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Impetigo is a superficial bacterial infection of the skin. It is a contagious condition particularly affecting children. In many instances, a topical antibacterial treatment is recommended to clear the disease. Topical antibiotics and antiseptics can be used, but the risk for antibiotic-induced bacterial resistance of the community-acquired type has been pointed out. The present study was undertaken as a randomized intra individual comparative trial between fusidic acid (FA) cream and povidone iodine (PVP-I) gel in 40 children suffering from impetigo. Cultures revealed Staphylococcus aureus in the vast majority of the cases. The lesions present on each upper limb were treated twice daily with one or the other test formulation. Clinical assessments were performed twice weekly until cure. After one week, cure was obtained in 57.5% of the PVP-I-treated limbs compared to 32.5% of the FA-treated limbs. At the end of treatment cure was obtained first on the PVP-I treated sites in 67.5% of cases compared to 15% on the FA-treated sites. Clinical cure occurred simultaneously on both test sites in 17.5% of cases. In conclusion, PVP-I provided faster clinical cure than FA. Considering the treatment cost, the rising community-acquired staphylococci resistance to FA, and the results of the present study, PVP-I gel appears superior to FA cream in childhood impetigo.

Fluorescence is a peculiar aspect of photoluminescence. Some intrinsic components of the skin are fluorophores. Other synthetic components are metabolized into fluorophores. These characteristics may be used for identifying some specific aspects of skin physiopathology. Recent technological evolution has provided new devices bringing sensitive and specific information from the skin. This review presents a synthesis of the progress made in the field of fluorescence and specular reflexion of incident UV light on the skin.

Aim: Both interstitial granulomatous dermatitis (IGD) and palisaded neutrophilic granulomatous dermatitis (PNGD) are rare disorders typically associated with systemic autoimmune conditions. They probably represent different aspects of a disease spectrum encompassing the concept of autoimmunity-related granulomatous dermatitis (ARGD). Case Report: A 61-year-old woman presented with ARGD and autoimmune hepatitis. The clinical presentation suggested PNGD, while histopathology was consistent with IGD. Discussion: The association of ARGD with autoimmune hepatitis is apparently a rare event. The present case shows that the clinicopathological correlation in ARGD does not always clearly fit with the classical presentations of IGD or PNGD.

Background Hypomelanosis of Ito is a rare genetic disorder characterized by whorled areas of hypomelanosis. The purpose of the present study was to revisit some aspects of Ito’s hypomelanosis. Methods Clinical observations included ultraviolet-light-enhanced visualization (ULEV) method. Histochemistry, immunohistochemistry, and electron microscopy were performed on biopsy samples from the hypopigmented areas and the surrounding skin. Results Both the ULEV and microscopic examinations revealed the heterogeneity of the pigmentation. Hypomelanosis was characterized by a reduction in melanosomes, both in melanocytes and keratinocytes. These organelles were immature and atypical, showing a weak tyrosinase immunoreactivity. Melanosome macroautophagy was prominent in keratinocytes. Some clusters of the same cells exhibited strong immunoreactivity for the Mac 387 antibody (Ca2+-dependent calprotectin). Ulex europaeus agglutinin-1 (UEA-1) decorated the superficial layers of the epidermis. Such features are typically found in functionally altered keratinocytes. A number of dermal cells exhibited intense phagocytic activity linked to lysozyme immunoreactivity. Conclusions Both the melanosome depletion and macroautophagy of immature melanosomes in keratinocytes appeared to represent prominent aspects of hypomelanosis of Ito. In sum, Ito’s hypomelanosis combines structural and functional changes affecting both the melanocytes and keratinocytes in the skin.

Under specific light illumination, particularly ultraviolet (UV) and near-UV light stimulation, the skin produces both specular light reflectance and, possibly, specific fluorescent emission. These properties offer diagnostic clues and disclose some peculiar functions of the skin. A series of superficial infections (erythrasma, some tinea capitis types, tinea/pityriasis versicolor, dermatophytoses, etc.) and pilosebaceous follicles enriched in Propionibacterium spp show fluorescence. This latter characteristic is downgraded or lost while on some anti-acne treatments. A quenching effect of fluorescence is observed following the application of sunscreens. The (pre)neoplastic areas prepared for methylaminolevulinate photodynamic therapy (MAL-PDT) show reddish fluorescence following drug metabolisation producing porphyrins by the abnormal activated cells. Of note, when using a recording sensitive CCD camera instead of casual visual observation, skin fluorescence may be superimposed on the specular reflectance of the incident light. With the current technology, these situations are not distinguished with confidence. Any harsh and scaly lesion appears brighter following yellowish specular light reflectance. Stratum corneum samplings collected on clear self-adhesive discs or cyanoacrylate skin surface strippings are conveniently examined ex vivo, taking advantage of the same optical properties.

Corneocyte accumulation (hyperkeratosis, xerosis) commonly occurs in the stratum corneum (SC) of the feet of diabetic patients, as well as menopausal women.To compare the effects of a 2.5% chitin-glucan formulation with its placebo, and commercially available glycerol formulations.This two-step controlled double-blind, randomized, intra-individual study was performed in 30 type 1 and 2 diabetic menopausal women suffering from xerosis of the feet. The formulations were applied once daily for 3 weeks. Electrometric assessments were performed on three sites of the feet at entry in the study, at weekly intervals during the treatment phase, and in a 2-week follow-up out of treatment. Positive controls consisted in two commercially available formulations enriched in glycerol.Data revealed an unequivocal benefit provided by the 2.5% chitin-glucan formulation compared with placebo. The electrometric values were significantly higher at each evaluation time during both treatment and follow-up phases. The two glycerol-enriched formulations showed slightly different kinetics of SC moisturization. A steep increase was followed by a plateau level and a rapid decline after stopping the treatments.The increased moisturization of the SC of the sole probably improves the desquamation process and reduces xerosis of the soles.

Objective There is ample clinical evidence that skin is responsive to physiopathological levels of circulating thyroid hormones. The aim of the study was to assess some physical changes of the skin in the presence of moderate thyroid dysfunction. Setting University Hospital. Patients and methods A total of 119 adults suffering from hypothyroidism or hyperthyroidism and 60 healthy controls were enrolled in this study. Hormonal dosages (TSH, fT3, fT4) were assessed in the serum. A series of biometrological assessments were also performed on the volar and dorsal aspects of the forearms. These included electrometric assessments (Nova Dermal Phase Meter®, Corneometer®), evaporimetry (Tewameter®), colorimetry (Mexameter®), ultrasound shear wave propagation (Reviscometer®) and squamometry X. Correlations were searched between each of the serum hormonal dosages and each of the biometrological parameters. Results The hormonal changes in the untreated patients with thyroid dysfunction were modest in intensity. A few outlier values with regard to the normal range were found for each biometrological parameter. No correlations were found between fT3 or fT4 and each of the physical parameters. By contrast, significant negative linear correlations were found between thyroid-stimulating hormone (TSH) and skin hydration measured by the Corneometer® and the Nova DPM®. Conclusion This multipronged exploratory study shows that direct or indirect effects of TSH may influence the stratum corneum hydration. This correlation seemed very sensitive, as no other specific biophysical parameter was significantly correlated with the thyroid hormonal concentrations in the serum. However, our findings do not exclude the possibility of some other skin changes supervening in case of more severe thyroid dysfunction. The mechanism by which TSH alters the stratum corneum hydration is yet unknown.

Interdigital intertrigo and onychomycosis has the potential cause of severe bacterial infectious complications with pain, mobility problems, abscess, erysipelas, cellulitis, fasciitis and osteomyelitis. In another hand, diabetic neuropathy, which affects 60-70% of those with diabetes mellitus, is one of the most troubling complications for persons with diabetes. These people are high suspecting to be infected by dermatophytic infections in interdigital spaces or onychomycosis witch are frequently induce damage to the stratum corneum, leading to bacterial proliferation and secondary infection. A patient presented with an asymptomatic warm, painless, erythematous swelling of the second left toe, which had been present for a few weeks. Clinically, the lesion was categorized as erysipelas upon an insidious abscess formation. Further investigation was undertaken to confirm the presence of diabetes. Leg erysipelas is a common affection which, according to various studies, has both local concomitants (interdigital intertrigo, lymphoedema, surgical antecedents) and/or general causes (immune suppression, diabetes, alcoholism, etc). Interdigital intertrigo, tinea pedis, and onychomycosis present as public health problems that could trigger serious deterioration in patient quality of life, due to complications induced by secondary bacterial infections.

Alopecic and Aseptic Nodules of the Scalp, first described as pseudo cyst of the scalp, represent a new clinical entity. The nodules are glistening and non fluctuating and the rest of the scalp remains normal. Their surface is rounded and domed and is the seat of an inflammatory cicatricial alopecia. We report one case of AANS and discuss about clinical features, histology, aetiology and treatment.

Auteur(s) : Gregory Szepetiuk1,2, Olivier Vanhooteghem1,2, Gebhard Muller3, Jean Jacques Stene4, Arjen F Nikkels2 1Department of Dermatology, Clinique Sainte-Elisabeth, B-5000, Namur, Belgique 2Department of Dermatology, CHU du Sart-Tilman, B-4000, Liege, Belgique 3Departement of Pathology, Clinique Sainte-Elisabeth, B-5000, Namur, Belgique 4Department of Dermatology, CHU Saint-Pierre, B-1000, Bruxelles, Belgique Schopf-Shultz-Passarge (SSP) syndrome is a rare ectodermal genodermatosis, [...]