Introduction Cold atmospheric plasma (CAP) has been clinically demonstrated to be an effective treatment for actinic keratosis (AK) in a number of case series. In this study, we evaluated the efficacy of CAP in the treatment of multiple AKs and assessed morphological changes induced on the skin field of cancerization both clinically and by high-frequency ultrasound (HFUS). Methods Patients with multiple grade I–II AKs of the scalp and/or face who were resistant or intolerant to conventional field-directed treatments were enrolled. CAP treatments were performed using a microwave-driven argon plasma jet. At baseline and 3 months after the last CAP session, performance indexes were determined using three-dimensional digital pictures and HFUS investigations were performed on a representative Olsen grade II AK and a small spot of clinically unaffected skin within the test area. Results Twelve patients were enrolled in the study. All clinical variables showed a statistically significant reduction after CAP. HFUS evaluation revealed that the total, epidermal and dermal thicknesses of the target AKs had not changed with treatment. CAP therapy significantly increased dermal density in both the target AK and the surrounding photodamaged skin and signficantly decreased the thickness of the subepidermal low-echogenic band in the perilesional skin, which is an ultrasound sign of photodamage. Conclusions Cold atmospheric plasma was found to be an effective treatment for patients with multiple AKs. CAP was not followed by skin atrophy. HFUS examiniation showed the CAP improved features of chronic photodamage of the dermis of the skin underlying and surrounding the AK spots.

The popularity of tattoos in the today's society brings with it a significant increase of the incidence of associated cutaneous reactions. Among the several complications that may occur after a tattooing procedure, allergic and photo‐allergic reactions, infections, and Koebner phenomenon are the most common ones observed. Most of these complications may be avoided by identifying, before tattooing, the presence of risk factors or comorbidities that may increase the risk of their onset.

remain high on the differential diagnosis. 2,8 Notably, peristomal skin complications are reported as high as 67%, and almost all patients with an ostomy experience some degree of irritant dermatitis. 2,9 Applying proper wound care principles to address devitalized tissue, infection and moisture imbalance are vital in the treatment of these other conditions. 10 We believe our patients' symptoms initially developed as an irritant dermatitis but were further exacerbated by poor wound healing and chronic irritation. If the clinical suspicion for PPG is low, we encourage an initial trial of aggressive wound care. After initiating proper wound care, clinical improvement without the use of immunosuppressants should raise suspicion for other common aetiologies of peristomal ulceration.

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BACKGROUND: Chronic leg ulcers affect approximately 1% to 2% of the European population, with an increasing prevalence. The treatment of chronic wounds is a socioeconomical problem worldwide. PURPOSE: The main purpose of the current investigation was to detect the etiology of leg ulcers treated in a dermatologic wound clinic from January 1, 2010, to December 31, 2019. METHODS: This retrospective observational study was performed at the Dermatologic Clinic of Spedali Civili in Brescia, Italy. The authors enrolled 465 patients with chronic leg ulcers. RESULTS: The 3 most represented causes of ulcers were vascular (238 patients, 51.2%), inflammatory (71 patients, 15.3%) and traumatic (43 patients, 9.3%). Altogether, a total of 13 different entities were identified as a cause of leg ulcer. CONCLUSION: Vascular genesis was the most common etiology of leg ulcers in this population, even though uncommon causes were also represented. These findings are in agreement with other studies reported in the literature.