Prebiotics have the potential to correct skin dysbiosis and contribute to the improvement of atopic dermatitis (AD) when incorporated in topical moisturizers and emollients. Biolin is a combination of two prebiotics, alpha-glucan-oligosaccaride and inulin. This is the first study to test Biolin containing creams in AD in children. The study is aimed at assessing the efficacy, tolerability, acceptability and effects on quality of life of three Biolin containing topical creams (face cream, body wash cream and moisturizing body cream) in children with AD. This is single center, open label study, carried for 8 weeks in parallel subgroups of children aged 0-3 years with mild to moderate AD (SCORAD<35). Face and body wash creams were tested for 56 consecutive days in a subgroup of 30 subjects and the moisturizing body cream in the other 30 subjects’ subgroup. SCORAD indexes, xerosis, erythema and edema were assessed at the 4 study visits. Parents’ assessments were carried at 14, 28 and 56 days. SCORAD indexes significantly decreased for all creams at t28 and t56; average decrease ranged from 57.7% to 58.3%. Xerosis reductions were statistically significant for all creams at t56; xerosis improved in 96.6% to 100% of children. No erythema or edema emerged in children without these signs at baseline. Averages of parameters assessed by parents (pruritus, dryness, skin softness, quality of life and creams characteristics) were 8 (out of 10) or higher at the end of the study. The Biolin containing creams tested were beneficial and well tolerated in children aged 0-3 years with mild to moderate AD. The regimens were well accepted by parents and judged to improve both clinical manifestations and quality of life.
Reed nevus or pigmented spindle cell nevus is a variant of Spitz nevus. Some Authors consider it as a single entity (1). Clinically, it is usually found on the extremities as an expansive, intensely and uniformly pigmented plaque or papule. The majority of cases arise before the age of 20 years, both sexes being equally affected. Generally, the lesions raise concerns because of their dark color. Histopathological criteria of Reed nevus are well-determined. Reed nevus is a junctional or mixed nevus of highly pigmented spindle melanocytic cells. They form nests with vertical and parallel orientation in relation to interpapillary crests. Transepidermal elimination of melanin through the stratum corneum can be observed along with numerous melanophages in the superficial dermis. Kamino bodies can also be seen between the melanocytic cells (1, 2). (...).
The incidence of prepubertal melanoma is not raising in children, unlike adolescent and adult (24). Its incidence therefore remains so low that no center is able to do statistics only based on its cases. Over the past 40 years in five Italian Pediatric Dermatology centers 15 cases of melanoma in children aged under 12 years were observed, 4 of which associated with large or multiple congenital melanocytic nevi. The latter, including two cutaneous melanomas arising on congenital melanocytic nevi and 2 meningoencephalic melanomas, started early - average age at diagnosis 18 months - and had poor prognosis quoad vitam. The 11 melanomas arising on normal skin – 8 cases – or associated with small congenital – 1 case – or acquired – 2 cases – melanocytic nevi started at a later age - average age 9.2 years - and had a good prognosis despite average thickness of 2 mm and lymph node involvement in 3/11 cases. These two categories of prepubertal melanoma, though so different from each other, shared the same nodular or ulcerative non specific, often amelanotic clinical appearance. Therefore, they were different and more difficult to be diagnosed as compared with pigmented and usually initially superficial spreading adult melanoma.
The results from the treatment of 10 children with vitiligo (phototype II - III) with topical Khellin + UVA (KUVA) therapy are presented. The irradiation sessions were held in a Waldmann 7001 K cabin and with PUVA 180 and 200 apparatuses. One hour before sessions 5 % khellin in greasy ointment was applied on the vitiliginous lesions. The initial exposure dose depended on phototype and was increased every second procedure. Treatments were given 3 - 4 times weekly. The patients did not receive any additional medicaments except for emollients. As a result of the therapy in all patients different degree of repigmentation (10 - 90 %) was observed. No phototoxic accidents or other side effects were encountered in any of the cases. Because of its low phototoxicity topical KUVA therapy could be used safely during all seasons without risk of developing severe erythema or blistering. It needs a little time and does not necessitate hospitalization of the patients.
Lymphomas are malignant tumors deriving from the proliferation of cells setting up the immune system. As these cells normally circulate with the blood in the whole organism, lymphomas are generalized tumors from their appearance. However, exceptions do exist leading the Authors of the European Organization for Research and Treatment of Cancer (EORTC) to say that morphologically identical lymphomas, when arising in different organs, are clonal proliferations of distinct lymphocyte subpopulations, which are in some way related to the organ where the lymphoma arose (45). Lymphomas are much less frequent in children as compared with adults. However, some Authors (5) established that 1/6,000 children under the age of 15 develops lymphoma. According to these Authors, the frequency of lymphomas follows only that of leukemias and brain tumors. (...)
During the Congress of the European Academy of Dermatology and Vene-reology, which was held in Geneva, from 11 to 15 October, 2000, many communications and posters were devoted to antimycotic treatment. Here these reports are summarized, giving particular emphasis to the problems of the pediatric age. We will essentially talk of the treatment of dermatophytoses, namely of the mycoses caused by the genus Dermatophytes. Then we well mention the treatment of pityriasis versicolor, candidiasis and sporotrichosis. Anyway, we will start with a review of the main systemic and topical therapeutical agents.
Over the last few years, new encouraging pharmacological approaches for the treatment of viral diseases have been evaluated. Among these is cidofovir, an inhibitor of the viral DNA synthesis. We report two patients, the first affected by plane warts of the face and the second by giant plantar wart, who were resistant to conventional therapies but promptly responded to a cream containing 1% cidofovir. Cidofovir, which is a purine nucleotide analogue of cytosine, is a promising new drug acting against a wide number of DNA viruses. Approved by intravenous administration only for the treatment of cytomegalovirus retinitis in patients with AIDS, recently topical cidofovir was found effective for the treatment of viral cutaneous lesions induced by herpes, pox and papilloma virus families.
It is believed that none of the partially effective treatments are appropriate for children with vitiligo. Initial steps are sunscreens and cover-up, and next, topical corticosteroids, topical or oral psoralens, calcipotriol and/UVR, narrow-band UVB. We clinically evaluated 34 children with vitiligo, -20F, 14M, whose age ranged between 4 and 16-, and examined the association with other autoimmune diseases. Results of four treatment methods - topical bethamethasone, topical calcipotriol, topical psoralen plus sun exposure and narrow- band UVB therapies- were compared. Family history of vitiligo was present in 12 patients (35%). Ten patients had focal, 11 patients segmental and 13 patients generalized type vitiligo. Poliosis, halo nevi, atopic dermatitis and diabetes mellitus type-I were associated diseases. Topical agents were used in focal and segmental vitiligo; generalized cases were treated with narrow-band UVB. Topical bethamethasone group showed repigmentation in 3/11 (27%) cases, calcipotriol group showed repigmentation in 1/10 (10%) cases. There was no satisfactory response in topical psoralen plus sunbath group. Narrow band UVB group showed follicular repigmentation in 7/13 (53%) cases without any side effect at the end of three months.
In the last few years, the henna tattoo fashion has widely spread throughout the Westerncountries. We report two cases of allergic contact dermatitis observed in children afterpaint on henna tattoo procedures. The patients came to our outpatients’ clinic for the onsetof erythematous and edematous, pruriginous lesions where the skin had been tattooed 3 weeks before. Treatment with topical steroids and systemic antihistamines led to theregression of the symptoms. Later, European Standard Series Patch Tests were positive in both cases for paraphenylenediamine (PPD) at 1%. We point out the young age of our twopatients (7 years) and the need to inform the public on the risks of this sensitization, due tothe widespread custom of this procedure.