Bullous cutaneous larva migrans: Case series and review of atypical clinical presentations Stefano Veraldi, Ermira Çuka, Paolo Pontini, Fabrizio Vaira Giornale Italiano Di Dermatologia E Venereologia, 2017 Hookworm-related cutaneous larva migrans (HRCLM) is caused by the penetration and migration in the epidermis of larvae of Ancylostoma braziliense and Ancylostoma caninum. It is characterized by slightly raised and erythematous tracks, located especially on the feet. These tracks may be single or multiple, serpiginous or linear, ramified and intertwined, accompanied by pruritus. Atypical clinical presentations of HRCLM are currently more frequent than in the past. We present six patients with bullous HRCLM and discuss the possible pathogenetic factors. Furthermore, we present a review of atypical clinical presentations of HRCLM. From 1998 to 2013 we observed approximately 180 patients with HRCLM. In all patients race, nationality, sex, age, country of infestation, location of the disease, clinical picture, laboratory and instrumental examinations and therapy were collected. In six patients (4 males and 2 females), we made a diagnosis, based on the history and clinical picture, of bullous HRCLM. The infestation was characterized by single or multiple blisters, round or oval in shape, of different size, with a clear serous fluid. Some tracks were also visible. All patients complained of pruritus. General physical examination and laboratory and instrumental examinations were normal or negative. Cytological examinations of the blisters showed the presence of lymphocytes and neutrophils, with numerous eosinophils. All patients were successfully treated with oral albendazole. Blisters appear because of the release by the larvae of lytic enzymes (metalloproteases and hyaluronidases). Furthermore, blisters might be the final clinical result of a delayed hypersensitivity reaction due to the release by larvae of unknown antigens. Finally, only in some patients, bullous HRCLM might represent an acute irritant/allergic contact dermatitis caused by topical drugs applied on the lesions. This hypothesis has been excluded in our patients because no topical treatment was made before our observation.
Bullous tungiasis Giornale Italiano Di Dermatologia E Venereologia, 2016
Cutaneous larva migrans Stefano Veraldi, Ermira Çuka, Fabrizio Vaira Dermatological Cryosurgery and Cryotherapy, 2016 Cutaneous larva migrans (CLM) is an infestation caused by penetration and migration in the epidermis of larvae of nematodes. Ancylostoma braziliense and Ancylostoma caninum are the species most frequently involved. CLM is characterized by slightly raised and erythematous tracks, very often accompanied by pruritus. CLM can sometimes heal spontaneously; on the other hand, a clinical variety characterized by a very long clinical course has been described. Most used therapies are cryotherapy, topical thiabendazole and oral albendazole and ivermectin.
Mycobacterium marinum skin infection in a sushi cook Giornale Italiano Di Dermatologia E Venereologia, 2016
Risk of radiation-induced skin neoplasms after radiotherapy for cutaneous malignant tumors: A study on 5875 patients Giornale Italiano Di Dermatologia E Venereologia, 2015
Impetigo Stefano Veraldi, Ermira Çuka European Handbook of Dermatological Treatments Third Edition, 2015
Radiotherapy of morphea-type basal cell carcinoma: Results in 127 cases M. Caccialanza, R. Piccinno, E. Çuka, S. Alberti Violetti, M. Rozza Journal of the European Academy of Dermatology and Venereology, 2014 BackgroundThe morphea‐type basal cell carcinoma (MBCC) is a rare form of basal cell carcinoma (BCC) with lower response to treatments than other types of BCC.ObjectiveTo evaluate the role of radiotherapy (RT) in the therapeutic strategy of MBCC.MethodsA retrospective study was performed on 127 patients affected with MBCC, who underwent RT in the period 1982–2013. RT was delivered with conventional energies ranging from 50 to 120 kV and the administration of a total dose ranging from 40 to 70 Gy (mean 56.17 Gy). The irradiated fields included a margin of 1.5 cm around the lesion.ResultsThe median follow‐up time was 29 months (range 1–324 months). Complete remission was observed in 122 patients (96.06%), partial remission in one (0.78%). Three cases were non‐responsive (2.36%). In one case (0.78%), the lesion failed to heal after RT, since the onset of radiodermatitis histologically ascertained. The cure rate was 81.08% after 5 years and 78.02% after 10 years from the end of RT. Twelve cases relapsed (10.2%).ConclusionBecause of the frequent diagnostic delay and its ill‐defined margins, MBCC is difficult to cure. Our results after 5 years from RT (cure rate 81.08%) are more satisfactory respect to the others reported in the literature (69% and 72.3%), but less good than those obtained in other forms of primary malignant neoplasms of the skin (92.43%). Nevertheless, we consider that RT plays an important role in the therapeutic strategy of MBCCs. In fact, it can be applied easily in elderly patients, and in peculiar localization of the disease (eyelid, nose and ear), without being invasive.
Treatment of sporotrichoid fish tank granuloma with pulsed clarithromycin Stefano Veraldi, Ermira Çuka, Gianluca Nazzaro Dermatology, 2014 Background: There is no established therapy of choice for Mycobacterium marinum skin infections; clarithromycin monotherapy was used in some anecdotical cases at changeable daily doses and length. Objective: To evaluate the efficacy and safety of pulsed clarithromycin monotherapy. Methods: 29 patients with a clinical diagnosis of sporotrichoid fish tank granuloma were admitted from 2002 to 2013. In 14 patients, the clinical diagnosis was confirmed by history, histopathology and bacteriological examinations. All patients were treated with clarithromycin (500 mg/day for 10 consecutive days/month for 5 months). Results: In 12 out of 14 patients (85.7%) complete clinical remission was recorded. Two patients showed partial remission after 3 months of therapy, but they were lost to follow-up and were therefore not considered evaluable. Conclusion: Our study suggests that pulsed clarithromycin monotherapy is effective and safe in sporotrichoid M. marinum skin infections.
Scabies acquired in Chinese massage centers Giornale Italiano Di Dermatologia E Venereologia, 2014
Staphylococcus aureus infection of the feet following fish pedicure S. Veraldi, G. Nazzaro, E. Çuka Infection, 2014 We report a case of Staphylococcus aureus infection of the feet that appeared after a “fish pedicure” (immersion of the feet in a tank with the fish Garra rufa, that nibbles off dead skin). Clinical picture was characterized by maceration, purulent discharge, scales, crusts, itching and burning sensation. Bacteriological examinations were positive for Staphylococcus aureus. Mycological examinations were negative. The patient was successfully treated with ciprofloxacin. Only one case of skin foot infection after fish pedicure was reported so far. Fish pedicure can be a potentially dangerous procedure in immunocompromised or diabetic patients.
Anthrax of the lower lip Stefano Veraldi, Gianluca Nazzaro, Ermira Çuka, Lorenzo Drago Oral Surgery Oral Medicine Oral Pathology and Oral Radiology, 2013
