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Biomedical subjects

Matilde Iorizzo

Publications and source records attributed to Matilde Iorizzo.

At least 19 recordsLinked to original sources
PubMed2006

Alopecia areata: a long term follow-up study of 191 patients.

BACKGROUND: The prognosis of alopecia areata (AA) is difficult to predict. Few studies report long-term follow-up of AA patients. OBJECTIVE: The purpose of this study is to better assess the long-term evolution of AA and the possible relationship between disease severity and treatment response with long-term prognosis. METHODS: One hundred ninety-one patients with AA who presented with a new diagnosis of AA between 1983 and 1990 were subsequently contacted by phone. Patients were queried regarding current disease status, treatments, and disease course. RESULTS: Severity of AA at first consultation ranged from mild (128 patients) to severe (63 patients). Fifty-five of 191 patients were affected by concomitant autoimmune or related inflammatory disease. Sixty-six of 191 patients were presently disease free (follow-up duration, 15-22 years; mean 17.74 years). These include 41 of 60 patients with S1 disease (68.3%), 22 of 68 patients with S2 disease (32.3%), 1 of 11 patients with S3 disease (9%), 1 of 14 patients with S4 disease (7.1%), and 1 of 11 patients with alopecia totalis (AT) (9.1%). Sixty-nine of 191 patients (36-1%) were presently affected by AT or alopecia universalis. There was a statistically significant tendency of severe patterns of AA to worsen over time. In children, 18 of 39 (13 with < or =S2 disease and 5 with > or =S3 disease) with AA had developed AT or alopecia universalis at long-term follow-up. In children, however, this trend was not statistically significant. Patients with severe AA who responded to topical immunotherapy seem to have a better prognosis than nonresponders. LIMITATIONS: Follow-up was only performed by phone. CONCLUSIONS: Severity of AA at time of first consultation is an important prognostic factor. Response to therapy (topical immunotherapy) may be associated with better prognosis. In children, the prognosis is worse; our study found that AA worsens over time.

Administration, Topical↗
PubMed2006

Finasteride treatment of female pattern hair loss.

OBJECTIVE: To evaluate the efficacy of oral finasteride therapy associated with an oral contraceptive containing drospirenone and ethinyl estradiol in premenopausal women with female pattern hair loss. SETTING: Outpatient consultation for hair disorders at the Department of Dermatology, University of Bologna. PATIENTS AND INTERVENTION: Thirty-seven women with female pattern hair loss were treated with oral finasteride, 2.5 mg/d, while taking an oral contraceptive containing drospirenone and ethinyl estradiol. Treatment efficacy was evaluated using global photography and the hair density score from videodermoscopy. A self-administered questionnaire was used to assess patient evaluation of treatment effectiveness. RESULTS: At 12-month follow-up, 23 of the 37 patients were rated as improved using global photography (12 were slightly improved, 8 were moderately improved, and 3 were greatly improved). No improvement was recorded in 13 patients. One patient experienced worsening of the condition. There was a statistically significant (P = .002) increase in the hair density score in 12 patients. No adverse reactions to the drug were reported. CONCLUSIONS: Sixty-two percent of the patients demonstrated some improvement of their hair loss with the use of finasteride, 2.5 mg/d, while taking the oral contraceptive. It is unclear whether the success was due to a higher dosage of finasteride (2.5 mg instead of 1 mg) or to its association with the oral contraceptive containing drospirenone, which has an antiandrogenic effect. Further studies are necessary to understand which patterns of female pattern hair loss respond better to this treatment.

5-alpha Reductase Inhibitors↗
PubMed2006

Drug-induced nail diseases.

Although many nail disorders have been associated with drug intake, most reports are anecdotal. Most nail changes caused by drugs are the outcome of acute toxicity to the nail epithelia; nail symptoms depend on which nail structure is damaged. The most com-mon symptoms include Beau's lines/onychomadesis, melanonychia, onycholysis, and periungual pyogenic granulomas. Drug-induced nail abnormalities are usually transitory and disappear with drug withdrawal, but sometimes persist over time. This article reviews drugs that have been consistently associated with nail abnormalities.

Adrenergic beta-Antagonists↗
PubMed2006

The nail in systemic diseases.

Although abnormalities of the nails have been reported in different systemic disorders,most of these abnormalities are nonspecific. This article reports and discusses only those nail signs that provide the clinician with clues for the diagnosis of systemic disorders.

Cardiovascular Diseases↗
PubMed2006

Efficacy and safety of a new clobetasol propionate 0.05% foam in alopecia areata: a randomized, double-blind placebo-controlled trial.

BACKGROUND: Clinical efficacy of topical corticosteroids in alopecia areata (AA) is still controversial. Positive clinical results have been obtained using ointments with occlusive dressing but this approach has a low patient compliance. Recently, a new topical formulation (thermophobic foam: Versafoam) of clobetasol propionate 0.05% has been introduced on the market (Olux, Mipharm, Milan, Italy) (CF). This formulation is easy to apply. After application to the skin the foam quickly evaporates without residues and it has a good patient compliance. In vitro studies have also shown that this formulation enhances the delivery of the active compound through the skin. AIM: To evaluate the efficacy, safety and tolerability of CF in the treatment of moderate to severe AA. SUBJECTS AND METHODS: Thirty-four patients with moderate to severe AA (eight men, mean age 40+/-13 years) were enrolled in a randomized, double-blind, right-to-left, placebo-controlled, 24-week trial. Alopecia grading score (AGS) was calculated at baseline and after 12 and 24 weeks of treatment using a 0-5 score (0=no alopecia; 5=alopecia totalis). Clobetasol foam and the corresponding placebo foam (PF) were applied twice a day for 5 days/week for 12 weeks (phase 1) using an intrapatient design (right vs. left). From weeks 13 to 24 each enrolled patient continued only with the treatment (both on the right and left site) that was judged to have a greater efficacy than that on the contralateral side (phase 2). The primary outcome of the trial, evaluated on an intention-to-treat basis, was the hair regrowth rate, which was evaluated using a semiquantitative score (RGS) (from 0: no regrowth, to 4: regrowth of 75%). RESULTS: At baseline the AGS was 4.1 (range: 2-5). Nine (26%) patients prematurely concluded the trial. At the end of phase 1, a greater hair regrowth was observed in 89% of the head sites treated with CF vs. 11% in the sites treated with PF. The RGS was 1.2+/-1.6 in the CF-treated sites and 0.4+/-0.8 in the PF-treated sites (P=0.001). A RGS of 2 (hair regrowth of more than 25%) was observed in 42% CF-treated sites and in 13% of PF-treated sites (P=0.027). In seven subjects (20%) a RGS of 3 to 4 (hair regrowth of 50%) was observed in CF-treated sites. In three subjects (9%) a RGS of 4 (hair regrowth of 75%) was observed in CF-treated sites. In one patient only, in a PF-treated region, a RGS of 3 was observed. The AS was reduced to 3.8 by CF treatment at the end of phase 1 and to 3.3 at the end of phase 2 (P=0.01). From weeks 12 to 24 the treatment with CF induced a further increase in the RGS (from 1.2 to 1.5+/-1.4). Forty-seven per cent of CF-treated patients had a RGS of 2 at the end of the trial. A total of eight patients (25%) at the end of the treatment with CF showed a RGS of 3. Folliculitis occurred in two patients. No significant modifications in cortisol and ACTH blood levels were observed during the trial. CONCLUSION: This new formulation of clobetasol propionate foam is an effective, safe and well-tolerated topical treatment for AA. This formulation has a good cosmetic acceptance and patient compliance profile.

Administration, Topical↗
PubMed2005

Frontal fibrosing alopecia in postmenopausal women.

BACKGROUND: Frontal fibrosing alopecia is a variety of cicatricial alopecia characterized by a band of frontal/frontoparietal hair recession and marked decrease or a complete loss of the eyebrows, typically observed in women who are postmenopausal. OBJECTIVE: The purpose of this study was to report clinical and histopathologic findings and results of treatment in a group of women affected by the disease. METHOD: A total of 14 women with alopecia of the frontal hairline were evaluated from June 2000 through July 2003 in our outpatient consultation for hair disorders. RESULTS: Clinical examination revealed a band of symmetric recession of the frontoparietal hairline extending to the preauricular areas associated with loss of follicular orifices, mild skin atrophy, and perifollicular erythema at the scalp margin. In all, 9 patients also had partial or total loss of the eyebrows. The histologic features of the scalp specimens were similar in all our patients with a reduction of the number of hair follicles, and a high number of intermediate and velluslike follicles. Intemediate and velluslike follicles were more commonly affected than terminal follicles by the lymphocytic inflammatory infiltrate and perifollicular fibrosis. CONCLUSION: Frontal fibrosing alopecia is a cicatricial alopecia that follows destruction of hair follicles by an inflammatory lymphocytic infiltrate that is localized around the upper portion of the hair follicle. It differs from lichen planopilaris because the lymphocytic infiltrate and fibrosis affect selectively the intermediate and the velluslike follicles of the frontal margin and eyebrows. The reason for this selective involvement is still unknown. Frontal fibrosing alopecia may represent a variety of lichen planopilaris with selective involvement of certain androgen-dependent areas. The affected follicles may have typical biologic markers that could explain the clinical and histologic features found in the disease. It is interesting to note that some of the patients treated with finasteride (2.5 mg/d) showed an arrest in the progression of the disease. Even if there is no proof for a hormonal basis of the disease, the effectiveness of finasteride in some patients may indicate that androgens might be partially responsible of the pathogenesis of the disease.

Aged↗
PubMed2005

Congenital pseudoclubbing of a fingernail caused by subungual hemangioma.

BACKGROUND: Nail dystrophies in newborns are rare and are particularly frightening when they appear as masses involving a single digit, suggesting the possibility of a tumor. OBJECTIVE: The aim of this study is to report 3 infants with a congenital pseudoclubbing appearance of a digit and with a reddish discoloration caused by the presence of a subungual hemangioma. METHODS: Diagnosis was based on clinical examination and ultrasonography. RESULTS: Clinical presentation and vitrocompression showed the presence of a vascular mass. Ultrasonography confirmed the diagnosis of a subungual hemangioma. The lesions showed a spontaneous regression on follow-up. CONCLUSION: Localization of hemangioma under the proximal nailfold is extremely rare and produces nail pseudoclubbing caused by capillary vessel proliferation in the soft tissue of the subungual region, which is associated with a reddish discoloration of the nail that typically fades with compression. Hemangiomas of infancy located in the proximal nailfold are rare, and, in our opinion, not at risk to become big masses with tissue damage and compression.

Female↗
PubMed2005

Treatment of onychomycosis with oral antifungal agents.

Onychomycosis is the most common nail disease and describes the invasion of the nail by fungi. Different clinical patterns of infection depend on the way and the extent by which fungi colonise the nail: distal subungual onychomycosis, proximal subungual onychomycosis, white superficial onychomycosis, endonyx onychomycosis and total dystropic onychomycosis. The type of nail invasion depends on both the fungus responsible and on host susceptibility. Treatment of onychomycosis depends on the clinical type of the onychomycosis, the number of affected nails and the severity of nail involvement. The goals for antifungal therapy are mycological cure and a normal looking nail. In this paper the treatment of onychomycosis with oral antifungal agents will be reviewed.

Administration, Oral↗
PubMed2005

The disappearing nail bed: a possible outcome of onycholysis.

Onycholysis is a separation of the nail plate from the underlying and/or lateral supporting structures (hyponychium, nail bed, lateral nail folds). It is a commonly seen disorder that is usually asymptomatic. We have observed a number of cases of onycholysis in which the distal nail bed appeared to shrink. The nail bed becomes keratinized and produces dermatoglyphics like the normal tip of a digit. This may explain why it is difficult to promote reattachment. If onycholysis persists, the condition is more likely to become irreversible and form the "disappearing nail bed." The best chance of resolving onycholysis is to try to identify the causative agent and institute early therapy.

Epidermis↗
PubMed2004

Drug-induced nail abnormalities.

A large number of drugs may be responsible for the development of nail changes, including cancer chemotherapeutic agents and retinoids, however, only a few classes of drugs are consistently associated with nail symptoms. Drug-induced nail abnormalities result from toxicity to the matrix, the nail bed, the periungual tissues or the digit blood vessels. The most common symptoms include Beau's lines, onychomadesis, melanonychia, onycholysis and periungual pyogenic granulomas. Drug-induced nail changes usually involve several or all of the nails. In most cases, nail abnormalities are asymptomatic, but can sometimes cause pain and impair manual activities.

Drug-Related Side Effects and Adverse Reactions↗
PubMed2003

Management of onychomycosis in children.

Terbinafine, itraconazole, and fluconazole are effective and well tolerated for treating onychomycosis in children. Dosage depends on body weight. Duration of treatment is the same for adults.

Antifungal Agents↗
PubMed2003

Treatment of nondermatophyte mold and Candida onychomycosis.

Mold onychomycosis often can be clinically suspected because of the presence of periungual inflammation. Treatment with systemic antifungals is very effective in onychomycosis caused by Aspergillus sp. Scopulariopsis brevicaulis and Fusarium sp. infection are difficult to eradicate and treatment with systemic antifungals should always be associated with topical treatment with nail lacquers. Candida onychomycosis is always a sign of immunodepression. Systemic treatment with itraconazole or fluconazole is usually effective, but relapses are very common.

Administration, Cutaneous↗
PubMed2003

Drug-induced nail abnormalities.

This article reviews the different nail symptoms produced by drugs. Drug-induced nail abnormalities may result from toxicity to the matrix, the nail bed or the periungual tissues. The most common symptoms include Beau's lines/onychomadesis, melanonychia, onycholysis, and periungual pyogenic granulomas. Nail changes usually affect several nails and in most cases are asymptomatic. Drugs that most frequently produce nail abnormalities include retinoids, indinavir, and cancer chemotherapeutic agents. In this article, we also include nail adverse effects as a result of radiotherapy since they are commonly observed in clinical practice.

Humans↗