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Tartaglia J, Piaserico S, Naldi L, Sechi A. Ablative CO 2-Assisted Laser for Topical Drug Delivery in Nail Psoriasis: A Systematic Review. Skin Appendage Disord 2024; 10:156-166. [PMID: 38572191 PMCID: PMC10987169 DOI: 10.1159/000535022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/01/2023] [Indexed: 04/05/2024] Open
Abstract
Background Nail psoriasis poses challenges for effective treatment, and topical drug delivery through the nail plate is limited. A novel approach to address this challenge involves the use of ablative fractional laser as a pretreatment strategy to enhance topical drug delivery for nail psoriasis. Summary This systematic review, conducted in accordance with PRISMA guidelines, involved an extensive literature search across PubMed/MEDLINE, EMBASE, and the Cochrane Library up to July 2023. The primary focus was on exploring studies that investigated the application of ablative laser technology to augment drug delivery for nail psoriasis. Key Messages (1) The review included seven randomized controlled trials, all examining the combination of fractional CO2 laser with topical treatments. These trials demonstrated varying degrees of improvement in nail psoriasis. (2) Patients undergoing laser treatment reported experiencing moderate levels of pain, effectively managed through the application of topical anesthesia. (3) Commonly observed side effects included erythema, swelling, and crusting, with the Koebner phenomenon being a rare occurrence. (4) Notably, patient satisfaction levels with the combined approach of laser and topical treatments were consistently high. In conclusion, the utilization of ablative CO2-assisted laser pretreatment, when used in conjunction with topical therapy, appears to be both effective and well-tolerated for the treatment of nail psoriasis. However, the establishment of optimal parameters and treatment intervals for fractional laser therapy remains an area for further research. Standardized studies are imperative to identify the most effective strategy for enhancing topical drug delivery in the context of nail psoriasis treatment.
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Affiliation(s)
- Jacopo Tartaglia
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Stefano Piaserico
- Dermatology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy
| | - Luigi Naldi
- UOC Dermatologia, Ospedale San Bortolo, Vicenza, Italy
| | - Andrea Sechi
- UOC Dermatologia, Ospedale San Bortolo, Vicenza, Italy
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2
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Pezzolo E, Sechi A, Tartaglia J, Naldi L. A critical evaluation of suitability of tralokinumab for treatment of moderate-to-severe atopic dermatitis in adolescents and adults. Expert Rev Clin Immunol 2024; 20:255-266. [PMID: 37955186 DOI: 10.1080/1744666x.2023.2283585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/10/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Atopic dermatitis (AD) is a chronic, intensely pruritic disease associated with significant patient burden. Recent advancements in AD pathogenesis have expanded its therapeutics pipeline. Tralokinumab is a fully human monoclonal antibody that binds specifically Interleukin (IL)-13, inhibiting the downstream IL-13 signaling. Phase 3 clinical trials and some real-world studies showed that tralokinumab, as monotherapy or in combination with topical corticosteroids, is efficacious and safe in adult patients with moderate-to-severe AD. Similar results were reported in a phase 3 trial in adolescents (aged ≥12 years). AREAS COVERED We review the role of IL-13 in AD and discuss the value of tralokinumab for treating moderate-to-severe AD, comparing efficacy and safety results derived from clinical trials and real-life data. EXPERT OPINION The role of IL-13 in AD supports a targeted therapeutic approach. Tralokinumab has proven efficacious and well-tolerated in a large proportion of patients confirming its value for treating moderate-to-severe AD from age 12 years onwards; it quickly improves itching and can maintain a high-level of response over time; it can be administered with flexible dosing schedules. Future studies will further clarify the role of IL-13 pathway and which patients would be best suited to tralokinumab, shifting AD treatment into an era of precision medicine.
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Affiliation(s)
- Elena Pezzolo
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
- Centro Studi GISED (Italian Group for Epidemiologic Research in Dermatology) - FROM (Research Foundation of Ospedale Maggiore Bergamo), Padiglione Mazzoleni - Presidio Ospedaliero Matteo Rota, Bergamo, Italy
| | - Andrea Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Jacopo Tartaglia
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Luigi Naldi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
- Centro Studi GISED (Italian Group for Epidemiologic Research in Dermatology) - FROM (Research Foundation of Ospedale Maggiore Bergamo), Padiglione Mazzoleni - Presidio Ospedaliero Matteo Rota, Bergamo, Italy
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3
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Dell'Antonia M, Pavan G, Lai D, Sechi A. Tinea capitis in newborns: Report of a case and review of the literature with a focus on treatment modalities. Pediatr Dermatol 2024; 41:302-306. [PMID: 37823546 DOI: 10.1111/pde.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/09/2023] [Indexed: 10/13/2023]
Abstract
Tinea capitis is a common disease in children but rare in newborns younger than 1 month of age. Only 29 cases of tinea capitis in newborns have been described in indexed literature from 1990 until now. While antifungal agents can be used topically and systemically, systemic antifungal therapy is generally accepted as the treatment of choice for tinea capitis due to limited penetration of topical agents into the hair follicle. However, there is a lack of data on the use of systemic antifungal agents in newborns, and there are reports of successful treatment of tinea capitis in newborns using only topical therapy. In this paper, we present a case of tinea capitis in a 29-day-old female baby and review the previous 29 reported cases.
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Affiliation(s)
- Massimo Dell'Antonia
- Dermatology Unit, Santi Giovanni e Paolo Hospital, ULSS3 Serenissima, Venice, Italy
| | - Giacomina Pavan
- Microbiology and Dermatology Units, San Bortolo Hospital, Vicenza, Italy
| | - Danila Lai
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
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Mioso G, Naldi L, Sechi A. Photoexposed Rash in an Older Adult. Cutis 2024; 113:E23-E25. [PMID: 38593102 DOI: 10.12788/cutis.0964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Affiliation(s)
- Guido Mioso
- Dr. Mioso is from the Dermatology Unit, Department of Medicine, University of Padova, Italy. Drs. Naldi and Sechi are from the Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Luigi Naldi
- Dr. Mioso is from the Dermatology Unit, Department of Medicine, University of Padova, Italy. Drs. Naldi and Sechi are from the Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Andrea Sechi
- Dr. Mioso is from the Dermatology Unit, Department of Medicine, University of Padova, Italy. Drs. Naldi and Sechi are from the Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
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Iorizzo M, Sirtoli Marcondes MT, Sechi A, Therianou A, Piraccini BM, Starace M. Female diffuse non-cicatricial alopecia-The diagnostic value of trichoscopy. J Eur Acad Dermatol Venereol 2024; 38:e142-e144. [PMID: 37702248 DOI: 10.1111/jdv.19493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Affiliation(s)
- M Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
| | | | - A Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - A Therianou
- Imperial College, NHS Healthcare Trust, London, UK
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Gnesotto L, Cutrone M, Mazzatenta C, Bassi A, Piccolo V, Sechi A. Topical Ivermectin for Permethrin-Resistant Scabies: A Useful Application. Dermatol Pract Concept 2024; 14:dpc.1401a29. [PMID: 38364400 PMCID: PMC10868950 DOI: 10.5826/dpc.1401a29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Laura Gnesotto
- Dermatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Mario Cutrone
- Pediatric Dermatology, Ospedale dell’Angelo Venezia, Ospedale San Bortolo Vicenza, Italy
| | | | - Andrea Bassi
- UO Dermatology-Azienda USL Toscana Nord Ovest, Lucca, Italy
| | | | - Andrea Sechi
- Pediatric Dermatology, Ospedale dell’Angelo Venezia, Ospedale San Bortolo Vicenza, Italy
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Sechi A, Starace M, Piraccini BM, Wortsman X. Ultrasound Features of Onychopapilloma at High-Frequency and Ultra-High Frequency. J Ultrasound Med 2024; 43:71-76. [PMID: 37750808 DOI: 10.1002/jum.16338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE This study aimed to identify the sonographic features of pathologically confirmed onychopapilloma cases. METHODS High-frequency up to 24 MHz and ultra-high frequency-ultrasound up to 71 MHz examinations were performed and correlated with their clinical and pathologic presentations. RESULTS Twenty-two cases met the criteria. Clinical presentations revealed longitudinal erythronychia in 63.3% of cases. The ultrasound examinations identified a hypoechoic band in the nail bed (86.3%), nail plate abnormalities including upward displacement (68.2%) and thickening (68.1%), focal hyperechoic focal spots on the nail plate (50%) and irregularities of the ventral plate (33.3%). Color Doppler imaging showed no hypervascularity of the nail bed in all studies. These findings correlate with histological characteristics of onychopapilloma, including nail bed acanthosis, papillomatosis, and layered hyperkeratosis. Recurrence occurred in two cases after surgery, with tumors showing proximal extension in the matrix region on ultrasound not evident during clinical examination. CONCLUSION High-frequency and ultra-high-frequency can provide anatomical information in onychopapilloma that could enhance understanding and management.
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Affiliation(s)
- Andrea Sechi
- Dermatology Unit, San Bortolo Hospital of Vicenza, Veneto, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Bologna, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Bologna, Italy
| | - Ximena Wortsman
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
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Starace M, Milan E, Summa G, Alessandrini AM, Sechi A, Iorizzo M, Di Chiacchio NG, Di Chiacchio N, Piraccini BM. Onychoscopic characteristics of Trichophyton rubrum and Trichophyton interdigitalis fungal infections: A multicentric study. Mycoses 2024; 67:e13673. [PMID: 37966016 DOI: 10.1111/myc.13673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/23/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Trichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, which often results unfeasible. OBJECTIVES The aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway. PATIENTS AND METHODS We conducted an observational retrospective study on 54 patients with a culture proven diagnosis of distal subungual onychomycosis of the toenail, caused by Trichophyton rubrum or Trichophyton mentagrophytes variant interdigitalis. Using a videodermatoscope we collected data on nail colour (white, yellow, orange, brown, dark) and on dermoscopic patterns (aurora, spikes, jagged, ruin, linear edge, dots, striae). RESULTS Fifty-four patients, with a total of 72 nails, were eligible for this study. Analysing the association between discoloration of the nail plate and type of infection (T. rubrum or T. interdigitalis), no correlation turned out to be statistically significant. Instead, significant associations between spikes and T. rubrum infection and striae and infection from T. interdigitalis were identified. Finally, a 100% specificity was identified for white colour and ruin pattern for T. rubrum infection, and brown colour, jagged border and aurora pattern for T. interdigitalis. CONCLUSIONS Trying to find relationships between specific pathogens and dermoscopic patterns, we found out an association between spikes and striae and T. rubrum and T. interdigitalis respectively. Further larger studies are however necessary to evaluate our preliminary findings.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Elisa Milan
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Giovanni Summa
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Andrea Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | | | - Nilton Gioia Di Chiacchio
- Faculdade de Medicina do ABC, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Nilton Di Chiacchio
- Head of Dermatology Clinic - Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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9
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Sechi A, d'Amore ESG, Naldi L, Bellettato M, May Lee M, Cutrone M. Relapsing subcutaneous nodules of the penis in a pediatric patient. Dermatol Reports 2023; 15:9687. [PMID: 38348422 PMCID: PMC10859902 DOI: 10.4081/dr.2023.9687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 02/12/2023] [Indexed: 02/15/2024] Open
Abstract
A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare. Only 18 published cases reported penile granuloma annulare. Medical management was advocated in 7/18 cases, either as a first-line or adjuvant therapy where surgery was not radical. Three patients received high-potency local steroids: two cases underwent adjuvant sessions of intralesional triamcinolone, and one patient received pentoxifylline orally. Surgery should be considered a second-line option since 5/8 of treated cases eventually recurred. The pentoxifylline-treated case witnessed a relapse after drug discontinuation, while topical steroids lead to complete recovery without relapses.
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Affiliation(s)
- Andrea Sechi
- Dermatologic Unit, San Bortolo Hospital, Vicenza
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, IRCCS University Hospital of Bologna S.Orsola-Malpighi Polyclinic
| | | | - Luigi Naldi
- Dermatologic Unit, San Bortolo Hospital, Vicenza
| | | | - Marco May Lee
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Italy
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Gnesotto L, Mioso G, Starace M, Piraccini BM, Naldi L, Sechi A. Nail Lichen Striatus Affecting Adjacent Nails: A Sign of Blaschko Lines. Dermatol Pract Concept 2023; 13:dpc.1304a208. [PMID: 37992341 PMCID: PMC10656183 DOI: 10.5826/dpc.1304a208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Laura Gnesotto
- Department of Medicine-DIMED, Unit of Dermatology, University of Padova, Padova, Italy
| | - Guido Mioso
- Department of Medicine-DIMED, Unit of Dermatology, University of Padova, Padova, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Luigi Naldi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
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11
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Sechi A, Iorizzo M, Piraccini BM, Cannata G. CO 2 Laser-Assisted Avulsion of the Proximal Nail Plate as a New Treatment Strategy in Patients Affected by Retronychia. Dermatol Surg 2023; 49:976-977. [PMID: 37584464 DOI: 10.1097/dss.0000000000003890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Affiliation(s)
- Andrea Sechi
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
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Fagotto L, Gnesotto L, Vincenzi C, Piraccini BM, Naldi L, Sechi A. Wickham striae on skin appendages: a helpful dermoscopic feature. Dermatol Reports 2023; 15:9698. [PMID: 37908602 PMCID: PMC10614556 DOI: 10.4081/dr.2023.9698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 11/02/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disease, clinically characterized by purpuric, itchy papules that typically spread on the trunk and extremities. Other body sites can also be affected, including mucosal membranes, nails, and the scalp. The use of dermoscopy is essential in determining the diagnosis of LP, as it may highlight pathognomonic features such as Wickham striae (WS). WS are thin, pearly white structures arranged in a reticular pattern that is observed over LP lesions and histologically correspond to epidermal hypergranulosis. WS is usually most visible on the oral mucosa but can also cover almost every active LP papule. Here, we report two cases of biopsy-proven LP that show WS on dermoscopy in two specific sites: the scalp and proximal nail fold.
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Affiliation(s)
- Laura Fagotto
- Dermatology Unit, Department of Medicine, University of Padova
| | - Laura Gnesotto
- Dermatology Unit, Department of Medicine, University of Padova
| | - Colombina Vincenzi
- Dermatology Division, IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna
| | - Bianca Maria Piraccini
- Dermatology Division, IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna
| | - Luigi Naldi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy
| | - Andrea Sechi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy.
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13
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Sechi A, Wortsman X. High-Frequency Ultrasound Features of Periungual Superficial Acral Fibromyxomas. J Cutan Med Surg 2023; 27:536-538. [PMID: 37485625 DOI: 10.1177/12034754231188436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Affiliation(s)
- Andrea Sechi
- Dermatology Unit Vicenza, San Bortolo Hospital of Vicenza, Vicenza, Italy
| | - Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Universidad de Chile, Santiago, Chile
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Marco May Lee
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Luigi Naldi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Andrea Sechi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
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Starace M, Cedirian S, Bruni F, Alessandrini AM, Quadrelli F, Sechi A, Piraccini BM. Clinical study on the efficacy and tolerability of an oral supplement based on arginine, l-cystine, zinc and B6 vitamin (Cystiphane®) in patients with telogen effluvium. Ital J Dermatol Venerol 2023; 158:255-261. [PMID: 37278502 DOI: 10.23736/s2784-8671.23.07576-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Telogen effluvium (TE) is a common cause of non-cicatricial hair loss with no treatment-standardized protocol. The aim of our study was to evaluate the efficacy, tolerability, and patient compliance of a treatment with an oral supplement based on arginine, l-cystine, zinc and B<inf>6</inf> vitamin (Cystiphane®, Laboratoires Bailleul, Geneva, Switzerland) with hair-growth properties, administered 4 times daily, in patients affected by TE. METHODS We recruited 20 patients, aged between 18 and 70 years old, affected by TE. Patients were asked to take the oral supplement as a monotherapy, four tablets daily, in one or two administrations during meals. The study lasted 3 months. We evaluated the efficacy and tolerability of the treatment both qualitatively by collecting the clinician's opinion through a clinical evaluation and clinical-anamnestic form filled in by the researcher, and quantitatively through global photography and trichoscopy. We collected the patient's opinion through a self-assessment test, at the beginning of the recruitment and after 3 months of treatment. RESULTS Eighteen patients were evaluated. After 3 months of taking the supplement, the researcher rated an average improvement of 2.89 at the clinical evaluation. For what concerns hair quantity, at the control trichoscopy, the mean trichoscopic value had risen to +2.055, whereas for hair diameter the mean trichoscopic diameter value had increased to +1.83. After 3 months of treatment, patients gave an average efficacy opinion of 3.61. CONCLUSIONS The oral supplement has proved effective as an adjuvant in the treatment of TE in our cohort of patients.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Aurora M Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Andrea Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Bianca M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Bortoluzzi P, Prigitano A, Sechi A, Boneschi V, Germiniasi F, Esposto MC, Romanò L, Pavan G, Matinato C, Veraldi S, Marzano AV, Grancini A. Report of terbinafine resistant Trichophyton spp. in Italy: Clinical presentations, molecular identification, antifungal susceptibility testing and mutations in the squalene epoxidase gene. Mycoses 2023. [PMID: 37139949 DOI: 10.1111/myc.13597] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
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.
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Affiliation(s)
- P Bortoluzzi
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A Prigitano
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - A Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - V Boneschi
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Germiniasi
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M C Esposto
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - L Romanò
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - G Pavan
- Department of Microbiology, San Bortolo Hospital, Vicenza, Italy
| | - C Matinato
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
| | - S Veraldi
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
- Department of Microbiology, San Bortolo Hospital, Vicenza, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
- Department of Microbiology, San Bortolo Hospital, Vicenza, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - A Grancini
- Laboratorio Analisi - Laboratorio di Batteriologia, Parassitologia e Micologia, Fondazione IRCCS O. Maggiore Policlinico, Milan, Italy
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Abstract
INTRODUCTION Phototherapy has been one of the first and still frequently used treatment modality for psoriasis. In the last decades, different types of lasers have been used for the treatment of psoriasis and other inflammatory skin diseases with variable success. AREAS COVERED Efficacy and safety of laser devices and intense pulsed light for the treatment of psoriasis. The literature search was conducted using the bibliographic databases MEDLINE, EMBASE and Cochrane. Search terms included "laser" AND "psoriasis", "IPL" AND "psoriasis", "intense pulsed light" AND "psoriasis". EXPERT OPINION Due to its high efficacy and safety profile 308nm Excimer laser retains its specific place in the treatment of plaque psoriasis as a first- or second-line therapy in mild disease or as an adjuvant treatment in case of partial response to systemic treatments in moderate to severe disease. Vascular lasers remain a last line therapy that can be tried in patients with recalcitrant limited plaques or nail affection. They are easy to apply and have a very good safety profile and tolerability, but the efficacy is limited. Fractional ablative lasers for application of laser assisted drug delivery appear interesting and a topic for further research. When using lasers for psoriasis, a good pre-treatment is mandatory.
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Affiliation(s)
- Kristine Heidemeyer
- Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
- Dermatology Department, S. Bortolo Hospital, Vicenza, Italy
| | - Mustafa Kulac
- Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
| | - Andrea Sechi
- Centro Studi GISED, Bergamo, Italy
- Dermatology Department, S. Bortolo Hospital, Vicenza, Italy
| | - Simone Cazzaniga
- Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland
- Centro Studi GISED, Bergamo, Italy
| | - Luigi Naldi
- Centro Studi GISED, Bergamo, Italy
- Dermatology Department, S. Bortolo Hospital, Vicenza, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- A Sechi
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine
| | - J Song
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
- University of Padua Faculty of Medicine and Surgery, Department of Medicine DIMED, Padova, Veneto, Italy
| | - M Dell'Antonia
- University of Cagliari, Dermatology Clinic, Department of Medical Sciences and Public Health
| | - K Heidemeyer
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
- Bern University Hospital Clinic for Dermatology, Department of Dermatology, Inselspital, Bern, Switzerland
| | - B M Piraccini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine
| | - M Starace
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine
| | - L Naldi
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
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Piccolo V, Bassi A, Grimalt R, Mazzatenta C, Argenziano G, Sechi A, Cutrone M. Lingua villosa nigra in a child after Covid: review and differential diagnosis with oral pigmentations of childhood. J Eur Acad Dermatol Venereol 2023. [PMID: 36974423 DOI: 10.1111/jdv.19070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/15/2023] [Indexed: 03/29/2023]
Affiliation(s)
| | - Andrea Bassi
- UO Dermatology- Azienda USL, Toscana, Nord Ovest, Lucca, Italy
| | - Ramon Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Andrea Sechi
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza
| | - Mario Cutrone
- Pediatric Dermatology, Ospedale dell'Angelo Venezia, Ospedale San Bortolo Vicenza
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20
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May Lee M, Naldi L, Pierobon E, Leuzzi M, Sechi A. Florid cutaneous papillomatosis and acanthosis nigricans as cutaneous findings in a patient with ovarian carcinoma. J Cosmet Dermatol 2023. [PMID: 36892107 DOI: 10.1111/jocd.15699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/05/2023] [Accepted: 02/16/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Marco May Lee
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Luigi Naldi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Elena Pierobon
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Andrea Sechi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
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21
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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] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Miriam Leuzzi
- Dermatology Unit-IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy.
| | - Andrea Sechi
- Dermatology Unit-IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Carlotta Baraldi
- Dermatology Unit-IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit-IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Iria Neri
- Dermatology Unit-IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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22
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Starace M, Viviani F, Carpanese MA, Alessandrini A, Sechi A, Patrizi A, Bianchi T. Diagnosis and Management of Intravenous Drug Users' Chronic Wounds: A Case Series Collection of a Single Center. INT J LOW EXTR WOUND 2022:15347346221121465. [PMID: 36036366 DOI: 10.1177/15347346221121465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Intravenous drug users (IVDUs) represent a very small group of patients affected by chronic wounds (CWs). Objectives: To assess the risk factors for CWs in IVDUs, to improve their treatment. Methods: A retrospective review of 7 IVDUs with CWs was performed at the Dermatology of the University of Bologna. Results: A history of 10 years of the most frequent injection was heroin in the gaiter area. The most observed comorbidities were HIV, HCV and HBV. They were treated most with an alginate with silver dressing with an average follow-up of 2.8 years. Conclusions: We would like to highlight the importance of clinical history in this type of patients and that in our experience specialized skin wounds risk assessment and management could be useful, aside from traditional compression therapy.
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Affiliation(s)
- M Starace
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - F Viviani
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - M A Carpanese
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - A Alessandrini
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - A Sechi
- 198202UOC Dermatologia - Ospedale San Bortolo, Vicenza, Italy
| | - A Patrizi
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - T Bianchi
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
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Starace M, Pampaloni F, Carpanese Miriam A, Sechi A, Bruni F, Alessandrini A. Is a triggering role or a causative role of PD-1/PDL-1 inhibitors in the development of paraneoplastic dermatomyositis? Dermatol Pract Concept 2022; 12:e2022105. [PMID: 36159126 PMCID: PMC9464532 DOI: 10.5826/dpc.1203a105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michela Starace
- Dermatology-IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
| | | | - Anna Carpanese Miriam
- Dermatology-IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
| | - Andrea Sechi
- Dermatology-IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
| | - Francesca Bruni
- Dermatology-IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
| | - Aurora Alessandrini
- Dermatology-IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Italy
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Sechi A, Patrizi A, Raone B. Intralesional steroid injections to target sinus tract fibrosis in hidradenitis suppurativa: Results from an ultrasound-based retrospective study. Dermatol Ther 2022; 35:e15710. [PMID: 35811390 DOI: 10.1111/dth.15710] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/25/2022] [Accepted: 04/11/2022] [Indexed: 12/28/2022]
Affiliation(s)
- Andrea Sechi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy.,IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division-Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division-Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Beatrice Raone
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division-Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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25
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Sechi A, Neri I, Patrizi A, Di Altobrando A, Clinca R, Caro RDC, Leuzzi M, Misciali C, Gaspari V. Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations. J Ultrasound 2022; 25:343-348. [PMID: 33527311 PMCID: PMC9148356 DOI: 10.1007/s40477-020-00537-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/22/2020] [Indexed: 11/24/2022] Open
Abstract
A single-center retrospective study reviewed the following sonographic features of 18 confirmed cases of localized cutaneous leishmaniasis to identify shared presentation patterns: echotexture, lesion borders, hypodermal involvement, soft-tissue changes, and vascular pattern. A second objective was to correlate these patterns with clinical characteristics, including sex, age, anatomical location, nodule vs. plaque presentation, raised borders, granulation tissue, swelling, hyperkeratotic crusting, disease onset, and healing time. Two main patterns were identified with high-frequency ultrasonography. The first pattern was characterized by a high level of inflammation and deep hypodermal involvement, while the second variant showed involvement limited to the dermis, with minimal inflammation. The "inflammatory pattern" showed ill-defined borders, mixed echotexture, prominent vascularity with central distribution, and was correlated with clinical signs of ulceration, granulation tissue, raised borders, and longer healing time (p < 0.05). The "pauci-inflammatory pattern" presented a well-defined structure with decreased echogenicity, reduced or absent vascularity with minimal soft-tissue changes, and was associated with a shorter healing time (p < 0.05).
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Affiliation(s)
- Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy.
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Ambra Di Altobrando
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Roberta Clinca
- Radiology Unit, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Bologna, Italy
| | | | - Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Cosimo Misciali
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
| | - Valeria Gaspari
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy
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Pierobon E, Sechi A, Germi L, Pezzolo E, Trevisan G, Feliciani C, Naldi L. Severe injection site reaction ensuing the first dose of mRNA COVID-19 vaccine: a case report. Ital J Dermatol Venerol 2022; 157:281-282. [PMID: 35373779 DOI: 10.23736/s2784-8671.22.07162-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Elena Pierobon
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy -
| | - Andrea Sechi
- Section of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Lerica Germi
- Section of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Elena Pezzolo
- Section of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | | | - Claudio Feliciani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luigi Naldi
- Section of Dermatology, San Bortolo Hospital, Vicenza, Italy
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Pierobon E, Germi L, Sechi A, Trevisan G, Pezzolo E, Feliciani C, Naldi L. Keratolysis exfoliativa-like eruption induced by ranolazine. Dermatol Reports 2022; 14:9264. [PMID: 35399369 PMCID: PMC8991443 DOI: 10.4081/dr.2022.9264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022] Open
Abstract
Dermatoses affecting palms may represent a dermatologic challenge from both the diagnostic, and therapeutic point of view. Patients with supposedly occupational dermatitis can spend months or even years in a frustrating attempt to avoid contact with possible irritants or allergens. To underline the importance of a thorough unbiased analysis of the patient’s history and clinical features, we present the iconic case of a bricklayer affected by a chronic, disabling desquamation of palms which in the end was classified as keratolysis exfoliativa (KE) attributed to ranolazine-intake, an antianginal drug. To the best of our knowledge, this specific adverse effect of druginduced KE of palms has never been reported before in association with ranolazine.
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Sechi A, Bassi A, Mazzatenta C, Cutrone M, Naldi L, Argenziano G, Piccolo V. Covid-19 and Covid-19 vaccine can slide along sides: a report of two cases of unilateral periflexural exanthem. J Eur Acad Dermatol Venereol 2022; 36:e595-e596. [PMID: 35305031 PMCID: PMC9114993 DOI: 10.1111/jdv.18093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/13/2022] [Accepted: 03/14/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Andrea Sechi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy.,IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Italy
| | - Andrea Bassi
- UO Dermatologia Lucca- Azienda USL Toscana Nordovest, Italy
| | | | - Mario Cutrone
- Pediatrics Unit, San Bortolo Hospital, Vicenza, Italy
| | - Luigi Naldi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy
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Bassi A, Mazzatenta C, Sechi A, Cutrone M, Vincenzo P. Not only toes and fingers: COVID vaccine‐induced chilblain‐like lesions of the knees. J Eur Acad Dermatol Venereol 2022; 36:e497-e498. [PMID: 35188988 PMCID: PMC9114987 DOI: 10.1111/jdv.18025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andrea Bassi
- UO Dermatologia Lucca‐ Azienda USL Toscana Nordovest Italy
| | | | - Andrea Sechi
- Dermatologic Unit San Bortolo Hospital Vicenza Italy
| | | | - Piccolo Vincenzo
- Dermatology Unit University of Campania Luigi Vanvitelli Naples Italy
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Bardazzi F, Guglielmo A, Abbenante D, Sacchelli L, Sechi A, Valeria Rita Starace M. New insights on alopecia areata during COVID-19 pandemic: when infection or vaccination seems to play a role. J Cosmet Dermatol 2022; 21:1796-1798. [PMID: 35182005 PMCID: PMC9115072 DOI: 10.1111/jocd.14864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/24/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Alba Guglielmo
- Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Diego Abbenante
- Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Lidia Sacchelli
- Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Andrea Sechi
- Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy.,Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy
| | - Michela Valeria Rita Starace
- Dermatology, IRCCS S. Orsola-Malpighi Polyclinic, Bologna, Italy.,Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna
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31
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Sechi A, Pierobon E, Pezzolo E, Germi L, Trevisan G, Zardo D, Riva G, Mondino S, Naldi L. Abrupt onset of Sweet syndrome, pityriasis rubra pilaris, pityriasis lichenoides et varioliformis acuta and erythema multiforme: unravelling a possible common trigger, the COVID-19 vaccine. Clin Exp Dermatol 2022; 47:437-440. [PMID: 34617317 PMCID: PMC8652785 DOI: 10.1111/ced.14970] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 12/25/2022]
Affiliation(s)
- A. Sechi
- Dermatology UnitOspedale San BortoloVicenzaItaly
- IRCCS University Hospital of Bologna S Orsola‐Malpighi Polyclinic Dermatology DivisionDepartment of Experimental, Diagnostic and Specialty Medicine (DIMES)Alma Mater Studiorum University of BolognaBolognaItaly
| | - E. Pierobon
- Section of DermatologyDepartment of Medicine and SurgeryUniversity of ParmaParmaItaly
| | - E. Pezzolo
- Dermatology UnitOspedale San BortoloVicenzaItaly
| | - L. Germi
- Dermatology UnitOspedale San BortoloVicenzaItaly
| | - G. Trevisan
- Dermatology UnitOspedale San BortoloVicenzaItaly
| | - D. Zardo
- Pathology UnitOspedale San BortoloVicenzaItaly
| | - G. Riva
- Pathology UnitOspedale San BortoloVicenzaItaly
| | - S. Mondino
- Health and Risk ManagementOspedale San BortoloVicenzaItaly
| | - L. Naldi
- Dermatology UnitOspedale San BortoloVicenzaItaly
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Sechi A, Zengarini C, Piraccini BM, Alessandrini A, Bruni F, Patrizi A, Naldi L, Starace M. Treatment of retronychia: A systematic review and suggested treatment algorithm. Dermatol Ther 2021; 35:e15251. [PMID: 34877747 DOI: 10.1111/dth.15251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 11/21/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022]
Abstract
Retronychia is an inflammatory disorder typical of the great toes characterized by arrested nail growth, ingrowth of the nail plate into the proximal nail fold and paronychia. There is no standardized treatment for retronychia, and its management should be weighed based on the severity stage, treatment modality, and clinical outcome. In this paper, a systematic review of the literature was performed to assess all published data regarding the treatment of retronychia. A total of 231 patients from 24 studies were included in the analysis. Conservative management was adopted in mild-intermediate forms, consisting of medical (topical or intralesional high-potency corticosteroids) and podiatric treatment (taping, clipping back the onycholytic plate, orthosis), leading to a global cure rate of 41.2%, with no reported side effects. Non-conservative management, that is, chemical or surgical avulsion of the nail plate, proved resolutive in 71.2% of cases. Surgical avulsion of the nail plate produced the highest cure rate (78.2%), but was burdened by 9.6% of long-term sequelae, mainly nail dystrophies. A decision-making algorithm was designed to give clinicians treatment indications based on the severity stage of retronychia, treatment invasiveness, and possible clinical outcomes.
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Affiliation(s)
- Andrea Sechi
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy.,Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy
| | - Corrado Zengarini
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luigi Naldi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy
| | - Michela Starace
- IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Starace M, Iorizzo M, Sechi A, Alessandrini AM, Carpanese M, Bruni F, Vara G, Apalla Z, Asz-Sigall D, Barruscotti S, Camacho F, Doche I, Estrada BD, Dhurat R, Gavazzoni MF, Grimalt R, Harries M, Ioannidis D, McMichael A, Melo DF, Oliveira R, Ovcharenko Y, Pirmez R, Ramot Y, Rudnicka L, Shapiro J, Silyuk T, Sinclair R, Tosti A, Vano-Galvan S, Piraccini BM. Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management. JAAD Int 2021; 5:11-18. [PMID: 34368790 PMCID: PMC8328568 DOI: 10.1016/j.jdin.2021.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, postinfectious telogen effluvium and trichodynia have also been reported. OBJECTIVE To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to the other signs and symptoms of the disease. METHODS Patients with a history of COVID-19 presenting to the clinics of a group of hair experts because of telogen effluvium and/or scalp symptoms were questioned about their hair signs and symptoms in relation to the severity of COVID-19 and associated symptoms. RESULTS Data from 128 patients were collected. Telogen effluvium was observed in 66.3% of the patients and trichodynia in 58.4%. Trichodynia was associated with telogen effluvium in 42.4% of the cases and anosmia and ageusia in 66.1% and 44.1% of the cases, respectively. In majority (62.5%) of the patients, the hair signs and symptoms started within the first month after COVID-19 diagnosis, and in 47.8% of the patients, these started after 12 weeks or more. LIMITATIONS The recruitment of patients in specialized hair clinics, lack of a control group, and lack of recording of patient comorbidities. CONCLUSION The severity of postviral telogen effluvium observed in patients with a history of COVID-19 infection may be influenced by COVID-19 severity. We identified early-onset (<4 weeks) and late-onset (>12 weeks) telogen effluvium.
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Affiliation(s)
- Michela Starace
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
| | - Andrea Sechi
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Aurora Maria Alessandrini
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Miriam Carpanese
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giulio Vara
- Radiology Unit, Policlinico Sant'Orsola, University of Bologna, Bologna, Italy
| | - Zoe Apalla
- Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stefania Barruscotti
- Department of Clinical-Surgical, Diagnostic and Pediatric Science, Institute of Dermatology, IRCCS Fondazione Policlinico San Matteo, University of Pavia, Pavia, Italy
| | - Francisco Camacho
- University of Seville, Medical-Surgical Dermatology Department, University Hospital, Seville, Spain
| | - Isabella Doche
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Bruna Duque Estrada
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem D Azulay, Rio de Janeiro, Brazil
| | - Rachita Dhurat
- Department of Dermatology, LTM Medical College & Hospital Sion, Mumbai, India
| | | | - Ramon Grimalt
- Facultat de Medicina i Ciencies de la Salut, UIC-Barcelona, Universitat Internacional de Catalunya, Sant Cugat del `Valles, Barcelona, Spain
| | - Matthew Harries
- Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, United Kingdom
| | - Dimitrios Ioannidis
- Department of Dermatology-Venereology, Aristotle University Medical School, Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Amy McMichael
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Daniel Fernandes Melo
- Department of Dermatology, University of State of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Rui Oliveira
- Trichology Unit, Dermatology Center CUF Descobertas Hospital, Lisbon, Portugal
| | - Yuliya Ovcharenko
- Department of General and Clinical Immunology and Allergology, V.N. Karazin Kharkiv National University Medical School, Kharkiv, Ukraine
| | - Rodrigo Pirmez
- Centro de Estudos dos Cabelos, Instituto de Dermatologia Prof. Rubem D Azulay, Rio de Janeiro, Brazil
| | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Jerry Shapiro
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York City, New York
| | - Tatiana Silyuk
- Hair Treatment and Transplantation Center, Private Practice, Saint Petersburg, Russia
| | | | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Sergio Vano-Galvan
- Dermatology Department, Ramon y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - Bianca Maria Piraccini
- Dermatology-IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Pierobon E, Germi L, Sechi A, Trevisan G, Pezzolo E, Feliciani C, Naldi L. Keratolysis exfoliativa-like eruption induced by ranolazione. Dermatol Reports 2021. [DOI: 10.4081/dr.2021.9264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Dermatoses affecting palms may represent a dermatologic challenge from both the diagnostic, and therapeutic point of view. Patients with supposedly occupational dermatitis can spend months or even years in a frustrating attempt to avoid contact with possible irritants or allergens. To underline the importance of a thorough unbiased analysis of the patient’s history and clinical features, we present the iconic case of a bricklayer affected by a chronic, disabling desquamation of palms which in the end was classified as keratolysis exfoliativa (KE) attributed to ranolazine-intake, an antianginal drug. To the best of our knowledge, this specific adverse effect of drug-induced KE of palms has never been reported before in association with ranolazine.
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35
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Sechi A, Patrizi A, Vara G, Golfieri R, Neri I. Bei CALME (childhood asymmetry labium majus enlargement): die Ruhe bewahren und nachverfolgen. J Dtsch Dermatol Ges 2021; 19:1276-1282. [PMID: 34541793 DOI: 10.1111/ddg.14528_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/26/2021] [Indexed: 11/27/2022]
Abstract
CALME steht für childhood asymmetry labium majus enlargement und bezeichnet eine physiologische, nichtneoplastische Schwellung des Weichteilgewebes der Labia majora. CALME wird durch die Vergrößerung einer oder mehrerer normaler vulvärer Gewebeanteile verursacht und weist keine äußere Kapsel auf. Vereinzelte Berichte in der Literatur haben das Augenmerk auf diese gutartige Veränderung gelenkt und die Notwendigkeit betont, invasive Eingriffe mit möglichen Dauerfolgen zu vermeiden. Die Ätiopathogenese von CALME ist nach wie vor umstritten, wobei die Hypothese einer hormonell bedingten stromalen Hyperplasie der großen Schamlippen gegenüber der Annahme eines gutartigen neoplastischen Prozesses favorisiert wird. Dieser Artikel zielt darauf ab, einen detaillierten Überblick über die klinischen, histologischen und apparativen Befunde bei CALME zu geben und einen abgestuften Algorithmus zur Herangehensweise und zum Management von genito-inguinalen Geschwülsten bei pädiatrischen Patienten zu erstellen.
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Affiliation(s)
- Andrea Sechi
- IRCCS University Hospital of Bologna St. Orsola-Malpighi Polyclinic Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- IRCCS University Hospital of Bologna St. Orsola-Malpighi Polyclinic Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giulio Vara
- Radiology Unit, University Hospital of Bologna St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Rita Golfieri
- Radiology Unit, University Hospital of Bologna St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Iria Neri
- IRCCS University Hospital of Bologna St. Orsola-Malpighi Polyclinic Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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36
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Starace M, Vezzoni R, Alessandrini A, Bruni F, Carpanese MA, Misciali C, Sechi A, Piraccini BM. Therapeutic approach with squaric acid dibutylester for steroid resistant-alopecia areata incognita: A pilot study of a single center. Dermatol Ther 2021; 34:e15096. [PMID: 34390608 DOI: 10.1111/dth.15096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/05/2021] [Indexed: 11/29/2022]
Abstract
Topical immunotherapy is widely used in the treatment of alopecia areata (AA). Alopecia areata incognita (AAI) is a relatively common disorder, predominantly affecting females, characterized by widespread hair thinning in the absence of typical alopecic patches. AAI can have a chronic relapsing course and in some cases can be resistant to current standard treatments. Topical immunotherapy has been used in the management of AA with encouraging results, but to date there are no literature studies reporting the efficacy of topical immunotherapy with squaric acid dibutylester (SADBE) in AAI. The aim of our study is to evaluate the efficacy and tolerance of topical immunotherapy with SADBE in AAI not responding to conventional steroid therapy. A total of 12 patients were enrolled in our Hair Disease Outpatient Service, with a proved histological diagnosis of AAI, and resistant to classical steroid therapy. Each patient underwent global photography, pull test, and trichoscopy at beginning and during the follow-ups. The efficacy of topical immunotherapy with SADBE was assessed by evaluating the changes of clinical and trichoscopic signs. Complete regrowth was achieved in 66.7% of cases (8/12), three patients remained unchanged on clinical evaluation but showed subclinical improvement on trichoscopy, whereas one patient progressed and worsened both on clinical and trichoscopic examination. All patients reported scalp diffuse mild erythema and itching the day after the application of SADBE, which were well tolerated. Three patients developed reactive cervical lymphoadenomegaly. No other side effects were observed. Topical immunotherapy with SADBE is widely used in the management of patchy AA and can be considered an effective alternative in resistant AAI, providing visible clinical and trichoscopic improvement in the majority of cases. Further studies are warranted to confirm and validate our findings.
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Affiliation(s)
- Michela Starace
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Roberta Vezzoni
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Aurora Alessandrini
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Miriam Anna Carpanese
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Andrea Sechi
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology-IRCCS, Policlinico Sant'Orsola, Department of Specialized, Experimental and Diagnostic Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Sechi A, Vaccari S, Parlangeli A, Vara G, Patrizi A. Homogeneous blue lumps of the nipple-areola complex in pubertal girls. Pediatr Dermatol 2021; 38:887-891. [PMID: 34184316 DOI: 10.1111/pde.14630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Retroareolar cysts are benign breast lesions caused by the obstruction and consequent dilatation of Montgomery tubercles. Herein, we report two cases of premenarchal girls who developed retroareolar cysts. Their course and differential diagnosis are discussed.
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Affiliation(s)
- Andrea Sechi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Giulio Vara
- Radiology Unit, University Hospital of Bologna Sant'Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Annalisa Patrizi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), IRCCS University Hospital of Bologna S Orsola-Malpighi Polyclinic Dermatology Division, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Sechi A, Patrizi A, Vara G, Golfieri R, Neri I. Keep CALME (childhood asymmetry labium majus enlargement) and follow up. J Dtsch Dermatol Ges 2021; 19:1276-1281. [PMID: 34164912 DOI: 10.1111/ddg.14528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/26/2021] [Indexed: 11/28/2022]
Abstract
CALME is the abbreviation of "childhood asymmetry labium majus enlargement" and denotes a physiological, non-neoplastic swelling of labium majus soft tissues. It is caused by the expansion of one or more normal vulvar tissue components and is devoid of a peripheral capsule. A few reports in the literature have raised awareness of this benign condition and stressed the need to avoid invasive procedures with possible permanent sequelae. The etiopathogenesis of CALME is still debated, although the hypothesis of a hormone-driven major labia stromal hyperplasia is favored over the assumption of a benign neoplastic process. This article aims to provide a detailed review of the clinical, histological, and instrumental findings of CALME and provide a step-based algorithm to approach and manage genito-inguinal masses in pediatric patients.
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Affiliation(s)
- Andrea Sechi
- IRCCS University Hospital of Bologna St. Orsola-Malpighi Polyclinic Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- IRCCS University Hospital of Bologna St. Orsola-Malpighi Polyclinic Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giulio Vara
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Via Albertoni 15, Bologna, Italia
| | - Rita Golfieri
- Department of Radiology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Via Albertoni 15, Bologna, Italia
| | - Iria Neri
- IRCCS University Hospital of Bologna St. Orsola-Malpighi Polyclinic Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Caposiena Caro RD, Chiricozzi A, Sechi A, Molinelli E, Venturini M, Candi E, Malvaso D, Peris K, Patrizi A, Offidani A, Calzavara-Pinton P, Bianchi L. Flares as dynamic predictive factor of response to adalimumab in hidradenitis suppurativa, real-life data. Ital J Dermatol Venerol 2021; 157:240-246. [PMID: 34159775 DOI: 10.23736/s2784-8671.21.07049-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is characterized by periodic worsening of both clinical manifestations and symptoms. The aim was to investigate the role of flare outbreak as a possible predictive factor of response to Adalimumab. METHODS 115 HS patients in treatment with adalimumab, with moderate-severe HS, ≥3 abscesses and inflammatory-nodules (ANs) from 5 Italian centers were included in this retrospective analysis. The information about gender, ages at onset/baseline, therapeutic delay, family history, body mass index, smoking, comorbidities, phenotypes, body areas, severity indexes at baseline was collected. Baseline characteristics, total number and timeline of flares were analysed by regression and survival analysis with Hidradenitis Suppurativa Clinical Response (HiSCR). RESULTS During the observational period, 80.9% of patients developed flares, detecting 252 flares. Univariate model identified five factors associated with the absence of response: age (p-value=0.020), comorbidities (p-value=0.030), genital-perineal involvement (pvalue= 0.004), no response at week-12 (p-value=0.027), and flares outbreak (p-value=0.010). Joint analysis of recurrent and terminal events showed a positive correlation between flare recurrence and no-response (p-value<0.001). Among the identified variables associated with poor response to the therapy: occurrence of a flare before week-12 was the one with the highest risk of no response (p-value<0.001). The limitations are: study's retrospective design, limited number of patients, absence either of a consensus about flare definition, placebo control group or standard therapy of flares during adalimumab therapy. CONCLUSIONS The analysis of a "dynamic" variable, as flares evaluation together with an appropriate clinical baseline assessment can be a useful approach to predict the middle-long-term response to adalimumab.
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Affiliation(s)
| | - Andrea Chiricozzi
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Marina Venturini
- Department of Dermatology, University of Brescia at ASST-Spedali Civili, Brescia, Italy
| | - Eleonora Candi
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Dalma Malvaso
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica - Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | | | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Guglielmo A, Virdi A, Vincenzi C, Zanotti Russo M, Sechi A, Patrizi A, Neri I. 'Colouring' wipes phenomenon: a peculiar skin pigmentation induced by ascorbic acid observed during lockdown. Clin Exp Dermatol 2021; 46:1075-1078. [PMID: 33577095 PMCID: PMC9213943 DOI: 10.1111/ced.14606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/06/2021] [Accepted: 02/10/2021] [Indexed: 11/30/2022]
Abstract
During the SARS‐CoV‐2 (COVID‐19) pandemic, an unusual outbreak of yellow–brown pigmentation on the skin of children was reported. Because of the restrictions on movement promulgated during the lockdown, most consultancies were performed using teledermatology. Data concerning personal care products and application of topical substances were collected, which revealed use of the same brand of wipes for all patients. A liquid chromatography–mass spectrometry analysis was performed to compare the components of the wipes before and after the observation of the pigmentation, in order to detect the responsible substance. This analysis revealed a level about 10‐fold higher than normal of ascorbic acid and its oxidation products (dehydroascorbic acid and L‐threonic acid) in the wipes associated with the pigmentation. These ‘colouring wipes’ represent a peculiar but harmless phenomenon that highlights the importance of careful questioning about personal care products used by patients.
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Affiliation(s)
- A Guglielmo
- Department of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Virdi
- Department of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - C Vincenzi
- Department of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - A Sechi
- Department of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Patrizi
- Department of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - I Neri
- Department of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Caposiena Caro RD, Chiricozzi A, Sechi A, Molinelli E, Venturini M, Candi E, DE Simone C, Peris K, Patrizi A, Offidani A, Calzavara-Pinton P, Bianchi L. Factors related to the onset and recurrence of flares in hidradenitis suppurativa patients treated with adalimumab. Ital J Dermatol Venerol 2021; 157:137-141. [PMID: 33982548 DOI: 10.23736/s2784-8671.21.06966-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is characterized by periodic worsening of symptoms. However, clinical parameters associated with flare are still to be established. The aim was too investigate factors associated with flare outbreak in HS patients in treatment with adalimumab. METHODS Moderate-severe HS patients were included in this retrospective analysis. In total, 115 HS patients treated with adalimumab from 5 Italian centers were reviewed. Gender, ages at onset/baseline, therapeutic delay, family history, body mass index, smoking, comorbidities, phenotypes, body areas involved, Hurley stage, International Hidradenitis Suppurativa Severity Score System (IHS4), Dermatology Life Quality Index (DLQI) and Visual Analogue Scale for pain (pain-VAS) were collected at baseline. Flares were modelled with baseline features using univariate and multivariate Coxregression. The factors significantly correlated with flares in the univariate model were analyzed using a recurrent event survival analysis (Andersen-Gill model) to assess the relation between them and flares recurrence. RESULTS During the observation period 80.9% of patients developed flares, detecting 252 flares, overall. A univariate model identified five risk factors associated with the outbreak of flares: age, therapeutic delay, groin involvement, Hurley III, higher IHS4, whereas, from multivariate model, only IHS4 resulted to be significantly correlated. Additionally, flares were positively associated with higher DLQI and pain-VAS. Finally, the Andersen-Gill model showed four factors correlated with flares recurrence: age, therapeutic delay, Hurley III and higher IHS4. The limitations are: study's retrospective design, absence of a consensus about flare definition. CONCLUSIONS An early treatment of HS may prevent both the disease progression and reduce the recurrence of flares.
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Affiliation(s)
| | - Andrea Chiricozzi
- Institute of Dermatology, Università Cattolica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Marina Venturini
- Department of Dermatology, University of Brescia at ASST-Spedali Civili, Brescia, Italy
| | - Eleonora Candi
- Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Clara DE Simone
- Institute of Dermatology, Università Cattolica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Ketty Peris
- Institute of Dermatology, Università Cattolica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annamaria Offidani
- Dermatological Unit, Department of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | | | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Sechi A, di Altobrando A, Cerciello E, Maietti E, Patrizi A, Savoia F. Drug Intake and Actinic Keratosis: A Case-Control Study. Dermatol Pract Concept 2021; 11:e2021031. [PMID: 33954014 DOI: 10.5826/dpc.1102a31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 10/31/2022] Open
Abstract
Background Actinic keratosis (AK) is a form of premalignant keratinocyte dysplasia. Recently, the role of photosensitizing drugs in the development of AK has been postulated. Objective This study evaluated a possible association between the use of photosensitizing drugs and the development of AK. A secondary aim was to identify a possible association between any medication other than those primarily examined and AK. Methods A single-center, case-control study assessed the cumulative drug exposure of 90 patients with AK and 90 controls visiting a dermatology service for other skin ailments. Before the visit, patients were interviewed to collect data on daily therapy and the lag-time of discontinued drugs within the last 2 years, and to record the drug's active ingredient, dosage, and duration of therapy. In addition, sociodemographic characteristics including age, sex, educational level, skin phototype, and cumulative sun exposure habits were gathered. Results By logistic regression, exposures to angiotensin II receptor blockers (ARBs) and antiplatelet agents were identified as independent risk factors for the development of AK. ARB intake was associated with AK only at high exposure (OR = 13.6; 95% CI, 2.0-93.8). The use of antiplatelet drugs was borderline, yet not significant, at low exposure (OR = 3.31; 95% CI, 0.86-12.7), but increased in a dose-dependent manner. The strongest correlation was found at the highest cumulative dose (>1100 dose unit-years (OR = 4.38; 95% CI, 1.16-16.6). Conclusions High exposure to ARBs and antiplatelet agents may promote AK carcinogenesis in at-risk patients.
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Affiliation(s)
- Andrea Sechi
- Dermatology, IRCCS Policlinico di Sant'Orsola. Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Italy
| | - Ambra di Altobrando
- Dermatology, IRCCS Policlinico di Sant'Orsola. Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Italy
| | - Eugenio Cerciello
- Dermatology, IRCCS Policlinico di Sant'Orsola. Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Italy
| | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Annalisa Patrizi
- Dermatology, IRCCS Policlinico di Sant'Orsola. Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Italy
| | - Francesco Savoia
- Dermatology, IRCCS Policlinico di Sant'Orsola. Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Italy
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Leuzzi M, Di Donato G, Baraldi C, Sechi A, Patrizi A, Neri I. Genitale Papeln bei einem Kind. J Dtsch Dermatol Ges 2021; 19:469-470. [PMID: 33709585 DOI: 10.1111/ddg.14188_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Giulio Di Donato
- Division of Paediatrics, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlotta Baraldi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Vara G, Rustici A, Sechi A, Mosconi C, Lucidi V, Golfieri R. Texture Analysis on Ultrasound: The Effect of Time Gain Compensation on Histogram Metrics and Gray-Level Matrices. J Med Phys 2021; 45:249-255. [PMID: 33953501 PMCID: PMC8074715 DOI: 10.4103/jmp.jmp_82_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/11/2020] [Accepted: 12/13/2020] [Indexed: 11/17/2022] Open
Abstract
Aims: Texture analysis (TA) is becoming an increasingly used tool in radiological research. Some papers have been published on its use in ultrasound (US), but the way in which the machine settings affect the features has not yet been fully explored. With this research, we analyze how the time gain compensation (TGC) influences the features of the gray-level matrices in the abdominal US setting. Subjects and Methods: We analyzed the images acquired from the hepatorenal acoustic window of a healthy 29-year-old volunteer acquired with different TGC settings. TA was carried out using the LifeX software. Results: Several both 1st and 2nd order gray-level matrices features showed a strong correlation with TGC settings. Conclusions: TGC settings must be accounted for when carrying out further TA studies.
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Affiliation(s)
- Giulio Vara
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Arianna Rustici
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Andrea Sechi
- Department of Specialized, Clinical and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
| | - Cristina Mosconi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Vincenzo Lucidi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Rita Golfieri
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Sechi A, Tartari F, Patrizi A, Virdi A, Leuzzi M, Neri I. Severe hidradenitis suppurativa in a patient affected by Hermansky-Pudlak Syndrome type 9: possible shared pathogenetic aspects. Ital J Dermatol Venerol 2021; 156:254-255. [PMID: 33423449 DOI: 10.23736/s2784-8671.20.06602-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Federico Tartari
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy -
| | - Annalucia Virdi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Guglielmo A, Sechi A, Patrizi A, Gurioli C, Neri I. Head and neck dermatitis, a subtype of atopic dermatitis induced by Malassezia spp: Clinical aspects and treatment outcomes in adolescent and adult patients. Pediatr Dermatol 2021; 38:109-114. [PMID: 33155738 DOI: 10.1111/pde.14437] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 10/03/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Head and neck dermatitis (HND) is a clinical variant of atopic dermatitis (AD), presenting in adolescence or adulthood and characterized by involvement of the head, neck, and superior part of the trunk. The role of Malassezia spp has been advocated in the pathogenesis of HND, and antifungal agents represent the treatment of choice. METHODS A retrospective single-center study was performed to define the clinical features and treatment response of HND among adolescent and adult patients. RESULTS Thirty-one patients were identified, 17 with "adolescent-onset" and 14 with "adult-onset" HND. Adolescent-onset HND positively correlated with a past history of AD and presented with exclusive head and neck involvement (P < .05). Adult-onset HND was associated with concomitant widespread atopic eczema, involving the flexural areas of the upper and lower limbs, trunk, nipples, or hands (P < .05). A positive response to itraconazole in combination with topical treatments was observed in both groups. CONCLUSIONS This study delineates two HND clinical phenotypes: adolescent vs adult onset. Different characteristics were observed in terms of relationship to AD and eczema localization. A history of AD in childhood and presentation with exclusive involvement of head and neck regions was observed predominantly in the adolescent-onset form, while adult-onset HND often occurred in association with diffuse dermatitis and a past history of AD was less frequent than in the adolescent group. The study is limited by the single-center retrospective nature, which may lead to diagnostic and selection biases, and the small cohort of patients.
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Affiliation(s)
- Alba Guglielmo
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Carlotta Gurioli
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Leuzzi M, Sechi A, Filippi F, Di Altobrando A, Gurioli C, Neri I. Infantile hemangioma with minimal or arrested growth and isolated spinal dysraphism: A new or underrecognized entity? Indian J Dermatol 2021; 66:559-561. [PMID: 35068518 PMCID: PMC8751710 DOI: 10.4103/ijd.ijd_267_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Sechi A, Patrizi A, Leuzzi M, Chessa MA, Neri I. Concomitant Onychomadesis and Skin Rash in a 3-Year-Old Child Affected by Hand, Foot, and Mouth Disease. Indian J Dermatol 2021; 66:106-108. [PMID: 33911309 PMCID: PMC8061493 DOI: 10.4103/ijd.ijd_325_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Andrea Sechi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. E-mail:
| | - Annalisa Patrizi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. E-mail:
| | - Miriam Leuzzi
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. E-mail:
| | - Marco Adriano Chessa
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. E-mail:
| | - Iria Neri
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. E-mail:
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Sechi A, Guglielmo A, Patrizi A, Bertuzzi C, Neri I, Pileri A. Atopic dermatitis and mycosis fungoides in a child: an overlooked association. Ital J Dermatol Venerol 2020; 156:625-626. [PMID: 33314899 DOI: 10.23736/s2784-8671.20.06856-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Alba Guglielmo
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Polyclinic, Bologna, Italy -
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Clara Bertuzzi
- Unit of Hematopathology, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Polyclinic, Bologna, Italy
| | - Alessandro Pileri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, St. Orsola-Malpighi Polyclinic, Bologna, Italy
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Sechi A, Patrizi A, Savoia F, Leuzzi M, Guglielmo A, Neri I. Terra firma-forme dermatosis: a systematic review. Int J Dermatol 2020; 60:933-943. [PMID: 33280096 DOI: 10.1111/ijd.15301] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 09/12/2020] [Accepted: 10/15/2020] [Indexed: 02/03/2023]
Abstract
Terra firma-forme dermatosis (TFFD) is an acquired pigmentation disorder that promptly regresses after applying isopropyl alcohol 70%. The clinical presentation ranges from patches of brownish discoloration to velvety hyperkeratotic plaques. Critical analyses of current data are lacking, so etiologies, pathogenesis, and disease associations are still debated in the literature. A literature search was done in the PubMed and Google Scholar databases to identify the published papers reporting clinical cases of TFFD. Of 102 papers screened, 64 met the including criteria. Overall, the records of 256 patients presenting a mean age of 18.34 years and a female:male ratio of 1:37 were reviewed. The present article aims to provide a key point-summary regarding the clinical outcome, associated comorbidities, pathogenesis, histopathology, dermoscopy, and therapeutic modalities of TFFD.
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Affiliation(s)
- Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Annalisa Patrizi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Francesco Savoia
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Miriam Leuzzi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Alba Guglielmo
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Iria Neri
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy
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