BackgroundPsoriasis largely affects daily activities and social interactions and has a strong impact on patients’ quality of life. Psoriatic patients have different attitudes toward their condition. Topical medications are essential for the treatment of psoriasis, but the majority of patients do not adhere to these therapies.ObjectiveThe history of treatment success or failure seems to influence patient attitude toward topical therapy. Therefore, it is important to understand the psychological, experiential, and motivational aspects that could be critical for treatment adherence, and to describe the different attitudes toward topical treatment. Furthermore, the physician–patient relationship and the willingness to trust the dermatologist may have a substantial role in encouraging or discouraging patients’ attitudes toward topical therapy.MethodsA survey was designed to collect aspects that could be relevant to understanding different patient attitudes toward psoriasis and its treatments. A total of 495 self-administered questionnaires compiled by psoriatic patients were analyzed from 20 Italian specialized hospital centers in order to provide a nationwide picture.ResultsPsoriatic patients have different perceptions and experiences in relation to their condition: half of them consider psoriasis as a disease, while the other half consider psoriasis as a disorder or a nuisance. Topical therapy is the most widely used treatment, even though it is not considered the most effective one and often perceived to be cosmetic. The main findings are: 1) inadequate patient education about this disease, 2) lack of information about topical treatment, and 3) lack of results within the expected time frame. Furthermore, physicians need to build a good relationship with psoriatic patients in order to motivate them, to trust in their care, and to adhere to treatment.ConclusionThis survey adds new and important details about daily life and well-being and the needs of psoriatic patients, providing suggestions for dermatologists to improve patients management.

Jejunal biopsies from patients with either dermatitis herpetiformis or coeliac disease were freeze-fractured and compared with normal jejunal biopsies. The intestinal mucosa of the normal biopsies showed a normal structure, with well-developed and tightly packed microvilli; in dermatitis herpetiformis and coeliac disease degenerative changes of the intestinal mucosa occurred. These changes appeared to be segmental in dermatitis herpetiformis and diffuse in coeliac disease. Emphasis is placed on changes in the tight junctional net at the base of the microvilli, which could represent cellular damage related to increased intestinal permeability to macromolecules in these diseases. An interpretative hypothesis for these observations is presented.

The authors report on the membrane alterations induced in vitro in dermatophytes and yeasts by the action of ciclopiroxolamine. The investigation was performed by means of the freeze-fracture technique and revealed modifications in particle distribution on the plasma membrane of both dermatophytes and Candida albicans; moreover, in the latter, the characteristic furrows observed on the P face showed a peculiar re-arrangement.The results were compared with those already known, obtained with other antimycotic drugs employing the same technique, and a correlation of the observed differences with the peculiar mode of action of this new antimycotic drug has been made.Zusammenfassung: Die Autoren berichten uber die Wirkung von Ciclopiroxolamin bei in vitro an Dermatophyten und Hefen induzierten Membran-Veriinderungen. Die Untersuchung wurde mit der Freeze-Fracture-Technik durchgetiihrt und zeigte Veriindemgen in der Partikel-Verteilung aufder plasmatischen Membran sowohl der Dermatophyten als auch bei Candidaalbicans; dariiber hinaus wiesen bei Candida albicans die charakteristischen Furchen, die sich auf der P-Flache befmden, eine besondere Neuanordnung auf.Diese Ergebnisse wurden mit den schon bekannten Erkenntnissen, die durch die gleiche Technik, jedoch mit anderen Antimykotika erzielt wurden, verglichen.Die gefundenen Unterschiede werden mit dem besonderen Wukuilgsmechanismus dieses neuen Antimykotikums in Zusammenhang gebracht. mykosen 29, No. 11 (1986)