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Bruni L, Cassio A, Di Natale V, Baronio F, Ortolano R, Pession A, Piraccini BM, Neri I. A Case of Acrodermatitis Dysmetabolica in a Child Affected by Citrullinemia Type I: When Early Diagnosis and Timely Treatment Are Not Enough. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1491. [PMID: 37761452 PMCID: PMC10529868 DOI: 10.3390/children10091491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
An infant with a prenatal diagnosis of citrullinemia, who started standard treatment at birth (L-arginine; sodium benzoate and a personalized diet characterized by a low protein intake and supplementation of essential nutrients and amino acids), presented at 4 months of age with extended, progressive, and severe skin lesions consistent with acrodermatitis dysmetabolica. Guidelines for the diagnosis and management of urea cycle disorders underline that a low-protein diet places patients at risk of essential fatty acids, trace elements, and vitamin deficiency. At hospital admission, our patient had normal levels of zinc and alkaline phosphatases. The plasmatic amino acid profile revealed a severe and generalized deficiency. In particular, the serum levels of arginine, valine, and isoleucine were very low and the dermatitis did not improve until the blood levels of these amino acids increased. In our patient, skin lesions happened despite an early diagnosis of citrullinemia and timely treatment due to compliance issues as a consequence of linguistic barriers.
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May Lee M, Naldi L, Piraccini BM, Starace M, Alessandrini A, Sechi A. Trichoscopy as a Tool to Evaluate Early Dissecting Cellulitis in Patients Affected by Hidradenitis Suppurativa: A Prospective Monocentric Observational Study. Skin Appendage Disord 2023; 9:275-279. [PMID: 37564688 PMCID: PMC10410102 DOI: 10.1159/000530630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/13/2023] [Indexed: 08/12/2023] Open
Abstract
Background Dissecting cellulitis (DC) is a rare neutrophilic dermatosis that leads to cicatricial alopecia. Although DC and Hidradenitis suppurativa (HS) have similar characteristics, their association remains poorly understood. Objectives In this prospective observational study, we used trichoscopy to identify subclinical signs of DC in male patients aged 18 years or older, presenting with HS. The objective of this study was to use trichoscopy to identify subclinical signs of DC in patients with confirmed diagnosis of HS. Method In this prospective, monocentric, observational study, we used trichoscopy to identify subclinical signs of DC in male patients aged 18 years or older, presenting with HS for their initial visit at our HS outpatient clinic from February 1, 2022, to January 31, 2023. Results Of the 23 male patients with HS, 8 (35%) had subclinical trichoscopy findings consistent with DC. The most frequent location was the vertex (6/8), and the majority of patients had early/inflammatory trichoscopic signs of DC (5/8). Additionally, patients with trichoscopic findings consistent with DC had a higher Hurley stage and the International Hidradenitis Suppurativa Severity Score System (IHS4). Among the cases with trichoscopic findings compatible with DC, the majority (6/8) were classified as having a "follicular" HS according to the Canoui-Poitrine classification. Patients were treated according to European S1 guidelines on HS. Conclusions This is the first study to evaluate subclinical DC findings in HS patients using trichoscopy. Although the trichoscopic findings of DC are heterogeneous, the use of this non-invasive technique, in conjunction with clinical evaluation, can improve diagnostic accuracy and lead to earlier diagnosis. These findings suggest a potential association between HS and DC, indicating the need for further studies to evaluate this relationship.
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Waśkiel-Burnat A, Rakowska A, Zaremba M, Maciejewska M, Blicharz L, Starace M, Iorizzo M, Piraccini BM, Olszewska M, Rudnicka L. Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about? Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00971-7. [PMID: 37423962 PMCID: PMC10366048 DOI: 10.1007/s13555-023-00971-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Numerous studies have indicated that alopecia areata is associated with a chronic systemic inflammation, which is considered as a risk factor for venous thromboembolism. The aim of the study was to evaluate the following markers of venous thromboembolism risk: soluble fibrin monomer complex (SFMC), thrombin-antithrombin complex (TATC), and prothrombin fragment 1 + 2 (F1 + 2) in patients with alopecia areata and compare them with healthy controls. METHODS In total, 51 patients with alopecia areata [35 women and 16 men; mean age: 38 (19-54) years] and 26 controls [18 women and 8 men; mean age: 37 (29-51) years] were enrolled in the study. The serum concentrations of thromboembolism markers were measured using an enzyme-linked immunosorbent assay (ELISA) kit. RESULTS An increased level of SFMC was detected in patients with alopecia areata compared with the controls [25.66 (20-34.86) versus 21.46 (15.38-29.48) µg/ml; p < 0.05)]. In addition, a higher level of F1 + 2 was observed in patients with alopecia areata in comparison with the control group [70150 (43720-86070) versus 38620 (31550-58840) pg/ml; p < 0.001]. No significant correlation was detected among SFMC or F1 + 2 and the Severity of Alopecia Tool (SALT) score, disease duration, or the number of the hair loss episodes. CONCLUSION Alopecia areata may be associated with an increased risk of venous thromboembolism. Regular screening and preventive management of venous thromboembolism may be beneficial in patients with alopecia areata, especially before and during systemic Janus kinase (JAK) inhibitors or glucocorticoid therapy.
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Starace M, Piraccini BM, Carpanese MA, Iorizzo M, Apalla Z. Folliculitis-Decalvans Like Alopecia During Treatment with EGFR Inhibitors for Lung Cancer: A Case Series of 6 Patients. Dermatol Pract Concept 2023; 13:e2023180. [PMID: 37557165 PMCID: PMC10412076 DOI: 10.5826/dpc.1303a180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 08/11/2023] Open
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Starace M, Yamagata JP, Cortez de Almeida RF, Frattini S, Bruni F, Alessandrini A, Iorizzo M, Melo DF, Neri I, Piraccini BM. A Practical Algorithm for the Management of Superficial Folliculitis of the Scalp: 10 Years of Clinical and Dermoscopy Experience. Dermatol Pract Concept 2023; 13:e2023131. [PMID: 37557142 PMCID: PMC10412046 DOI: 10.5826/dpc.1303a131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Superficial folliculitis of the scalp (SFS) is a common complaint in clinical practice, and initial presentation may be difficult to differentiate as they may appear very similar to each other. OBJECTIVES The aim of this thesis is to describe the pathologies that occur clinically as folliculitis of the scalp, identify their causes and characteristics and create a standardized classification. METHODS This is a retrospective clinical, dermoscopic and histopathological study over 10 years of dermatologic consultations. Only individuals with a confirmed diagnosis of SFS (updated diagnostic criteria or biopsy) were included. RESULTS In this review, we describe the various clinical features of different causes of SFS in ninety-nine cases and divided into infectious due to fungus, bacteria, or virus and inflammatory conditions such as rosacea, acneiform eruption and Ofuji syndrome. CONCLUSIONS The clinician must differentiate SFS from other underlying scarring disorders to prevent poorer outcomes. We created an algorithm to help the clinician reach a proper diagnosis.
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Iorizzo M, Waśkiel-Burnat A, Anedda J, Piraccini BM, Apalla Z, Rudnicka L, Starace M. Persistent Chemotherapy-Induced Alopecia Treated With Low Dose Oral Minoxidil: A Multicenter Retrospective Case Series of 15 Patients. Dermatol Pract Concept 2023; 13:e2023152. [PMID: 37557121 PMCID: PMC10412018 DOI: 10.5826/dpc.1303a152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 08/11/2023] Open
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Zengarini C, Orioni G, Cedirian S, Bardazzi F, Ferrari T, Piraccini BM, Raone B. Is Ultrasound more Helpful than Microbiological Testing to Diagnose Atypical Mycobacteriosis Infection? Indian J Dermatol 2023; 68:327-328. [PMID: 37529463 PMCID: PMC10389154 DOI: 10.4103/ijd.ijd_779_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
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Maltoni G, Cedirian S, Scozzarella A, Bernardini L, Piraccini BM, Starace M. A child with generalized hypertrichosis due to secondary topical minoxidil exposure. Pediatr Dermatol 2023. [PMID: 37042338 DOI: 10.1111/pde.15329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/02/2023] [Indexed: 04/13/2023]
Abstract
Hypertrichosis is defined as excessive hair growth anywhere on the body in either males or females. It may be caused by genetic conditions, endocrinological disorders, exposure to specific medications (including phenytoin, minoxidil and diazoxide) and other less frequent causes. We report the case of a 1-year-old boy with a family history of thyroid disease and alopecia areata who presented with generalized hypertrichosis due to secondary exposure to topical minoxidil. We discuss an uncommon cause of hypertrichosis and the importance of considering a wide differential diagnosis.
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Sacchelli L, Vincenzi C, Piraccini BM, Neri I. Allergic contact dermatitis caused by topical timolol for the treatment of infantile hemangioma: an underestimated adverse event? J Eur Acad Dermatol Venereol 2023. [PMID: 37016964 DOI: 10.1111/jdv.19092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/29/2023] [Indexed: 04/06/2023]
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Starace M, Vezzoni R, Alessandrini A, Bruni F, Baraldi C, Misciali C, Zelin E, Iorizzo M, Piraccini BM. Superficial acral fibromyxoma: clinical, dermoscopic and histological features of a rare nail tumor. J Eur Acad Dermatol Venereol 2023. [PMID: 37016967 DOI: 10.1111/jdv.19101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 03/28/2023] [Indexed: 04/06/2023]
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Sechi A, Song J, Dell'Antonia M, Heidemeyer K, Piraccini BM, Starace M, Naldi L. Adverse events in patients treated with Jak-inhibitors for alopecia areata: a systematic review. J Eur Acad Dermatol Venereol 2023. [PMID: 37013725 DOI: 10.1111/jdv.19090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
Recently, the impressive efficacy of JAK-inhibitors (JAK-I) in alopecia areata (AA) has been described in several studies; however, to date, there is limited information on the safety of JAK-I in AA patients. For this reason, on the August 18th 2022, a systematic review was performed to collect the pre-marketing and post-marketing data on the safety of JAK-I in patients treated for AA, evaluating for each molecule the reported adverse events (AEs) in indexed literature and their frequency. The keywords "alopecia areata" AND "Jak-inhibitors OR Janus-kinase Inhibitors" were searched on PubMed, Embase, and Cochrane databases. Of 407 studies retrieved, 28 papers met the requirements and were used in our review, including 5 RCTs and 23 case series, overall 1719 patients were included and the safety of 6 JAK-I was assessed (baricitinib, brepocitinib, deuruxolitinib, ritlecitinib, ruxolitinib, tofacitinib). Systemic JAK-I were well tolerated, most of the AEs were mild, and the withdrawal rate for AEs was very low and inferior to placebo in controlled studies (1.6% vs. 2.2%). Laboratory abnormalities represented 40.1% of AEs associated with oral JAK-I, which mostly included the rise in cholesterol, transaminase, triglycerides, creatine phosphokinase (CPK), and sporadic cases of neutro/lymphocytopenia. The remaining AEs involved the respiratory tract (20.8%), the skin (17.2%), the urogenital (3.8%), or the gastroenterological (3.4%) tract. Increased rates of infections involved not only the upper (19.0%) and lower (0.3%) respiratory tract, but also the urogenital system (3.6%), and the skin (4.6%). Isolated cases of grade 3 to 4 AEs have been reported, including myocardial infarction, hypertensive urgencies, cellulitis, rhabdomyolysis, neutropenia, and high elevation of creatinine kinase. No fatal outcomes were reported. AEs reported with topical formulation included scalp irritation and folliculitis. The main limit of this review is the lack of data related to post-marketing surveillance, which should be maintained on a long-term basis.
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Starace M, Pampaloni F, Bruni F, Quadrelli F, Cedirian S, Baraldi C, Misciali C, Di Martino A, Sabatelli P, Merlini L, Piraccini BM. Alopecia in Patients with Collagen VI-Related Myopathies: A Novel/Unrecognized Scalp Phenotype. Int J Mol Sci 2023; 24:ijms24076678. [PMID: 37047652 PMCID: PMC10095448 DOI: 10.3390/ijms24076678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/01/2023] [Accepted: 04/01/2023] [Indexed: 04/14/2023] Open
Abstract
Collagen VI-related myopathies are characterized by severe muscle involvement and skin involvement (keratosis pilaris and impaired healing with the development of abnormal scars, especially keloids). Scalp involvement and hair loss have not been reported among cutaneous changes associated with collagen VI mutations. The aim of this study is to describe the clinical, trichoscopic, and histological findings of the scalp changes in patients affected by COL VI mutations and to estimate their prevalence. Patients with Ullrich congenital muscular dystrophy were enrolled and underwent clinical and trichoscopic examinations and a scalp biopsy for histopathology. Five patients were enrolled, and all complained of hair loss and scalp itching. One patient showed yellow interfollicular scales with erythema and dilated, branched vessels, and the histological findings were suggestive of scalp psoriasis. Two patients presented with scarring alopecia patches on the vertex area, and they were histologically diagnosed with folliculitis decalvans. The last two patients presented with scaling and hair thinning, but they were both diagnosed with folliculitis and perifolliculitis. Ten more patients answered to a "scalp involvement questionnaire", and six of them confirmed to have or have had scalp disorders and/or itching. Scalp involvement can be associated with COL VI mutations and should be investigated.
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Starace M, Alessandrini AM, Cua VCS, Cucinotta FF, Bruni F, Iorizzo M, Piraccini BM. Retrospective study correlating the clinical outcome of alopecia areata with specific prognostic factors. J Eur Acad Dermatol Venereol 2023; 37:e499-e500. [PMID: 36377915 DOI: 10.1111/jdv.18748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
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Neri I, Guglielmo A, Virdi A, Leuzzi M, Piraccini BM, Chessa MA. New insights on acral peeling dermatoses: An overlooked skin manifestation during COVID-19 pandemic. J Eur Acad Dermatol Venereol 2023; 37:e449-e450. [PMID: 36514988 PMCID: PMC9877920 DOI: 10.1111/jdv.18815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
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Dika E, Starace M, Alessandrini A, Patrizi A, Baraldi C, Misciali C, Fanti PA, Waśkiel-Burnat A, Rudnicka L, Piraccini BM. The Histopathologic Evaluation of Diagnostic Procedures in Nail Melanoma. Dermatol Pract Concept 2023; 13:dpc.1302a92. [PMID: 37196263 DOI: 10.5826/dpc.1302a92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION The diagnostic delay in nail melanoma (NM) has been repeatedly emphasized. It may be related to both clinical misinterpretations and to errors in the bioptic procedure. OBJECTIVES To assess the efficacy of histopathologic examination in different diagnostic biopsies in NM. METHODS We retrospectively investigated the diagnostic procedures and histopathologic specimens referred to the Laboratory of Dermatopathology for the clinical suspicion of NM from January 2006 to January 2016. RESULTS Eighty-six nail histopathologic specimens were analyzed consisting in 60 longitudinal, 23 punch and 3 tangential biopsies. A diagnosis of NM was performed in 20 cases, benign melanocytic activation in 51 cases and melanocytic nevi in 15 patients. Longitudinal and tangential biopsy were diagnostic in all cases, regardless of the clinical suspicion. Nail matrix punch biopsy instead was not diagnostic in most of the cases (13/23 specimens). CONCLUSIONS In the presence of an NM clinical suspicion, longitudinal biopsy is recommended (lateral or median) because it provides exhaustive information on the characteristics of melanocytes morphology and distribution in all the components of the nail unit. Tangential biopsy, recently encouraged by expert authors due to the optimal surgical outcome, in our experience gives incomplete information on tumor extension. Punch matrix biopsy gives limited evidence in the diagnosis of NM.
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Massiot P, Pinto PC, Leclerc-Mercier S, Rasmont V, Piraccini BM, Rudnicka L, Reygagne P, Melo DF, Vano-Galvan S, Wu WY, Kerob D. Clinical benefit and tolerance profile of a keratolytic and hydrating shampoo in subjects with mild to moderate psoriasis. Results from a double-blind, randomized, vehicle-controlled study. J Cosmet Dermatol 2023. [PMID: 36942745 DOI: 10.1111/jocd.15693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/12/2023] [Accepted: 02/14/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Scalp psoriasis frequently goes with other disease location and may lead to a significant burden and impairment of quality of life (QoL). Adherence to local treatments is a frequent problem. A keratolytic and hydrating shampoo containing 2% salicylic acid, 5% urea, and 1% glycerin (active shampoo) has been developed for psoriasis-prone scalp. OBJECTIVE To assess the efficacy and tolerability of an active shampoo in subjects with mild to moderate scalp psoriasis. MATERIALS AND METHODS A single-center, randomized, double-blind, vehicle-controlled study was conducted on 67 adults with mild to moderate psoriasis. The active shampoo or its vehicle were applied daily for 14 days and 3 times/week for another 14 days. Assessments included the Psoriasis Scalp Severity Index (PSSI), Investigator Global Assessment (IGA), calculated total surface affected hair, scalp greasiness, irritation, and assessed scalp dermatitis-specific quality-of-life issues using SCALPDEX and product acceptability. RESULTS The active shampoo significantly (p < 0.05) reduced the PSSI by 39.0%, 37.2%, 63.0%, and 69.0% immediately after washing compared to a 22.8%, 5.5%, 19.6%, and 13.0% with the vehicle at Days 1, 8, 15, and 30, respectively. SCALPDEX items, IGA, and irritation significantly (p < 0.05) reduced with the active shampoo. Hair and scalp greasiness improved continuously with both products until Day 21. Subject-reported symptom scores paralleled the positive evolution of clinical signs. The active shampoo was well tolerated, subjects were highly satisfied and had an improved QoL. CONCLUSION The active shampoo significantly improved clinical signs, symptoms, and QoL of mild-to-moderate scalp psoriasis compared to the vehicle. It was very well tolerated and highly appreciated by the subjects.
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Iorizzo M, Gioia Di Chiacchio N, Di Chiacchio N, Grover C, Lipner SR, Richert B, Piraccini BM, Starace M, Tosti A. Intralesional steroid injections for inflammatory nail dystrophies in the pediatric population. Pediatr Dermatol 2023. [PMID: 36939031 DOI: 10.1111/pde.15295] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/26/2023] [Indexed: 03/21/2023]
Abstract
Intralesional injections of triamcinolone acetonide are widely used to successfully treat several inflammatory nail conditions. This procedure is well described in adults, but less frequently reported in children and teenagers, being largely considered too invasive and fear-provoking for pediatric patients. Our report shows how this procedure is feasible and successful in children, even without a digital block. The step-by-step technique and tips to reduce pain should encourage clinicians to offer it as an alternative option to children with inflammatory nail disorders.
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Henning MAS, Hay R, Rodriguez-Cerdeira C, Szepietowski JC, Piraccini BM, Ferreirós MP, Arabatzis M, Sergeev A, Nenoff P, Kotrekhova L, Nowicki RJ, Faergemann J, Padovese V, Prohic A, Skerlev M, Schmid-Grendelmeier P, Sigurgeirsson B, Gaitanis G, Lecerf P, Saunte DML. Position statement: Recommendations on the diagnosis and treatment of Malassezia folliculitis. J Eur Acad Dermatol Venereol 2023. [PMID: 36912427 DOI: 10.1111/jdv.18982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 02/07/2023] [Indexed: 03/14/2023]
Abstract
Malassezia is a lipophilic yeast that is a part of the human mycobiome. Malassezia folliculitis appears when the benign colonization of the hair follicles, by the Malassezia yeasts, becomes symptomatic with pruritic papules and pustules. Although Malassezia folliculitis is common in hospital departments, diagnosing and treating it varies among dermatologists and countries. The European Academy of Dermatology and Venereology Mycology Task Force Malassezia folliculitis working group has, therefore, sought to develop these recommendations for the diagnosis and management of Malassezia folliculitis. Recommendations comprise methods for diagnosing Malassezia folliculitis, required positive findings before starting therapies and specific treatment algorithms for individuals who are immunocompetent, immunocompromised or who have compromised liver function. In conclusion, this study provides a clinical strategy for diagnosing and managing Malassezia folliculitis.
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Piraccini BM, Comito F, Melotti B, Stanganelli I, Medri M, Savoia F. Cemiplimab-Induced Alopecia Areata. Int J Trichology 2023; 15:77-78. [PMID: 37701555 PMCID: PMC10495066 DOI: 10.4103/ijt.ijt_107_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/03/2022] [Indexed: 09/14/2023] Open
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Fino E, Chessa MA, Starace M, Piraccini BM, Mazzetti M. Soothing with one's words: Positive doctor-patient communication modulates post-surgery pain and quality of physical activity in patients undergoing nail surgery. J Eur Acad Dermatol Venereol 2023; 37:e322-e324. [PMID: 35993152 DOI: 10.1111/jdv.18544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022]
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Bardazzi F, Viviani F, Piraccini BM, Lasagni C, Bigi L, Manfredini M, Pongetti L, Di Lernia V, Corazza M, Pepe F. Tildrakizumab in Complex Psoriatic Patients: An Experience in Emilia-Romagna (Italy). J Cutan Med Surg 2023; 27:126-132. [PMID: 36995351 DOI: 10.1177/12034754231155889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Background IL-23 inhibitors are the latest class of biologic drugs approved for moderate-to-severe psoriasis. Objectives to investigate real-life safety and efficacy of tildrakizumab. Methods demographic data, medical history, psoriasis disease history, PASI, DLQI, BSA, NAPSI were recorded at weeks 0, 12, 24, 36. Results PASI, BSA, DLQI and NAPSI all decreased rapidly during the 36 week follow-up period. PASI score reduced from 12.28 to 4.65 by week 12, followed by a further decrease to 1.18 at week 36 Multiple logistic regression showed that smoking, BMI ≥30, ≥3 comorbidities, previous systemic traditional or biologic drugs, psoriatic arthritis nor difficult-to-treat areas influenced the reduction of PASI and NAPSI scores during treatment with tildrakizumab ( P > .05). Conclusions we assessed a good performance of tildrakizumab in patients with multiple comorbidities, multi-failure, elderly patients, and in subjects with psoriatic arthritis.
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Starace M, Rubin AI, Di Chiacchio NG, Pampaloni F, Alessandrini A, Piraccini BM, Iorizzo M. Diagnosis and surgical treatment of benign nail unit tumors. J Dtsch Dermatol Ges 2023; 21:116-129. [PMID: 36808456 DOI: 10.1111/ddg.14942] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/25/2022] [Indexed: 02/22/2023]
Abstract
Little is known about benign non-melanocytic nail tumors, probably due to their low pathogenicity. They are commonly misdiagnosed as inflammatory or infective diseases. They have various features, depending on the type of tumor and its location in the nail apparatus. The typical sign of a tumor is the presence of a mass and/or secondary nail changes from damaged nail structures. In particular, if a single digit is affected by a dystrophic sign or a symptom is reported without any explanation, the presence of a tumor should always be ruled out. Dermatoscopy helps to enhance visualization of the condition and in many cases supports the diagnosis. It may also assist in identifying the right place to biopsy, but it never replaces surgery. Most common non-melanocytic nail tumors are analyzed in this paper, including glomus tumor, exostosis, myxoid pseudocyst, acquired fibrokeratoma, onychopapilloma, onychomatricoma, superficial acral fibromyxoma and subungual keratoacanthoma. The aim of our study is to review the main clinical and dermatoscopic characteristics of the most common benign non-melanocytic nail tumors, to correlate them with the histopathology and to advise practitioners of the best surgical management.
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Starace M, Rubin AI, Di Chiacchio NG, Pampaloni F, Alessandrini A, Piraccini BM, Iorizzo M. Diagnose und chirurgische Behandlung gutartiger Tumoren der Nägel. J Dtsch Dermatol Ges 2023; 21:116-130. [PMID: 36808451 DOI: 10.1111/ddg.14942_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/25/2022] [Indexed: 02/22/2023]
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Starace M, Orioni G, Alessandrini A, Bruni F, Baraldi C, Misciali C, Piraccini BM. Digital Ulcers: Multidisciplinary Approach and Dermatological Management. Dermatol Pract Concept 2023; 13:dpc.1301a19. [PMID: 36892353 PMCID: PMC9946100 DOI: 10.5826/dpc.1301a19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Digital ulcers represent a current public health issue, due to the relevant difficulties in their management and their tendency to become chronic, non-healing lesions. OBJECTIVES Our case series represents an opportunity to discuss the main comorbidities of digital ulcers and to present an evidence-based treatment protocol that has proved highly effective in our clinical practice. METHODS We collected the clinical data about clinical features, associated diseases and diagnostic therapeutical procedures of 28 patients with digital ulcers referred to our Wound Care Service at S. Orsola-Malpighi Hospital. RESULTS Digital ulcers were divided into 5 categories, based on the causative agent: peripheral artery disease: 5/16 females and 4/12 males, diabetes-associated wounds: 2/16 females and 1/12 males, mixed wounds: 4/12 males, pressure wounds: 3/16 females and 2/12 males, and immune-mediated diseases associated with wounds: 6/16 females and 1/12 males. Each group received specific management, based on the characteristics of the ulcer and the underlying comorbidities. CONCLUSIONS The clinical evaluation of digital wounds requires a thorough knowledge of their aetiopathogenesis. A multidisciplinary approach is necessary to achieve a precise diagnosis and correct treatment.
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Leuzzi M, Sechi A, Baraldi C, Piraccini BM, Neri I. An unusual swelling of the fingers. Clin Rheumatol 2023; 42:307-309. [PMID: 36045305 DOI: 10.1007/s10067-022-06355-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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