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Biomedical subjects

G Micali

Publications and source records attributed to G Micali.

105 records · Page 6Linked to original sources

Use of squaric acid dibutylester (SADBE) for cutaneous warts in children.

We evaluated the efficacy of squaric acid dibutylester (SADBE) contact immunotherapy for the treatment of warts on a series of 188 children. Included in the study were those children who satisfied at least two of the following criteria: single or multiple sites with several warts, warts resistant to repeated medical and/or surgical treatments, recurrent multiple warts, and patient or parent refusal to undergo destructive or surgical treatment. Excluded from the study were children with single warts or with flat warts located exclusively on the face and children less than 2 years of age. Treatment consisted of twice weekly applications of serial dilutions of SADBE (0.03-3%) for no more than 10 weeks. Of the 148 children who completed the study, 124 (84%) showed complete clinical resolution with no significant side effects. Of those with total clinical resolution, 101 completed a 24-month follow-up with no relapses. Twenty-four (16%) children were nonrespondent. No apparent correlation between treatment response and age, gender, anatomic site, lesion type, or atopy was found. Contact immunotherapy with SADBE is a relatively safe and effective alternative treatment in the management of multiple and resistant cutaneous warts in children.

Adjuvants, Immunologic↗

Familial atrophia maculosa varioliformis cutis: an ultrastructural study.

Atrophia maculosa varioliformis cutis is a rare and distinctive form of idiopathic facial macular noninflammatory atrophy that may rarely be observed in members of the same family. We describe two brothers, ages 14 and 16 years, with spontaneously appearing, asymptomatic, varioliform and linear atrophic lesions. Their past medical history was positive for varicella occurring in childhood without residual facial scarring. Routine laboratory investigations and screening for circulating autoantibodies were negative. Both patients were concordant for HLA A2 and DQ4.1. Routine and ultrastructural histologic examination of a punch biopsy specimen showed the presence of scarce, small, fragmented elastic fibers and compact collagen bundles associated with hypertrophic fibroblasts in the dermis. Our patients remained clinically stable, untreated, over a 2-year follow-up period. No long-term follow-up data have previously been reported.

Adolescent↗

High-magnification videodermatoscopy: a new noninvasive diagnostic tool for scabies in children.

A study of 100 children suspected of having scabies was carried out using high-magnification (HM) videodermatoscopy as the only diagnostic tool. HM videodermatoscopy reaches magnifications of up to 600x and allows a detailed inspection of the skin. Rapid and clear identification of mites, migration burrows, eggs, and feces was obtained in 62 of 100 patients. None of the 38 patients with negative findings showed any sign of infestation 2 weeks later. HM videodermatoscopy is rapid, effective, and sensitive, especially in those cases with nonspecific clinical features, and allows clear detection of diagnostic details usually not appreciable at lower magnifications. It has high specificity, with no chance of false-positive results, and being noninvasive, it eliminates the risk of accidental infections. Finally, the most important advantage in children is its high compliance rate, as it does not cause pain or physical or psychological discomfort. It may be used for primary diagnosis as well as for posttherapeutic follow-up and for screening of family members, thus reducing the risk of persistence and diffusion of the infestation.

Adolescent↗

Phospholipase activity in Malassezia furfur pathogenic strains.

The lipophilic dimorphic yeast Malassezia furfur is a common skin commensal and the aetiological agent of pityriasis versicolor. A source of lipids is essential for its growth, and there are already demonstrations of in vitro lipase and lipoxygenase production. In eight wild strains, isolated from patients with pityriasis versicolor, we showed a phospholipase activity using a medium containing egg yolk emulsion as the only source of lipids; in this medium M. furfur grows and produces a phospholipase zone. Adding manganese sulphate, an unspecific inhibitor of phospholipase activity, M. furfur does not grow, because the lipophilic fungus cannot utilize the egg yolk as a source of fatty acids. Adding Tween 60 to the same medium, M. furfur also grows in presence of manganese sulphate.

Culture Media↗

Cellular blue nevus of the scalp infiltrating the underlying bone: case report and review.

Cellular blue nevi (CBN) are benign tumors of the skin derived from dermal melanocytes histologically characterized by increased cellularity and often by a dual cell population of nevoid cells. CBN rarely tend to invade the underlying tissues. Only six cases of CBN of the scalp invading the skull have been reported. A new case of a CBN infiltrating the underlying bone is presented. The patient, a 23-year-old woman, had a large hairless area on her right parietal scalp, present since the early months of life. Her past medical history included, on the same site, the presence, at birth, of a raised, dark, soft and hairless mass that was subsequently electrodesiccated. Radiographs of the skull showed an area of osteolysis underlying the cutaneous lesion. Histologic examination of a biopsy specimen revealed a CBN of the scalp infiltrating the underlying bone. Surgical resection of the entire lesion was planned. There were no other anomalies or malignancies. The patient is currently being followed in our clinic.

Adult↗

Lipoid proteinosis: a case report.

An 8-year-old Italian boy, born to consanguineous parents, with clinical, histopathologic, and ultrastructural findings of lipoid proteinosis is reported. The main signs of the syndrome-papulonodular, hyperkeratotic and verrucous lesions distributed over the skin of the head and extremities, hoarseness, and dysphagia-were present in the child. The mother had papulonodular lesions on her hands and also complained of slowness in healing.

Child↗

Oral terbinafine in the treatment of multi-site seborrhoic dermatitis: a multicenter, double-blind placebo-controlled study.

Seborrheic dermatitis (SD) is a common disorder for which no satisfactory curative treatment exists. Preliminary studies suggest that terbinafine may be effective. The efficacy and tolerability of oral terbinafine was evaluated in multi-site SD in a randomized, double-blind, placebo-controlled study. For this purpose, 174 adult patients with SD lesions involving >or=3 skin areas, each causing >or=2 moderate/severe symptoms according to a pre-defined clinical score, were classified according to the localization of lesions: patients with lesions predominantly involving non-exposed skin areas, such as scalp and hairline and sternum and/or interscapular area (Population A, n=83) or patients with lesions in exposed sites, mainly the face (Population B, n=91). Patients were randomized to oral terbinafine (250 mg/day ) (n=86) or matching placebo (n=88), each given for 6 weeks. Primary efficacy variable was the response rate, defined as >or=50% decrease in baseline total clinical score without rescue medication intake after 6 weeks of treatment. The main secondary assessments were: subject's global assessment of relief and proportion of patients satisfied with treatment. Recurrence rate was assessed in responder patients during a 4-week treatment-free period. In Population A the response rate after 6 weeks of treatment was significantly higher with terbinafine (70% vs 45.4%; p=0.03) and so was the proportion of patients who reported relief (75% vs 41%; p=0.007) and who were satisfied (66% vs 40%; p=0.02). No significant differences were recorded in Population B. Adverse events occurred in 11.5% of terbinafine patients and 8% of placebo patients. One patient discontinued treatment with terbinafine because of adverse events (mild tachycardia and insomnia). In conclusion, our results show that terbinafine is significantly more effective than placebo in reducing the severity of SD lesions in nonexposed sites. Clinical trials comparing terbinafine to standard treatment regimens in different types of patients with SD are warranted.

Administration, Oral↗

[Local flaps in the reconstruction of the hypopharyngeal-esophageal tract].

The authors present the developments made in the use of cutaneous cervical flaps in the reconstruction of the hypopharyngo-cervical esophagus since Mikulicz first introduced the technique in 1886. Mention is made of the most recent, valid reconstructive possibilities which have resulted in a progressive reduction in the use of cervical flaps. The advantages and disadvantages of the Wookey-operation are enumerated and considerations are made regarding the validity of this technique. The authors conclude that the use of cutaneous cervical flaps remains an effective method, particularly when more limited extirpation and/or further reconstructive stages are required or when a patient's poor general state contraindicates more stressing procedures.

Esophagus↗

[Poland syndrome. Clinical and structural considerations].

The Authors reported 4 cases of Poland Syndrome. In one of these was possible to perform a skin and muscle biopsy. The clinical aspects of the patients, compared with those observed in the literature are reported. The disease is a malformative syndrome, and the histological features of skin and muscle appeared not structurally affected.

Adolescent↗

[Cutaneous lymphoid hyperplasia (pseudolymphoma) secondary to vaccination].

Cutaneous lymphoid hyperplasia (CLH) is a reactive proliferation of SALT--skin-associated lymphoid tissue--following trauma, insect bites, drugs and other undetermined stimuli. Only a case of CLH resulted from allergy hyposensitization injections was reported in literature. We report a second case of post-vaccinal CLH occurred in a 37 year-old man. A light microscopic and immunohistochemical study was performed. CLH immunoarchitectural analysis revealed features analogous to those of reactive lymph nodes.

Adult↗

Evaluation of transdermal theophylline pharmacokinetics in neonates.

Theophylline may be administered by several routes, but problems are associated with neonatal dosing. The transdermal route may provide a safer and noninvasive method of administration, yet produce therapeutic concentrations in a consistent and reliable manner. To study the feasibility of this in the apnea of prematurity, stable neonates were administered a subtherapeutic transdermal dose for 24 hours in order to assess pharmacokinetics and bioavailability. This was followed with routine intravenous theophylline therapy according to institutional policy. Six of nine neonates had detectable serum theophylline concentrations that increased slowly after patch application. Mean (+/- SD) maximum serum concentration was 2.4 +/- 1.3 micrograms/ml, mean time to maximum serum concentration was 22 +/- 8.2 hours, and mean latency period was 8.0 +/- 4.9 hours. Mean total amount of theophylline delivered to the skin was 18.6 +/- 4.1 mg. Mean fractional absorption at 30 hours was 0.25 +/- 0.12. These data demonstrate that it is possible to produce systemic theophylline concentrations with a transdermal patch in preterm infants sufficient to study pharmacokinetics and bioavailability, and that transdermal delivery of therapeutic doses is technologically feasible.

Administration, Cutaneous↗