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Androgenic alopecia (AGA) is an esthetic condition with varying psycho-social implications, easily accepted by some patients and tolerated only with difficulty by others. Modern therapeutic options such as 5α-reductase inhibitors have significant outcomes, but also exert significant side effects in a subset of patients. The literature describes three distinct situations regarding finasteride administration, a compound largely used for AGA. Some studies show finasteride to be very safe with minimal or no side effects. Other studies take a more cautious approach, recognizing such side effects but, at the same time, considering the putative relationship between finasteride and adverse effects to be disputable, given that placebo administration in AGA is associated with relatively similar or even more severe side effects. Finally, some authors/studies are concerned that, when compared to placebo, finasteride administration may result in side effects with greater frequency and severity, and sometimes that persist even after treatment cessation in the form of post-finasteride syndrome. Several factors presented in this paper appear to explain finasteride inconsistency regarding its therapeutic and side effects. Such factors should be further investigated and used to categorize subjects into distinct subgroups, either predisposed to adverse reactions or more tolerant of the finasteride administration. [ABSTRACT FROM AUTHOR]

Oral lichen planus (OLP) is a chronic, immunologically mediated disease, defined by periods of exacerbation and quiescence. The disease is associated with a low mortality risk, but in some instances, morbidity can be important, especially in extensive, erosive forms, with a significant impact on the quality of life. OLP is a chronic T-cell mediated inflammatory disease involving the oral cavity, the most common lesions being located on the oral mucosa, tongue and gums. Its etiology remains in part unknown, but several factors proved to be involved in the development of the disease (drugs, dental materials, infectious agents, psychological factors, autoimmunity and genetic predisposition). The therapeutic approach should take into account the type of lesion and the extent of the disease, as well as the possible adverse effects. Although several therapies are available, OLP treatment still remains a challenge. Photodynamic therapy (PDT) is widely used in dermatology, finding applicability in the treatment of an increasing number of conditions. Recent research has shown the role of PDT in the treatment of OLP. It is a minimally invasive therapy with few side effects and promising results. [ABSTRACT FROM AUTHOR]

Lichen planus (LP) is an immune-mediated inflammatory disease that particularly affects the skin and mucous membranes. Its etiology remains elusive, however some trigger factors, including viral or bacterial antigens, drugs and metals, have been postulated. There is a higher prevalence of hepatitis C virus (HCV) infection among patients with LP, with some geographical variations. HCV is an enveloped RNA virus that belongs to the Flaviviridae family and in most instances causes chronic liver infections. It has been hypothesized that HCV may contribute to LP development, but the link between the two disorders is not fully understood. It is still debatable whether HCV leads to the occurrence of LP lesions directly by replication inside the infected cells or indirectly by activating immunological pathways. Molecular studies have revealed HCV RNA in specimens collected from patients with LP. The autoimmune theory was also suggested given that several studies have revealed viral replication and immune response activation associated with autoantibody synthesis. The aim of this review is to summarize the main potential mechanisms involved in the association between LP and HCV infection. Understanding the link between the two disorders may shed some light on the pathogenesis of LP, which is a challenging issue. [ABSTRACT FROM AUTHOR]

Recent data suggest that severe psoriasis is an independent risk factor for chronic renal disease. In the present study, we investigated the role of related-purine derivatives as predictors of renal dysfunctions in patients with psoriasis. A prospective study was conducted on a group of 45 patients with psoriasis vulgaris and 45 control cases, monitored over a 5-year period. Alterations of renal function, albumin/creatinine ratio (ACR, mg/g) and UA/creatinine ratio (UACR, mg/mg) were determined in spontaneous urine samples. The status of related-purine derivatives was evaluated by quantification of uric acid (UA, mg/dl), adenosine deaminase (ADA, UI/mg protein), xanthine oxidase (XO, UI/mg protein) and 8-hydroxy-deoxy-guanosine levels (8-OHdG, ng/ml) in serum samples. Compared to the controls, in patients with psoriasis there was an increase in related-purine derivatives levels, which was demonstrated by the elevated serum levels of UA (5.1±0.4 vs. 5.4±1.0, P=0.066), ADA (0.14±0.08 vs. 0.29±0.12, P=0.052), XO (0.22±0.11 vs. 0.42±0.21, P=0.011) and 8-OHdG (3.1±0.05 vs. 8.3±4.7, P=0.002). The serum levels of related-purine derivatives were associated with the severity of psoriasis. In addition, there was a link between the serum levels of related-purine derivatives and markers of renal impairment. There were positive correlations between 8-OHdG and ACR (r=0.452, P=0.028) and between ADA, XO, UA, 8-OHdG and UACR (r=0.297 and P=0.032, r=0.301 and P=0.002, r=0.431 and P=0.027, r=0.508 and P=0.002) and negative correlations between UA, 8-OHdG and the estimated glomerular filtration rate (r=−0.301 and P=0.036, r=−0.384 and P=0.002). Thus, severe psoriasis is a risk factor for the development of renal disease. [ABSTRACT FROM AUTHOR]

Psoriasis is a common disease affecting people worldwide. Although many researchers have tried to understand, throughout history, the mechanisms involved in the pathogenesis of the disease and despite considerable progress that has been made, a plethora of key aspects are still waiting to be discovered. In the last 2,000 years, the treatment evolved from an empirical stage to the modern therapy oriented to targeting molecules shown to be involved in the occurrence of the disease. In this paper we are reviewing the great discoveries that have marked the history of psoriasis, as well as the latest advances in the treatment of the disease. [ABSTRACT FROM AUTHOR]

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Melanoma is one of the most aggressive tumors and its incidence is on the rise. The low rates of survival in metastatic melanoma has led to the development of new drugs for this type of patient, such as biological therapy which has shown remarkable results. This therapy is based on stimulation of the immune system to fight tumoral cells through: injection of cytokines with immunomodulatory properties (interleukin-2, alphainterferon), vaccination with tumor antigens or immune cells that process tumor antigens, adoptive immunotherapy, inhibition of immune checkpoints (PD-1, CTLA-4), inhibition or stimulation of immune modulator molecules (OX-40, LAG-3), inhibition of signaling pathways involved in cell proliferation (Raf/MAPK/ERK signaling pathway), or administration of oncolytic viruses. Biological therapy in melanoma has shown promise in laboratory and clinical studies, with more therapeutic targets to be revealed as new molecular and cellular mechanisms of the disease are discovered. [ABSTRACT FROM AUTHOR]

Mammary Paget's disease is a rare form of cancer, which involves the nipple-areola complex. In most cases it is associated with an underlying tumor of the breast. Diagnosis is based on clinical appearance and is confirmed by histopathological examination. Imaging tests play an important role in detecting the associated ductal carcinoma. We present the case of a 90-year-old woman, who presented to our clinic for an erythemato-squamous lesion that covers her entire left nipple. The lesion was previously treated as eczema. Histopathological examination revealed features characteristic of Paget's disease. [ABSTRACT FROM AUTHOR]

The constant generation of reactive carbonyl species (RCSs) by lipid peroxidation during aerobic metabolism denotes their involvement in cell homeostasis. Skin represents the largest organ of the body that is exposed to lipid peroxidation. Previous studies have suggested the involvement of oxidative stress in the development of lichen planus (LP), a chronic inflammatory skin condition with a complex pathogenesis. The aim of our study is to investigate a panel of pro-oxidants (4-hydroxy-nonenal (4-HNE), thiobarbituric acid reactive substances (TBARS), and malondialdehyde (MDA)), the total antioxidant status (TAS), and thiol-disulfide homeostasis parameters (TDHP), including total thiol (TT), native thiol (NT), disulfides (DS), DS/NT ratio, DS/TT ratio, and NT/TT ratio. The comparative determinations of serum levels of 4-HNE, TBARS, and MDA in patients with LP (n = 31) and controls (n = 26) show significant differences between the two groups (4-HNE: 7.81 ± 1.96 µg/mL vs. 6.15 ± 1.17 µg/mL, p < 0.05, TBARS: 4.23 ± 0.59 µmol/L vs. 1.99 ± 0.23 µmol/L, p < 0.05, MDA: 32.3 ± 6.26 ng/mL vs. 21.26 ± 2.36 ng/mL). The serum levels of TAS are lower in LP patients compared to the control group (269.83 ± 42.63 µmol/L vs. 316.46 ± 28.76 µmol/L, p < 0.05). The serum levels of TDHP are altered in LP patients compared to controls (NT: 388.10 ± 11.32 µmol/L vs. 406.85 ± 9.32., TT: 430.23 ± 9.93 µmol/L vs. 445.88 ± 9.01 µmol/L, DS: 21.06 ± 1.76 µmol/L vs. 19.52 ± 0.77µmol/L). Furthermore, a negative association between pro-oxidants and TAS is identified (4-HNE – rho = −0.83, p < 0.01, TBARS – rho = −0.63, p < 0.01, and MDA – rho = −0.69, p < 0.01). Understanding the mechanisms by which bioactive aldehydes exert their biological effects on the skin could help define effective therapeutical strategies to counteract the cytotoxic effects of these reactive metabolic intermediates. [ABSTRACT FROM AUTHOR]

Buschke-Löwenstein tumor (BLT) is a rare premalignant disorder, with a considerable potential of malignant transformation into squamous cell carcinoma; HPV infection (especially HPV 6 and HPV 11) have an important role in the ethiopathogeny of the disease, along with immunosuppression- usually caused by HIV virus, a frequently encountered association. We report on the case of a 47 year old male patient who addresses our clinic for the occurrence of a giant tumoral lesion located in the intergluteal cleft, which had rapidly evolved despite the repeatedly negative HIV testing. The histopathologic examination confirms the clinical diagnosis of BLT; wide surgical excision of the tumor with safety margins was not followed by recurrence, during a follow-up period that exceeded 12 months. The case is distinguished through the large dimensions of the tumor, the extremely rare anatomical situation and the rapid evolution, despite the absence of HIV immunosuppression. [ABSTRACT FROM AUTHOR]