Kaposi sarcoma (KS) is a rare disease that was not frequently identified before the widespread occurrence of AIDS. Even today, it remains a challenge for physicians to diagnose, particularly in its early stages, often requiring referral to specialists and further investigations. Dermoscopy, a non-invasive imaging technique, reveals a distinctive rainbow pattern that strongly indicates KS. Moreover, advanced imaging tools like optical coherence tomography (OCT) can provide additional information though specific disease-related patterns have not been fully established yet. These emerging techniques show promise in facilitating early diagnosis of skin-related KS and monitoring the effectiveness of treatments. However, biopsy remains the definitive method for confirming the disease. In this study, we present two cases of cutaneous Kaposi sarcoma, documented using OCT, both before and after treatment with imiquimod 5% cream. The study highlights the potential of OCT in evaluating disease progression and treatment response, as well as the usefulness of dermoscopy in detecting early indicators of KS. By integrating these advanced imaging techniques, the diagnosis and management of cutaneous KS could be improved, leading to timely interventions and better patient outcomes.

Background and Objectives: Cellulite, or edemato-fibro-sclerotic panniculopathy (EFP), is characterized by dermal and hypodermal changes leading to adipose tissue accumulation and compromised venous circulation. This study investigates the efficacy of a hypertonic cream containing concentrated sodium chloride (Jovita Osmocell^®) in addressing water retention and structural alterations in adipose tissue, aiming to interrupt the cellulite formation process. Materials and Methods: A 12-week, prospective, monocentric, double-blind, placebo-controlled study enrolled 30 female subjects with grade II or III cellulite. Patients were randomized to receive hypertonic cream or a placebo. Thigh circumference, ultrasound evaluations, and standardized photographs were collected at baseline, intermediate, and endpoint visits. Adverse events were monitored. Results: After 84 days, the hypertonic cream group exhibited a significant reduction in thigh circumference compared to the placebo group (p = 0.0037). B-mode ultrasound examinations revealed significant changes in the parameters studied, such as the thickness of the subcutaneous tissue. No statistically significant changes were noticed in the placebo group. Volunteers reported the investigational product’s pleasantness and good anti-cellulite activity, with no reported adverse events. Conclusions: The hypertonic cream demonstrated efficacy in reducing thigh circumference, addressing water retention and structural alterations in adipose tissue. The proposed mechanism involves osmosis, releasing accumulated fluids between fat cells, supporting drainage, and reducing inflammation. This study supports the efficacy and safety of hypertonic sodium chloride emulsions in cellulite treatment and confirms safety and user satisfaction.

Background/Objectives: Actinic keratoses (AKs), also known as solar keratoses, are considered premalignant skin lesions that can evolve into squamous cell carcinoma (SCC). Among the available options, 5-fluorouracil (5-FU) remains a cornerstone. Methods: This study is a retrospective analysis of our database of the non-melanoma skin cancer outpatient clinic. The main objective was to evaluate patients treated with 4% 5-FU cream for AK lesions. The efficacy of 4% 5-FU was evaluated retrospectively by measuring the percentage of patients who achieved complete clearance. A secondary efficacy measure was the percentage of partial clearance, defined as at least a 75% reduction in lesion count. Additionally, the study aimed to assess the safety of 4% 5-FU cream. Results: We included 150 patients clinically diagnosed with AK, treated with 4% 5-FU cream and evaluated 432 lesions. Complete clearance of lesions was observed in 138 patients (92%) with partial clearance in 12 patients (8%). At 12 months, the recurrence rate was 11%. Conclusions: Based on our analysis, 4% 5-FU cream is an effective and well-tolerated treatment for AKs, particularly in patients with extensive field cancerization. While local skin reactions are a natural part of its mechanism, they are manageable and do not outweigh clinical benefits.

Background: Keloids are fibroproliferative scars with a prominent vascular component, and pulsed dye laser (PDL) is an established treatment, but objective imaging biomarkers of response are lacking. Objective: To evaluate whether dynamic optical coherence tomography (D-OCT) can provide quantitative, depth-resolved monitoring of keloid vascular remodeling under PDL and to explore candidate metrics for hypothesis-generating assessment in future studies. Methods: We conducted a prospective single-case pilot, hypothesis-generating study of a thoracic keloid treated with three sessions of 595 nm PDL, acquiring D-OCT scans at baseline and approximately 30, 60, and 90 days over a standardized 4 × 4 mm region of interest at 0.15, 0.30, and 0.50 mm depths. Primary D-OCT metrics included vascular en-face area, vessel length density, junction density, and mean vessel caliber. Results: The superficial layer (0.15 mm) showed an almost complete collapse of vascular signal (area −88% vs. baseline), the intermediate layer at 0.30 mm exhibited a sustained ~39% reduction in vascular area with parallel decreases in length and caliber at stable branching, and the deep layer at 0.50 mm showed modest area changes with longer but thinner vessels. These depth-resolved changes were consistent with clinical improvement in Vancouver Scar Scale and POSAS scores. Conclusions: D-OCT yielded quantitative, clinically interpretable vascular metrics that align with the expected effects of PDL in this single patient. In this patient, the percentage reduction in vascular area at 0.30 mm by week 8 emerged as a candidate quantitative metric for response monitoring; thresholds in the order of ≥25% could be tested prospectively as hypothesis-generating cut-offs in future controlled and reliability-tested studies, but are not proposed here as validated clinical criteria.

Background: Teledermatology is the application of information and telecommunication technologies in the field of dermatology to provide remote care services based on the exchange of clinical information within a network of professionals or between professionals and patients. Tele-trichoscopy is a non-invasive, inexpensive, and easy-to-use method that applies the principle of surface microscopy at different magnifications. Alopecia areata is a non-scarring alopecia with a chronic evolution, which often needs a close follow-up. Objectives: The aim of our work was to analyze the possible benefits of telemedicine for the follow-up of patients with alopecia areata. Materials and Methods: We enrolled patients with alopecia areata, identified during the first trichological evaluation, and we divided the patients into two groups. One group was provided with the devices necessary for a telemedicine follow-up. The other group had a conventional follow-up. The total follow-up time was one year. All of the patients’ photos were blindly evaluated by a team of expert dermatologists who were asked to indicate the quality of the images. The photos were also evaluated to identify disease markers. During the follow-up period, questionnaires were administered to both groups of patients to assess the quality of the visit, the level of patient satisfaction, and to identify any issues encountered by the patients. Results: There was a high degree of concordance between the images obtained by outpatient trichoscopy and those obtained by telemedicine. The satisfaction levels were the same between the patients followed via telemedicine and those seen in the outpatient clinic. Conclusions: Telemedicine applied to trichology using trichoscopy was proven to be a valid system for managing the follow-up of patients suffering from chronic recurrent scalp diseases and, above all, for maintaining continuity of care.

Basal cell carcinoma (BCC) is the most frequent skin cancer, and surgery remains the treatment of choice, particularly in high-risk subtypes and sites. However, in low-risk cases and in patients where cosmetic outcome is a priority, alternative strategies, including laser therapy, have been proposed. Different laser sources offer potential advantages in terms of minimal invasiveness, healing time, and cosmetic outcome, but their clinical role remains a matter of debate. This narrative review critically analyses the available evidence on the use of lasers in the treatment of basal cell carcinoma, with a focus on ablative lasers, vascular lasers, and laser-assisted photodynamic therapy. Mechanisms of action, main clinical results, limitations, and the emerging contribution of non-invasive imaging for case selection and response monitoring are discussed. Ablative lasers, in particular CO₂, show favourable results in superficial low-risk BCC, while clearance reliability decreases with increasing tumour depth. Vascular lasers may offer short-term control in selected lesions but with limited long-term data. Laser-assisted PDT represents a promising strategy to extend the indication of PDT to selected nodular forms. Overall, the literature is limited by methodological heterogeneity, incomplete stratification, and short follow-ups. Well-designed comparative studies, standardised protocols, and objective controls will be essential to define the real clinical space of laser therapy in basal cell carcinoma.