Alopecia areata (AA) is an organ-specific autoimmune disorder that targets anagen phase hair follicles. The course is unpredictable and current available treatments have variable efficacy. Nowadays, there is relatively little evidence on treatment of AA from well-designed clinical trials. Moreover, none of the treatments or devices commonly used to treat AA are specifically approved by the Food and Drug Administration. The italian Study Group for Cutaneous annexial disease of the italian Society of dermatology proposes these italian guidelines for diagnosis and

Background Antibiotic (AB) treatment is one of the first steps in the management of hidradenitis suppurativa (HS).Bacteria, in HS patients, may play a double role, as triggering factors of inflammatory reactions and/or agents of infection.Objectives The aims of this study are as follows: (i) to assess prevalence and AB resistance of bacterial growths in HS patients (ii) assessment of the clinical relevance of obtained data in guiding the selection of the most effective AB therapy.Methods Purulent material from 137 skin lesions of HS patients was collected with swabs. Bacterial flora and AB sensitivity were determined using microbiological cultures for aerobic and anaerobic bacteria. Results A total of 114 samples resulted positive for bacteria. Sample was collected from the axillae, groin and perianal areas. A total of 163 single bacterial growths were observed; 55% were Gram-positive and 44% were Gram-negative.Among them, 18.4% were anaerobic. The most frequent bacterial families included enterobacteriaceae (30.7%), Staphylococcus (25.2%) and Streptococcus (14.1%). The most frequent genus or species were proteus spp. (13.5%) andEscherichia coli (9.8%). The prevalence of AB resistance observed was clindamycin 65.7%, rifampicin 69.3%, penicillin 70.0%, ciprofloxacin 74%, tetracycline 84.7% and erythromycin 89.0%. A limitation of the study is represented the short culture period adopted which may have impaired the isolation of anaerobes.Conclusions Bacterial growth in HS patients has shown a high level of resistance to ABs, including rifampicin, clindamycin and tetracyclines, cited as an empiric choice in HS therapeutic guidelines. A targeted and specific AB therapy, driven by microbiological evaluations with prolonged culture periods, seems more appropriate than empiric, generic, non-specific, therapeutic approaches. Current knowledge regarding HS bacterial AB resistance should be considered in the update of current therapeutic guidelines for HS.

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journal/cod and insect bites. 6 The main components of lavender oil, that is, the terpenes linalool, linalyl acetate, and caryophyllene, have been shown to autoxidize, forming sensitizing hydroperoxides. 7 Pure lavender oil was shown to be a weak sensitizer, but the oxidized form was classified as a moderate allergen. Furthermore, essential oils are usually complex mixtures in which new sensitizing substances could form over time in chemical reactions between the components of the mixture; different sensitizers together could induce a stronger inflammatory reaction than a single one. 7,8 Identifying the responsible allergenic component of essential oils is difficult, and, moreover, cosensitization to multiple perfumes and essential oils is common. This may be explained by pseudo-cross-reactivity, cross-reactivity, or concomitant sensitization. 9 In our cases, the patients showed many allergies simultaneously; both of them were allergic to fragrance mix I. For this reason, it is important to advise patients who are allergic to perfumes to avoid "natural" products. A recent study showed that the prevalence of contact allergy to lavender was 2.2%, and that the three most frequent concomitant positive reactions were to fragrance mix I, fragrance mix II, and Myroxylon pereirae resin. 10 It is important to remember that the exposure to lavender could go unreported, because patients have the false belief that anything "natural" is "safe."

Adverse reactions to ecographic gels, mainly allergic contact dermatitis or contact urticaria, have been described in patients who undergo ultrasound procedures. This report describes 2 cases of occupational allergic contact dermatitis (OACD) in 2 obstetrical sonographers