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A Tosti

Publications and source records attributed to A Tosti.

At least 19 recordsLinked to original sources

Role of foods in the pathogenesis of chronic paronychia.

BACKGROUND: Chronic paronychia is a condition that is pathologically characterized by spongiotic inflammation; it can be exacerbated by various and concomitant factors. OBJECTIVE: The aim of this study was to assess whether chronic paronychia in food handlers may have clinical, pathologic, and immunohistochemical similarities with immediate contact dermatitis caused by foods. METHODS: Twenty food handlers affected by chronic paronychia were submitted to patch tests with the fresh foods that were suspected of being the cause of the dermatitis. RESULTS: Nine patients had a positive reaction to a 20-minute open patch test with fresh foods applied on the proximal nailfold. In two patients the pathologic study of the positive open patch test site showed acanthosis, exocytosis, and spongiosis of the epidermis and the presence of an inflammatory lymphocytic infiltrate in the dermis. CONCLUSION: Our results confirm the view that an immediate hypersensitivity reaction to foods can be responsible for some cases of chronic paronychia in food handlers.

Adolescent

Follicular mucinosis in alopecia areata.

The pathological features of alopecia areata were described in association with those of follicular mucinosis in the scalp pathology of an 18-year-old woman. The immunohistochemical picture of the inflammatory infiltrate showed a high CD4/CD8 ratio (25:1), which was significantly different from the CD4/CD8 ratio in patients with alopecia areata. The abundance of helper/inducer cells along with the involvement of the upper part of the hair follicles might explain the development of follicular mucinosis in this case. Different possibilities were discussed, but the clinical presentation and the follow-up favored the clinical and pathological interpretation of alopecia areata with incidental findings of follicular mucinosis.

Adolescent

A multicentre study of contact sensitization in children. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali (GIRDCA).

The results of 7 months of patch testing with a standard series of 26 allergens in 323 children with eczematous conditions or itching palmoplantar psoriasis under the age of 14 years are reported. 114 (35.3%) of the children had 1 or more positive reactions to this standard series. 28 children (8.7%) were polysensitive. On the basis of personal history, additional series of allergens and/or specific allergens were also tested. 61.7% (90/146) of positive reactions were considered relevant to the current dermatitis. Metals, medicaments, preservatives or fragrances, and shoe components were the major sources of contact sensitization. It is suggested that patch testing be done more frequently in evaluating dermatitis in children.

Adolescent

Contact dermatitis in hairdressers: the Italian experience. Gruppo Italiano Ricerca Dermatiti da Contatto e Ambientali.

A multicenter study was performed in 9 Italian centers by members of the GIRDCA, to evaluate the frequency and source of contact sensitization in a group of 302 hairdressers with dermatitis. Occupational habits and use of preventive measures were specifically investigated both in these 302 hairdressers and in a further group of 240 hairdressers who answered a questionnaire. The results showed the presence of an occupationally relevant sensitization in 60.9% of the 302 hairdressers. This proportion included 52 hairdressers who had negative patch tests to the hairdressers' series but showed positive reactions to other allergens, such as nickel, rubber additives, preservatives and fragrances, which were judged relevant to their occupation. Among hair dyes, PPD caused 73 reactions (24.2%), PAP 32 reactions (10.6%), ONPPD 24 reactions (7.9%), and PTD 40 reactions (13.2%). A low incidence of sensitization was detected in our hairdressers to resorcinol and pyrogallol (1.3% for each substance). Among permanent wave allergens, positive reactions to GMTG were found in 11.3% of patients, while ATG gave a lower rate of positive reactions (5.0%). Allergic contact dermatitis due to APS was also relatively common (11.3%). 4 hairdressers in this study gave a positive reaction 30 min after a provocative test with latex gloves, patch testing to the rubber series being negative. Enquiry regarding preventive measures revealed that the majority of hairdressers use gloves when doing hair dyeing, but rarely use them for washing dyed hair or for doing permanent waving. The infrequent use of preventive measures by Italian hairdressers was confirmed by the results of the questionnaire, and possibly explains the high frequency of skin problems (12.5%) in the hairdressing population that was specifically interviewed.

Adolescent

Contact dermatitis in hairdressers' clients.

The aim of our study was to report the frequency of sensitization to hairdressing allergens in a group of patients with contact dermatitis, in whom previous treatments with hair dyes or permanent wave solutions were suspected to be the cause. 49 of 261 hairdressers' clients (18.7%), who were patch tested with the hairdressers' screening series in the years 1985-1990, showed one (27) or more (22) positive reactions to hairdressing chemicals. This study confirms hair dyeing to be the procedure associated with the highest risk of sensitization among hairdressers' clients. Among hair dye allergens, PPD is the most frequent sensitizer (7.3%). A low rate of sensitization to the PPD derivatives PAP, ONPPD and PTD was detected in these clients, there being no differences in the frequency of sensitization to the 3 substances (4.2%, 4.6% and 4.6%, respectively). Only 0.4% of clients were positive to resorcinol, while pyrogallol showed a 2.3% rate of sensitization. Sensitization to GMTG was found in 3.3% of patients. ATG was an infrequent sensitizer (1.1%). Allergic contact dermatitis due to APS is quite rare (2.7%), in view of the widespread use of this compound. A positive open patch test in 1 hairdressers' client, who complained of generalized urticaria after hair bleaching, confirmed the diagnosis of immediate contact reaction due to APS. Sensitization to hairdressing allergens among consumers (18.7%) is possibly more frequent than sensitization to other cosmetic ingredients. We previously detected a 14.3% rate of sensitization to cosmetic ingredients in patients with suspected allergic contact dermatitis caused by cosmetics. On the other hand, reactions to cosmetic ingredients were also common in our patients. This may indicate that hairdressers' clients make greater use of cosmetics than average.

Adolescent

Atrichia and papular lesions: report of a case.

We report a case of atrichia with papular lesions in a 4-year-old girl. The scalp was completely hairless since birth, except for dark, shiny, coarse hair on the frontoparietal region. Eyelashes and eyebrows were sparse. Numerous papular lesions developed on the hairless scalp, cheeks and neck during the second year of life. Teeth and sweating function were normal. The family history was negative. Histologic examination of a papular lesion showed the presence of a keratin-filled cyst in contact with the overlying epidermis. The pathology of the bald scalp showed the presence of tubular epithelial structures devoid of hair bulbs extending from the epidermis to the deep dermis and the superficial hypodermis. Sebaceous and outer root sheath differentiation was evident in most of the tubular structures that also frequently contained small ducts surrounded by two or three layers of flat epithelial cells. The superficial dermis contained horny cysts, similar to those present on the cheeks.

Alopecia

Telogen effluvium due to recombinant interferon alpha-2b.

Five of 10 patients receiving long-term recombinant interferon alpha-2b therapy complained of considerable hair loss. The pull test and the trichogram showed a telogen count consistent with a telogen effluvium. In 2 patients the telogen count progressively improved despite continuing the treatment, whereas in 3 patients the trichogram continued to show an increased telogen count until interferon therapy was discontinued. Pohl-Pinkus hair constrictions were also present in 2 patients.

Adult

Cutaneous complications of artificial hair implantation: a pathological study.

Five patients who developed severe cutaneous complications after artificial hair implantation were subjected to a scalp biopsy. The pathology showed the presence of hyperplastic epidermal proliferations that produced infundibulum-like structures around the implanted fibers in the superficial dermis. A dense acute inflammatory infiltrate surrounded the artificial fibers in the superficial dermis. In the deep dermis a granulomatous infiltrate was present whereas in the hypodermis the inflammatory infiltrate was sparse and the fibers were embedded in fibroplasia. The pathology of a patient who did not present any skin inflammation after artificial hair implantation showed similar pathological features but the absence of acute inflammation suggesting that bacterial infections play a major role in the development of the cutaneous complications of hair implantation. Since definitive treatment of the infections is ineffective until the fibers are removed from the scalp, surgical treatment was required in 2 of our patients.

Adult

Doubled nail of the thumb. A rare form of polydactyly.

Bifid thumb is a rare manifestation of polydactyly. The trait is autosomal dominant, but the expressivity is highly variable. It must be distinguished from apical dystrophy, a rare form of brachydactyly. Severe surgical procedures have been suggested for both functional and cosmetic reasons. Two families affected are described.

Adult

Linear alopecia mucinosa along Blaschko lines.

We present a case of linear reversible non-inflammatory alopecia mucinosa in a 25-year-old Nigerian patient. The patient exhibited an arciform bald patch on the scalp and follicular mucinosis in both lesions. The possible relationships between the unusual linear arrangement of alopecia mucinosa along Blaschko's lines and lichen striatus are discussed.

Adult

Psoriasiform acral dermatitis. Report of three cases.

The authors report 3 patients affected by psoriasiform acral dermatitis, a distinctive clinical entity characterized by a chronic dermatitis of the terminal phalanges, associated with marked shortening of the nail beds of the affected fingers. The skin biopsy showed in all cases the pathological features of a subacute spongiotic dermatitis. X-ray examination of affected fingers showed no bone or soft tissue changes. Differential diagnosis of psoriasiform acral dermatitis included psoriasis, atopic or contact dermatitis and corticosteroid-induced distal phalangeal atrophy.

Acrodermatitis

[Psoriasis arthropathica. A review of the literature, general considerations and the authors' personal experience].

A retrospective study has been carried out on 897 psoriatic patients in order to verify the incidence and radiological patterns of psoriatic arthropathy (PA). Site of involved joints, appearance and degree of involvement were correlated with extent of skin disease and blood test results. Sixty-five patients (7%) showed "clinical" arthritis whereas only 20 cases (2.2%) were radiologically positive; among them, 35% were classified as "severe" forms. Peripheral arthritis was observed in all cases, involving the hand in 85% of patients. The distal interphalangeal joints were the most affected location in the feet (78%) and the proximal interphalangeal joints in the hands (94%). The extant small peripheral joints were involved in decreasing rates proceeding proximally. Bilateral and asymmetric involvement was observed in most of the patients; hypertrophic interphalangeal joints erosion was the typical pattern in 100% of cases, evolving in rheumatoid-like ankylosis in 23% of them. Spondylitis and/or sacroiliitis were associated in 50% of patients. No correlation between degree of arthritis and skin disease was found in our series, with the exception of proximal and axial joints arthritis, in which extensive skin disease and severe small joints involvement were associated in 80% of cases. Clear differential features were demonstrated between peripheral PA and rheumatoid arthritis, and between spinal involvement in PA and ankylosing spondylitis. Poor correlation of distal arthritis to psoriatic nail involvement was also demonstrated.

Adult

Alopecia totalis: is treating nonresponder patients useful?

The purpose of this study was to assess the effectiveness of different treatments in patients with alopecia totalis or universalis who did not respond to sensitizing therapies. Twenty-six patients, who had been receiving sensitizing therapy for at least 1 year without any response, were randomly assigned to receive the following treatments: topical 10% cyclosporine in oily solution (eight patients), PUVA (eight patients), and intravenous thymopentin (ten patients). None of them had any acceptable regrowth after at least 6 months of treatment. Our results suggest that other treatments are not useful in patients with 100% hair loss who fail to respond to sensitizing therapies.

Administration, Topical