We have conducted a multicentre case-control study to assess the epidemiological importance of previously suggested risk factors for psoriasis, including family history of the disease, smoking and alcohol consumption. Newly diagnosed psoriatics, with a history of skin manifestations no longer than 2 years were eligible as cases; as controls we selected subjects with newly diagnosed dermatological conditions other than psoriasis. Interviews were performed by trained medical investigators using a structured questionnaire. Two-hundred and fifteen cases, aged 16-65 years (median age 38), and 267 controls, aged 15-65 years (median age 36), were interviewed and included in the analysis. Family history was a risk factor for psoriasis; the multiple logistic regression (MLR) adjusted-odds ratio was 18.8 (95% confidence interval 6.4-54.8) for a history in parents, and 3.2 (95% confidence interval 1.5-6.6) for a history in siblings. The risk of psoriasis was higher for current smokers than for those who had never smoked. The MLR adjusted odds ratio was 2.1 (95% confidence interval 1.1-4.0) for people smoking 15 cigarettes or more per day. The risk of psoriasis was higher for alcohol drinkers: compared with teetotallers the MLR adjusted-odds ratios were 1.3 (95% confidence interval 0.8-2.3) for subjects drinking one or two drinks/day and 1.6 (95% confidence interval 0.9 to 3.0) for those drinking three or more. However, the trend in risk was not statistically significant. Our study confirms the role of family history in psoriasis and provides some evidence of a dose-response relationship for an association between smoking habits and psoriasis.

Background Creeping eruption (CE), which is characteristic of tropical and subtropical regions, is being increasingly frequently observed in Italy. The presence on the beaches of stray animals infected by nematodes of the Ancylostoma species favors contact between human skin and the larva-infested soil.Materials and methods Our experience with 56 patients (13 cryotherapy, one thiabendazole together with cryotherapy, six thiabendazole, two albendazole with cryotherapy, and 34 albendazole) is described. Results A prompt and de®nitive cure was achieved in all 56 patients. The therapeutic effectiveness of the various methods used is therefore equivalent. ConclusionsWe believe that albendazole should be considered the ®rst choice for treatment. It is extremely well tolerated and patient compliance is good. Albanese, Venturi, and GalbiatiTreatment of larva migrans cutanea Pharmacology and therapeutics ã

A 68-year-old man had had for 3 years a severe onychodystrophy involving all fingers and toes which clinically mimicked nail lichen planus. The nail biopsy showed amyloid deposits in the superficial dermis of the nail matrix. Physical, pathological and laboratory examinations confirmed the diagnosis of primary systemic amyloidosis. At the time of the diagnosis the patient did not present any other cutaneous sign of systemic amyloidosis.

Trichophyton soudanense is an anthropophilic dermatophyte originating in Africa. Over the last 30 years sporadic cases have been reported in countries that had colonial relations with the endemic areas. In recent times, as a result of growing racial mixing linked to migratory movements, this strain has become increasingly integrated with the species most commonly responsible for dermatophytoses. This phenomenon has occurred, although only recently, in Italy too, where there has been a heavy influx of foreign immigrants over the last few years.

Summary. Tinea pedis is a common and frequently recurring dermatophytic infection, which is extremely difficult to eradicate. The often inevitable persistence of predisposing conditions, especially maceration, suggests that application of powders containing antifungal medication to the affected area could be effective in preventive therapy against recurrence. For this study we used one of the most recent azole antifungal agents, fenticonazole. Thirty patients affected with tinea pedis were cured with topical antifungal treatment; both the diagnosis and the cure were confirmed by microscopic and cultural mycological analyses. The results of subsequent double blind antifungal versus placebo treatment (controlled with clinical and mycological tests over a period of 4 months and with a final statistic evaluation) confirmed the effectiveness of such therapy in reducing the frequency of tiresome relapses in such patients. Zusammenfassung. Tinea pedis ist eine ver‐breitete und oft rezidivierende Dermatophyten‐Infektion, die schwierig zu beseitigen ist. Die oft unvermeidbare Persistenz disponierender Faktoren, insbesondere Mazeration, legt die Vermutung nahe, daß die Anwendung antimyzetischer Puder am befallenen Bereich eine präventive Wirkung auf solche Rezidive haben könnte. In der vorliegenden Studie wurde Fenticonazol, eines der jüngst entwickelten Azol‐Antimykotika, eingesetzt. Dreißig Patienten mit Tinea pedis wurden mittels topischer antimykotischer Behandlung geheilt; Diagnose und Heilung wurden mikroskopisch und kulturell‐mykologisch abgesichert. Die Ergebnisse der anschließenden Doppelblindstudie: Fenticonazol gegen Plazebo, die klinisch und mykologisch über den Zeitraum von vier Monaten hinweg kontrolliert und statistisch ausgewertet wurden, belegen die Wirksam‐keit einer solchen Prophylaxe in der Reduktion der Häufigkeit der Rezidive an diesen Patienten.

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A 22‐year‐old Senegalese man, who had been in Italy for 2 years, in a good general state of health and with an unremarkable medical history, had been suffering for an unspecified length of time from widespread itching, along with the gradual appearance of numerous keratotic nodular lesions, sometimes interspersed with areas of lichenification in a picture of progressive xerosis ( Fig. 1). During a previous stay in our hospital department, he had suffered a serious attack of asthma, with hypereosinophilia (19%) and an increase in serologic immunoglobulin E (IgE) (2000 IU/mL). 1 Clinical view of the lesions on the left leg A histologic examination of a lesion removed from the patient's back revealed the presence of slight acanthosis and an inflammatory infiltrate in the surface and middle dermis, mainly consisting of lymphocytes and a few eosinophils ( Fig. 2). 2 Histologic view of a lesion (hematoxylin and eosin, × 250) A parasitologic examination of the feces revealed the cause of the clinical picture, and led to the identification of Strongyloides stercoralis ( Fig. 3). The patient was subjected to a short cycle of treatment with albendazole, 400 mg/day for three consecutive days. 3 Parasite isolated from the feces (direct examination, × 100) The patient was kept under observation for the next 6 months, and his clinical picture and symptomatology slowly but gradually improved. Examination of the feces gave a negative result.

Direct oral anticoagulants (DOACs) have demonstrated safety and efficacy in stroke prevention in patients with non-valvular atrial fibrillation (NVAF). In terms of safety, there was a significant reduction of intracranial hemorrhages (ICH) in patients treated with DOACs over warfarin. To date, a specific antidote for edoxaban is not yet available. The management of ICH relies on the use of coagulation factors. This article reports a case of a 73-year-old woman with NVAF who had cerebral hematoma in the right intraparenchymal thalamus-capsular area while on therapy with edoxaban 60 mg/day. The computed tomography (CT) brain scan showed hematoma of >18mm diameter. The patient was timely treated with four-factor prothrombin complex concentrate (4F-PCC) at 50 IU/kg. After 6 hrs patient's symptoms alleviated and she was successfully recovered within 6 days. A repeated CT scan of the brain in 3 weeks showed improvement. The patient's treatment with edoxaban 30 mg/day restarted after 8 weeks.