Split-thickness skin autografts (AGs) are the standard surgical treatment for severe burn injuries. However, the treatment of patients with substantial skin loss is limited by the availability of ...donor sites for skin harvesting. As an alternative to skin autografts, our research group developed autologous self-assembled skin substitutes (SASSs), allowing the replacement of both dermis and epidermis in a single surgical procedure. The aim of the study was to assess the clinical outcome of the SASSs as a permanent coverage for full-thickness burn wounds. Patients were recruited through the Health Canada's Special Access Program. SASSs were grafted on debrided full-thickness wounds according to similar protocols used for AGs. The graft-take and the persistence of the SASS epithelium over time were evaluated. 14 patients received surgical care with SASSs. The mean percentage of the SASS graft-take was 98 % (standard deviation = 5) at 5 to 7 d after surgery. SASS integrity persisted over time (average follow-up time: 3.2 years), without noticeable deficiency in epidermal regeneration. Assessment of scar quality (skin elasticity, erythema, thickness) was performed on a subset of patients. Non-homogeneous pigmentation was noticed in several patients. These results indicated that the SASS allowed the successful coverage of full-thickness burns given its high graft-take, aesthetic outcome equivalent to autografting and the promotion of long-term tissue regeneration. When skin donor sites are in short supply, SASSs could be a valuable alternative to treat patients with full-thickness burns covering more than 50 % of their total body surface area.
Our study sought to describe ocular surface alterations at baseline and after 4 months of dupilumab treatment in patients with severe AD. Our findings highlight that all 25 patients showed ocular ...surface alterations prior to dupilumab treatment. Dupilumab may cause the worsening of clinical or subclinical pre‐existing ocular alterations belonging to the spectrum of AKC.
Background
Numerous reports of resistance to terbinafine in Trichophyton spp. from all over the world are arousing justified attention and concern. Point mutations in the gene that encodes the ...squalene epoxidase (SQLE) enzyme are responsible for these therapeutic resistances.
Objectives
Primary objective of the study was to describe first isolates of Trichophyton spp. resistant to terbinafine among the patients treated between September 2019 and June 2022 at the Dermatology Units of Ospedale Maggiore Policlinico and San Bortolo Hospital. Secondary objective was to study the resistance mechanism.
Methods
Patients with confirmed Trichophyton spp. infection has been treated with systemic and topical terbinafine. Patients were then re‐evaluated 12 weeks after the therapy. Patients with incomplete or absent response to terbinafine underwent a new skin scraping for direct mycological examination, new identification of dermatophyte species from culture and MALDI‐TOF, molecular species identification, antifungal susceptibility testing and molecular analysis of SQLE gene.
Results
We identified five patients without clinical response to treatment with terbinafine. The DNA sequencing of the ITS region identified one Trichophyton rubrum and four Trichophyton indotineae. The T. rubrum strain showed minimum inhibitory concentration (MIC) (90% growth inhibition) of 4 mg/L for terbinafine. The four T. indotineae strains showed a MICs range of 0.25–4 mg/L for terbinafine. The analysis of the SQLE gene in the T. rubrum strain showed a nucleotide substitution generating a missense mutation (L393F). The SQLE gene sequencing in the T. indotineae strains showed a nucleotide substitution generating a missense mutation (F397L) in two strains, a nucleotide substitution L393S in one strain and a nucleotide substitution F415C in another strain.
Conclusions
We report the first cases of terbinafine‐resistant Trichophyton isolates in the Italian population. Solid antifungal management programs will be needed to promote more responsible use of antimycotics and preserve their therapeutic efficacy to control antifungal resistance.
Sunflower crops are grown in different regions worldwide. However, the stress caused by water excess in the soil impairs this crop growth and yield. The aim of the present study was to determine the ...response of sunflower plants to long periods of water excess during initial development stages. Water excess treatments were applied at the initial development of these plants at the sowing day, three days after sowing, at plant emergence, and at V2 and V4 stages. The treatments had different duration periods (0, 48, 96, 144, 192, and 240 hours) and were applied at three sowing dates. The current experiment is factorial and was carried out according to a completely random design. Two plant pots, treated under greenhouse conditions, made up the experimental units. Plant emergence, leaf area, plant height, shoot dry mass, maximum root length, main root length and root dry mass were herein assessed. Water excess is more harmful to sunflower plants during the sowing-emergence period. It substantially reduces emergence, plant density, shoot and root growth, even after 48-hour stress. Moreover, water excess leads to the formation of adventitious and secondary roots.
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