Summary Atopic dermatitis (AD) is a common disease affecting both children and adults. AD develops from a complex interplay between environmental, genetic, immunologic and biochemical factors. Genetic factors predispose atopic subjects to mount exaggerated Th2 responses and to a poorly efficient epidermal barrier, which may be sufficient to initiate inflammation in the skin and may favor allergic sensitization. Thus AD can present with different clinical pheno‐types. AD is classically distinguished into an intrinsic and extrinsic form, which are clinically identical but the former lacks high level specific IgE and is not associated with respiratory atopy. Although in many cases AD presents with monotonous eczematous lesions on the face, neck and skin folds, it may also present with other features. Very common is nummular eczema, which in many instances may be the dominant expression of AD. In other patients, AD affects limited areas (periorificial eczema, nipple eczema, cheilitis, hand eczema) or its main presentation is with excoriated papules and nodules (atopic prurigo). In conclusion, AD is a multifaceted disease affecting patients with epidermal barrier dysfunction and dry and sensitive skin. The recognition of the less common AD phenotypes is essential for proper patient management.

Atopic dermatitis (AD) is a common disease affecting both children and adults. AD develops from a complex interplay between environmental, genetic, immunologic and biochemical factors. Genetic factors predispose atopic subjects to mount exaggerated Th2 responses and to a poorly efficient epidermal barrier, which may be sufficient to initiate inflammation in the skin and may favor allergic sensitization. Thus AD can present with different clinical pheno-types. AD is classically distinguished into an intrinsic and extrinsic form, which are clinically identical but the former lacks high level specific IgE and is not associated with respiratory atopy. Although in many cases AD presents with monotonous eczematous lesions on the face, neck and skin folds, it may also present with other features. Very common is nummular eczema, which in many instances may be the dominant expression of AD. In other patients, AD affects limited areas (periorificial eczema, nipple eczema, cheilitis, hand eczema) or its main presentation is with excoriated papules and nodules (atopic prurigo). In conclusion, AD is a multifaceted disease affecting patients with epidermal barrier dysfunction and dry and sensitive skin. The recognition of the less common AD phenotypes is essential for proper patient management.

No abstract

Background: Topical retinoid and antibacterial agents are commonly used as first-line treatments in mild/moderate acne vulgaris (AV). Adherence to retinoid treatment could be limited by the low local tolerability. Literature data show that up to 15% of patients prematurely stop the treatment with retinoids because of skin irritation. A medical device in gel formulation containing tretinoin (0.02%), glycolic acid (4%) and clindamycin (0.8%) is available. So far, no real-life, prospective data regarding efficacy and tolerability of this gel are available. We performed a prospective, multicenter, pragmatic 12-week, assessor-blinded trial. Primary outcomes were the changes of Total acne lesions (TL) count. Secondary outcomes were the evolution of Global Acne Grading System score (GAGS) e and Noninflammatory (NI-L) and Inflammatory (I-L) lesions count. An additional secondary outcome was also to evaluate the local tolerability of the gel. Materials and methods: In a real-life multicenter trial, 159 subjects with mild/moderate AV of the face were enrolled after their informed consent in a 12-week trial. Subjects were instructed to apply the gel once daily at evening.