Line-field confocal optical coherence tomography of xanthogranuloma: Correlation with vertical and horizontal histopathology

Line‐field confocal optical coherence tomography (LC‐OCT) is a new noninvasive technique for a real‐time, vertical, and horizontal imaging of the skin at cellular resolution. A 47‐year‐old female presented with a 6‐month history of an asymptomatic yellowish papule. LC‐OCT evaluation was able to show the diagnostic microscopic features of xanthogranuloma and showed an excellent correlation with vertical and horizontal histopathological sections by revealing enlarged dermal papillae containing multiple, bright roundish giant cells, corresponding to foamy histiocytes, and giant cells characterized by a dark center surrounded by a highly hyper‐refractile peripheral ring, corresponding to Touton cells. LC‐OCT may represent a valid, noninvasive alternative to histopathological examination in clinically atypical cases of xanthogranuloma.

A novel treatment of diaper dermatitis in children and adults

Background

Diaper dermatitis (DD) is an acute inflammatory reaction, regardless of the cause, of the diaper‐covered area. Topical skin barrier repair cosmetic products are the mainstay treatment to cure and/or prevent DD.

Aims

To assess the efficacy/tolerability of a zinc gluconate‐taurine/zinc oxide and panthenol/ glycerin/ Butyrospermum parkii butter barrier cream using clinical evaluation.

Methods

In this prospective, open‐label trial, 20 patients (10 infants/10 adults), with mild/moderate DD enrolled at the Dermatology University Clinic of Catania (Italy) were instructed to apply the cream twice daily for 30 days. Degree of erythema was performed clinically by a 5‐point severity scale (from 0 = no erythema to 4 = severe erythema), at baseline, at 15 and 30 days. An Investigator Global Assessment (IGA) using a 6‐point scale (from −1 = worsening to 4 = complete response/clear) along with product tolerability was also performed at 15 and 30 days. Statistical analysis was performed using SAS version 9.

Results

At 15 days, a reduction of clinical erythema assessment (CEA) from baseline was observed (mean from 3.2 ± 0.8 to 2.5 ± 0.3; p < 0.06), that although nonsignificant, showed a significant progressive improvement at 30 days (mean from 3.2 ± 0.8 to 1.1 ± 0.9; p < 0.0001) without any age differences.

Conclusions

Our preliminary results indicate that the tested barrier cream may represent a promising approach in DD rash. It may be used in mild‐to‐moderate forms in monotherapy without significant side effects or, where required, in association with pharmacological agents. Its long‐term use is likely safe.

Clinical evidences of urea at low concentration

Urea is a hygroscopic molecule that, because of its moisturising properties, is topically used for the treatment of skin dryness at concentrations ranging from 2% to 12% in different formulations. Based on existing literature, low-concentration urea-containing products are effective in the treatment and/or prevention of xerosis in some skin disorders such as ichthyosis, atopic dermatitis and psoriasis, or unrelated to specific skin diseases. Generally, urea formulations at low concentration are well-tolerated and suited for the treatment of large skin areas, once or twice daily, even for a long period of time. At low concentrations stinging and burning sensation is rare and transient, whit no reported sensitisation despite its widespread use.