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Lichen sclerosus (LS) is a chronic inflammatory disease of the skin, and the gold standard for treatment is the use of the very potent topical steroids, but they can have side effects. Previously, we demonstrated that OZOILE (stable ozonides) were effective in children affected by LS, reducing the inflammatory process and stimulating tissue regeneration of the foreskin, showing a similar efficacy to steroid treatment. In this study, the modulation of inflammatory and oxidative stress pathways was evaluated by qRT-PCR and Western blotting in foreskins affected by LS removed from patients untreated or treated with OZOILE or corticosteroid cream formulations for 7 days before circumcision. OZOILE induced a significant increase in NRF2 and SOD2 levels, while it did not produce change in MIF, NF-kB subunits, and MMPs in comparison to untreated foreskins. Conversely, steroid topical treatment produced a significant reduction in the expression of p65, MIF, and MMP9, but it did not cause variation in NRF2 and SOD2 levels. These results demonstrate that the use of OZOILE as cream formulation exhibits effects on NRF2 signaling, and it does not induce NF-κB activation, unlike corticosteroids. On the basis of our biochemical data, further studies evaluating the role of NRF2 signaling cascade are necessary.

Dear Editor, I would like to express my sincere appreciation for the publication and detailed discussion of therapies for dermatological and inflammatory conditions, as exemplified in the recent article “Onychocryptosis: a retrospective study of clinical aspects, inflammation treatment, and pain management using Ozoile as a hydrogel and cream formulation” by Vincenzo Francavilla et al. This insightful study has provided a comprehensive overview of the management of onychocryptosis, a common and often distressing condition, and has highlighted the innovative use of OZOILE® in a clinical setting.1 [...]

Varicocele (VC) is an abnormal venous dilatation and/or tortuosity of the pampiniform plexus in the scrotum (1). VC is one of the main factors causing male infertility and affects about 15% of all healthy male adults and about35% of patients with primary infertility (2), so it isparticularly important to clarify the pathogenetic mechanism in the course of male infertility. There is no single pathogenetic factor that alone justifies the adverse effects of varicocele on the testes. The pathogenesis of disease is complex and multifactorial, with several proposed mechanisms acting in synergy. Indeed, blood stasis negatively affects spermatogenesis by causing an increase in scrotal temperature (usually below 2°C at body temperature), hypoxic damage (stagnant hypoxia), a reflux of renal and adrenal catabolites, and last a modification of the testicular hormonal balance.

Acute scrotum is a set of signs and symptoms that should lead the patient to go to a first aid center. There are different causes of these signs and symptoms, but testicular torsion is identified as the main ones and can be suspected thanks to a careful history, physical examination and testicular ultrasound. It is important to quickly differentiate the various conditions associated with acute scrotum in order to optimize surgery times and preserve testicular vitality. Often the radiological study is essential to identify the causes of acute scrotum, in particular the testicular Doppler ultrasound is sensitive and specific for testicular torsion, infact it is considered the gold standard for diagnosis. However, the radiological study can delay surgical treatment and reduce testicular vitality. So TWIST score was proposed. It is based on the identification of signs and symptoms that can lead at clinical diagnosis of testicular torsion. Our narrative of literature review analyzes TWIST score validity and shows the utility of an adequate clinical examination obtaining a diagnosis of torsion cord, reducing the costs and the time of surgical treatment resulting in a higher likelihood of preserving testicular vitality

Background: A major worry of juvenile penile LS is potential malignant degeneration to spinocellular carcinoma (SCC) in adulthood. LS is characterized by increased CD8+ and CD57+ cells, dermal sclerosis, epidermal atrophy, and hyperkeratosis. p53 and Ki67 are reliable premalignant markers. Our aim was to define the LS immunohistochemical profile of foreskin in children, focusing on tissue immune response and cell proliferation. Methods: Thirty specimens of foreskins removed from pediatric patients during circumcision were included: six from ritual operation (A), twelve from phimosis (B), and twelve from phimosis with LS (C). Formalin-fixed paraffin-embedded sections were stained for histomorphology and immunohistochemistry. A quantitative evaluation for CD8, CD57, p53, and Ki-67 and a statistical analysis were performed. Results: As compared to groups A and B, the samples from group C patients showed an acanthotic epidermis, a dermal band of lymphoid infiltrate with a significant enhancement of CD8+ CD57+ lymphocytes, and a keratinocytic hyperplasia with an overexpression of Ki67+ and p53+ cells. Conclusions: Immunohistological findings confirmed an immune reaction and proliferative behavior in juvenile LS of foreskin. We believe that radical circumcision should be the first treatment of choice in pediatric patients with clinical suspicious of LS for the potential risk of transformation to SCC in adulthood.