Recent studies have shown a correlation between an increased number of mast cells in patients wit... more Recent studies have shown a correlation between an increased number of mast cells in patients with atopic dermatitis (AD) resulting in raised plasma levels of nerve growth factor (NGF), pointing to a possible key role of their interaction in the pathogenesis of AD. It is well known that mast cells synthesize, store and release NGF. Mast cells and NGF both appear to be involved in tissue inflammation and neuroimmune interactions, with NGF acting as a general "alert" molecule capable of recruiting and priming both local tissue and systemic defense processes following stressful events. Also, NGF has been demonstrated to increase mast cell histamine content and intracellular tryptase activity in a dose- and time-dependent fashion. Endogenous aliamides are capable of down-regulating mastocyte reactivity by their action through the vanilloid (VR1) receptors, and keratinocytes, and through the CB1 and CB2 cannabinoid receptors linked to G-protein, also expressed by sensitive nerve endings, macrophages, and epithelial cells. Therefore, aliamide action should be regarded as a multifaceted mechanism interfering with the inflammatory process occurring in AD further beyond the known and controversial anti-histamine pharmacologic effect. In this regard, the reduction of mast cell degranulation by adelmidrol, as demonstrated by in vitro and in vivo investigations in animals, would interfere with the release of other inflammatory mediators, including NGF. Based on these considerations, a pilot study aimed to assess the efficacy and safety of twice daily application of a topical emulsion containing adelmidrol 2%, a novel aliamide, in a series of 20 patients (11 male and 9 female, mean age 8 (range 3-16) years) affected by mild AD was performed. Complete resolution with no side effects was observed in 16 (80%) patients after 4 weeks of treatment, with no relapses at 8-week follow up. Six patches in six subjects with multiple lesions that had not been treated and served as controls showed no improvement. Controlled clinical studies in larger series are warranted to confirm the efficacy of aliamide in the management of AD.
... John G. Albertini, MD; Michele Maroon, MD; William B. Tyler, MD; Geisinger Medical Center, Da... more ... John G. Albertini, MD; Michele Maroon, MD; William B. Tyler, MD; Geisinger Medical Center, Danville, Pa REPORT OF A CASE ... Maria R. Nasca, MD; Rocco De Pasquale, MD; Franco Dinotta, MD; Giuseppe Micali, MD; University of Catania, Catania, Italy REPORT OF A CASE ...
The efficacy and safety of imiquimod, an immune-response modifier approved for the treatment of a... more The efficacy and safety of imiquimod, an immune-response modifier approved for the treatment of anogenital warts that has antiviral and antitumor activity, in the management of an extensive superficial basal cell carcinoma (sBCC) of the face as an alternative to surgical treatment was evaluated in a 75-year-old male with a 4-year history of a progressively enlarging lesion located on the right temporal region. Imiquimod 5% cream was applied daily until clinical resolution. Histopathological confirmation of clinical diagnosis and of tumor clearance were performed before starting treatment and at the end of treatment, respectively. Moreover, monthly post-treatment follow-up visits were planned. At physical examination, an ovalar, erythematous and slightly infiltrated plaque of 5 x 4 cm in size (approximately 20 cm2), partly eroded and crusted, with a sharp, raised, pearly edge, was evident on the right temporal region of the patient. Histopathological examination of a biopsy specimen ...
High-risk human papillomavirus (HPV) types have been linked with genital carcinomas. However, the... more High-risk human papillomavirus (HPV) types have been linked with genital carcinomas. However, the exact relation between HPV and erythroplasia of Queyrat (EQ), for example, in-situ carcinoma of the glans and prepuce, is still unclear. The aim of this study was to detect the presence of lesional HPV-DNA in patients with EQ. Paraffin-embedded biopsies were obtained from the glans or inner foreskin of 11 adult uncircumcised patients (mean age 67.7 years; range 57-79) with EQ. An equal number of randomly selected uncircumcised healthy control patients underwent a single brush cytology smear of the penile mucosa. Biopsy specimens and brushings were then assayed by a highly sensitive two-step nested PCR technique based on MY11/MY09 consensus primers and general GP5+/GP6+ PCR primers, followed by cycle sequencing. Statistical evaluation was performed using conditional logistic regression analysis. None of the EQ or control samples proved to be positive for the presence of HPV-DNA. The find...
Primary leiomyosarcomas of the penis are rare. Clinically and pathologically, these tumors fall i... more Primary leiomyosarcomas of the penis are rare. Clinically and pathologically, these tumors fall into two groups: superficial and deep. Superficial lesions usually are low grade and show a limited tendency toward distant metastasis. In contrast, deep-seated tumors usually show a more aggressive behavior associated with a poor prognosis. A 62-year-old man with a superficial leiomyosarcoma of the glans penis is reported. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Giornale italiano di dermatologia e venereologia : organo ufficiale, Società italiana di dermatologia e sifilografia, 2009
Genital herpes, a viral infection caused by Herpes simplex virus (HSV), is the most common cause ... more Genital herpes, a viral infection caused by Herpes simplex virus (HSV), is the most common cause of genital ulceration. Patients with a severe decrease in cellular immunity, such as patients positive for Human immunodeficiency virus (HIV) infection, are more likely to develop atypical, severe, disseminated and/or chronic HSV infections. On the other hand, there is an increase incidence of HIV detection among patients positive for HSV infection, as genital ulcers represent a potential portal of entry of HIV into the host. A case of a 52-year-old homosexual man with a two-month history of multiple erythematous ulcerative lesions on the perianal area, the buttocks, and the third left finger is presented. According to the clinical history, the clinical findings and the laboratory results, a diagnosis of HSV infection was made and treatment with valaciclovir was started, which led to complete regression of lesions 30 days later. The atypical features of the herpetic lesions, along with a...
Lentigo maligna (LM) is an in situ variant of cutaneous melanoma, which usually occurs in sun-dam... more Lentigo maligna (LM) is an in situ variant of cutaneous melanoma, which usually occurs in sun-damaged skin. Surgical treatment of LM is often difficult and not well accepted by patients, as lesions are usually quite large and located on the face. Imiquimod 5% cream is a local immune response modifier that has been used off-label to treat LM. The authors report of 2 female patients with LM on the nose (aged 39 and 48 years) treated with imiquimod 5% cream applied 5 times a week for a total duration of 4 months. Videodermatoscopy, a noninvasive diagnostic technique, was used to address the diagnosis and to monitor treatment response with imiquimod therapy and during follow-up. At the end of the treatment period, the lesions had cleared in both patients, with no evident remnants confirmed by videodermatoscopy. The patients refused to undergo a control biopsy, but complied for a 30-month followed-up period which revealed no evident changes. The authors' experience, in agreement with...
Imiquimod (IQ) is an immune-response modifying agent, first approved by FDA for the topical treat... more Imiquimod (IQ) is an immune-response modifying agent, first approved by FDA for the topical treatment of external genital and perianal warts in 1997. It induces, through stimulation of Toll-like receptors (TLRs) localized on the surface of antigen-presenting cells, synthesis and release of several endogenous pro-inflammatory cytokines such as interferon-alpha (IFN-alpha), tumor necrosis factor-alpha (TNF-alpha) and interleukins (IL) 6 and 12, which in turn stimulate both the innate and acquired immune pathways, resulting in upregulation of natural antiviral and antitumor activity. IQ 5% cream has been used for the treatment of a wide variety of dermatologic conditions in which the immune system is thought to play a role in regression of the disease. In some disorders, such as genital and perianal warts, actinic keratoses, basal cell carcinomas, Bowen's disease and molluscum contagiosum, relative safety and efficacy are supported by randomized controlled trials of IQ. However, it...
Recent studies have shown a correlation between an increased number of mast cells in patients wit... more Recent studies have shown a correlation between an increased number of mast cells in patients with atopic dermatitis (AD) resulting in raised plasma levels of nerve growth factor (NGF), pointing to a possible key role of their interaction in the pathogenesis of AD. It is well known that mast cells synthesize, store and release NGF. Mast cells and NGF both appear to be involved in tissue inflammation and neuroimmune interactions, with NGF acting as a general "alert" molecule capable of recruiting and priming both local tissue and systemic defense processes following stressful events. Also, NGF has been demonstrated to increase mast cell histamine content and intracellular tryptase activity in a dose- and time-dependent fashion. Endogenous aliamides are capable of down-regulating mastocyte reactivity by their action through the vanilloid (VR1) receptors, and keratinocytes, and through the CB1 and CB2 cannabinoid receptors linked to G-protein, also expressed by sensitive nerve endings, macrophages, and epithelial cells. Therefore, aliamide action should be regarded as a multifaceted mechanism interfering with the inflammatory process occurring in AD further beyond the known and controversial anti-histamine pharmacologic effect. In this regard, the reduction of mast cell degranulation by adelmidrol, as demonstrated by in vitro and in vivo investigations in animals, would interfere with the release of other inflammatory mediators, including NGF. Based on these considerations, a pilot study aimed to assess the efficacy and safety of twice daily application of a topical emulsion containing adelmidrol 2%, a novel aliamide, in a series of 20 patients (11 male and 9 female, mean age 8 (range 3-16) years) affected by mild AD was performed. Complete resolution with no side effects was observed in 16 (80%) patients after 4 weeks of treatment, with no relapses at 8-week follow up. Six patches in six subjects with multiple lesions that had not been treated and served as controls showed no improvement. Controlled clinical studies in larger series are warranted to confirm the efficacy of aliamide in the management of AD.
... John G. Albertini, MD; Michele Maroon, MD; William B. Tyler, MD; Geisinger Medical Center, Da... more ... John G. Albertini, MD; Michele Maroon, MD; William B. Tyler, MD; Geisinger Medical Center, Danville, Pa REPORT OF A CASE ... Maria R. Nasca, MD; Rocco De Pasquale, MD; Franco Dinotta, MD; Giuseppe Micali, MD; University of Catania, Catania, Italy REPORT OF A CASE ...
The efficacy and safety of imiquimod, an immune-response modifier approved for the treatment of a... more The efficacy and safety of imiquimod, an immune-response modifier approved for the treatment of anogenital warts that has antiviral and antitumor activity, in the management of an extensive superficial basal cell carcinoma (sBCC) of the face as an alternative to surgical treatment was evaluated in a 75-year-old male with a 4-year history of a progressively enlarging lesion located on the right temporal region. Imiquimod 5% cream was applied daily until clinical resolution. Histopathological confirmation of clinical diagnosis and of tumor clearance were performed before starting treatment and at the end of treatment, respectively. Moreover, monthly post-treatment follow-up visits were planned. At physical examination, an ovalar, erythematous and slightly infiltrated plaque of 5 x 4 cm in size (approximately 20 cm2), partly eroded and crusted, with a sharp, raised, pearly edge, was evident on the right temporal region of the patient. Histopathological examination of a biopsy specimen ...
High-risk human papillomavirus (HPV) types have been linked with genital carcinomas. However, the... more High-risk human papillomavirus (HPV) types have been linked with genital carcinomas. However, the exact relation between HPV and erythroplasia of Queyrat (EQ), for example, in-situ carcinoma of the glans and prepuce, is still unclear. The aim of this study was to detect the presence of lesional HPV-DNA in patients with EQ. Paraffin-embedded biopsies were obtained from the glans or inner foreskin of 11 adult uncircumcised patients (mean age 67.7 years; range 57-79) with EQ. An equal number of randomly selected uncircumcised healthy control patients underwent a single brush cytology smear of the penile mucosa. Biopsy specimens and brushings were then assayed by a highly sensitive two-step nested PCR technique based on MY11/MY09 consensus primers and general GP5+/GP6+ PCR primers, followed by cycle sequencing. Statistical evaluation was performed using conditional logistic regression analysis. None of the EQ or control samples proved to be positive for the presence of HPV-DNA. The find...
Primary leiomyosarcomas of the penis are rare. Clinically and pathologically, these tumors fall i... more Primary leiomyosarcomas of the penis are rare. Clinically and pathologically, these tumors fall into two groups: superficial and deep. Superficial lesions usually are low grade and show a limited tendency toward distant metastasis. In contrast, deep-seated tumors usually show a more aggressive behavior associated with a poor prognosis. A 62-year-old man with a superficial leiomyosarcoma of the glans penis is reported. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Giornale italiano di dermatologia e venereologia : organo ufficiale, Società italiana di dermatologia e sifilografia, 2009
Genital herpes, a viral infection caused by Herpes simplex virus (HSV), is the most common cause ... more Genital herpes, a viral infection caused by Herpes simplex virus (HSV), is the most common cause of genital ulceration. Patients with a severe decrease in cellular immunity, such as patients positive for Human immunodeficiency virus (HIV) infection, are more likely to develop atypical, severe, disseminated and/or chronic HSV infections. On the other hand, there is an increase incidence of HIV detection among patients positive for HSV infection, as genital ulcers represent a potential portal of entry of HIV into the host. A case of a 52-year-old homosexual man with a two-month history of multiple erythematous ulcerative lesions on the perianal area, the buttocks, and the third left finger is presented. According to the clinical history, the clinical findings and the laboratory results, a diagnosis of HSV infection was made and treatment with valaciclovir was started, which led to complete regression of lesions 30 days later. The atypical features of the herpetic lesions, along with a...
Lentigo maligna (LM) is an in situ variant of cutaneous melanoma, which usually occurs in sun-dam... more Lentigo maligna (LM) is an in situ variant of cutaneous melanoma, which usually occurs in sun-damaged skin. Surgical treatment of LM is often difficult and not well accepted by patients, as lesions are usually quite large and located on the face. Imiquimod 5% cream is a local immune response modifier that has been used off-label to treat LM. The authors report of 2 female patients with LM on the nose (aged 39 and 48 years) treated with imiquimod 5% cream applied 5 times a week for a total duration of 4 months. Videodermatoscopy, a noninvasive diagnostic technique, was used to address the diagnosis and to monitor treatment response with imiquimod therapy and during follow-up. At the end of the treatment period, the lesions had cleared in both patients, with no evident remnants confirmed by videodermatoscopy. The patients refused to undergo a control biopsy, but complied for a 30-month followed-up period which revealed no evident changes. The authors' experience, in agreement with...
Imiquimod (IQ) is an immune-response modifying agent, first approved by FDA for the topical treat... more Imiquimod (IQ) is an immune-response modifying agent, first approved by FDA for the topical treatment of external genital and perianal warts in 1997. It induces, through stimulation of Toll-like receptors (TLRs) localized on the surface of antigen-presenting cells, synthesis and release of several endogenous pro-inflammatory cytokines such as interferon-alpha (IFN-alpha), tumor necrosis factor-alpha (TNF-alpha) and interleukins (IL) 6 and 12, which in turn stimulate both the innate and acquired immune pathways, resulting in upregulation of natural antiviral and antitumor activity. IQ 5% cream has been used for the treatment of a wide variety of dermatologic conditions in which the immune system is thought to play a role in regression of the disease. In some disorders, such as genital and perianal warts, actinic keratoses, basal cell carcinomas, Bowen's disease and molluscum contagiosum, relative safety and efficacy are supported by randomized controlled trials of IQ. However, it...
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