until 1 week, in four patients (10%) until 2 weeks, and in two patients (5%) until 3 weeks after the patient was cured. The mean mite DNA load during these periods was only 4Á20% (95% confidence interval 0Á93-7Á47) of the peak DNA load, and none of these patients had clinical or microscopic recurrence of infestation. Therefore, scabies mite DNA may be detectable during the follow-up period after cure, but its presence may be the result of epidermal turnover to liberate mite DNA rather than relapse or treatment failure, especially if the DNA load is less than 10% of the peak load In conclusion, our study demonstrated that a nested realtime quantitative PCR assay targeting the cox1 gene of S. scabiei is useful not only for the diagnosis of scabies but also for post-treatment monitoring. This PCR assay may not completely replace traditional skin scraping and microscopic examinations in terms of time and cost, but it may help physicians who have not previously diagnosed scabies or used dermoscopy to diagnose scabies accurately. The assay may also be helpful in the diagnosis of patients with atypical symptoms and signs, and may be helpful in identifying cure or recurrence during post-treatment monitoring.
On 31 December 2019 from the Chinese city of Wuhan, Hubei, comes the first case of 'atypical ARDS/interstitial pneumonia'. On 11 February 2020, the WHO officially announced the name of the emergent disease associated with new coronavirus identified as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2): COVID-19 (Coronavirus Disease 2019). 1 On 13 February, 72 000 cases have been officially recorded in China, among which 15 000 were registered in Hubei province only, with 242 deaths in a single day. After that, Chinese republic has ordered drastic containment measures for fighting SARS-CoV-2 virus spreading. 1 On 11 March 2020, the World Health Organization (WHO) stated that the international outbreak of SARS-CoV-2 new coronavirus infection had to be considered a pandemic. 2 To date, 14 April 2020, 213 countries are affected worldwide with 1 812 734 confirmed cases and 113 675 deaths worldwide since the epidemic outbreak. 3 In this scenario, probably the most important strategic goal for dermatologists is to assess what their active involvement in this global pandemic might be. For this reason, our goal is to provide the 'state of the art' on this topic. Our personal experience, and a full extensive review of literature, led us to focus our attention on several topics in the management of dermatological patients during the SARS-CoV-2 pandemic, and four main topics have been identified. They are: (ⅰ) cutaneous manifestations related to COVID-19, (ⅰⅰ) the implications of SARS-CoV-2 infection for use of biological drugs and other immunosuppressive and immunomodulatory therapies in dermatological patients, (ⅰⅰⅰ) occupational skin diseases related to hygienic washing and use of personal protective equipment (PPE) to avoid SARS-CoV-2 infection among patients and clinicians, and (iv) strategic implications in planning dermatological clinical assistance to population during SARS-CoV-2 pandemic. Skin manifestations due to SARS-CoV-2 infection are different and often underestimated, since the general conditions of patients are critical, as in several cases of hospitalized COVID-19. However, the most common symptoms of COVID-19 disease are reported in Table 1. Validated studies encompassing a sufficiently large number of patients to fully describe the most frequent ongoing skin manifestations of COVID-19 are not yet available. However, many Myalgia or arthralgia 164 (14.9) Chills 126 (11.5)
Topical and systemic antibiotic therapy remains the first-line treatment for mild-tomoderate hidradenitis suppurativa (HS). However, literature data on antibiotic resistance in HS are growing. A total of 134 patients with mild-to-moderate HS were retrospectively evaluated. Seventy-three patients (group A) received topical clindamycin 1% and 61 patients (group B) received topical resorcinol 15%. We evaluated the efficacy and tolerability of topical 15% resorcinol versus topical 1% clindamycin in mild-to-moderate HS, comparing the clinical response at 12 weeks of treatment. Patients treated with resorcinol 15% showed a significant improvement in Hidradenitis Suppurativa Clinical Response, International Hidradenitis Suppurativa Severity Score System, and Pain Visual Analogue Scale score from baseline compared to patients treated with clindamycin 1%. Topical resorcinol 15% could be a valid alternative to clindamycin in the management of acute and long-standing HS, limiting antibiotic use and antimicrobial resistance.
Lynde C Long-term adalimumab efficacy in patients with moderate-to-severe hidradenitis suppurativa/acne inversa: 3-year results of a phase 3 open label extension study. J
Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by painful nodules, abscesses, and fistulas, localized to the areas of the folds where apocrine glands are present: the armpits, groin, inframammary region, and genital or perineal region. The management is still challenging, and it includes mainly systemic antibiotics, immunosuppressors, and biologic agents. Antibiotics are frequently used in the management of HS for their anti-inflammatory, immunomodulatory, and antimicrobial properties, but no data have been reported regarding the use of dalbavancin in HS. The aim of our practice was to evaluate efficacy, flare, and disease-free survival after dalbavancin therapy in a selected population with HS. We report the experience of the Ancona Dermatology Clinic in treating HS flare-ups with dalbavancin and its rationale for use. Our observation shows that the use of dalbavancin is an effective and well-tolerated treatment for the management of Hurley stage II-III HS; currently, dalbavancin should be considered as a supportive therapy for selected patients.
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