Switching to boosted protease inhibitor plus a second antiretroviral drug (dual therapy) for treatment simplification: a multicenter analysis.

Background: To assess the role of drugs used in dual therapy (DT), as cART simplification, over the risk of treatment failure.

Materials And Methods: Patients starting DT regimen composed by a boosted protease inhibitor (PI/r): darunavir (DRV/r), lopinavir (LPVr) or atazanavir (ATV/r) plus a second drug: raltegravir (RAL), maraviroc (MRV) etravirine (ETR), lamivudine (3TC) or tenofovir (TDF), this one generally used in HBV co-infected patients, were included. The effect of each drug as well as other clinical and virological cofactors over treatment failure was assessed using survival analysis.

Cutaneous mastocytosis combined with eruptive melanocytic nevi and melanoma. Coincidence or a linkage in the pathogenesis?

Background: Cellular combinations in the same neoplasm can have intriguing physiopathological implications, which may be useful to better understand the biology of the diseases.

Main Observations: Urticaria pigmentosa in association with eruptive melanocytic nevi was observed in a female patient. Maculopapular lesions extended at the base of different melanocytic nevi and the histopathological examination revealed the presence of a mast cell population in the papillary and reticular dermis combined with overlying melanocytic nevi.

Physical and dosimetric optimization of laser equipment in dermatology: a preliminary study.

The aim of this preliminary study is to investigate the correlation between clinical set-up at present used in the treatment of specific skin conditions and laser beam absorbed power in the tissue. This study focused on the CO2 and Nd-Yag laser equipment used in the daily clinical practice in the Department of Dermatology of San Gallicano Institute in Rome. Different types of tissue-equivalent material with various water and haemoglobin concentrations were tested to evaluate laser beam attenuation power.

Challenges in HIV Vaccine Research for Treatment and Prevention.

Many attempts have been made or are ongoing for HIV prevention and HIV cure. Many successes are in the list, particularly for HIV drugs, recently proposed also for prevention. However, no eradication of infection has been achieved so far with any drug.

Combined use of monopolar radiofrequency and transdermal drug delivery in the treatment of melasma.

Background: Melasma is a common acquired pigmentary disorder that has a considerable psychological impact on the patient. The recurrent and refractory nature of this condition makes it difficult for treatment.

Objective: We aim to evaluate the efficacy and safety of a combined system that simultaneously uses monopolar radiofrequency (RF) and transdermal drug delivery of phytocomplex containing 1% kojic acid in the treatment of melasma.

Preliminary comparison of fractional laser with fractional laser plus radiofrequency for the treatment of acne scars and photoaging.

Background: The therapeutic approach to the treatment of acne scars and photoaging varies according to the type of lesion. Traditional carbon dioxide (CO2 ) laser is associated with long healing times, persistent erythema, and high risk of post-inflammatory hyperpigmentation. Fractional laser technology, which involves the application of microscopic beams of pixilated light inducing focal zones of tissue injury surrounded by normal tissue, is currently used for the treatment of acne scars and photoaging.

Lichen sclerosus and the risk of malignant progression: a case series of 159 patients.

Aim And Methods: We analyzed 159 stored specimens of Lichen Sclerosus (LS) collected in the period 1999-2011 from 159 patients, in order to evaluate the histological patterns, clinical outcomes and possible associations with malignancies. The histopathologic analysis revealed 145 cases (males and females) with LS alone, 7 in whom penile LS was associated with spinocellular carcinoma (SCC), and 7 in whom LS was associated with a pseudocarcinomatous-hyperplasia (PCH). Extragenital LS was found in 20% (17/85) of the males and 78% (58/74) of the females.

Efficacy of the melanocortin analogue Nle4-D-Phe7-α-melanocyte-stimulating hormone in the treatment of patients with Hailey-Hailey disease.

Background: Hailey-Hailey disease (HHD) is a rare, chronic and recurrent blistering disorder, which is characterized clinically by erosions occurring primarily in intertriginous regions, and histologically by suprabasal acantholysis. Oxidative stress plays a specific role in the pathogenesis of HHD, by regulating the expression of factors playing an important role in keratinocyte proliferation and differentiation.

Aim: Given the significance of oxidative stress in HHD, we investigated the potential effects of the antioxidant properties of an α-MSH analogue, Nle4-D-Phe7-α-MSH (afamelanotide), in HHD lesion-derived keratinocytes.

Another point of view on p16 and Ki67 expression in melanocytic and non-melanocytic cutaneous lesions.

The new analysis of the expression of cell cycle regulators (used in various neoplasms) and the nominal immunohistologic assays still represent valid and feasible diagnostic methods in most pathology practice. We examined 114 paraffin-embedded histologic specimens of melanocytic cutaneous lesions. The primary objective of this study was to explore diagnostic potential of the two important cell cycle regulators, p16 and Ki67, also evaluating the variations of expression by use of a semi quantitative graded scale.

Biliopancreatic diversion: when a cure becomes a disease.

Phrynoderma is a type of follicular hyperkeratosis located primarily on the extensor surfaces of the extremities. It is most commonly seen in Africa and Southeast Asia, where it is correlated with malnutrition; however, it is rare in developed countries, where it is often the result of malabsorption secondary to pancreatic insufficiency, colectomy, chronic giardiasis, and bariatric surgery. Here, we report a case of a 51-year-old white male patient, who presented to our Institute with a 1-year history of diffuse, reddish-brown asymptomatic papules associated with follicular nodules.

Dermoscopy of pigmented lesions of the vulva: a retrospective morphological study.

Background: The dermoscopic patterns of pigmented skin tumors are influenced by the body site.

Objective: To evaluate the clinical and dermoscopic features associated with pigmented vulvar lesions.

Methods: Retrospective analysis of clinical and dermoscopic images of vulvar lesions.

Underestimated clinical features of postadolescent acne.

Background: Postadolescent acne is usually described as an inflammatory, mild-to-moderate dermatosis, frequently involving the lower third of the face, the jawline, and the neck. However, we have also frequently observed a clinical form predominantly characterized by retention lesions (microcomedones and macrocomedones), with few inflammatory lesions (comedonal postadolescent acne [CPAA]), which appears significantly correlated with cigarette smoking.

Objective: We sought to investigate the clinical features of postadolescent acne in a group of female patients affected by acne and its relationship with cigarette smoking.

Four novel mutations of the coproporphyrinogen III oxidase gene.

Here we report the characterization of four novel mutations and a previously described one of the coproporphyrinogen III oxidase (CPO) gene in five Italian patients affected by Hereditary Coproporphyria (HCP). Three of the novel genetic variants are missense mutations (p.Gly242Cys; p.

Poverty, dignity, and forgotten skin care: dermatology in the stream of human mobile population.

Skin diseases represent the greatest public health care problem in all developing countries. Tropical diseases tend to cluster in poor populations and often are defined as "neglected" because the investments made to combat them seem negligible compared with the massive amounts expended globally on the health problems of developed countries. After reviewing the worldwide situation, this article explains the principles of community dermatology and discusses the work of the San Gallicano Institute in Rome, which has developed a model for reducing the number of people suffering from dermatologic and other diseases and has established the first dermatologic hospital in Ethiopia.

Poverty, health and development in dermatology.

The WHO Constitution states that "The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political, economic or social condition." The right to health means that governments must generate conditions in which everyone can be as healthy as possible. Such conditions range from ensuring availability of health services, healthy and safe working conditions, adequate housing and nutritious food.

Vulvar primitive melanoma and sentinel lymph node: case report.

The case of a 54-year-old woman who developed vulvar melanoma arising from a melanocytic lesion, extending from the clitoris to the left labium minor, without clinical involvement of the groin node station bilaterally is presented. The patient first underwent an incisional diagnostic biopsy that revealed a melanoma 4 mm in thickness; subsequently preoperative lymphoscintigraphy with 99m Tc Nanocoll was executed. Surgery consisted of a radio-controlled lymphadenectomy and radical vulvectomy.

Heterogeneity of mutations in the ferrochelatase gene in Italian patients with erythropoietic protoporphyria.

Mutations and a low-expressed allele IVS3-48c (in trans to the mutation) of the ferrochelatase (FECH) gene are responsible for erythropoietic protoporphyria (EPP) which is characterized clinically by cutaneous photosensitivity. In this study of 15 Italian EPP families, we identified 10 different FECH gene mutations, six of them were novel mutations (Q32X; IVS2-2, a-->g; IVS3-67, g-->a; 488-501del 14bp; IVS5-3, c-->t and 757-761delAGAAG). Four were known mutations (213insT; R115X; S264L and 899-900delTG).

Juxta-clavicular beaded lines.

We present a case series of 63 patients diagnosed with juxta-clavicular beaded lines. This condition is more frequent in dark-skinned people and corresponds to an anatomical variant of simple sebaceous hyperplasia. In view of the strong reactivity of the melanocytes in dark-skinned people, and of the possible hypochromic results, no treatment is advised.

Skin diseases highlighting essential global public health priorities.

Which are the essential global public health activities that should be carried out in order to attain the largest impact on poverty reduction and health improvement in the world? Since its foundation in 2001 the Human Mobile Population Committee (HMPC) has continued to devote its efforts to finding answers to this question, with a particular focus on the skin diseases of the Human Mobile Population (HMP) and other groups of disadvantaged people. In this article we present the model of socio-sanitary activity in the field of Migration, Poverty and Health of the Department of Preventive Medicine of Migration, Tourism and Tropical Dermatology (Dept.) at San Gallicano Institute--Research Institute for Hospitalization and Treatment (IRCCS)--in Rome (Italy).

Relevance of thyroiditis and of other autoimmune diseases in children with vitiligo.

Background: Studies that clearly define the possible association of childhood vitiligo with autoimmune and/or endocrine diseases are lacking.

Objective: To examine the presence of autoimmune disorders, in particular of thyroid disease, in paediatric patients with vitiligo and investigate the utility of such screening in these patients.

Methods: One hundred and twenty-one paediatric patients (40 males, 81 females) with vitiligo were grouped in segmental and non-segmental vitiligo.