currently available as a soft tissue able to improve the comfort of the patient with AD.

Adverse events with anti-epidermal growth factor receptor therapy mainly involve the skin. The most common cutaneous adverse event is an acneiform eruption, which occurs in more than 50% of cases. The aim of this paper is to report the case of rosaceiform eruption induced by erlotinib in an 81-year-old-man and to discuss the pathogenetic role of Demodex folliculorum mites, found in the present patient, using skin scraping.

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease which usually starts during the first years of life. In the management of AD, the correct approach requires a combination of multiple treatments to identify and eliminate trigger factors, and to improve the alteration of the skin barrier. In this article we try to explain the importance of skin care in the management of AD in relation to the use of textiles: they may be useful to improve disrupted skin but they are also a possible cause of triggering or worsening the lesions. Garments are in direct contact with the skin all day long, and for this reason it is important to carefully choose suitable fabrics in atopic subjects who have disrupted skin. Owing to their hygienic properties fabrics produced from natural fibres are preferential. Wool fibres are frequently used in human clothes but are irritant in direct contact with the skin. Wool fibre has frequently been shown to be irritant to the skin of atopic patients, and for this reason wool intolerance was included as a minor criterion in the diagnostic criteria of AD by Hanifin and Rajka in 1980. Cotton is the most commonly used textile for patients with AD; it has wide acceptability as clothing material because of its natural abundance and inherent properties like good folding endurance, better conduction of heat, easy dyeability and excellent moisture absorption. Silk fabrics help to maintain the body temperature by reducing the excessive sweating and moisture loss that can worsen xerosis. However, the type of silk fabric generally used for clothes is not particularly useful in the care and dressing of children with AD since it reduces transpiration and may cause discomfort when in direct contact with the skin. A new type of silk fabric made of transpiring and slightly elastic woven silk is now commercially available (Microair Dermasilk) and may be used for the skin care of children with AD. The presence of increased bacterial colonization has been demonstrated in patients with AD. Such colonization has been included in the group of trigger factors for eczema in AD. Silver products have recently been demonstrated to offer two advantages in the control of bacterial infections. Textiles may be used not only for clothes, but also to prevent dust mite sensitization in atopic patients. A marked clinical improvement of AD was observed in a group of adults and children with positive skin tests (not necessarily towards mites), after an intensive eradication programme for mite allergens. Skin treatment with acaricide and house dust mite control measures can decrease AD symptoms. Different textiles have various potential worsening links with allergies: e.g. clothing has been proposed as an additional source of exposure to mite and cat allergens. On the other hand, special textiles can be used to prevent dust mite sensitization.