Background/objective
Although 40% of psoriasis patients reported skin pain, this symptom is often underestimated. A new formula of calcipotriol plus betamethasone dipropionate (Cal/BD) has been recently approved for psoriasis treatment. Therefore, we aimed to evaluate the efficacy of Cal/BD aerosol foam on skin pain of patients with plaque psoriasis.
Methods
A real‐life 4‐week prospective, open study on Cal/BD aerosol foam (not compared to vehicle or emollient cream) was performed in adult psoriasis patients attending three Dermatology units located in Campania region, Italy, between March and October 2018. Inclusion criteria were a history of skin pain over the last week and psoriatic involvement of the palmar area. Before (t0) and after a course of once daily application of Cal/BD aerosol foam for 4 weeks (t1), the following items were evaluated: Psoriasis Area and Severity Index (PASI), Physician Global Assessment (PGA) index of target plaque on palmar region, subjective skin pain features through Pain Qualities Assessment Scale questionnaire and skin pain threshold measured by pressure digital algometer at palmar psoriatic plaques.
Results
Seventy‐five patients (43 male, mean age of 43.2 years) were enrolled. After 4 weeks of therapy with Cal/BD aerosol foam, a significant improvement in both PASI (mean: 6.5 ± 2.1 at t0 vs. 2.3 ± 1.6 at t1) and palmar plaques PGA (mean: 3.6 at t0 vs. 1.7 at t1) was observed (P < 0.001). The mean intensity score of skin pain decreased from 7.6 to 1.3 (P < 0.001); among skin pain qualities, intense, sensible, aching and unpleasant showed the highest rate of reduction (t0–t1: 6.3, 6.3, 6.1 and 5.8, respectively). Pain threshold of palmar skin lesions increased at t1.
Conclusions
Our real‐life study suggested that Cal/BD aerosol foam may represent a valid topical anti‐psoriatic treatment, not only improving skin lesions, but also relieving cutaneous pain, thus contributing to ameliorate patients' quality of life.
Cutaneous leishmaniasis is challenging to treat. Various drugs have been proposed to manage this condition, with variable results. In this case report, we describe laser‐assisted delivery of rifamycin to treat this infection. Two sessions of fractional CO2 laser were performed one month apart. Each was followed by a topical application of rifamycin for three days. Resolution with minimal scarring was obtained, suggesting this technique might be safe and effective in treating cutaneous leishmaniasis.
Key Clinical MessageKleresca® biophotonic platform utilizing fluorescent light energy effectively decreased the inflammatory and erythematous reaction common in rosacea subtypes 1, 2, and 3. Kleresca® may be considered as a single treatment for rosacea, targeting multiple features, or combined with invasive methods for an enhanced normalizing and healing profile of the skin.
Vitiligo is a depigmenting skin condition that affects 0.5%-2% of the global population of all ethnic groups and skin types, with no distinctions. The condition is defined by the selective loss of melanocytes, resulting in non-scaly, chalky-white macules. Vitiligo is considered a cosmetic issue, even though its symptoms can be psychologically distressing and significantly impact everyday life.It is now firmly recognized as an autoimmune disease, with hereditary and environmental components, as well as metabolic issues, oxidative stress, and cell detachment. 1 The diagnosis of vitiligo is clinical and usually straightforward, based on the presence of acquired, amelanotic macules with clear edges in a typical distribution: periorificial, lips and distal extremity tips, penis, segmental, and frictional areas. Generally, laboratory tests are not required, but histological samples show a total loss of melanin pigment and a lack of melanocytes. Lymphocytes may occasionally be seen at the advancing edge of the lesions. 2 Phototherapy (ultraviolet A and B), topical and systemic immunosuppressants (corticosteroids, calcineurin inhibitors), may assist in slowing the progression of vitiligo, stabilize depigmented lesions, and stimulate repigmentation. 3,4 As most therapies are time-demanding and require long-term follow-up, management may need an individualized therapeutic strategy in which patients should always be consulted.Cosmetic camouflage advice from a cosmetician or a professional nurse should be supplied to people with vitiligo that affects exposed regions. 1
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