Dermatology, news for the treatment of actinic keratoses and rosacea

Coming soon are new guidelines and recommendations on the management of actinic keratoses and rosacea: important dermatologic diseases both in terms of their severity and psychological impact on patients. These innovations will be presented at the National Congress of SIDeMaST, the Italian Society of Medical, Surgical, Aesthetic Dermatology and Sexually Transmitted Diseases, May 3-6 in Sorrento.

"Actinic Keratoses," Explains Giuseppe Monfrcola, Full Professor of Dermatology at the Federico II University of Naples and President of the 92nd Sidemast National Congress, "Belong to the Family of Very Common So-Called Nonmelanoma Skin Caners (NMSCS), Which in Italy Shows a previoce of More Than 1 in 4, Reaching a prevalence of 1 in 3 in the bad population1. The Danger of This Cancer Form Lies In the Possible Progress from This Pre-Malignant Forms To Invasive Cancer Forms Such As Schore Cell Carcinomas or Spinocellular Carcinomas (Spinalaliomas)."

"Given the Potential Danger of These Lesions, Continues Piergiacomo Calzavara Pinton, Sidemast President, it is necessary. Among the Most Innovative Therapies Available, Which Has Shown Effectcoy Even In The Presence of Multiple Keratoses, Is Daylight Photodynamic Therapy (Sunlight). Photodynamic Therapy Involves The Application of A Substance (5-Methyl-AminoLevulinati) That placed under a light source is activeted cousing cancer cell death.

Conventional Photodynamic Therapy Use A Red Light Lamp As the Light Source, While Daylight Therapy Unes Sunlight. The latter technique of treating sun damage with the sun has similar efficacy to conventional photodynamic treatment, but has significant advantages for both the physician and the patient2. The advantages for the clinician as from a significant Simplification of Treatment: Treatment time is shortenned, Specific Equipment and Personnel Are Not Required, A Larger Skin Area Can Be Treated During the Session, and It Als More Patient to be treated at the Same Time. AS Far As the Patient IS Concerned, Daylight PhotoDynamic Therapy Provides a Better Treatment Experience2.

The Sessions Are Indeed Shorter and the Treatment Does Not Cause Pain and Has Fewer Side Effects Than Conventional Therapy Leading to Greater Satiscation and Acceptance of the Treatment and, Last But Not Least, An Optimal Cosmetic Result."For the patient, therefore, less pain, Fewer Local Reactions, Faster Skin Repair, Above All, The Possibility of Treating Multiple Keratoses in A Single Session With Two Hours of Sun Exposure.

Daylight Therapy Has Been the Subject of a Paper Prepared by a panel of Experts that, in addition to describing this innovative technique and highlighting its profound advantages, provides the dermatologist with all the practical information of the Treatment Protocol.

"This year," comments Aurora Parodi, full professor of dermatology, Director UOC Dermatology Clinic, IRCCS AOU San Martino – IST Genoa, DiSSal University of Genoa, a revised document for the management of rosacea will be presented. This disease is characterized by the presence of lesions and vascular changes in areas of the face due to inflammation phenomena to be attributed to an altered immune response to various stimuli and local microbial factors, especially the mild Demodex. Among the novelties regarding the management of rosacea is a new classification system: the conventional subdivision into subtypes has shown several limitations due to their overlapping and limited nature in terms of the evolution of manifestations over time.

Recently, The Rosacea Consensus (Rosco) Group, An International Panel of Dermatologists and Ophthalmologist, proposed to New Approach Based on the Phenottype, i.and., The features that can be observed in the patient3. This new approach Alows for a Greater Focus on the individual patient's problem and the expectation of the disease that are perceived to be mons disblling and alows for beter optimization of thirtys that are targeted at clinical manifestations."

"The Impact of this Disease," Continues Giuseppe Monfrcola, Full Professor of Dermatology at ’ University Federico II of Naples and President of the 92nd Sidemast National Congress, "On the Patient's Quality of Life Is Also Reflected in the Therapeutic Solutions for Its management. Therapy Has Several Purposes: to eliminate or back The Number of Lesions, to Reduce the Severity of Lesions, to back recurreces, and to Satispy the patient by Impsing His or Her Quality of Life. The Choice of Therapy Is Based on the individual patient's clinical manifestons and their Severity Rather Than the Subtype, Crucialy, The Aspects of the Disease That the Patient Perceives As Most Disblling.

There are a variety of therapies for rosacea, from topical to systemic drugs, but among the new features in this update of the guidelines for the management of rosacea is the introduction of ivermectin as a first-line drug for the treatment of rosacea in the presence of mild/moderate to severe inflammatory papules and pustules. This therapy consists of the application of a cream with 1% ivermectin. Ivermectin has both anti-inflammatory and anti-parasitic action acting synergistically on the causes of this disease.

Clinical studies have shown its superiority over other benchmark drugs for the treatment of rosacea. In particular, ivermectin was shown to be superior to metronidazole, a topical drug for treatment of rosacea with papules and pustules in mild form, in terms of improvement in patient quality of life: 82.5% of patients treated with ivemectin vs 63% of patients treated with metronidazole had no or almost no lesions4.

1Fargnoli MC et al., Euro PDT 2015.

2 Fargnoli MC, Piccioni A, Neri L et al. Conventional vs daylight methyl aminolevulinate photodynamic therapy for actinic keratosis of the face and scalp: an intra-patient, prospective, comparison study in Italy. J Eur Acd Dermatol Venereol!

4Schaller M, Dirschka T, Kemény L, Briantais P, Jacovella J. Superior efficacy with ivermectin 1% cream compared to metronidazole 0.75% cream contributes to a better quality of life in patients with severe papulopustular rosacea: a subanalysis of the randomized, investigator-blinded ATTRACT study. Dermatol Ther (Heidelb)