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We report our experience relating to both the use of dupilumab in patients with a previous history of cancer and the onset of tumour in patients receiving dupilumab. In our centre 280 patients suffering from moderate-to-severe AD and treated with dupilumab have been prospectively collected from January 2019 to October 20205 . Out of them, a previous history of cancer was found in 7 patients.

Background Tinea capitis is a cutaneous fungal infection common among 3 to 7 year old children but it is rare in the first year of life. Case presentation We present a case of a 12-month-old infant with erythematous scalp lesions combined with hair loss. He was suspected of dermatophytosis and mycological analysis of all suspected lesions was performed. Clinical features and culture results confirmed tinea capitis caused by Microsporum canis. The infant patient was treated with griseofulvin for 2 months. However, 15 days later at the end of treatment he presented with a single vesicle positive for M. canis. Griseofulvin therapy continued for another month. After 3 months of follow-up, no recurrence was observed. Conclusions In infant, sometimes tinea capitis is misdiagnosed and underreported because it is similar to other scalp pathologies. Therefore, if erythematous scalp lesions are present, they must be examined from a mycological point of view to inform the differential diagnosis. Once diagnosed, treatment of tinea capitis can pose a dilemma because different factors may influence the choice between equally effective therapies (i.e. safety, age, formulation, cost). This case report suggests that it is important to establish an accurate diagnosis and treatment for this dermatophytosis to avoid recurrences or therapeutic failures, especially in infants. Electronic supplementary material The online version of this article (10.1186/s12887-019-1433-7) contains supplementary material, which is available to authorized users.

Autoimmune connective tissue-diseases are more frequent in women and deserve a multidisciplinary approach in which the dermatologist play a major role together with other physicians. Pregnancy in these patients has to be considered a high-risk situation, because of possible worsening of the mother's disease and increased morbility and mortality for the fetus; also, therapies have to be chosen carefully because some drugs cannot be used during pregnancy. For all these reasons, the decision to become pregnant needs to consider the type of disease, stage of disease, age and clinical condition, and requires a multidisciplinary approach. A correct counselling, a close monitoring, a specific approach based on the risks involved and the use of appropriate therapies are the keys to obtain optimal pregnancy outcomes.

BACKGROUND Psoriasis is a common inflammatory skin disease that affects people of every age; prevalence in pediatric population is unknown because of the lack of studies. METHODS We collected data about patients 0-18 years old coming to our center in the period from November 2010 to September 2012. RESULTS We found 69 children (38 males, 31 females) affected by psoriasis, with a male-to-female ratio of 1.2 and a prevalence of 0.75%. Plaque psoriasis was the most common clinical manifestation (72.54%), followed by guttate psoriasis (13%). The most frequent comorbidities were overweight and obesity (26%). Most patients had a mild disease with PASI

The particular combination of polydeoxyribonucleotides, l-carnitine, calcium ions, proteolytic enzyme and other ingredients acts in a synergetic way in the regeneration of skin and connective tissues. This new formulation of active principles was tested in vitro as a cell and tissue culture medium and in vivo for various preparations in support of tissue regeneration. In vitro, the new blend allowed the maintenance of skin biopsies for more than 1 year in eutrophic conditions. Immunocytochemical analyses of fibroblasts isolated from these biopsies confirmed a significant increase of the epidermal and connective wound-healing markers such as collagen type I, collagen type IV, cytokeratin 1 (CK1), CK5, CK10 and CK14 versus controls. To examine the effects of the new compound in vivo, we studied impaired wound healing in genetically diabetic db/db mice. At day 18, diabetic mice treated with the new composition showed 100% closure of wounds and faster healing than mice treated with the other solutions. This complex of vital continuity factors or life-keeping factors could be used as a tissue-preserving solution or a cosmetic/drug/medical device to accelerate wound healing in the treatment of patients with deficient wound repair to promote the regeneration of cutaneous and connective tissues (injuries-wound, dermatitis) and prevent the recurrent relapses.

Introduction Nous presentons un cas trompeur d’alopecie cicatricielle neoplasique du cuir chevelu (CC), dont le diagnostic, retenu uniquement apres biopsie, a permis de decouvrir et traiter un carcinome mammaire inconnu. Observation Une femme de 72 ans se presentait en consultation a la suite de l’apparition, depuis un an, d’une alopecie progressive du CC, resistante aux traitements locaux. Au moment de notre premiere observation, la patiente etait sous clobetasol propionate et minoxidil 2 % en application locale depuis 3 mois. Le tableau clinique montrait des plaques d’alopecie du C.C. avec aspect cicatriciel, sans signes inflammatoires decelables, ni autre alteration de la peau hormis l’absence de follicules pileux et une legere augmentation de consistance a la palpation. En raison de l’aspect cicatriciel, une biopsie du CC avait ete pratiquee. L’examen histologique montrait la presence de cellules histiocytaires epitheliales atypiques avec, dans le derme, des cellules en bague a chaton exprimant les recepteurs hormonaux œstrogeniques et progesteroniques. L’aspect evoquait une metastase cutanee de carcinome mucineux du sein. La derniere mammographie de depistage de la patiente, effectuee 3 ans auparavant, etait normale. Une nouvelle mammographie montrait une alteration structurale du quadrant supero-lateral. La microbiopsie du nodule confirmait le diagnostic de carcinome lobulaire et la patiente etait adressee au centre d’oncologie mammaire pour la prise en charge ( Fig. 1 et 2 ). Discussion En excluant le melanome, les cancers du poumon et du sein sont les principales sources de metastases cutanees. Dans la plupart des cas les metastases cutanees apparaissent apres le diagnostic du cancer primitif, mais peuvent etre rarement la premiere manifestation d’une neoplasie viscerale. La perte de cheveux en plaques isolees ou multiples causees par la metastatisation d’un cancer, au niveau du cuir chevelu est nommee alopecie neoplasique. Les cellules metastatiques peuvent detruire les follicules pileux en causant une fibrobroplasie par liberation de mediateurs d’inflammation, par attraction de cellules inflammatoires qui se substituent a la population de cellules normales. Le cancer du sein est a l’origine de la plupart des alopecies neoplasiques (84 %). Le cancer du sein est, en termes d’incidence, le plus frequent chez la femme. Son pronostic est le plus favorable grâce au diagnostic precoce par le depistage systematique et a l’amelioration de la prise en charge. Les metastases cutanees sont presentes dans 23,9 % des stades IV. Les carcinomes occultes, cherches devant la decouverte d’une metastase ne representent que 0,1–0,8 %. Conclusion La decouverte des carcinomes par la presence de metastase du cuir chevelu est tres rare et peut representer un vrai defi diagnostic pour le dermatologue. Reconnaitre une alopecie neoplasique est tres important pour decouvrir un cancer occulte.

Background The majority of available systemic therapies have never been systematically investigated in moderate to severe childhood plaque psoriasis. For this reason, treatment preferences for moderate to severe psoriasis in childhood are still unknown. The aim of this study was to investigate the systemic treatment patterns of moderate to severe psoriasis in children and adolescents aged 18 or older in Italy. Additional secondary outcomes were duration of treatment and reasons for discontinuation. Methods In order to define differences in treatment patterns, we performed a chart review of all consecutive patients treated with systemic drugs during an index period of 5 years. Consecutive sampling of all patients with psoriasis aged ≤18 years, who had been treated with at least one systemic drug over a 5-year period, was made. Results The records of 58 consecutive patients, 27 males, 31 females. with moderate to severe psoriasis treated with at least one systemic therapy were reviewed. The median age (standard deviation) at the start of the first systemic treatment was 11.7±3.7 years. The most preferred first-line systemic treatment was cyclosporine, which was administered as first systemic treatment in 53.4% of patients, followed by acitretin in 22.4% of patients, etanercept and PUVA respectively in 8.6%, methotrexate in 6.8%. 48.2% of patients received a second systemic treatment due to inefficacy or side effects of the first-line therapy during the index period. Because of the small sample, and voluntary contribution, selection bias may have occurred. Conclusions A considerable variation in the management of the first-line systemic therapy in children with moderate to severe psoriasis was observed. Cyclosporine was most commonly preferred as a first-line treatment. The availability of new therapeutic agents could change the scenario of treatment patterns in childhood psoriasis.

Cyclosporine (CysA) is effective for psoriasis in adult patients but little data exist about its efficacy and safety in childhood and adolescence psoriasis.To assess the effectiveness and safety of CysA for childhood and adolescence psoriasis.Retrospective analysis of a group of children and adolescents (age 17 years) with plaque psoriasis treated with CysA at several Italian dermatology clinics.Our study population consisted of 38 patients. The median age at the start of treatment was 12.3 years. Therapy duration varied from one to 36 months. The median maintenance dosage per day was 3.2 mg/kg (range 2-5 mg/kg). Fifteen patients (39,4%) achieved a complete clearance or a good improvement of their psoriasis defined by an improvement from baseline of ≥75% in the psoriasis area and severity index (PASI) at week 16. Eight patients (21.05%) discontinued the treatment due to laboratory anomalies or adverse events. Serious events were not recorded.In this case series, CysA was effective and well-tolerated treatment in a significant quote of children. CysA, when carefully monitored, may represent a therapeutic alternative to the currently used systemic immunosuppressive agents for severe childhood psoriasis.

BACKGROUND Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis. METHODS Retrospective analysis of a group of children and adolescents (

Dermatophytosis caused by Trichophyton rubrum is the most common cutaneous fungal infection in industrialized countries and worldwide with high recurrence and lack of treatment response. In addition, patients with cutaneous and concurrent toenail lesions are often misdiagnosed and therefore treated with an inappropriate therapy. In this study, we evaluated five previously misdiagnosed cases of T.rubrum chronic dermatophytosis sustained by two variants at sites distant from the primary lesion. Our patients were successfully treated by systemic and topical therapy, and 1 year after the end of therapy follow-up did not show any recurrence of infection.

Objective: To determine the epidemiology and the aetiology of tinea capitis in the elderly in Turin (Italy). Methods: We prospectively collected all cases of adult tinea capitis in the Dermatology Clinic of the University of Turin from January 1997 to December 2012. Results: 13 patients (4 males and 9 females) with a mean age of 56.5 years were found to be affected by tinea capitis among a total number of 508 (2.6%). Diagnosis was made on clinical appearance and mycological examination. Culture identified M. canis in 7 patients (53.8%), T. mentagrophytes in 3 patients (23.1%), T. rubrum in 2 patients (15.4%) and T. violaceum in 1 patient (7.7%). 6 cases reported contact with animals. Treatment consisted in administration of Griseofulvin at the dose of 500 mg/d or Terbinafine at the dose of 250 mg/d for at least 8 weeks. A complete recovery was observed in 10 patients, whereas 3 of them suffered from cicatritial alopecia. Conclusion: This study wants to highlight the importance of considering tinea capitis as a differential diagnosis in elderly patients with scaly scalp lesions, even though it is considered to be rare in adults.

Different haptoglobin (Hp) phenotypes play a role in several pathologic processes including infectious diseases. In order to evaluate the role of iron storage and metabolism in susceptibility to herpetic manifestations, we studied the frequency of the Hp phenotypes and iron metabolism in patients affected by H. Simplex virus 1 or 2 (HSV-1 or HSV-2), compared with controls. Hp phenotype and iron metabolism were determined in 100 patients with recurrent HSV-1 or HSV-2 manifestations during the relapses, and in 110 healthy subjects. The frequencies of the three Hp phenotypes in the patient group compared to the control group were 18% versus 14.5% p = NS for Hp 1.1, 25% versus 40% p = 0.03 for Hp 2.2 and 57% versus 45.5% p = NS for Hp 2.1. All iron metabolism parameters tested showed significant differences between patients and controls; haemoglobin (Hb), ferritin, and serum iron were lower, while transferrin was higher in the patients than in controls. Reductions in iron availability may be a risk factor for relapsing lesions of HSV-1 or HSV-2. Hp 2.2 phenotype may offer some protection against the recurrence of Herpes labialis or genitalis manifestations.

The increased prevalence of dermatomycoses along with the wide range of organisms now recognized as potential pathogens needs accurate laboratory isolation and identification of the aetiological agents. In this report three cases of foot dermatomycoses due to filamentous fungi commonly present in the environment with ubiquitous distribution are described in immunocompetent subjects. Skin and nail samples were collected, suspended in 20% KOH solution, examined under a light microscope and cultured in Mycobiotic agar and Sabouraud dextrose agar containing chloramphenicol to detect fungal growth. Phoma herbarum, Chaetomium globosum, and Microascus cinereus were isolated and identified.

This report documents tinea pedis and tinea unguium in a 7-year-old child. In all cultures Trichophyton rubrum was present. As tinea pedis and tinea unguium affect adults more often than children, they might be overlooked and misdiagnosed in the latter.

There is an increased incidence of the morbidity and mortality associated with fungal infections caused by resistant fungi in various groups of patients; therefore the monitoring of their susceptibility to antifungal agents to be necessary for optimizing clinical therapeutic treatment. The susceptibility profiles of recent clinical yeasts and yeast-like fungi isolated from Turin’s Hospitals to current antifungal drugs are here reported. Candida albicans was the most frequently isolated species (40%), followed by C. glabrata (22%).A high rate of susceptibility to all antifungal agents tested was observed and low evidence of resistance was found.