We describe a 79-year-old female with a chronic venous ulceration infected by Staphylococcus aureus and Enterococcus faecalis and not responsive to conventional treatments. The patient was treated with Methyl-Aminolaevulinate Photodynamic Therapy (MAL-PDT). After four weeks the cutaneous swabs become negative and we observed a significant clinical improvement. Therefore we suppose that MALPDT could represent a valid therapeutic option in the treatment of infected chronic ulcers.

Systemic vasculitis is a group of heterogeneous diseases characterized by inflammation and blood vessel walls necrosis. Usually the skin is one of the first organs involved, especially with damage of small to medium size vessels. The cutaneous patterns may help clinicians to diagnose these diseases at the beginning of their course, preventing complications due to internal organ involvement. The following case presents a patient with a microscopic polyangiitis that started with several skin ulcerations localized on the inferior limbs.

Scleroderma is an autoimmune disease characterized by skin and internal organs involvement. Cutaneous ulcerations is one of the most important complication. It may cause pain, disability and may lead to infections, scarring and amputation. Sclerodermic skin ulcers management is quite complex and involves non-pharmacologic and pharmacologic modalities both for the treatment and the prevention. In this report, authors describe a case of refractory skin ulcerations in a sclerodermic patient treated with endothelin receptor antagonist Bosentan. Bosentan changed the course of cutaneous lesions leading to their complete healing. This treatment represents an alternative therapeutic approach for sclerodermic skin ulcers and it may be taken into consideration for the ongoing development of a new management of cutaneous wounds.

We described a case report of a 36-year-old woman with a 10-year-history of idiopathic CD4+ T-lymphocitopenia and Kaposi's sarcoma HHV8+ who developed recurrent pleural effusion. Laboratory and instrumental tests with morphologic, immunophenotypic and molecular analysis of pleural sediment suggest us the diagnosis of primary effusion lymphoma (PEL). The term primary effusion lymphoma defines an extranodal non-Hodgkin's lymphoma HHV8-related, usually classified as a B-cell lymphoma, that grows in liquid-phase within body cavities. The case reported by the Authors appears to be of great interest for its epidemiological and clinical features.

Pyoderma Gangrenosum (PG) is a rare ulcerative cutaneous condition with distinctive characteristics, and the aetiology is not clear yet. PG is commonly associated with inflammatory bowel disease (Ulcerative Colitis and Crohn's disease). The features of PG are not specific histopathologically and for this reason diagnosis is based on clinical feature. There is no single successful treatment for PG. In fact certain type of lesions respond more readily to some therapies than others. Local treatments (advanced wound care, local corticosteroids, local immunomodulator agents) may be sufficient for some clinical features, while others may be required systemic therapy (corticosteroids, immunosuppressive therapy, intravenous immune globulins, TNF-alpha blocking agents). We present four cases of PG associated with inflammatory bowel diseases treated with different therapeutic approaches.

Acroangiodermatitis is a rare vasoproliferative disorder, usually affecting the lower limbs and is associated with congenital or acquired vascular conditions. There are two variants of acroangioderm matitis-Mali type (associated with venous hypertension) and Stewal Bluefarb type, which is associated with arteriovenous malformation, or acquired iatrogenic arteriovenous fistula in patients with chronic renal failure. Acroangiodermatitis is clinically characterized by angiomatous papules and plaques, which mimics Kaposi's sarcoma. The authors present a case of a 63-year-old man with acroangiodermatitis of the lower limbs and chronic venous insufficiency who was treated with elastocompressive therapy.