Cutaneous and plasma fibrinolytic activities are not deficient in patients with systemic sclerosis.
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Endothelium, Vascular↗
Biomedical subjects
T Lotti
Publications and source records attributed to T Lotti.
Why should we use PUVA treatment in pigmented purpuric lichenoid dermatitis?
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Adult↗
Chronobiology, fibrinolysis, and systemic sclerosis.
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Circadian Rhythm↗
Treatment of aquagenic pruritus with topical capsaicin cream.
BACKGROUND: Aquagenic pruritus is characterized by pruritus after contact with water; there are no objective cutaneous changes. Capsaicin, which induces the release of neuropeptides from A delta and C cutaneous nerve fibers, has been successfully used in the treatment of several dermatoses associated with pruritus. Among the many different neuropeptides present in human skin, the undecapeptide substance P has been shown to cause pruritus. OBJECTIVE: We evaluated the clinical effect and searched for alterations in cutaneous neuropeptidergic fibers before and after treatment with capsaicin cream. METHODS: Five patients with aquagenic pruritus were treated with capsaicin cream 0.025%, 0.5% or 1.0% three times daily for 4 weeks. Direct immunofluorescence (DIF) was performed before and after treatment to evaluate the storage of neuropeptides in the A delta and C type cutaneous nerve fibers. RESULTS: Before treatment (when by DIF the neuropeptidergic fibers appeared filled with neuropeptides), contact with water consistently provoked itching. After capsaicin treatment (when by DIF the neuropeptidergic fibers were depleted of neuropeptides), contact with water did not evoke pruritus. Areas of skin treated with the vehicle alone showed no clinical improvement or change in neuropeptide content. CONCLUSION: This study suggests that neuropeptides, including substance P, may contribute to mediating the itch in aquagenic pruritus.
Administration, Topical↗
Aquagenic pruritus, PUVA and capsaicin treatments.
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Capsaicin↗
The purpuras.
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Blood Coagulation Disorders↗
Hyaluronic acid in cutaneous intrinsic aging.
BACKGROUND: In elderly individuals all components of the skin and subcutaneous tissue undergo histologic and ultrastructural changes. The turgidity of the dermis appears decreased, presumably due to altered patterns and levels of glycosaminoglycans (GAGS), especially hyaluronic acid and dermatan sulfate that are the most common. A linear, age-related decrease in the content of GAGS (mainly hyaluronic acid) has been hypothesized in human aged skin. METHODS: We used the cationic dye Alcain Blue to selectively stain hyaluronic acid within the dermis in old and young subjects to compare ultrastructurally its topography and variations with age. RESULTS: We demonstrated a progressive reduction in the number of electron-dense granules of hyaluronic acid and of their filaments until they were completely absent in subjects aged 60. CONCLUSIONS: We propose that the variations of the levels of hyaluronic acid in the dermis in aging could account for some of the most striking alterations of the aged skin, including decreased turgidity, less support for microvessels, wrinkling, and altered elasticity.
Adult↗
Ultrastructural study of hyaluronic acid before and after the use of a pulsed electromagnetic field, electrorydesis, in the treatment of wrinkles.
BACKGROUND: Treatment of wrinkles has become an increasing problem for dermatologists. Hyaluronic acid is a component of the family of glycosaminoglycans (GAGS, substances known for their property of retaining water), that significantly decreases with aging and in wrinkles. A new technique that uses a specific pulsed electromagnetic field, electrorydesis, has been introduced in the treatment of wrinkles associated with aging. The treatment is based on the reported in vitro effects of specific electromagnetic fields on fibroblast cultures (e.g., an increase in DNA synthesis and in the production of collagen and presumably also of GAGS). METHODS: The in vivo effects of the electromagnetic field on aged skin (3 subjects aged 50, 56 and 60 years), with particular focus on the ultrastructural modifications and GAGS amount before and after the treatment, were evaluated by electron microscope. RESULTS: The ultrastructural study (tissue stained with alcian blue) showed after treatment a significant increase (p < 0.005) of the electron-dense granules (corresponding to hyaluronic acid), located in collagen elastic fibers, and in the soluble matrix. This presumably leads to subsequent edema that was clinically evident after the treatment. CONCLUSIONS: These data suggest that the increased levels of GAGS and the subsequent edema of the dermis could explain at least in part the clinical changes observed after electrorydesis treatment (e.g., swelling and "disappearance" of the wrinkle).
Electromagnetic Fields↗
alpha-Interferon cream restores decreased levels of Langerhans/indeterminate (CD1a+) cells in aged and PUVA-treated skin.
Langerhans/indeterminate (CD1a+) cells are known for their role in stimulating T-lymphocyte-dependent immune reactions. They are normally present in the skin and are modified in a variety of different pathological and physiological events, including aging. Linear decrease of CD1a+ cells with aging (both true aging and photoaging) is considered the most important cause of reduced immunosurveillance in aged old skin of the elderly. Recently it has been suggested that alpha-interferon might have an effect on increasing levels of dendritic cells in aged and photoaged skin. We studied biopsies from the preauricular area in 15 subjects (5 subjects aged 18-21 years, 5 aged 57-75, and 5 aged 30-45 who underwent PUVA therapy, total irradiation 120 J/cm2) before and after the application of alpha-interferon cream. Our findings show that dendritic cells are significantly decreased in the 57- to 75-year-old group compared to the 8- to 21-year-old group. After PUVA therapy we also found a decrease in Langerhans cells. Our study shows that the application of alpha-interferon cream induces an increase in cutaneous CD1a+ cells and HLA-DR+ cells in both older subjects and subjects who have undergone PUVA therapy. On the basis of these results, one could hypothesize that alpha-interferon cream may have some beneficial effects on photoaging-reduced immunosurveillance.
Administration, Topical↗
Microstructural disorders of tunica albuginea in patients affected by impotence.
The role played by the tunica albuginea in the erection mechanism seems to be very significant in promoting the constriction of sub-albugineal venous reticulum and trans-albugineal effluent veins, as well as providing an inextensible protective structure to the arteriolae and to the intracavernous nerves. The passive function exerted by the tunica albuginea is a result of its structure, which is rich in collagenic fibers, linked by elastic fiber bridges. The presence of structural disorders in the tunica albuginea of 16 patients suffering from psychogenic, arteriogenic and venogenic impotence is evaluated. The results obtained show a significant decrease in elastic fibers in the tunica albuginea of impotent patients compared to a control group of 5 patients with normal erection activity. This structural disorder could result in tunica albuginea alteration and, therefore, in erection insufficiency.
Adult↗
Atypical mycobacterial infections of the skin.
The term nontuberculosis mycobacteria or environmental mycobacteria should now be used rather than atypical mycobacteria. This article reviews the epidemiology and prevalence of the infections in humans as well as classifies them into four groups.
Humans↗
[Imaging diagnosis of non-lymph node metastasis of bladder carcinoma].
Assessment of presence of metastatic disease (m.d.) in bladder cancer (b.c.) can represent a main problem as influencing the appropriate therapeutic policy (mostly the indication to radical surgery). Evaluation of the real cost-effectiveness ratio of radiographic and radionuclide diagnostic work-up induced us to retrospectively review historical data about our b.c. patients (pts). From March 1988 to June 1991, 76 not consecutive pts with histologically proven bladder cancer were included in this study. 5 Pts were staged as T1, 25 as T2, 18 as T3a, 23 as T3b, 5 as T4. 2 Pts were graded as G1, 27 as G2, 44 as G3, 3 as Gx. Age varied from 39 to 89 years (average: 62.3). 79 Pts underwent the "basic work-up" (including chest plain film, bone and liver scans) and at least one follow-up control. 266 chest plain films, 22 chest x-ray tomograms, 2 chest CT scans, 27 bone x-ray tomograms, 231 bone scans, 240 liver scans, 17 liver ultrasonographies were totally realized. All pts underwent at least an abdomen-pelvic CT, but related results are not considered in the study. Fine needle aspiration cytologic biopsies were realized in selected cases; also these results are not selectively reported here. Together with cytologic positive results, only progression of m.d. was considered as its definite presence. Conventional x-ray examination (plain film integrated by x-ray tomograms of "suspicious" findings) resulted sufficiently complete and accurate to reveal chest m.d. Concerning skeletal diagnostic survey, only 6 pts (26%) out of 23 pts with "positive" bone scans really resulted affected by m.d.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Treatment of psoriasis vulgaris with topical calcipotriol: is the clinical improvement of lesional skin related to a down-regulation of some cell adhesion molecules?
Calcipotriol is demonstrably efficacious for the treatment of psoriasis by virtue of its effects on the skin's immune system and on epidermal growth. We performed this study to emphasize the difference in the expression of certain cell adhesion molecules (CAMs) (ICAM-1, ELAM-1, LFA-1, VLA-3, VLA-6) in lesional and perilesional skin of 10 patients with psoriasis, before and after treatment with topical Calcipotriol. We took two biopsies of lesional and perilesional skin from each patient before and after treatment and then performed an immunohistochemical study to observe the expression of these CAMs, utilizing monoclonal antibodies against these adhesion molecules. We noticed reduced levels of infiltrating cells along with the expression of ICAM-1, LFA-1, ELAM-1 and of CAMs VLA-3, VLA-6 in basal and suprabasal keratinocytes. On the basis of these data we hypothesize that, besides epidermal keratinocytes, another target for Calcipotriol may be the skin's own immune system, suggesting that Calcipotriol can modify T lymphocyte activity (IL-1 dependent) through a down-regulation of CAMs.
Administration, Topical↗
Microstructural disorders of tunica albuginea in patients affected by Peyronie's disease with or without erection dysfunction.
Peyronie's disease, the etiology of which remains unknown, is characterized by a focal or multifocal disorder of penile tunica albuginea. An excessive collagen deposition gives rise to the formation of the plaque, which is fibrotic first and then becomes calcific. Typical symptoms of the disease are painful erection, pathological bending of the erect penis and impotence at the more advanced stages (43% of the cases). There is evidence that the tunica albuginea has a fundamental role in the erection mechanism. We evaluated the tunica albuginea of patients suffering from Peyronie's disease, with or without impotence, and found progressive disorders of the microstructure in areas that were not affected by fibrocalcific formations. There was a significant decrease (p < 0.0001) of elastic fiber concentration (55.05 +/- 23.83 per high power field) in patients with Peyronie's disease compared to the concentration in the tunica albuginea of a control group (128.50 +/- 11.79 per high power field). Moreover, when the elastic fiber concentration in the tunica albuginea of patients Peyronie's disease and normal erection (71.36 +/- 12.00 per high power field) was compared to the concentration in the tunica albuginea of those with Peyronie's disease and impotence (33.14 +/- 4.84 per high power field) a significant difference was noted (p < 0.0001).
Biopsy↗
Evaluation of penile deep arteries in psychogenic impotence by means of duplex ultrasonography.
Echo Doppler flowmetric investigation in patients with erectile insufficiency represents an effective method for hemodynamic evaluation of the penis. The detection of referential standard parameters is helpful to understand the pathogenesis of the disease, since patients with erectile insufficiency due to psychogenic factors cannot be distinguished from normal subjects by means of current diagnostic techniques. Echo Doppler flowmetry applied to rigorously selected subjects with psychogenic impotence allowed for detection of hemodynamic parameters in the penis after corpora cavernosa stimulation with 10 micrograms. prostaglandin E1. Flowmetric investigation was performed only on the deep cavernous artery, since it is well known that the penile dorsal artery does not undergo hemodynamic alterations after stimulation with drugs. A statistically meaningful difference existed between the systolic flow in the psychogenic impotence subjects (group 1) and the controls (group 2, p < 0.0001). In the same manner, the diastolic flows (right and left cavernous arteries, p < 0.0002 and p < 0.0001, respectively) and diameter increase rates of the investigated arteries following stimulation were also different. According to these results, echo Doppler flowmetry could represent the only instrumental method able to detect patients with psychogenic impotence.
Adult↗
Recalcitrant pyoderma gangrenosum responsive to cyclosporine.
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Adolescent↗
Mesoglycan treatment restores defective fibrinolytic potential in cutaneous necrotizing venulitis.
BACKGROUND: Cutaneous necrotizing venulitis (CNV) is a clinical disorder associated with segmental inflammation and fibrinoid necrosis of the dermal venules. It usually presents clinically as palpable purpura, even sometimes as nodules, bullae, ulcers, and urticarial lesions. This form, when showing as leukocytoclastic vasculitis is apparently characterized by the tissue deposition of circulating immune complexes and by reduced cutaneous (CFA) and plasma (PFA) fibrinolytic activity due to reduced release of plasminogen activator (PA) from the venular endotheliocytes. Reduced CFA and PFA cause large amounts of fibrin deposits in both intra- and perivascular areas, which are able to magnify and self perpetuate the inflammatory processes following immune complex deposition. METHODS: We have studied both the PFA and CFA potential (the maximum amount of PA released in the skin after certain stimuli) and the deposits of immunoglobulins, C3, and fibrin related antigen, before and after intradermal injection of histamine (a substance able to provoke endothelial release of PA), in three subjects affected by CNV before and 20 days after 10 mg/kg/day I.M. treatment with the fibrinolytic agent mesoglycan. RESULTS: Cutaneous fibrinolytic activity and CFA potential, reduced prior to treatment, was normal after treatment, while the deposits of immunoglobulins (IgA, IgG and IgM), C3, and fibrin related antigen, detected with direct immune fluorescence (DIF) showed similar findings before and after treatment. CONCLUSIONS: These data suggest that reduced CFA may play a major role in the pathogenesis of the immunologically mediated injury in CNV. The intraperivascular deposition of fibrin is favored. The fibrinolytic agent mesoglycan seems effective in restoring defective fibrinolysis in patients affected by cutaneous necrotizing venulitis, suggesting that in cases with reduced cutaneous fibrinolytic activity (or potential) the use of a fibrinolytic agent should be considered.
Adult↗