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Cantisani C, Taliano A, Longo C, Bortone G, Gargano L, Musolff N, Pellacani G. Dynamic optical coherence tomography and reflectance confocal microscopy of basal cell carcinoma of the nipple-areola complex. Br J Dermatol 2024; 190:933. [PMID: 38468188 DOI: 10.1093/bjd/ljae104] [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: 02/07/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Affiliation(s)
- Carmen Cantisani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome
| | - Alberto Taliano
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome
| | - Caterina Longo
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia
- Dermatology Department, University of Modena and Reggio Emilia, Italy
| | - Giulio Bortone
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome
| | - Luca Gargano
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome
| | - Noah Musolff
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome
| | - Giovanni Pellacani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome
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Cantisani C, Musolff N, Longo C, Di Guardo A, Rovaldi E, Rossi G, Sasso F, Farnetani F, Rega F, Bánvölgyiv A, Azzella G, Paolino G, Pellacani G. Dynamic optical coherence tomography evaluation in locally advanced basal cell carcinoma during sonidegib treatment. J Eur Acad Dermatol Venereol 2024; 38:967-973. [PMID: 38270330 DOI: 10.1111/jdv.19806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cancer in the Caucasian population. It has a multifactorial pathogenesis, in which constitutive activation of the Sonic Hedgehog signalling (SHH) pathway (via mutations in PTCH1 or SMO genes) represents by far the most common genetic aberration. The introduction of vismodegib and sonidegib, two SHH pathway inhibitors, changed the therapeutic approach of locally advanced and metastatic BCCs. EADO's (European Association of Dermato-Oncology) new staging system refers to these as 'difficult-to-treat' BCCs. OBJECTIVE The aim was to evaluate sonidegib's effectiveness in patients affected by difficult-to-treat BCCs by using non-invasive diagnostic techniques. METHODS We retrospectively evaluated 14 patients (4 females, 10 males; mean age 77 ± 11 years) affected by difficult-to-treat BCCs treated with oral sonidegib 200 mg/day that were followed with total body videodermoscopy (V-Track, Vidix 4.0) and dynamic optical coherence tomography (D-OCT, VivoSight Dx) since May 2022. Considering the risk of rhabdomyolysis routine blood tests, especially for creatine kinase concentrations, were performed. All treated patients were inserted in the BasoCare database, which aims to offer support to patients taking sonidegib. Complete and partial responses were evaluated by the overall reduction of the number of lesions and their individual sizes. Safety was evaluated by assessing the occurrence and severity of adverse reactions. RESULTS Eighty per cent achieved complete clearance and 75% reduction of diameter. D-OCT scans performed at every follow-up showed concordance with clinical appearance and demonstrated reduction of hyporeflective structures, that is, islets of tumour cells and overall improvement of morphology. CONCLUSION Sonidegib can be considered an effective treatment option in cases where surgery or radiotherapy would be unfeasible or has previously failed, although pigmented lesions did not show complete clearance, suggesting that there are factors other than the SHH pathway involved in tumour growth. Videodermoscopy and D-OCT were useful in the quick and seamless follow-up of lesions and added valuable information in assessing efficacy.
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Affiliation(s)
- C Cantisani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - N Musolff
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - C Longo
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
- Dermatology Department, University of Modena and Reggio, Emilia, Italy
| | - A Di Guardo
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - E Rovaldi
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - G Rossi
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - F Sasso
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - F Farnetani
- Dermatology Unit, Department of Surgical, Medical and Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - F Rega
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - A Bánvölgyiv
- Department of Dermatology, Venereology and Dermato-oncology, Semmelweis University, Budapest, Hungary
| | - G Azzella
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - G Paolino
- Unit of Dermatology, IRCCS, Ospedale San Raffaele, Milano, Italy
- Unit of Dermatologic Clinic, Università Vita-Salute San Raffaele, Milano, Italy
| | - G Pellacani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
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Guida S, Longo C, Ronga R, Stabile G, Podo Brunetti A, Bigotto GD, Conforti C, Ciardo S, Cantisani C, Paolino G, Mercuri SR, Nisticò SP, Zerbinati N, Rongioletti F, Pellacani G. Melasma and reflectance confocal microscopy: from baseline to treatment monitoring. Int J Dermatol 2024. [PMID: 38448367 DOI: 10.1111/ijd.17117] [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] [Received: 01/14/2024] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 03/08/2024]
Abstract
Melasma is a frequent condition worldwide, and it represents one of the most challenging disorders to treat in cosmetic dermatology. One of the critical factors for treatment prognosis is the assessment of the depth and distribution of pigment within the hyperpigmented area. Nowadays, non-invasive skin imaging techniques, such as reflectance confocal microscopy (RCM), have been used to estimate pigment distribution and depth within different skin layers. This article aims to provide a systematic review of RCM applications in melasma, providing terminology and investigating characteristics of melasma at baseline and after medical and laser treatment. Our results support the recognition of two main types of melasma, epidermal and mixed type, thanks to the role of RCM in highlighting the precise pigment depth location in the skin non-invasively. RCM treatment monitoring enables the objectification of pigment variations after treatment and the identification of prognostic factors for different treatment modalities. After the era of the application of RCM as a technique applied strictly to skin cancers, additional cosmetic applications are emerging, such as the application of melasma treatment monitoring.
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Affiliation(s)
- Stefania Guida
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Ronga
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - Giorgio Stabile
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy
| | - Antonio Podo Brunetti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy
| | - Gianmarco D Bigotto
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Paolino
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Santo R Mercuri
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology and Cosmetology Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Steven P Nisticò
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Nicola Zerbinati
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Franco Rongioletti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Hospital, Milan, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Cantisani C, Paolino G, Di Guardo A, Gomes V, Carugno A, Greco ME, Musolff N, Azzella G, Rossi G, Soda G, Longo C, Pellacani G. Diagnostic Imaging of Agminated Blue Lesions and Blue Lesions with Satellitosis: Case Series with a Concise Review of the Current Literature. J Clin Med 2024; 13:894. [PMID: 38337588 PMCID: PMC10856709 DOI: 10.3390/jcm13030894] [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: 12/03/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Background: Agmination and/or satellitosis in pigmented blue lesions is a phenomenon rarely mentioned in the literature and not well known. This phenomenon can be expressed by several benign and malignant pigmented blue lesions, such as blue nevi, Spitz nevi, melanocytoma and melanoma. On this spectrum, dermoscopy, reflectance confocal microscopy (RCM) and dynamic Optical coherence tomography (D-OCT) represent non-invasive imaging technologies, which may help clinicians in the diagnosis of melanoma and non-melanoma skin cancers in daily clinical practice. Methods: Currently, in the literature there is a lack of new data about agminated blue lesions and blues lesions with satellitosis, as well as the lack of a recent and updated review of the literature about this topic. Therefore, considering that clinicians must be confident with the diagnosis of these rare skin lesions, we decided to carry out this work. Results: In this paper, four new cases of agminated pigmented cutaneous lesions were described. Moreover, a review of the current literature on this topic was performed. Conclusions: A clinical-pathological correlation is often needed to reach a correct diagnosis; currently, dermoscopy and non-invasive diagnostic techniques, such as reflectance confocal microscopy and optical coherence tomography, due to the depth of these skin lesions in the dermis, can only make a partial and limited contribution.
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Affiliation(s)
- Carmen Cantisani
- Department of Dermatology, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Antonio Di Guardo
- Department of Dermatology, Sapienza University of Rome, 00185 Rome, Italy
| | - Vito Gomes
- Department of Anatomy and Pathology, Ospedale San Filippo Neri, 00135 Rome, Italy
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
- Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, 20126 Milan, Italy
| | | | - Noah Musolff
- Department of Dermatology, Sapienza University of Rome, 00185 Rome, Italy
| | - Giulia Azzella
- Department of Dermatology, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanni Rossi
- Department of Dermatology, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppe Soda
- Department of Molecular Medicine, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy
| | - Caterina Longo
- Dermatology Department, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Azienda Unità Sanitaria Locale–IRCCS di Reggio Emilia, Skin Cancer Center, 42122 Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Dermatology, Sapienza University of Rome, 00185 Rome, Italy
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Faldetta C, Kaleci S, Chester J, Ruini C, Ciardo S, Manfredini M, Guida S, Chello C, Cantisani C, Young JN, Cabral P, Gulati N, Guttman-Yassky E, Pellacani G, Farnetani F. Melanoma clinicopathological groups characterized and compared with dermoscopy and reflectance confocal microscopy. J Am Acad Dermatol 2024; 90:309-318. [PMID: 37988042 DOI: 10.1016/j.jaad.2023.09.084] [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: 05/24/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Dermoscopic and reflectance confocal microscopy (RCM) correlations between morphologic groups of melanoma have not yet been described. OBJECTIVE Describe and compare dermoscopic and RCM features of cutaneous melanomas with histopathological confirmation. METHODS Single center, retrospective analysis of consecutive melanomas evaluated with RCM (2015-2019). Lesions were clinically classified as typical, nevus-like, amelanotic/nonmelanoma skin cancer (NMSC)-like, seborrheic keratosis (SK)-like and lentigo/lentigo maligna (LM)-like. Presence or absence of common facial and nonfacial melanoma dermoscopic and RCM patterns were recorded. Clusters were compared with typical lesions by multivariate logistic regression. RESULTS Among 583 melanoma lesions, significant differences between clusters were evident (compared to typical lesions). Observation of dermoscopic features (>50% of lesions) in amelanotic/NMSC-like lesions consistently displayed 3 patterns (atypical network, atypical vascular pattern + regression structures), and nevus-like and SK-like lesions and lentigo/LM-like lesions consistently displayed 2 patterns (atypical network + regression structures, and nonevident follicles + heavy pigmentation intensity). Differences were less evident with RCM, as almost all lesions were consistent with melanoma diagnosis. LIMITATIONS Small SK-like lesions sample, single RCM analyses (no reproduction of outcome). CONCLUSION RCM has the potential to augment our ability to consistently and accurately diagnose melanoma independently of clinical and dermoscopic features.
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Affiliation(s)
- Cristina Faldetta
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Cristel Ruini
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany; Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Silvana Ciardo
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Dermatology Clinic, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- School of Medicine Vita Salute San Raffaele University, Milan, Italy; Dermatologic Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Chello
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Jade N Young
- Department of Dermatology, Mount Sinai, New York, New York
| | | | | | | | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Cantisani C, Ambrosio L, Annessi E, Longo C, Farnetani F, Pezzini C, Condorelli A, Annessi G, Bonetti LR, Guida S, Cota C, Tammaro A, Chello C, Pellacani G. Dermoscopic, Histological, Confocal Microscopy Correlation of Atypical-Dysplastic Melanocytic Nevi. Dermatol Pract Concept 2024; 14:dpc.1401a36. [PMID: 38364391 PMCID: PMC10868881 DOI: 10.5826/dpc.1401a36] [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] [Accepted: 08/08/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION The term "atypical melanocytic nevus" (AMN) is used as a synonym for dysplastic nevus (DN) in clinical practice. Although the criteria for diagnosis of AMN/DN by the Agency for Research on Cancer helps to differentiate AMN/DN from common acquired nevi, they do not have high degrees of specificity, as they are similar to those used for the diagnosis of melanoma. OBJECTIVES In this retrospective study we evaluated the correlation and diagnostic concordance of dermoscopy, confocal microscopy, and histological examination in 50 AMN. METHODS A graded scale was used to compare histological examination with dermoscopy and confocal microscopy. Low magnification histological images of only the central part of lesions were examined. This allowed histological diagnoses based almost exclusively on architectural criteria instead of simultaneously architectural and cytological, as in the global histological examination. RESULTS Our data demonstrate that the diagnostic accuracy of dermoscopy and confocal microscopy diagnosis of the clinical aspects of AMN/DN as nevi or melanomas tends to be equivalent, being fair for nevi and excellent for melanomas. The total percentage of AMN suggested that the accuracy of confocal microscopy in the diagnosis of melanoma (86.7%) is greater than that of dermoscopy (73.3%). CONCLUSIONS This study demonstrated that diagnostic assessments of AMN/DN by dermoscopy and confocal microscopy are accurate and often coincide with those of histological examination and that their combined use helps to better manage and monitor these patients by facilitating early detection of melanomas and reducing unnecessary excisions of benign melanocytic lesions.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Luca Ambrosio
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Emanuele Annessi
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Caterina Longo
- Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Claudia Pezzini
- Dermatology Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Giorgio Annessi
- Dermatopathology Unit, Istituto Dermopatico dell'Immacolata, IRCCS, Roma, Italy
| | - Luca Reggiani Bonetti
- Department of Diagnostic Clinic and Public Health Medicine University of Modena and Reggio Emilia, Italy
| | - Stefania Guida
- School of medicine Vita Salute San Raffaele University, Dermatology Clinic, IRCS San Raffaele Hospital, Milan, Italy
| | - Carlo Cota
- Genetic Research Molecular Biology and Dermopathology Unit San Gallicano Dermatology Unit, IRCCS, Rome Italy
| | - Antonella Tammaro
- NESMOS Dermatology Department, Sapienza University of Rome, Rome, Italy
| | - Camilla Chello
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
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Guida S, Alma A, Fiorito F, Megna A, Chester J, Kaleci S, Ciardo S, Manfredini M, Rongioletti F, Perrot JL, Rubegni P, Chello C, Cantisani C, Pellacani G, Cinotti E, Farnetani F. Lentigo maligna and lentigo maligna melanoma in vivo differentiation with dermoscopy and reflectance confocal microscopy: A retrospective, multicentre study. J Eur Acad Dermatol Venereol 2023; 37:2293-2300. [PMID: 37357442 DOI: 10.1111/jdv.19291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 05/26/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Dermoscopic predictors of lentigo maligna (LM) and lentigo maligna melanoma (LMM) have been recently reported, but these have not been reported in reflectance confocal microscopy (RCM). OBJECTIVES (i) To validate dermoscopic predictors for LM/LMM, (ii) to identify RCM patterns in LM and LMM, and (iii) correlations between dermoscopic and RCM features in LM and LMM. MATERIALS AND METHODS A retrospective, multicentre study of consecutive lesions with histologically proven LM or LMM subtypes of the head and face, with complete sets of dermoscopic and RCM images. RESULTS A total of 180 lesions were included (n = 40 LMM). Previously reported differential dermoscopic features for LM subtypes were confirmed. Other features significantly associated with LMM diagnosis included irregular hyperpigmented areas, shiny white streaks, atypical vessels and light brown colour at dermoscopy and medusa head-like structures, dermal nests and nucleated cells within the papillae at RCM (p < 0.05). Correlations among LM lesions between dermoscopic and RCM features included brown to-grey dots and atypical cells (epidermis), grey colour and inflammation and obliterated follicles and medusa head-like structures. Among LMM lesions, significant correlations included obliterated follicles with folliculotropism, both irregular hyperpigmented areas and irregular blotches with widespread atypical cell distribution (epidermis), dermal nests and nucleated cells within the papillae (dermis). Irregular blotches were also associated with medusa head-like structures (dermal epidermal junction [DEJ]). CONCLUSIONS Dermoscopic and RCM features can assist in the in vivo identification of LM and LMM and many are correlated. RCM three-dimensional analysis of skin layers allows the identification of invasive components in the DEJ and dermis.
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Affiliation(s)
- Stefania Guida
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonio Alma
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Flavio Fiorito
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Andrea Megna
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvana Ciardo
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Franco Rongioletti
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jean L Perrot
- Department of Dermatology, University Hospital of Saint Etienne, Saint-Etienne, France
| | - Pietro Rubegni
- Dermatology Section, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Camilla Chello
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Elisa Cinotti
- Dermatology Section, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, Siena, Italy
| | - Francesca Farnetani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Cantisani C, Baja AV, Gargano L, Rossi G, Ardigò M, Soda G, Boostani M, Kiss N, Pellacani G. Optical Coherence Tomography as a Valuable Tool for the Evaluation of Cutaneous Kaposi Sarcoma Treated with Imiquimod 5% Cream. Diagnostics (Basel) 2023; 13:2901. [PMID: 37761269 PMCID: PMC10529460 DOI: 10.3390/diagnostics13182901] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/11/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
Kaposi sarcoma (KS) is a rare disease that was not frequently identified before the widespread occurrence of AIDS. Even today, it remains a challenge for physicians to diagnose, particularly in its early stages, often requiring referral to specialists and further investigations. Dermoscopy, a non-invasive imaging technique, reveals a distinctive rainbow pattern that strongly indicates KS. Moreover, advanced imaging tools like optical coherence tomography (OCT) can provide additional information though specific disease-related patterns have not been fully established yet. These emerging techniques show promise in facilitating early diagnosis of skin-related KS and monitoring the effectiveness of treatments. However, biopsy remains the definitive method for confirming the disease. In this study, we present two cases of cutaneous Kaposi sarcoma, documented using OCT, both before and after treatment with imiquimod 5% cream. The study highlights the potential of OCT in evaluating disease progression and treatment response, as well as the usefulness of dermoscopy in detecting early indicators of KS. By integrating these advanced imaging techniques, the diagnosis and management of cutaneous KS could be improved, leading to timely interventions and better patient outcomes.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (A.-V.B.); (L.G.); (G.R.); (G.S.); (G.P.)
| | - Alexandru-Vasile Baja
- Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (A.-V.B.); (L.G.); (G.R.); (G.S.); (G.P.)
| | - Luca Gargano
- Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (A.-V.B.); (L.G.); (G.R.); (G.S.); (G.P.)
| | - Giovanni Rossi
- Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (A.-V.B.); (L.G.); (G.R.); (G.S.); (G.P.)
| | - Marco Ardigò
- Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute—IRCCS, 00144 Rome, Italy;
| | - Giuseppe Soda
- Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (A.-V.B.); (L.G.); (G.R.); (G.S.); (G.P.)
| | - Mehdi Boostani
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (M.B.); (N.K.)
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary; (M.B.); (N.K.)
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (A.-V.B.); (L.G.); (G.R.); (G.S.); (G.P.)
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Reginelli A, Russo A, Berritto D, Patane V, Cantisani C, Grassi R. Ultra-High-Frequency Ultrasound: A Modern Diagnostic Technique for Studying Melanoma. Ultraschall Med 2023; 44:360-378. [PMID: 37068509 DOI: 10.1055/a-2028-6182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The development of new ultra-high-frequency devices with a resolution of 30 μm makes it possible to use ultrasound in the study of new small anatomical units and to apply this tool to new fields of pathology. Cutaneous melanoma is a severe skin disease with an incidence of approximately 160 000 new cases each year and 48 000 deaths. In this paper, we evaluate the role of HFUS in the diagnosis of cutaneous melanoma, describe the sonographic appearance of skin layers in the pre-excision phase as well as of lesion features, and correlate the characteristics with pathological examination.
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Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | - Anna Russo
- Department of Radiology, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | - Daniela Berritto
- Department of Clinical and Experimental Medicine, Foggia University Hospital, Foggia, Italy
| | - Vittorio Patane
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | | | - Roberto Grassi
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
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10
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Pietkiewicz P, Navarrete-Dechent C, Salwowska N, Cantisani C, Goldust M, Errichetti E. Ultraviolet-Induced Fluorescence Dermatoscopy Reveals Fluorescent Clues in Pitted Keratolysis. Dermatol Pract Concept 2023; 13:dpc.1303a242. [PMID: 37557130 PMCID: PMC10412013 DOI: 10.5826/dpc.1303a242] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Paweł Pietkiewicz
- Dermatology Private Practice, Poznań, Poland
- Polish Dermatoscopy Group, Poznań, Poland
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Natalia Salwowska
- Polish Dermatoscopy Group, Poznań, Poland
- Department of Dermatology, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, Rome, Italy
| | - Mohamad Goldust
- Department of Dermatology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Enzo Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
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11
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Lampitelli S, Cantisani C, Rega F, Chello C, Farnetani F, Pellacani G. Identification of Novel Dermoscopic Patterns for "Featureless Melanoma": Clinical-Pathological Correlation. Dermatol Pract Concept 2023; 13:dpc.1302a80. [PMID: 37196275 DOI: 10.5826/dpc.1302a80] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2022] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Diagnosis of melanoma can be very difficult because of its phenotypic and histological heterogeneity. Difficult-to-diagnose melanoma can be represented by mucosal melanoma, pink lesions, amelanotic melanoma (amelanotic lentigo maligna, amelanotic acral melanoma, desmoplastic melanoma), melanoma arising on sun-damaged facial skin, and "featureless melanoma". OBJECTIVES The aim of the study was to improve the identification of featureless melanoma (scoring 0-2 according to the 7-point-checklist) describing the variegated dermoscopic features and their histopathological correlation. METHODS Study samples included all melanomas excised based on clinical and/or dermoscopic findings in the period between January 2017 and April 2021. Before excisional biopsy, all lesions were recorded by means of digital dermoscopy at the department of Dermatology. Only lesions with a diagnosis of melanoma and a high quality of dermoscopic images were included in this study. After clinical and dermoscopic evaluation of 7-point checklist score, single dermoscopic and histological features were considered for lesions with a score of 2 or lower and a diagnosis of melanoma (corresponding to dermoscopic featureless melanoma). RESULTS A total of 691 melanomas fulfilled inclusion criteria and were retrieved from the database. The 7-point checklist evaluation identified 19 "negative-featureless" melanoma. The 100% of the lesions with score 1 showed a globular pattern. CONCLUSIONS Dermoscopy is still the best diagnostic method for melanoma. The 7-point checklist provides a simplification of standard pattern analysis because of the algorithm based on a scoring system and the lower number of features to recognize. In the daily practice it is more comfortable for many clinicians to keep in mind a list of principles that may help in the decision.
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Affiliation(s)
- Salvatore Lampitelli
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - Carmen Cantisani
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - Federica Rega
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - Camilla Chello
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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12
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Ardigò M, Bianchi L, Cantisani C, Cota C, DI Raimondo C, DI Stefani A, Fargnoli MC, Franceschini C, Pellacani G, Peris K, Persechino S, Plebani S, Potenza C, Proietti I, Quattrini L, Cantonetti M. Mycosis fungoides: creation of a prospective, interdisciplinary and multicenter study in central Italy. Ital J Dermatol Venerol 2023; 158:156-157. [PMID: 36943388 DOI: 10.23736/s2784-8671.23.07377-2] [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: 03/23/2023]
Affiliation(s)
- Marco Ardigò
- Porphyrias and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy -
| | - Luca Bianchi
- Dermatology, Tor Vergata University, Rome, Italy
| | | | - Carlo Cota
- Dermatopathology, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | | | | | - Chiara Franceschini
- Porphyrias and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | | | - Ketty Peris
- Dermatology, Sacred Heart Catholic University, Rome, Italy
| | | | - Sara Plebani
- Hematology, San Salvatore Hospital, L'Aquila, Italy
| | | | - Ilaria Proietti
- Dermatology, Polo Pontino, Sapienza University, Latina, Italy
| | | | - Maria Cantonetti
- Lymphoproliferative Diseases Unit, Tor Vergata University, Rome, Italy
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13
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Tammaro A, Kulakowska KA, Cantisani C, Parisella FR, Scarabello A, Adebanjo GAR. Female genital mucosal lesions associated with COVID-19 vaccination: A brief review of the literature. J Eur Acad Dermatol Venereol 2023; 37:e143-e146. [PMID: 36310391 PMCID: PMC9874779 DOI: 10.1111/jdv.18711] [Citation(s) in RCA: 1] [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: 08/06/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Antonella Tammaro
- NESMOS Department of DermatologySapienza University of RomeRomeItaly
| | | | - Carmen Cantisani
- NESMOS Department of DermatologySapienza University of RomeRomeItaly
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14
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Roberto M, Panebianco M, Aschelter AM, Buccilli D, Cantisani C, Caponnetto S, Cortesi E, d’Amuri S, Fofi C, Ierinò D, Maestrini V, Marchetti P, Marignani M, Stigliano A, Vivona L, Santini D, Tomao S. The value of the multidisciplinary team in metastatic renal cell carcinoma: Paving the way for precision medicine in toxicities management. Front Oncol 2023; 12:1026978. [PMID: 36713496 PMCID: PMC9879059 DOI: 10.3389/fonc.2022.1026978] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/07/2022] [Indexed: 01/14/2023] Open
Abstract
The new landscape of treatments for metastatic clear cell renal carcinoma (mRCC) is constantly expanding, but it is associated with the emergence of novel toxicities, adding to up to those observed in the tyrosine-kinase inhibitor (TKI) era. Indeed, the introduction of immune checkpoint inhibitors (ICIs) alone or in combination has been associated with the development of immune-related adverse events (irAEs) involving multiple-organ systems which, even if rarely, had led to fatal outcomes. Moreover, due to the relatively recent addition of ICIs to the previously available treatments, the potential additive adverse effects of these combinations are still unknown. A prompt recognition and management of these toxicities currently represents a fundamental issue in oncology, since it correlates with the outcome of cancer patients. Even if clinical guidelines provide indications for the management of irAEs, no specific protocol to evaluate the individual risk of developing an adverse event during therapy is currently available. A multidisciplinary approach addressing appropriate interventions aimed at reducing the risk of any insidious, severe, and/or dose-limiting toxicity might represent the most efficacious strategy to timely prevent and manage severe irAEs, allowing indirectly to improve both patients' cancer-specific survival and quality of life. In this review, we reported a five-case series of toxicity events that occurred at our center during treatment for mRCC followed by the remarks of physicians from different specialties, pinpointing the relevant role of an integrated and extended multidisciplinary team in a modern model of mRCC patient management.
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Affiliation(s)
- Michela Roberto
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Martina Panebianco
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy,*Correspondence: Martina Panebianco,
| | - Anna Maria Aschelter
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Dorelsa Buccilli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Department of Dermatology, Complex Operative Unit (UOC) of Dermatology, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Salvatore Caponnetto
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit B, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Enrico Cortesi
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit B, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Sara d’Amuri
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Claudia Fofi
- Department of Clinical and Molecular Medicine, Nephrology and Dialysis Unit, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Debora Ierinò
- Department of Clinical and Molecular Medicine, Oncology Unit, Sant’ Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Scientific Direction, Istituto Dermopatico dell’Immacolata (IDI-IRCCS), Rome, Italy
| | - Massimo Marignani
- Head Liver Disease Section, Digestive and Liver Diseases Department, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Antonio Stigliano
- Department of Clinical and Molecular Medicine, Endocrinology Unit, Sant ‘Andrea University Hospital, Sapienza University of Rome, Rome, Italy
| | - Luca Vivona
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
| | - Daniele Santini
- Complex Operative Unit (UOC) Oncologia Medica, Sapienza University, Polo Pontino, Latina, Italy
| | - Silverio Tomao
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Medical Oncology Unit A, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Italy
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15
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Cantisani C, Rega F, Ambrosio L, Grieco T, Kiss N, Meznerics FA, Bánvölgyi A, Vespasiani G, Arienzo F, Rossi G, Soda G, Pellacani G. Syphilis, the Great Imitator-Clinical and Dermoscopic Features of a Rare Presentation of Secondary Syphilis. Int J Environ Res Public Health 2023; 20:1339. [PMID: 36674095 PMCID: PMC9859468 DOI: 10.3390/ijerph20021339] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/04/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
Syphilis is characterized by a wide range of variable clinical symptoms; therefore, it is often referred to as "The Great Imitator". Here, we report the case of a 69-year-old hepatitis-C-positive MSM patient, who was admitted to our clinic due to a solitary firm painless erythematous maculopapular lesion with a central crater-like crust on the upper right thigh that occurred two months prior. The dermoscopy showed an erythematous, copper-colored, oval lesion with diffuse monomorphic dotted and glomerular vessels, central crust, and circular scaling (Biett's sign). The histological findings ruled out neoplasia and described a plasma cell infiltrate and endothelial swelling. Finally, the combination of the dermoscopic image, histological findings and the additionally acquired knowledge about the sexual history of the patient at the second visit led to the diagnosis, which was then confirmed with serological tests. Dermoscopy may become a supportive tool to facilitate the recognition of secondary syphilis; however, the reporting of these atypical cases is crucial to highlight the many faces of the disease so that clinicians consider syphilis as part of the differential diagnosis of non-specific lesions.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Federica Rega
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Luca Ambrosio
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Teresa Grieco
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Norbert Kiss
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - András Bánvölgyi
- Department of Dermatology, Venereoslogy and Dermatooncology, Semmelweis University, H-1085 Budapest, Hungary
| | - Giordano Vespasiani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Francesca Arienzo
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza Medical School” University of Rome, 00161 Rome, Italy
| | - Giovanni Rossi
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
| | - Giuseppe Soda
- Department of Radiological, Oncological and Pathological Sciences, “Sapienza Medical School” University of Rome, 00161 Rome, Italy
| | - Giovanni Pellacani
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza Medical School” University of Rome, 00185 Rome, Italy
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16
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Cantisani C, Ambrosio L, Cucchi C, Meznerics FA, Kiss N, Bánvölgyi A, Rega F, Grignaffini F, Barbuto F, Frezza F, Pellacani G. Melanoma Detection by Non-Specialists: An Untapped Potential for Triage? Diagnostics (Basel) 2022; 12:diagnostics12112821. [PMID: 36428881 PMCID: PMC9689879 DOI: 10.3390/diagnostics12112821] [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: 10/10/2022] [Revised: 10/26/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The incidence of melanoma increased considerably in recent decades, representing a significant public health problem. We aimed to evaluate the ability of non-specialists for the preliminary screening of skin lesions to identify melanoma-suspect lesions. MATERIALS AND METHODS A medical student and a dermatologist specialist examined the total body scans of 50 patients. RESULTS The agreement between the expert and the non-specialist was 87.75% (κ = 0.65) regarding the assessment of clinical significance. The four parameters of the ABCD rule were evaluated on the 129 lesions rated as clinically significant by both observers. Asymmetry was evaluated similarly in 79.9% (κ = 0.59), irregular borders in 74.4% (κ = 0.50), color in 81.4% (κ = 0.57), and diameter in 89.9% (κ = 0.77) of the cases. The concordance of the two groups was 96.9% (κ = 0.83) in the case of the detection of the Ugly Duckling Sign. CONCLUSIONS Although the involvement of GPs is part of routine care worldwide, emphasizing the importance of educating medical students and general practitioners is crucial, as many European countries lack structured melanoma screening training programs targeting non-dermatologists.
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Affiliation(s)
- Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy
| | - Luca Ambrosio
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy
| | - Carlotta Cucchi
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy
| | - Fanni Adél Meznerics
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
- Correspondence:
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, 1085 Budapest, Hungary
| | - Federica Rega
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy
| | - Flavia Grignaffini
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy
| | - Francesco Barbuto
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy
| | - Fabrizio Frezza
- Department of Information Engineering, Electronics and Telecommunications, Sapienza University of Rome, 00184 Rome, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy
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17
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Paolino G, Di Nicola MR, Cantisani C, Fania L, Didona D. Editorial: Genetic mutations in cutaneous malignancies and non-cutaneous diseases. Front Med (Lausanne) 2022; 9:987494. [PMID: 36045921 PMCID: PMC9421424 DOI: 10.3389/fmed.2022.987494] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology and Cosmetology, IRCCS Ospedale San Raffaele, Segrate, Italy
- Unità di Dermatologia Clinica, Università Vita-Salute San Raffaele, Milan, Italy
- *Correspondence: Giovanni Paolino
| | | | - Carmen Cantisani
- Unit of Dermatology, Sapienza Medical School of Rome, Policlinico Umberto i Hospital, Rome, Italy
| | - Luca Fania
- IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Dario Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
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18
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Cantisani C, Rossi R, Nisticò SP, Vitiello M, Farnetani F, Bennaro L, Pellacani G. Management of patients with giant basal cell carcinoma during SARS COV2 outbreak in Italy. Transl Biophotonics 2022; 4:e202200009. [PMID: 35942364 PMCID: PMC9350373 DOI: 10.1002/tbio.202200009] [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: 04/25/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most frequently occurring type of all cancers, and represents 80% of all skin cancer. The estimated lifetime risk for BCC in the white population is between 33% and 39% for men and 23% and 28% for women. Its incidence doubles every 25 years and is increasing in the young population. Death is uncommon and seems to decrease in the last years, probably due to early and better diagnosis. BCC arises from abnormal and uncontrolled growth of basal cells. It is a slow-growing tumor, therefore usually curable at an early stage with surgery or alternative treatment, such as cryotherapy, laser, photodynamic therapy, retinoids and topical agent like 5-Fluorouracil cream, imiquimod cream, and so forth. Topical treatment of superficial basocellular carcinoma is a viable option, when surgery is not an advisable treatment, especially in the case of giant basocellular carcinoma. In this subtype, imiquimod 5% cream can be a safe and effective treatment, but there are few reports in available literature. We present our case series of eight patients with superficial giant basocellular carcinoma successfully treated with imiquimod 5% cream, which showed clinical improvement after 8 weeks of treatment.
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Affiliation(s)
- Carmen Cantisani
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
| | - Raimondo Rossi
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
| | | | - Martina Vitiello
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
| | | | - Luigi Bennaro
- Department of Health SciencesMagna Grecia UniversityCatanzaroItaly
| | - Giovanni Pellacani
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
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19
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Grieco T, Gomes V, Rossi A, Cantisani C, Greco ME, Rossi G, Sernicola A, Pellacani G. The Pathological Culprit of Neuropathic Skin Pain in Long COVID-19 Patients: A Case Series. J Clin Med 2022; 11:jcm11154474. [PMID: 35956094 PMCID: PMC9369885 DOI: 10.3390/jcm11154474] [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: 06/22/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 02/04/2023] Open
Abstract
Cutaneous neurosensory symptoms have become increasingly reported findings in COVID-19; however, these virus-related manifestations are largely overlooked, and their pathology is poorly understood. Moreover, alterations of skin sensibility currently recognize no clear histopathology substrate. The purpose of this study was to provide pathology evidence of neurosensory skin system involvement in COVID-19 patients complaining of subjective neurological symptoms affecting the skin. Out of 142 patients, six long COVID-19 cases complaining of cutaneous subjective neurological symptoms assessed on an NTSS-6 questionnaire underwent histopathological and immunohistochemical analyses of skin areas affected by paroxysmal diffuse burning and itching sensations. Two patients also performed electroneurography examination. The histology investigation showed hypertrophic glomus vascular bodies with hypertrophic S100+ perineural sheath cells and adjacent hypertrophy of the nerve branches associated with increased basophil polysaccharide matrix. Electroneurography revealed disturbances of A-delta and C dermal neuronal fibers. The main limitation of this study consisted of a limited number of skin biopsy samples, requiring further investigation. Histopathology findings are consistent with hypertrophy of nerve endings, suggesting a condition such as “dermal hyperneury”, a recently reported small nerve hypertrophy condition affecting sensory C fibers. Such a neuropathic basis could explain dysesthesia experienced by the patients, as previously described in postherpetic neuralgia.
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Affiliation(s)
- Teresa Grieco
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
| | - Vito Gomes
- Department of Anatomy and Pathology, Ospedale San Filippo Neri, Via G. Martinotti 20, 00183 Rome, Italy;
| | - Alfredo Rossi
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
| | - Carmen Cantisani
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
| | - Maria Elisabetta Greco
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
| | - Giovanni Rossi
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
| | - Alvise Sernicola
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
- Correspondence:
| | - Giovanni Pellacani
- Department of Clinical Internal Anesthesiological and Cardiovascular Sciences, “Sapienza” University of Rome, Viale del Policlinico 155, 00161 Rome, Italy; (T.G.); (A.R.); (C.C.); (M.E.G.); (G.R.); (G.P.)
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20
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Tammaro A, Cantisani C, Chello C, Adebanjo GAR, Lilli L, Farnetani F, Filippi C, Covelli E, Rogges E, Pellacani G. A Challenging Nodular Lesion of the Ear. Medicina (B Aires) 2022; 58:medicina58020269. [PMID: 35208592 PMCID: PMC8877636 DOI: 10.3390/medicina58020269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/24/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022] Open
Abstract
Skin nodular lesion are really frequent, but rapidly growing ones needs to be quickly removed since they can hide really aggressive skin tumor. Among malignant lesion Merkel cell carcinoma arise. It is a rare neuroendocrine skin tumor highly aggressive, not easy to diagnose at first stage, since at first diagnosis it is already widespreading all over the body. In order to renew interest in this letal skin tumori is mandatory to remind high risk population which include elderly people, white skin, chronically exposed to UV immunocompromised. Our unhappy case was described to increase awareness on this kind of skin tumor, since new drug appeared in the market can give an hope to these patients.
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Affiliation(s)
- Antonella Tammaro
- NESMOS Dermatology Department, Sapienza Medical School of Rome, 00141 Rome, Italy; (A.T.); (C.C.); (G.A.R.A.); (E.C.)
| | - Carmen Cantisani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, 00161 Rome, Italy; (F.F.); (G.P.)
- Correspondence: ; Tel.: +39-0649976930
| | - Camilla Chello
- NESMOS Dermatology Department, Sapienza Medical School of Rome, 00141 Rome, Italy; (A.T.); (C.C.); (G.A.R.A.); (E.C.)
- Dermatology Department, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | | | - Lavinia Lilli
- Biological Science Department, “Roma Tre” University, 00154 Rome, Italy;
| | - Francesca Farnetani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, 00161 Rome, Italy; (F.F.); (G.P.)
| | - Chiara Filippi
- ENT Department, Sapienza University of Rome, 00161 Rome, Italy;
| | - Edoardo Covelli
- NESMOS Dermatology Department, Sapienza Medical School of Rome, 00141 Rome, Italy; (A.T.); (C.C.); (G.A.R.A.); (E.C.)
| | - Evelina Rogges
- Pathology Department, Sapienza University of Rome, 00161 Rome, Italy;
| | - Giovanni Pellacani
- UOC of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, 00161 Rome, Italy; (F.F.); (G.P.)
- Dermatology Department, University of Modena and Reggio Emilia, 41124 Modena, Italy
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21
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Di Matteo E, Pampena R, Pizzichetta MA, Cinotti E, Chester J, Kaleci S, Manfredini M, Guida S, Dika E, Moscarella E, Lallas A, Apalla Z, Argenziano G, Perrot JL, Tognetti L, Lai M, Cantisani C, Roberti V, Fiorani D, Baraldi C, Veneziano L, Papageorgiou C, Ciardo S, Rubegni P, Zalaudek I, Patrizi A, Longo C, Bianchi L, Pellacani G, Farnetani F. Unusual Dermoscopic Patterns of Basal Cell Carcinoma Mimicking Melanoma. Exp Dermatol 2022; 31:890-898. [PMID: 35102605 PMCID: PMC9305787 DOI: 10.1111/exd.14533] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 09/05/2021] [Revised: 12/23/2021] [Accepted: 01/27/2022] [Indexed: 12/25/2022]
Abstract
Background Basal cell carcinoma can simulate melanoma and specific dermoscopic criteria have not yet been defined in a large cohort. Objective To identify dermoscopic “trump” characteristics for differential diagnosis, identify cluster groups and assess the clinical impact of this study's findings. Methods Retrospective, multicentric comparative study of atypical, non‐facial basal cell carcinoma (≥1 seven‐point checklist criteria) and melanoma (with at least one BCC criteria) at dermoscopy. Observed dermoscopic features were used to develop a proposed score. Lesion clusters were defined with hierarchical analysis. Clinical impact was assessed with a blinded reader study following this study's results. Results A total of 146 basal cell carcinoma and 76 melanoma were included. Atypical vascular pattern was common to most lesions (74.5%). Twelve trump features were included in the proposed score (sensitivity 94.1% and specificity 79.5%). Cluster analysis identified 3 basal cell carcinoma and 3 melanoma clusters. Findings improved overall diagnostic accuracy and confidence (26.8% and 13.8%, respectively; p < 0.001). Conclusions These findings support the notion that atypical vascular pattern should be considered a shared feature of both melanoma and atypical basal cell carcinoma. Our proposed score improves diagnostic accuracy and confidence. Absence of pigmented features was associated with lower diagnostic accuracy and confidence.
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Affiliation(s)
- Eleonora Di Matteo
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133, Rome, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria A Pizzichetta
- Division Medical Oncology and Preventive Oncology, National Cancer Institute, Aviano, Italy.,Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Elisa Cinotti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, Italy
| | - Johanna Chester
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Shaniko Kaleci
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Emi Dika
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Aimilios Lallas
- First Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Zoe Apalla
- Second Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | - Jian L Perrot
- Department of Dermatology, University Hospital of Saint-Etienne, Saint-Etienne Cedex 2 42055, France
| | - Linda Tognetti
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, Italy
| | - Michela Lai
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carmen Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Roberti
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Diletta Fiorani
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, Italy
| | - Carlotta Baraldi
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Leonardo Veneziano
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Chryssoula Papageorgiou
- Second Department of Dermatology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - Silvana Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Pietro Rubegni
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria Alle Scotte Hospital, Viale Bracci 16, Siena, 53100, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy
| | - Annalisa Patrizi
- Dermatology, IRCCS di Policlinico Sant'Orsola Hospital, Bologna, Italy.,Dermatology Section, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, University of Bologna, 40138, Bologna, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133, Rome, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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22
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Farnetani F, Pedroni G, Lippolis N, Giovani M, Ciardo S, Chester J, Kaleci S, Pezzini C, Cantisani C, Dattola A, Manfredini M, Dika E, Patrizi A, Pellacani G. Facial seborrheic keratosis with unusual dermoscopic patterns can be differentiated from other skin malignancies by in vivo reflectance confocal microscopy. J Eur Acad Dermatol Venereol 2021; 35:e784-e787. [PMID: 34161654 DOI: 10.1111/jdv.17470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/17/2021] [Accepted: 06/22/2021] [Indexed: 12/14/2022]
Affiliation(s)
- F Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - G Pedroni
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - N Lippolis
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - M Giovani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Ciardo
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - J Chester
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Kaleci
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Pezzini
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Cantisani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - A Dattola
- Department of Dermatology, University of Rome 'Tor Vergata', Rome, Italy
| | - M Manfredini
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - E Dika
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - A Patrizi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - G Pellacani
- Dermatology Unit, Department of Surgical, Medical, Dental and Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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23
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Paolino G, Di Nicola MR, Cantisani C, Mercuri SR. Pityriasis rosea infection in a COVID-19 patient successfully treated with systemic steroid and antihistamine via telemedicine: Literature update of a possible prodromal symptom of an underlying SARS-CoV-2 infection. Dermatol Ther 2021; 34:e14972. [PMID: 33993616 PMCID: PMC8209955 DOI: 10.1111/dth.14972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/09/2021] [Accepted: 05/12/2021] [Indexed: 12/05/2022]
Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology, IRCCS San Raffaele Hospital, Milan, Italy.,Dermatologic Clinic, Sapienza University of Rome, Rome, Italy
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24
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Kiss N, Cantoresi F, Lampitelli S, Marino R, Bánvölgyi A, Wikonkál NM, Cantisani C. Emergency dermatology: Three-month experience from an Italian academic outpatient clinic during lockdown for COVID-19 pandemic. Dermatol Ther 2020; 33:e14390. [PMID: 33037759 PMCID: PMC7646024 DOI: 10.1111/dth.14390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 08/30/2020] [Revised: 09/25/2020] [Accepted: 10/01/2020] [Indexed: 01/11/2023]
Abstract
Dermatology is a field of medicine where urgent cases occur commonly. However, access to specialized emergency dermatology services is very limited. Following the declaration of the COVID‐19 pandemic, the cessation of all elective dermatology visits was widely urged. Accordingly, in Italy, a country severely affected by the pandemic, various measures were applied and the care at university clinics was limited to urgent cases. Here we retrospectively analyzed data of patients who presented at an Italian academic outpatient clinic reserved only for emergency cases. In total, 252 patients (109 males and 143 females) with a mean age of 55.25 ± 20.99 years were cared for at our clinic during a three‐month period. We classified 10 patients (4%) as real emergency cases. Pityriasis rosea was diagnosed in three patients. Many patients sought care for skin cancer screening. In 131 patients (52%) dermoscopic skin examinations were performed. In 39 patients (15%), actinic keratosis or nonmelanoma skin cancer was detected, while melanoma was diagnosed in three patients, two of which were proven later as in situ melanoma. About 111 patients (44%) visited our clinic for other, nonurgent skin diseases. Our results imply that many patients felt that their skin problems required immediate attention, even if this could not be justified. Melanoma care may be considered an emergency care for its highly malignant potential and the possibility of rapid spreading. Adequately taken photos with a dermoscope may be readily read without the presence of specialist in the emergency room to prevent unnecessary delay in diagnosing oncologic skin diseases.
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Affiliation(s)
- Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Franca Cantoresi
- Department of Dermatology and Venereology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Salvatore Lampitelli
- Department of Dermatology and Venereology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Raffaella Marino
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - András Bánvölgyi
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Norbert M Wikonkál
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Carmen Cantisani
- Department of Dermatology and Venereology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
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25
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Tosti G, Salvini C, Barisani A, Grazi R, Pirola S, Cantisani C, Vaccari S, Madnani N. Vulval hidradenoma papilliferum: a clinical and dermoscopic study. Clin Exp Dermatol 2020; 45:1035-1039. [PMID: 32356582 DOI: 10.1111/ced.14254] [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: 04/13/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/16/2022]
Abstract
Hidradenoma papilliferum (HP) is a rare, slow-growing, benign adnexal tumour with apocrine differentiation. It usually affects the anogenital region in adult women and is clinically polymorphous, mimicking other benign or malignant neoformations. The dermoscopic features of vulval HP have not been reported yet. We report the clinical and dermoscopic features in a case series of histopathologically proven vulval HPs. Dermoscopy may be a useful tool for the diagnosis of vulval HP. To our knowledge, our paper represents the first report of dermoscopic findings in a series of vulval HPs in a multiracial population.
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Affiliation(s)
- G Tosti
- Melanoma Division, IRCCS, European Institute of Oncology, Milan, Italy
| | - C Salvini
- Unit of Dermatology, USL Toscana Centro-Prato Hospital, Prato, Italy
| | - A Barisani
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - R Grazi
- Vita-Salute San Raffaele University, Milan, Italy
| | - S Pirola
- Pathology Division, IRCCS, European Institute of Oncology, Milan, Italy
| | - C Cantisani
- Dermatology Complex Operative Unit, Policlinico Umberto I, Sapienza Medical School of Rome, Rome, Italy
| | - S Vaccari
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - N Madnani
- PD Hinduja National Hospital and Sir HN Reliance Foundation Hospital, Mumbai, India
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26
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Paolino G, Bearzi P, Pampena R, Longo C, Frascione P, Rizzo N, Raucci M, Carbone A, Cantisani C, Ricci F, Didona D, Frattini F, Bulotta A, Gregorc V, Mercuri SR. Clinicopathological and dermoscopic features of amelanotic and hypomelanotic melanoma: a retrospective multicentric study. Int J Dermatol 2020; 59:1371-1380. [PMID: 32726478 DOI: 10.1111/ijd.15064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 03/27/2020] [Revised: 05/13/2020] [Accepted: 06/18/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Amelanotic and hypomelanotic melanoma (AHM) has a higher risk of delayed diagnosis and a significant lower 5-year melanoma-specific survival compared to pigmented melanoma. Our aim was the evaluation of the clinicopathological/dermoscopic features of amelanotic melanoma (AM) and hypomelanotic melanoma (HM). METHODS All participants had a personal history of AHM. We defined HM as showing clinical/dermoscopic pigmentation in < 25% of the lesion's surface and histopathological focal pigmentation, while AM as melanomas with clinical/dermoscopic and histopathological absence of pigmentation. RESULTS The most common phenotypic traits among the 145 AHM patients were as follows: phototype II, blue-grey eyes, and dark brown hair. Red hair was present in 23.8% AHM cases (AM = 22.60%; HM = 25.80%). The most affected area was the back (29.5%). A total of 67.1% were classified as AM and 32.9% as HM. The most represented hair colors in AM and HM were, respectively, blonde and dark brown hair. Median Breslow thickness was 1.7 mm, superficial spreading melanoma (SSM) and nodular melanoma (NM) were the most represented histotypes, and mitotic rate > 1 × mm2 was reported in 73.3% cases, and regression was significantly more present in HM. Dermoscopy showed high prevalence of white structureless zones (63.4%), linear looped vessels (58.8%), linear irregular vessels (50.0%), and arborizing vessels (47.2%). Multivariate logistic regression confirmed the association between the presence of pigmentation and the following: histological regression, dermoscopic globules, and arborizing vessels. CONCLUSIONS Predominance of red hair in AHM patients was not confirmed. AHM affects mostly intermittent sun-exposed body areas. The deeper median Breslow thickness (versus pigmented melanoma), the association of AM with the nodular histotype, and the high mitotic rate highlight the AHM's aggressiveness. HM's higher levels of regression can be explained by the presence of pigmentation, driving the underlying immune response. AHM showed a polymorphous vascular pattern and significant presence of arborizing vessels (especially HM).
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Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.,Dermatologic Clinic, La Sapienza University of Rome, Rome, Italy
| | - Pietro Bearzi
- Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy.,Università Vita Salute San Raffaele, Milano, Italy
| | - Riccardo Pampena
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Caterina Longo
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Pasquale Frascione
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Nathalie Rizzo
- Department of Pathology, IRCCS Ospedale San Raffaele, Milan, Italy
| | | | - Anna Carbone
- Oncologic and Preventative Dermatology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Carmen Cantisani
- Dermatologic Clinic, La Sapienza University of Rome, Rome, Italy
| | - Francesco Ricci
- Melanoma Unit, Istituto Dermopatico dell'Immacolata (IDI), Rome, Italy
| | - Dario Didona
- Melanoma Unit, Istituto Dermopatico dell'Immacolata (IDI), Rome, Italy
| | | | - Alessandra Bulotta
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Vanesa Gregorc
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Santo R Mercuri
- Unit of Dermatology, IRCCS Ospedale San Raffaele, Milan, Italy
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Paolino G, Cantoresi F, Mercuri SR, Cantisani C. Clinical evaluation and efficacy of Imiquimod 3.75% cream for the treatment of actinic keratosis, pigmented basal cell carcinomas, and actinic cheilitis. Dermatol Ther 2020; 33:e13356. [PMID: 32239714 DOI: 10.1111/dth.13356] [Citation(s) in RCA: 2] [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] [Received: 12/23/2019] [Revised: 03/07/2020] [Accepted: 03/26/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Giovanni Paolino
- Unit of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy.,Unit of Dermatology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Franca Cantoresi
- Unit of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - Santo R Mercuri
- Unit of Dermatology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carmen Cantisani
- Unit of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
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28
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Cantisani C, Cantoresi F, Mercuri SR, Binic I, Golubovic M, Marino R, Paolino G. Efficacy of imiquimod 3.75% cream for the treatment of solar lentigo. Dermatol Ther 2020; 33:e13256. [DOI: 10.1111/dth.13256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 01/21/2020] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Carmen Cantisani
- Unit of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School University of Rome Rome Italy
| | - Franca Cantoresi
- Unit of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School University of Rome Rome Italy
| | | | - Iva Binic
- Department of Internal Medicine, University of Nis Nis Serbia
| | - Masa Golubovic
- Department of Internal Medicine, University of Nis Nis Serbia
| | - Raffaella Marino
- Department of Internal Medicine, Ferrara Medical School Ferrara Italy
| | - Giovanni Paolino
- Unit of Dermatology, Policlinico Umberto I Hospital, Sapienza Medical School University of Rome Rome Italy
- Unit of Dermatology – IRCCS San Raffaele Scientific Institute Milan Italy
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Cantisani C, Magri F, Iacovino C, Soda G, Bergler-Czop BB, Marino R, Tornese A, Cantoresi F. Blue nevus with satellitosis in a pregnant patient. Ital J Dermatol Venerol 2020; 156:78-79. [PMID: 32041936 DOI: 10.23736/s2784-8671.19.06409-5] [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)
- Carmen Cantisani
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy -
| | - Francesca Magri
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Chiara Iacovino
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Giuseppe Soda
- Department of Molecular Medicine, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | | | - Raffaella Marino
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Tornese
- Department of Molecular Medicine, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
| | - Franca Cantoresi
- Department of Dermatology and Venereology, Umberto I Polyclinic Hospital, Sapienza University, Rome, Italy
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30
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Cantisani C, Magri F, Iacovino C, Soda G, Bergler-Czop BB, Marino R, Tornese A, Cantoresi F. Blue nevus with satellitosis: a case report in a pregnant patient. Ital J Dermatol Venerol 2020. [DOI: 10.23736/s0392-0488.19.06409-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Alsorori E, Kiss N, Medvecz M, Naqeshbandi AF, Bergler-Czop B, Alsarari I, Cantisani C. A case of granuloma faciale successfully treated with systemic dapsone. Dermatol Ther 2019; 33:e13162. [PMID: 31705567 DOI: 10.1111/dth.13162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Ezeldeen Alsorori
- Department of Dermatology, University of Science and Technology, Sanaa Hospital, Rome, Yemen
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Márta Medvecz
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - Ahmad F Naqeshbandi
- Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Beata Bergler-Czop
- Department of Dermatology, Medical University of Silesia, Katowice, Poland
| | - Inas Alsarari
- Department of Dermatology, University of Science and Technology, Sanaa Hospital, Rome, Yemen
| | - Carmen Cantisani
- Department of Dermatology and Venereology, Sapienza University of Rome, Rome, Italy
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32
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Cantisani C, Amori P, Vitiello G, Tirant M, Thuong VN, Lotti T, Matovic D, Hajzler ZP, Vojvodic A. Nonsurgical blepharoplasty. Dermatol Ther 2019; 32:e13119. [PMID: 31606942 DOI: 10.1111/dth.13119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/30/2019] [Revised: 09/11/2019] [Accepted: 09/26/2019] [Indexed: 11/30/2022]
Abstract
The eyes are an important component of facial aesthetics. They are in the center of an anatomical area of the face very important for rejuvenation procedures, the so-called "periorbital region." The appearance of the eyes therefore decisively influences the perception of the aesthetics and aging of the entire face. In juvenile age, the skin of the periocular area is elastic and tonic, without sun damage; the eyebrow is full, well defined, and not descending; there is a clear and visible fold of the upper eyelid, with minimal dermatochalasis; the lower eyelid is tense and well positioned. The aim of this preliminary study is to define a protocol for the use of plasma technology in the treatment of aging signs of the periorbital region. The protocol is aimed to provide predictable, constant, and safe results.
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Affiliation(s)
- Carmen Cantisani
- UOC of Dermatology, Umberto I Hospital Sapienza Medical School of Rome, Italy
| | - Paolo Amori
- University Unit of Dermatology and Regenerative Medicine, University of Rome G. Marconi, Rome, Italy
| | - Gabriella Vitiello
- University Unit of Dermatology and Regenerative Medicine, University of Rome G. Marconi, Rome, Italy
| | - Michael Tirant
- University Unit of Dermatology and Regenerative Medicine, University of Rome G. Marconi, Rome, Italy
| | - Van N Thuong
- Department of Dermatology and Venereology, National Medical University of Hanoi, Hanoi, Vietnam
| | - Torello Lotti
- University Unit of Dermatology and Regenerative Medicine, University of Rome G. Marconi, Rome, Italy
| | - Dusica Matovic
- Department of Dermatology and Venereology, Military Medical Academy, Belgrade, Serbia
| | - Zorica P Hajzler
- Department of Dermatology and Venereology, Military Medical Academy, Belgrade, Serbia
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy, Belgrade, Serbia
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33
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Cantisani C, Kiss N, Naqeshbandi AF, Tosti G, Tofani S, Cartoni C, Carmosino I, Cantoresi F. Nonmelanoma skin cancer associated with Hydroxyurea treatment: Overview of the literature and our own experience. Dermatol Ther 2019; 32:e13043. [PMID: 31364787 DOI: 10.1111/dth.13043] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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: 02/21/2019] [Revised: 07/15/2019] [Accepted: 07/27/2019] [Indexed: 12/16/2022]
Abstract
Nonmelanoma skin cancer is the most common malignant tumor in the fair skin population, with each year several millions of diagnosed cases. Their most common risk factors are fair skin, a history of excessive ultraviolet light exposure, chronic inflammatory skin conditions, exposure to radiation, and contact with arsenic. Certain drugs can also be associated with a higher risk of nonmelanoma skin cancer. These include hydroxyurea, which acts as a metabolic inhibitor of ribonucleotide reductase and a potent nonalkylating myelosuppressive agent. It is used for the treatment of various myeloproliferative disorders, including chronic myeloid leukemia, polycythemia vera, and essential thrombocytopenia. Several publications describe an increased occurrence of skin manifestations following hydroxyurea treatment. A growing body of evidence indicates a possible role of hydroxyurea in skin cancer progression. In this review article, we summarize some relevant observations about the association of hydroxyurea and skin cancer, and we describe our own clinical experiences to provide up to date recommendations about the care of patients on hydroxyurea therapy.
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Affiliation(s)
- Carmen Cantisani
- UOC of Dermatology, Policlinico Umberto I, Sapienza Medical School of Rome, Rome, Italy
| | - Norbert Kiss
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | | | - Giulio Tosti
- Melanoma and Soft Tissue Sarcoma Division, IRCCS, European Institute of Oncology, Milan, Italy
| | - Sonia Tofani
- UOC of Dermatology, Policlinico Umberto I, Sapienza Medical School of Rome, Rome, Italy
| | - Claudio Cartoni
- Translational and precision medicine Hematology Department Umberto I Hospital Sapienza University, Rome, Italy
| | - Ida Carmosino
- Translational and precision medicine Hematology Department Umberto I Hospital Sapienza University, Rome, Italy
| | - Franca Cantoresi
- UOC of Dermatology, Policlinico Umberto I, Sapienza Medical School of Rome, Rome, Italy
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34
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Dehpouri T, Rokni GR, Narenjbon NA, Goldust M, Yamauchi PS, Wollina U, Lotti T, Kircik L, Lernia VGD, Sonthalia S, Vojvodic A, Szepietowski J, Bahadoran P, Errichetti E, Cantisani C, Atzori L, Rezaee E, Kutlubay Z, Engin B, Nisticò S, Damiani G, Conic RRZ, Goren A, Čabrijan L, Tchernev G. Evaluation of the glycemic effect of methotrexate in psoriatic arthritis patients with metabolic syndrome: A pilot study. Dermatol Reports 2019; 11:7965. [PMID: 31210916 PMCID: PMC6547029 DOI: 10.4081/dr.2019.7965] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 12/04/2018] [Accepted: 01/18/2019] [Indexed: 01/10/2023] Open
Abstract
Methotrexate (MTX) is a systemic immunosuppressant drug used for the treatment of psoriasis and psoriatic arthritis. Previous studies demonstrated a potential association between psoriasis and diabetes mellitus, obesity, atherosclerosis, hypertension, eventuating into metabolic syndrome. This study aimed at exploring the glycemic effects of MTX in psoriatic arthritis (PsA) patients. In this prospective cross-sectional study, 27 patients with PsA were evaluated. The status of PsA and presence of accompanying metabolic syndrome was determined by standard criteria and indices. Blood indicators including HbA1c, erythrocyte sedimentation rate, fasting blood sugar, total cholesterol, high-density lipoprotein, triglycerides, and C-reactive protein were examined before and 12 weeks after MTX therapy. There were no significant changes between HbA1c levels before and after MTX therapy in both genders (men: P=0.131, women: P=0.803). In addition, HbA1c levels in PsA patients with metabolic syndrome were not different before and after treatment (P=0.250). Finally, HbA1c levels did not change in PsA patients without metabolic syndrome before and after therapy (P=0.506). MTX in PsA patients does not appear to have hyperglycaemic effects in the short-term and can be safely used in patients with metabolic syndrome and diabetes.
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Affiliation(s)
- Tannaz Dehpouri
- Student Research Committee, Mazandaran University of Medical Sciences, Ramsar International Branch, Ramsar, Iran
| | | | | | - Mohamad Goldust
- Department of Dermatology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Paul S Yamauchi
- Dermatology Institute and Skin Care Center, Santa Monica, California, USA.,Division of Dermatology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital of the Technical University of Dresden, Dresden, Germany
| | - Torello Lotti
- Department of Dermatology, "Guglielmo Marconi" University, Rome, Italy
| | - Leon Kircik
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Sidharth Sonthalia
- Skinnocence: The Skin Clinic & Research Center, Gurugram, Haryana, India.,Dermasource India, Gurugram, Haryana, India
| | - Aleksandra Vojvodic
- Department of Dermatology and Venereology, Military Medical Academy, Belgrade, Serbia
| | - Jacek Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Enzo Errichetti
- Department of Experimental and Clinical Medicine, Institute of Dermatology, University of Udine, Udine, Italy
| | - Carmen Cantisani
- Department of Dermatology, "Umberto I" Hospital, "Sapienza" University of Rome, Rome, Italy
| | - Laura Atzori
- Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Elham Rezaee
- Department of Pharmaceutical Chemistry, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zekayi Kutlubay
- Department of Dermatology, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Burhan Engin
- Department of Dermatology, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey
| | - Steven Nisticò
- Department of Health Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Giovanni Damiani
- Department of Medical and Surgical Pathophysiology and Transplantation, University of Milan, Dermatology Unit, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinico, Milan, Italy.,Young Dermatologists Italian Network (YDIN), Centro Studi GISED, Bergamo, Italy
| | - Rosalynn R Z Conic
- Department of Dermatology, Case Western Reserve University, Cleveland, OH, USA
| | - Andy Goren
- Department of Dermatology, "Guglielmo Marconi" University, Rome, Italy
| | - Leo Čabrijan
- Department of Dermatovenereology, Rijeka Clinical Hospital Center, Rijeka, Croatia
| | - Georgi Tchernev
- Medical Institute of Ministry of Interior (MVR), Department of Dermatology, Venereology and Dermatologic Surgery, Sofia, Bulgaria
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35
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Cantisani C, Naqeshbandi AF, Goldust M, Lampitelli S, Cantoresi F, Alsorori E. Type I leucocyte adhesion deficiency in Yemenian family managed with appropriate treatment: A case series. Dermatol Ther 2019; 32:e12864. [PMID: 30834665 DOI: 10.1111/dth.12864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 11/22/2018] [Revised: 01/09/2019] [Accepted: 02/10/2019] [Indexed: 02/04/2023]
Abstract
Primary immunodeficiencies are rare, inherited diseases, characterized by altered function or absence of immune cells. Among them is leukocyte adhesion deficiency Type I (LAD-I), an autosomal recessive disorder characterized by primary immunodeficiency, caused by mutations in the ITGB2 gene which produces inability of leucocytes to migrate toward the area of inflammation and is associated with recurrent life-threatening bacterial and fungal infections. Pyoderma gangrenosum (PG) is an uncommon noninfectious neutrophilic dermatosis, characterized by recurrent, necrotic ulcers. It is a diagnosis of exclusion and can be challenging and its management is empirical, with local (topical tacrolimus or intralesional triamcinolone) or systemic immunosuppressive therapy (oral or intravenous glucocorticoids, sulfasalazine, especially in cases associated with Crohn's disease, cyclosporine and, recently, anti-tumor necrosis factor drugs such as Infliximab, Etanercept, and Adalimumab). Though skin ulcerations are common, predominant clinical presentation as PG can often mimic other diseases. It is unusual in children even more in LAD-I. Here, we present a Yemenian family with LAD-I from consanguineous relatives. All patients had history of chronic recurrent skin ulcerations without any bleeding tendency, associated with persistent neutrophilia and requiring steroids and antibiotics. There was no history of delayed cord separation and the condition was initially diagnosed as epidermolysis bullosa, but successively as PG. LAD-I should be kept in mind while evaluating patients with PG especially in children with persistent neutrophilia in the absence of other rheumatological disorders. Its diagnosis is extremely important from the management perspective, as treating these patients without adequate antibiotic cover may be fatal, as happened to one of our patient, and these patients often require hematopoietic stem cell transplantation for permanent cure. Therefore, genetic counseling especially in population with high consanguinity is mandatory.
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Affiliation(s)
- Carmen Cantisani
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | | | - Mohamad Goldust
- Department of Dermatology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Salvatore Lampitelli
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - Franca Cantoresi
- UOC of Dermatology, Umberto I Hospital, Sapienza Medical School of Rome, Rome, Italy
| | - Ezeldeen Alsorori
- Department of dermatology, University of Science and Technology Hospital, Sana'a, Yemen
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36
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37
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Paolino G, Didona D, Scarnò M, Tallarico M, Cantoresi F, Calvieri S, Mercuri SR, Piccolo D, Bottoni U, Kyriakou A, Cantisani C. Sequential treatment of daylight photodynamic therapy and imiquimod 5% cream for the treatment of superficial basal cell carcinoma on sun exposed areas. Dermatol Ther 2018; 32:e12788. [DOI: 10.1111/dth.12788] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/20/2018] [Accepted: 11/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Giovanni Paolino
- Dermatology ClinicLa Sapienza‐Università di Roma Rome Italy
- Dermatology and Cosmetology UnitSan Raffaele Hospital Milan Italy
| | - Dario Didona
- Klinik für Dermatologie und AllergologieUniversitätsklinikum Marburg Marburg Germany
| | - Marco Scarnò
- Super Computing Applications and Innovation (SCAI)CINECA Rome Italy
| | | | | | | | | | | | - Ugo Bottoni
- Dermatology ClinicUniversity Magna Grecia Catanzaro Italy
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38
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Cantisani C, Paolino G, Scarnò M, Didona D, Tallarico M, Moliterni E, Losco L, Cantoresi F, Mercuri SR, Bottoniτ U, Calvieri S. Sequential methyl-aminolevulinate daylight photodynamic therapy and diclofenac plus hyaluronic acid gel treatment for multiple actinic keratosis evaluation. Dermatol Ther 2018; 31:e12710. [PMID: 30253027 DOI: 10.1111/dth.12710] [Citation(s) in RCA: 6] [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: 06/18/2018] [Revised: 07/24/2018] [Accepted: 08/12/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Carmen Cantisani
- UOC of Dermatology, Policlinico Umberto I, Sapienza University of Rome
| | - Giovanni Paolino
- Dermatology and Cosmetology Unit, San Raffaele Hospital, Milan, Italy
| | - Marco Scarnò
- Super Computing Applications and Innovation (SCAI), CINECA, Rome, Italy
| | - Dario Didona
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Marburg, Marburg, Germany
| | | | - Elisa Moliterni
- UOC of Dermatology, Policlinico Umberto I, Sapienza University of Rome
| | - Luigi Losco
- UOC of Plastic Surgery, Policlinico Umberto I, Sapienza University of Rome
| | - Franca Cantoresi
- UOC of Dermatology, Policlinico Umberto I, Sapienza University of Rome
| | | | - Ugo Bottoniτ
- UOS of Dermatology, University of Magna Grecia, Catanzaro, Italy
| | - Stefano Calvieri
- UOC of Dermatology, Policlinico Umberto I, Sapienza University of Rome
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Didona D, Ruggeri S, Paolino G, Cantisani C, Caposiena Caro RD, Moliterni E, Didona B. Spiny keratoderma of the palms in a patient with diabetes mellitus type 1: what came first, the chicken or the egg? GIORN ITAL DERMAT V 2018; 153:734-735. [PMID: 30246957 DOI: 10.23736/s0392-0488.17.05654-1] [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)
- Dario Didona
- First Dermatologic Division, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy -
| | - Salvatore Ruggeri
- First Dermatologic Division, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Giovanni Paolino
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - Carmen Cantisani
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | | | - Elisa Moliterni
- Department of Dermatology, La Sapienza University of Rome, Rome, Italy
| | - Biagio Didona
- First Dermatologic Division, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
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40
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Didona D, Mostaccioli S, Paolino G, Cantisani C, Caposiena Caro RD, Viti G, Didona B. Shiitake dermatosis in a Caucasian woman. Ital J Dermatol Venerol 2018; 153:586-588. [PMID: 29767489 DOI: 10.23736/s0392-0488.17.05591-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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)
- Dario Didona
- First Division of Dermatology, Istituto Dermopatico dell'Immacolata, Rome, Italy -
| | - Stefania Mostaccioli
- First Division of Dermatology, Istituto Dermopatico dell'Immacolata, Rome, Italy
| | | | | | | | - Giacomo Viti
- Clinic of Dermatology, Sapienza University of Rome, Rome, Italy
| | - Biagio Didona
- First Division of Dermatology, Istituto Dermopatico dell'Immacolata, Rome, Italy
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41
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Tosti G, Iacobone AD, Preti EP, Vaccari S, Barisani A, Pennacchioli E, Cantisani C. The Role of Photodynamic Therapy in the Treatment of Vulvar Intraepithelial Neoplasia. Biomedicines 2018; 6:biomedicines6010013. [PMID: 29393881 PMCID: PMC5874670 DOI: 10.3390/biomedicines6010013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 01/04/2018] [Revised: 01/25/2018] [Accepted: 01/30/2018] [Indexed: 01/30/2023] Open
Abstract
Background: vulvar intraepithelial neoplasia is a non-invasive precursor lesion found in 50–70% of patients affected by vulvar squamous cell carcinoma. In the past, radical surgery was the standard treatment for vulvar intraepithelial neoplasia, however, considering the psychological and physical morbidities related to extensive surgery, several less aggressive treatment modalities have been proposed since the late 1970s. Photodynamic therapy is an effective and safe treatment for cutaneous non-melanoma skin cancer, with favorable cosmetic outcomes. Methods: in the present paper, the results of selected studies on photodynamic therapy in the treatment of vulvar intraepithelial neoplasia are reported and discussed. Results: Overall, complete histological response rates ranged between 20% and 67% and symptom response rates ranged between 52% and 89% according to different studies and case series. Conclusions: the real benefit of photodynamic therapy in the setting of vulvar intraepithelial neoplasia lies in its ability to treat multi-focal disease with minimal tissue destruction, preservation of vulvar anatomy and excellent cosmetic outcomes. These properties explain why photodynamic therapy is an attractive option for vulvar intraepithelial neoplasia treatment.
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Affiliation(s)
- Giulio Tosti
- Division of Melanoma, Soft Tissue Sarcomas and Rare Tumors, Istituto Europeo di Oncologia, Via G. Ripamonti 437, 20141 Milano, Italy.
| | | | | | - Sabina Vaccari
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
| | - Alessia Barisani
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, 40138 Bologna, Italy.
| | - Elisabetta Pennacchioli
- Division of Melanoma, Soft Tissue Sarcomas and Rare Tumors, Istituto Europeo di Oncologia, Via G. Ripamonti 437, 20141 Milano, Italy.
| | - Carmen Cantisani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, 00185 Rome, Italy.
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Fargnoli MC, Ibbotson SH, Hunger RE, Rostain G, Gaastra MTW, Eibenschutz L, Cantisani C, Venema AW, Medina S, Kerrouche N, Pérez-Garcia B. Patient and physician satisfaction in an observational study with methyl aminolevulinate daylight photodynamic therapy in the treatment of multiple actinic keratoses of the face and scalp in six European countries. J Eur Acad Dermatol Venereol 2017; 32:757-762. [PMID: 29136306 PMCID: PMC6084323 DOI: 10.1111/jdv.14691] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 08/18/2017] [Accepted: 11/03/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Guidelines recommend treating actinic keratoses (AKs) as they are recognized as precursors of invasive squamous cell carcinoma. OBJECTIVE The objective of this study was to collect real-world clinical data on the use of methyl aminolevulinate daylight photodynamic therapy (MAL DL-PDT) for the treatment of face and scalp AK in Europe. METHODS A prospective, multicenter, non-interventional study was conducted in six European countries in patients receiving a single treatment of MAL DL-PDT for face and/or scalp AK. Patient-reported outcomes were assessed by patient questionnaires at baseline and at 3 months after treatment, efficacy was assessed at 3 months using a 6-point global improvement scale, and adverse events (AE) were recorded at each visit. RESULTS Overall, 325 patients were enrolled from 52 investigational centres, 314 of whom attended the 3-month visit. Most patients had multiple lesions (58.4% had >10 lesions) with lesions mainly located on the scalp (60.0%) and/or forehead (54.2%). AKs were predominantly grade I (39.4%) or grade II (33.2%), and 10.5% of patients had grade III lesions. The proportions of patients and physicians that were overall satisfied to very satisfied with the MAL DL-PDT treatment were 80.4% and 90.3%, respectively. The vast majority of patients (90.0%) would consider using MAL DL-PDT again if needed. Physician-assessed efficacy at 3 months was at least much improved in 83.5% of patients, with 45.9% of patients requiring no retreatment. Related AEs were reported in 15% of patients. CONCLUSION Use of MAL DL-PDT for multiple face and/or scalp AKs resulted in high levels of patient and physician satisfaction in clinical practice in Europe, reflecting the good efficacy and high tolerability of this convenient procedure.
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Affiliation(s)
- M C Fargnoli
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | - S H Ibbotson
- Photobiology Unit, Ninewells Hospital & Medical School, University of Dundee, Dundee, UK
| | - R E Hunger
- Department of Dermatology, Bern University Hospital, Inselspital, Bern, Switzerland
| | | | | | - L Eibenschutz
- Dermato Oncology Unit, San Gallicano Dermatological Institute, Rome, Italy
| | - C Cantisani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - S Medina
- Dermatology Department, Príncipe de Asturias University Hospital, Madrid, Spain
| | | | - B Pérez-Garcia
- Department of Dermatology, Ramón y Cajal University Hospital, Madrid, Spain
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Cantisani C, Paolino G, Melis M, Faina V, Romaniello F, Didona D, Cardone M, Calvieri S. Actinic Keratosis Pathogenesis Update and New Patents. ACTA ACUST UNITED AC 2017; 10:40-48. [PMID: 27142784 DOI: 10.2174/1872213x10666160504104825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 05/03/2016] [Accepted: 05/03/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND Actinic keratosis is a common premalignant skin lesion. Because of its increasing incidence, several efforts have been made to earlier detectection and to improve knowledge on photocarcinogenic pathways of keratinocytes. As a consequence, recently new discoveries have been done in this field. OBJECTIVE Starting from our previous review on actinic keratosis, we reviewed the literature focusing on pathogenesis and new patents in order to highlight the most recent progresses in diagnosis and therapeutic approach. CONCLUSION Although several efforts have been done in the field of photodamaged skin, new upgrades in diagnosis and therapy are needed to detect superficial actinic keratosis earlier, to improve the disease free survival of patient and to better treat the field cancerization.
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Affiliation(s)
- Carmen Cantisani
- Department of Dermatology and Plastic Surgery, Sapienza University, Rome, Italy, Policlinico Umberto I Hospital, Rome, Italy.
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Paolino G, Garelli V, Didona D, Cantisani C, Rossi A, Donati P, Muscardin LM. Melanosis of the lower lip subverted by filler injection: a simulator of early mucosal melanoma. Australas J Dermatol 2017; 58:71-72. [PMID: 28195323 DOI: 10.1111/ajd.12475] [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: 11/26/2022]
Affiliation(s)
| | | | - Dario Didona
- Prima Divisione Dermatologica, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | | | - Alfredo Rossi
- Dermatological Clinic, Sapienza University of Roma, Rome, Italy
| | - Pietro Donati
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
| | - Luca M Muscardin
- Dermatopathological Laboratory, San Gallicano Institute of Rome, Rome, Italy
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45
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Paolino G, Moliterni E, Didona D, Cardone M, Lopez T, Garelli V, Richetta AG, Bottoni U, Cantisani C, Rossi A, Calvieri S. Serum tryptase levels in melanoma patients: case-control study and review of the literature. GIORN ITAL DERMAT V 2017; 154:18-25. [PMID: 28079340 DOI: 10.23736/s0392-0488.17.05524-9] [Citation(s) in RCA: 2] [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] [Indexed: 11/08/2022]
Abstract
BACKGROUND Serum tryptase results from the constant release of the enzyme from mast cells and serum tryptase levels are commonly considered to be related to the total number of mast cells. They are increased in several malignancies, as pancreatic carcinoma, angiosarcoma, hepatic carcinoma and proliferative and/or non-proliferative hematological disorders. Contrariwise, it has been reported that the number of tryptase- and chymase-positive mast cells was lower in deeply invasive melanoma compared to in-situ melanoma and dysplastic nevi. Considering the underlying pathophysiological linkages between mast cells and melanocytes and that serum tryptase is related to angiogenesis, tissue-degrading proprieties and metastatization, we have decided to evaluate serum tryptase levels in melanoma patients and in a healthy control. METHODS We performed a case-control study evaluating serum tryptase in melanoma and in healthy group. Starting from an initial general analysis, we have performed a sub-analysis for each sample. RESULTS In general population serum tryptase was statistically higher in elderly patients. Generally, in melanoma patients, median serum tryptase was in lower normal range. We found a decreasing of serum tryptase levels from the healthy control to thin (≤1.00 mm Breslow thickness), reaching the lowest levels in thicker melanoma (≥1.01 mm Breslow thickness), in ulcerated and metastatic melanoma. CONCLUSIONS Tryptase may have a protective role in melanoma or in the early stage of the tumorigenesis. Serum tryptase is an easy and useful biomarker to better investigate melanoma biology.
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Affiliation(s)
| | | | - Dario Didona
- Clinic of Dermatology and Allergology, Marburg University Hospital, Marburg, Germany -
| | | | - Teresa Lopez
- Clinic of Dermatology, Sapienza University, Rome, Italy
| | | | | | | | | | - Alfredo Rossi
- Clinic of Dermatology, Sapienza University, Rome, Italy
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D'Epiro S, Salvi M, Luzi A, Mattozzi C, Luci C, Macaluso L, Marzocca F, Salvo V, Cantisani C, Paolino G, Calvieri S, Richetta AG. Drug cutaneous side effect: focus on skin ulceration. Clin Ter 2016; 165:e323-9. [PMID: 25203350 DOI: 10.7417/ct.2014.1750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Skin ulcers are defined as tissue loss interesting the deeper layers of the dermis and hypodermis, with low tendency to spontaneous healing. They cause disability related to pain, risk of infection and amputation, chronic management, requiring working absence with notably economic burden. The major cause is often related to underlying vascular disease, infections, tumors, autoimmunity, trauma, even if literature occasionally reported several cases of drug inducing skin ulceration. Most of drugs involved are chemotherapy agents and more recently molecular target therapies. Evidences supporting these drugs as the major cause of skin ulcers include delay of onset after therapy initiation, improvement after withdrawal of the drug, recurrence after its reintroduction and, sometimes, simultaneous occurrence of other skin lesions that have previously been reported to be associated with these agents. Attention should be reserved to patients undergoing antineoplastic agents, especially if previously affected by predisposing comorbidities, considering such side effect as possible differential diagnosis for skin ulceration in neoplastic patients.
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Affiliation(s)
- S D'Epiro
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - M Salvi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - A Luzi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Mattozzi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Luci
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - L Macaluso
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - F Marzocca
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - V Salvo
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Cantisani
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - G Paolino
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - S Calvieri
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - A G Richetta
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
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Cantisani C, Paolino G, Pellacani G, Didona D, Scarno M, Faina V, Gobello T, Calvieri S. MAL Daylight Photodynamic Therapy for Actinic Keratosis: Clinical and Imaging Evaluation by 3D Camera. Int J Mol Sci 2016; 17:ijms17071108. [PMID: 27409613 PMCID: PMC4964483 DOI: 10.3390/ijms17071108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/13/2016] [Accepted: 06/30/2016] [Indexed: 11/16/2022] Open
Abstract
Non-melanoma skin cancer is the most common skin cancer with an incidence that varies widely worldwide. Among them, actinic keratosis (AK), considered by some authors as in situ squamous cell carcinoma (SCC), are the most common and reflect an abnormal multistep skin cell development due to the chronic ultraviolet (UV) light exposure. No ideal treatment exists, but the potential risk of their development in a more invasive form requires prompt treatment. As patients usually present with multiple AK on fields of actinic damage, there is a need for effective, safe, simple and short treatments which allow the treatment of large areas. To achieve this, daylight photodynamic therapy (DL-PDT) is an innovative treatment for multiple mild actinic keratosis, well tolerated by patients. Patients allocated to the PDT unit, affected by multiple mild-moderate and severe actinic keratosis on sun-exposed areas treated with DL-PDT, were clinically evaluated at baseline and every three months with an Antera 3D, Miravex(©) camera. Clinical and 3D images were performed at each clinical check almost every three months. In this retrospective study, 331 patients (56.7% male, 43.3% female) were treated with DL-PDT. We observed a full clearance in more than two-thirds of patients with one or two treatments. Different responses depend on the number of lesions and on their severity; for patients with 1-3 lesions and with grade I or II AK, a full clearance was reached in 85% of cases with a maximum of two treatments. DL-PDT in general improved skin tone and erased sun damage. Evaluating each Antera 3D images, hemoglobin concentration and pigmentation, a skin color and tone improvement in 310 patients was observed. DL-PDT appears as a promising, effective, simple, tolerable and practical treatment for actinic damage associated with AK, and even treatment of large areas can be with little or no pain. The 3D imaging allowed for quantifying in real time the aesthetic benefits of DL-PDT's increasing compliance.
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Affiliation(s)
- Carmen Cantisani
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Giovanni Paolino
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena 41121, Italy.
| | - Dario Didona
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Marco Scarno
- Interuniversity Consortium for Supercomputing (CINECA), Rome 00185, Italy.
| | - Valentina Faina
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
| | - Tommaso Gobello
- Istituto Dermopatico dell'Immacolata (IDI) Hospital, Rome 00195, Italy.
| | - Stefano Calvieri
- Department of Dermatology, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00185, Italy.
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Paolino G, Didona D, Clerico R, DE Vita G, Corsetti P, Ambrifi M, Cantisani C, Bottoni U, Richetta AG, Lopez T, Calvieri S. Cancer surveillance series: role of demographic aspects, altitude and latitude in the extracutaneous malignant melanoma in a residential study. GIORN ITAL DERMAT V 2016; 151:133-139. [PMID: 26889723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Extracutaneous melanoma (ECM) is a very rare malignancy and its biology differs from that of cutaneous melanoma. Residential studies can offer an important contribution to the study of this disease. METHODS We characterized the distribution of ECM according to residential and demographic baseline characteristics. We computer-searched patients that removed an ECM, and we analyzed all demographic and residential parameters. Disease free survival (DFS), date of death or last follow-ups were evaluated. The same parameters were analyzed using hazards-regression. Finally, we used the multiple regressions between DFS and the predictors. RESULTS A total of 44 ECM patients were included in our analysis. Median DFS was of 10 months; at Log-Rank Test and Cox-hazard regression, the variable age (P<0.01; P<0.004) and latitude (P<0.02; P<0.006) reached a statistical significance; at multiple logistic regression, the significance was instead maintained only for the variable age. General OS was of 42 months at Log-Rank Test age (P<0.001), as well as latitude (P<0.006) maintained its significance at hazard-regression. CONCLUSIONS Demographic and residential aspects can play an important role in the study of this rare disease, supporting the assumption that ECM are generated by processes actually unknown, as demonstrated in our results compared with those of the literature.
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Affiliation(s)
- Giovanni Paolino
- Dermatologic Clinic, La Sapienza University of Rome, Rome, Italy -
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Paolino G, Didona D, Lopez T, Alesini F, Cantisani C, Richetta AG, Soda G, Calvieri S. Agminated Blue Nevus: Two Case Reports and a Mini-review of the Literature. Acta Dermatovenerol Croat 2016; 24:37-41. [PMID: 27149129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Agminated blue nevus (ABN) is a melanocytic nevus rarely mentioned in the literature and not well known. The term agminated is used when many blue nevi are clustered together in a sharply demarcated area ≤10 cm. Specific dermatoscopic features have not currently been clearly defined. We describe two cases of ABN and provide a review of the literature, reporting the main points in order to facilitate the diagnosis of this rare entity.
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Affiliation(s)
| | - Dario Didona
- Dario Didona, MD, Viale del Policlinico, 155, 00186 Rome, Italy;
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Rotunno R, Paolino G, Cantisani C, Solito C, Calvieri S, Curatolo P. Predictive factors in non-melanoma skin cancers treated with electrochemotherapy. Ital J Dermatol Venerol 2016; 153:11-18. [PMID: 26989995 DOI: 10.23736/s0392-0488.16.05336-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The management of non-melanoma skin cancers may benefit from alternative treatments and in this spectrum electrochemotherapy plays a pivotal role. The aim was to describe the predictive features of patients with cutaneous carcinomas treated with electrochemotherapy, with regard to clinical, pathological and instrumental predictors. METHODS We analyzed disease free survival (DFS), and overall survival (OS) for each patient. Assuming that the effects of the predictor variables are constant over time, the independent predictive factors were assessed by Cox-proportional hazards regression in both univariate and multivariate analyses. RESULTS We can assess that in the brief-term (DFS), the patients' age, tumor-site, tumor size, photo-type and the dose of the cytotoxic drug showed a statistical significant better behavior. However, in the multivariate, only the variables tumor's site (P=0.01) and tumor appearance (P=0.03) reached the statistical significance. In the long-term, female patients, patients with a median age ≤70 years, with III-IV photo types and patients, which received a dosage of bleomycin, ≤14 mg/m2 presented a significant better behavior. However in the multivariate analysis a significance was maintained for the variables tumor's appearance (HR: 11.6; 95% CI: 11.56 to 27.5; P=0.01), infiltration (HR:0.11; 95% CI: 0.012 to 0.9; P=0.04), electrode type (HR:0.19; 95% CI:0.04 to 0.8; P=0.03) and photo type (HR:5.7; 95% CI:1.3 to 24.3; P=0.01). CONCLUSIONS According to our results, in electrochemotherapy different individual variables can have an important influence, which shows how this treatment could improve. The refinement of the technique and the optimization of patients' selection has the aim to improve the therapeutic response.
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Affiliation(s)
- Roberta Rotunno
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy -
| | - Giovanni Paolino
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Carmen Cantisani
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Carmen Solito
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Stefano Calvieri
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
| | - Pietro Curatolo
- Dermatologic Clinic, University of Rome "La Sapienza", Rome, Italy
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