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Background  Alopecia areata (AA) is an autoimmune disease affecting about 2% of the population, which has a considerable impact on quality of life (QoL). There are no disease‐specific questionnaires to assess QoL in patients suffering from AA. Objective  To validate a new disease‐specific questionnaire for AA, named AA‐QLI, and to compare the consequent Quality of Life Index (QLI) with the commonly known Dermatology Life Quality Index (DLQI) to verify if it can provide a more comprehensive tool for patients. Methods  A total of 50 patients affected by AA were administered both the AA‐QLI, created by us, and the well‐known DLQI. With the aim to detect suitable QLI, we propose to use two multivariate analyses:  a principal component analysis approach on the data collected with both questionnaires to compare their capability to measure the QoL;  a structural equation modelling on our AA‐QLI to identify which category of symptoms mostly affects the QoL. Results  The scores of both the questionnaires are quite close, except for a few cases. Statistical analysis shows a higher specificity of the AA‐QLI for evaluating QoL. Among the three areas in which AA‐QLI is divided, ‘Relationship’ has a major impact on the QLI, followed by ‘Subjective symptoms’; ‘Objective signs’ has a lower weight on the QLI. Conclusion  AA‐QLI is a good instrument to evaluate the real impact of AA on QoL. It can be helpful both for the physician and for the patient.

Co-precipitation is by far the most common synthesis for magnetic iron oxide nanoparticles (IONPs), as cheap and environmentally friendly precursors and simple experimental procedures facilitate IONP production in many labs. Optimising co-precipitation syntheses remains challenging however, as particle formation mechanisms are not well understood. This is partly due to the rapid particle formation (within seconds) providing insufficient time to characterise initial precipitates. To overcome this limitation, a flow chemistry approach has been developed using steady-state operation to "freeze" transient reaction states locally. This allowed for the first time a comprehensive analysis of the early stages of co-precipitation syntheses via in-situ Small Angle X-ray Scattering and in-situ synchrotron X-Ray Diffraction. These studies revealed that after mixing the ferrous/ferric chloride precursor with the NaOH base solution, the most magnetic iron oxide phase forms within 5 s, the particle size changes only marginally afterwards, and co-precipitation and agglomeration occur simultaneously. As these agglomerates were too large to achieve colloidal stability via subsequent stabiliser addition, co-precipitated IONPs had to be de-agglomerated. This was achieved by adding the appropriate quantity of a citric acid solution which yielded within minutes colloidally stable IONP solutions around a neutral pH value. The new insights into the particle formation and the novel stabilisation procedure (not requiring any ultra-sonication or washing step) allowed to design a multistage flow reactor to synthesise and stabilise IONPs continuously with a residence time of less than 5 min. This reactor was robust against fouling and produced stable IONP solutions (of ~ 1.5 mg particles per ml) reproducibly via fast mixing (< 50 ms) and accurate temperature control at large scale (> 500 ml/h) for low materials cost.

BackgroundNew chemotherapic agents and new protocols in oncology have led to an increasing survival rate in patients affected by tumors. However, this increased use has been accompanied by a growth in the incidence of cutaneous side effects and a worsening of patients’ quality of life. Appropriate management of skin toxicity associated with chemotherapic agents is therefore necessary for suitable drug administration and to improve quality of life and clinical outcomes.MethodsWe have clinically examined 100 patients affected by cancer, determining type, frequency, treatment, and evolution of side effects related to chemotherapy.ResultsThe prevalent cutaneous side effects in patients undergoing chemotherapy are skin rash, xerosis, pruritus, paronychia, hair abnormality, and mucositis. The clinical cases are reported in detail.ConclusionOncological therapies have become more selective and have low systemic toxicity because of their high specificity, but cutaneous side effects are common and may worsen the quality of life of these patients.

Acneiform rash is the most common side effect of epidermal growth factor receptor (EGFR) inhibitors (EGFRis), and it occurs in 50-100% of patients. This condition can affect the quality of life of these patients and can sometimes lead to a discontinuation of the antineoplastic therapy. Several recent prospective studies have addressed and evaluated different interventions to mitigate or reduce the severity of EGFRis-associated skin rash. With this aim, we have established a dermocosmetological outpatient clinic for cancer patients at the Department of Clinical Medicine and Surgery, University of Naples Federico II in collaboration with the Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami. An interdisciplinary network of physicians can improve the quality of life of the cancer patients, focusing on such important aspects as dermocosmetological skin care, but also on the evaluation of new therapeutic and diagnostic algorithms in order to make further progress in the field of prevention. In this review, we summarize the state of the art of the epidemiology, pathogenesis, and treatment of EGFRis acneiform rash, and we describe our outpatient clinical experience.

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A mathematical model for the liquid-phase synthesis of spherical nanoparticles in continuous flow microand milli-reactors was developed, accounting for residence time distributions (RTD). These distributions were derived for the reactants and the particles involved in the synthesis. The kinetic parameters needed to describe the reactions were calculated from experimental data available in the literature from batch reactors, with the aid of population balance modelling. They were subsequently used, without further modification, to simulate the synthesis in flow reactors via population balance modelling, averaging the results at the reactor outlet using the reactor RTDs. The model was employed to describe the synthesis of silica nanoparticles as a case study, and validated against flow reactor results from the literature. The results demonstrate direct RTD effects and indirect diffusion-induced effects on the evolution of the particle size distribution during the flow synthesis. The former are created by the inherent widening of the RTDs, due to the different residence time experienced by each fluid element, leading to a broadening of the particle size distribution. The latter are induced by the difference in diffusivity between nanoparticles and liquid reactants, which leads to different dispersion processes in the reactor for the different components of the reaction mixture. These effects appear as the major cause of particle size distribution difference between (single phase) flow and batch syntheses. Highlights • A model for the design of microreactors synthesising nanoparticles is proposed; • The model utilises only kinetics and diffusion parameters from the literature; • Residence time distribution effects on nanoparticle size distribution is quantified; • Effects of transport phenomena on reaction kinetics in the flow synthesis are shown.

Spitz nevus is an uncommon, benign melanocytic neoplasm that shares many clinical and histological features with melanoma. It presents clinical ambiguity that makes the diagnosis and management of the patient difficult. We present our experience in the management of Spitz nevus by rigorous dermoscopic long-term follow-up of 8 Spitz nevi in patients younger than 12 years. Dermoscopic images, acquired every 6 months, show evolution and modifications of these lesions. The aim of this paper is to better understand the long-term modifications of nevi with starburst pattern to avoid surgical excision of these lesions in the pediatric age group.