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Venturi F, Lambertini M, Melotti B, De Paolis M, Dika E. Effective management of infiltrative locally advanced basal cell carcinoma of the tibia with sonidegib. Int J Dermatol 2024; 63:685-687. [PMID: 38351632 DOI: 10.1111/ijd.17083] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 04/28/2024]
Affiliation(s)
- Federico Venturi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Martina Lambertini
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Barbara Melotti
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Emi Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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2
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Artosi F, Costanza G, Di Prete M, Garofalo V, Lozzi F, Dika E, Cosio T, Diluvio L, Shumak RG, Lambiase S, Di Raimondo C, Campa S, Piscitelli P, Miani A, Bianchi L, Campione E. Epidemiological and clinical analysis of exposure-related factors in non-melanoma skin cancer: A retrospective cohort study. Environ Res 2024; 247:118117. [PMID: 38218521 DOI: 10.1016/j.envres.2024.118117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion. AIMS We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities. METHODS Descriptive and inferential statistical analyses were performed to evidence differences between continous variable and Spearman rank test for dicotomical variables. Charlson Comorbidity Index was calculated to obtain the 10-years survival rate in order to identify the mean comorbidity burden of our patients. RESULTS Considering patients with comorbidities (73.81%), actinic keratoses (AKs) was the most frequent lesion. In patients with a history of previous melanoma, basal cell carcinoma (BCC) was predominant (ANOVA test, p < 0.05) with a statistically significant correlation (rho = 0.453; p < 0.01). Squamous cell carcinoma (SCC) showed a higher rate in arterial hypertension patients, followed by the chronic heart failure and hematologic neoplasms (60%, 29.7% and 32.1%, respectively) groups. Men were more affected than women, representing 61.54% of patients. Chronic sun exposure is directly correlated with SCC rho = 0.561; p < 0.01), whereas BCC correlated with a history of sunburns (rho = 0.312; p < 0.05). CONCLUSIONS History of photo-exposition had an important role on NMSC development especially for work or recreational reasons. Sex, age, and presence of comorbidities influenced different NMSC types. BCC was more frequent in younger patients, associated with melanoma and sunburns. The presence of SCC is associated with older patients and the hypertension group. AKs were diagnosed predominantly in oldest men, with a chronic sun-exposure history, and hematologic neoplasms group.
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Affiliation(s)
- Fabio Artosi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Monia Di Prete
- Dermatopathology Laboratory, Istituti Fisioterapici Ospitalieri, Istituto San Gallicano, via Fermo Ognibene 23, 00144, Rome, Italy.
| | - Virginia Garofalo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Emi Dika
- Dermatology, IRCCS Policlinico Sant'Orsola, via Massarenti 9, 40138, Bologna, Italy.
| | - Terenzio Cosio
- PhD Course Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Laura Diluvio
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Sara Lambiase
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Cosimo Di Raimondo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Serena Campa
- Italian Society of Environmental Medicine, SIMA, Italy.
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine, SIMA, Italy; University of Salento, Lecce, Italy.
| | - Alessandro Miani
- Italian Society of Environmental Medicine, SIMA, Italy; Department of Environmental Sciences and Policies, University of Milan, Milan, Italy.
| | - Luca Bianchi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Elena Campione
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
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Maloberti T, De Leo A, Coluccelli S, Sanza V, Gruppioni E, Altimari A, Comito F, Melotti B, Marchese PV, Dika E, Venturi F, Corti B, Ciccimarra G, Ciceu CA, Tallini G, de Biase D. Molecular Characterization of Advanced-Stage Melanomas in Clinical Practice Using a Laboratory-Developed Next-Generation Sequencing Panel. Diagnostics (Basel) 2024; 14:800. [PMID: 38667446 PMCID: PMC11048853 DOI: 10.3390/diagnostics14080800] [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: 03/09/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Cutaneous melanoma is one of the most lethal tumors among skin cancers, characterized by complex genetic and molecular alterations that result in uncontrolled cell proliferation and metastatic spread. Next-generation sequencing (NGS) enables the simultaneous examination of numerous genes, making this molecular technique essential for melanoma diagnosis, prognostic stratification, and therapy planning. Herein, we present the experience with our laboratory-designed NGS panel for the routine assessment of advanced-stage melanoma. A total of 260 specimens of advanced-stage melanomas were evaluated utilizing a laboratory-developed multi-gene NGS panel, which allowed the investigation of 229 amplicons in 25 oncogene/oncosuppressor genes. The NGS panel proved to be a reliable tool, failing to produce results in only 1.2% of the samples tested. BRAF and TERT were the two more commonly altered genes in 44.0% and 59.9% of samples, respectively. In 59.3% of the mutated cases, at least two concomitant variants were detected. In eight cases, both primary lesion and metastatic disease were analyzed by NGS. In all specimens (8/8, 100%), a perfect concordance in variants harbored by the primary and recurrence lesions was observed. Finally, this study described the validity of a laboratory-developed multi-gene NGS panel built specifically for advanced-stage melanomas in ordinary clinical practice.
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Affiliation(s)
- Thais Maloberti
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
| | - Antonio De Leo
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (E.D.); (F.V.)
| | - Sara Coluccelli
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
| | - Viviana Sanza
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
| | - Elisa Gruppioni
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
| | - Annalisa Altimari
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
| | - Francesca Comito
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy (B.M.); (P.V.M.)
| | - Barbara Melotti
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy (B.M.); (P.V.M.)
| | - Paola Valeria Marchese
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy (B.M.); (P.V.M.)
| | - Emi Dika
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (E.D.); (F.V.)
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Federico Venturi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (E.D.); (F.V.)
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Barbara Corti
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Giulia Ciccimarra
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy; (G.C.); (C.A.C.)
| | - Crina Adriana Ciceu
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy; (G.C.); (C.A.C.)
| | - Giovanni Tallini
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy; (E.D.); (F.V.)
| | - Dario de Biase
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (T.M.); (A.D.L.); (S.C.); (V.S.); (E.G.); (A.A.); (G.T.)
- Department of Pharmacy and Biotechnology, University of Bologna, 40138 Bologna, Italy; (G.C.); (C.A.C.)
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Scotti B, Melotti B, Baraldi C, Comito F, Venturi F, Lambertini M, Dika E. Analysis of basal cell carcinomas' histological subtypes and relative response to vismodegib in six patients diagnosed with Gorlin-Goltz syndrome: A retrospective study. J Eur Acad Dermatol Venereol 2024; 38:e339-e341. [PMID: 37909360 DOI: 10.1111/jdv.19608] [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: 07/12/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023]
Affiliation(s)
- Biagio Scotti
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Barbara Melotti
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinic of Sant'Orsola, Italy
| | - Carlotta Baraldi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesca Comito
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinic of Sant'Orsola, Italy
| | - Federico Venturi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Martina Lambertini
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Emi Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Moscarella E, Di Brizzi EV, Alpi P, Arcelli A, Badellino S, Bossi P, Calzavara-Pinton PG, Di Stefani A, Dika E, Eibenschutz L, Fargnoli MC, Fionda B, Gravina GL, Leonulli BG, Longo C, Lospalluti L, Nardone V, Pimpinelli N, Quaglino P, Queirolo P, Rubegni P, Tagliaferri L, Troiani T, Vavassori A, Argenziano G. Indications for adjuvant radiotherapy in high-risk cutaneous squamous cell carcinoma with clear margins: a Delphi consensus. Br J Dermatol 2024; 190:578-579. [PMID: 38092023 DOI: 10.1093/bjd/ljad495] [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: 07/26/2023] [Revised: 10/31/2023] [Accepted: 01/13/2024] [Indexed: 03/16/2024]
Abstract
The aim of this study was to provide indications for adjuvant radiotherapy in high-risk cutaneous squamous cell carcinoma.
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Affiliation(s)
- Elvira Moscarella
- Dermatology Unit, University of Campania L. Vanvitelli, Naples,Italy
| | | | - Paolo Alpi
- Radiation Oncology Unit, Santa Maria Annunziata Hospital, Bagno a Ripoli, Florence, Italy
| | - Alessandra Arcelli
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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6
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Mussi M, Zengarini C, Alessandrini A, Dika E. Nodular basal cell carcinoma on an autologous split-thickness skin graft after melanoma surgery. Dermatol Reports 2024; 16:9682. [PMID: 38623373 PMCID: PMC11017710 DOI: 10.4081/dr.2023.9682] [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: 02/08/2023] [Accepted: 02/24/2023] [Indexed: 04/17/2024] Open
Abstract
Not available
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Affiliation(s)
- Martina Mussi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Corrado Zengarini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Emi Dika
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
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7
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Veronesi G, Scotti B, Vaccari S, Baraldi C, Magnaterra E, Dika E. Onychopapilloma: does free edge confocal microscopy of the nail improve the diagnosis? Skin Res Technol 2024; 30:e13592. [PMID: 38282281 PMCID: PMC10823149 DOI: 10.1111/srt.13592] [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: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Affiliation(s)
- Giulia Veronesi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of DermatologyDepartment of Medical and Surgical Sciences (DIMEC)Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Biagio Scotti
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of DermatologyDepartment of Medical and Surgical Sciences (DIMEC)Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Sabina Vaccari
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of DermatologyDepartment of Medical and Surgical Sciences (DIMEC)Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Carlotta Baraldi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of DermatologyDepartment of Medical and Surgical Sciences (DIMEC)Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Elisabetta Magnaterra
- Section of DermatologyDepartment of Health SciencesUniversity of FlorenceFlorenceItaly
| | - Emi Dika
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of DermatologyDepartment of Medical and Surgical Sciences (DIMEC)Alma Mater StudiorumUniversity of BolognaBolognaItaly
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8
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Rapparini L, Venturi F, Gelati C, Giorgini F, Pignatti M, Placa ML, Scotti B, Veronesi G, Dika E. Reflectance confocal microscopy features of chronic radiodermatitis: A useful tool for presurgical mapping. Skin Res Technol 2024; 30:e13621. [PMID: 38391115 PMCID: PMC10885167 DOI: 10.1111/srt.13621] [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: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024]
Affiliation(s)
- Luca Rapparini
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
| | - Federico Venturi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
| | - Chiara Gelati
- Plastic SurgeryIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Federico Giorgini
- Plastic SurgeryIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Marco Pignatti
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
- Plastic SurgeryIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Michelangelo La Placa
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
| | - Biagio Scotti
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
| | - Giulia Veronesi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
| | - Emi Dika
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical SciencesAlma Mater Studiorum University of BolognaBolognaItaly
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Venturi F, Tassone D, Baraldi C, Alessandrini A, Dika E. Reflectance confocal microscopy features of ink spot lentigo: When in-vivo digital biopsy can avoid unnecessary excisions. Skin Res Technol 2024; 30:e13554. [PMID: 38174779 PMCID: PMC10765350 DOI: 10.1111/srt.13554] [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: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Federico Venturi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
| | - Danela Tassone
- Plastic surgery unitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
| | - Carlotta Baraldi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
| | - Aurora Alessandrini
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
| | - Emi Dika
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
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10
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Rapparini L, Alessandrini A, Scotti B, Dika E. Invasive penile glans Squamous Cell Carcinoma (peSCC) and Reflectance Confocal Microscopy (RCM): is it a valuable alternative to histopathology? Skin Res Technol 2024; 30:e13564. [PMID: 38174773 PMCID: PMC10765344 DOI: 10.1111/srt.13564] [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: 12/14/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Luca Rapparini
- Dermatology Unit OncologicIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC) Dermatology, Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Aurora Alessandrini
- Dermatology Unit OncologicIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC) Dermatology, Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Biagio Scotti
- Dermatology Unit OncologicIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC) Dermatology, Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Emi Dika
- Dermatology Unit OncologicIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC) Dermatology, Alma Mater StudiorumUniversity of BolognaBolognaItaly
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Venturi F, Cedirian S, Mussi M, Alessandrini A, Dika E. Reflectance Confocal Microscopy Combined with Dermoscopy and Histology in the Diagnostic Setting of Pigmented Eccrine Poroma: A Retrospective Study. Dermatol Pract Concept 2024; 14:dpc.1401a88. [PMID: 38364398 PMCID: PMC10868961 DOI: 10.5826/dpc.1401a88] [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: 07/09/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Pigmented eccrine poroma (PEP) is a unique variant of a benign adnexal tumor known as eccrine poroma. Distinguishing PEPs from other pigmented lesions can be challenging due to overlapping clinical and dermoscopic features. OBJECTIVES To provide a comprehensive analysis of the dermoscopic, confocal (RCM), and histological features of PEPs. METHODS We undertook a retrospective study of the clinical, dermoscopic, RCM and histopathological features of PEPs that were surgically excised and histopathologically recognized. Data on epidemiological, clinical, dermoscopic, RCM and histopathological features were collected from the databases of the Skin Cancer Unit, IRCCS Policlinico di Sant' Orsola, between January 2021 and May 2023. RESULTS The study population consisted of 61 patients, including 34 females (55.7%) and 27 males (44.3%). Dermoscopic examination of 61 PEPs revealed the presence of irregular borders (55.7%), milia-like cysts (50.8%), brown pseudo-network (41%), cerebriform pattern (34.4%), comedo-like openings (29.5%), atypical vessels (26.2%), glomerular vessels (18%), fingerprint-like perifollicular structures (8.2%), dots (4.9%) and dotted vessels (4.9%). RCM imaging was collected from 11 cases and showed mostly well-defined tumor nests with small cells in 100% of cases, bright structures in the upper dermis representing melanocytes and melanophages (63.6%), dark round spaces within the tumor nests (54.5%), well-demarcated borders of the nest (45.5%) and dilated and prominent vessels in upper dermis (27.3%). Histopathological pattern analysis revealed PEP sensu stricto (PEPss) as the most frequent (54.1%). CONCLUSIONS The distinctive dermoscopic patterns, along with the confocal features aid in the differentiation from other pigmented lesions.
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Affiliation(s)
- Federico Venturi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Martina Mussi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emi Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Dika E, Scotti B, Alessandrini A, Veronesi G. Lentigo maligna (LM) of the auricular concha: Confocal microscopy and dermoscopy. Skin Res Technol 2024; 30:e13557. [PMID: 38186059 PMCID: PMC10772466 DOI: 10.1111/srt.13557] [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: 11/22/2023] [Accepted: 11/25/2023] [Indexed: 01/09/2024]
Affiliation(s)
- Emi Dika
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero ‐ Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical SciencesAlma Mater Studiorum ‐ University of BolognaBolognaItaly
| | - Biagio Scotti
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero ‐ Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical SciencesAlma Mater Studiorum ‐ University of BolognaBolognaItaly
| | - Aurora Alessandrini
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero ‐ Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical SciencesAlma Mater Studiorum ‐ University of BolognaBolognaItaly
| | - Giulia Veronesi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero ‐ Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical SciencesAlma Mater Studiorum ‐ University of BolognaBolognaItaly
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Maltoni L, Baraldi C, Roda M, Grendele A, Dika E, Vaccari S. A Growing Conjunctival Pigmentation - Videodermoscopy of Conjunctival Melanoma. Dermatol Pract Concept 2024; 14:dpc.1401a91. [PMID: 38364380 PMCID: PMC10868916 DOI: 10.5826/dpc.1401a91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Lorenzo Maltoni
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater, University of Bologna, Bologna, Italy
| | - Carlotta Baraldi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater, University of Bologna, Bologna, Italy
| | - Matilde Roda
- Ophthalmolgy Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Arianna Grendele
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Ophthalmolgy Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - Emi Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater, University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater, University of Bologna, Bologna, Italy
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14
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Cedirian S, Venturi F, Baraldi C, Dika E. Dermoscopic, confocal, and histological analysis of cutaneous sarcoidosis. Skin Res Technol 2024; 30:e13552. [PMID: 38174825 PMCID: PMC10765345 DOI: 10.1111/srt.13552] [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: 11/22/2023] [Accepted: 11/30/2023] [Indexed: 01/05/2024]
Affiliation(s)
- Stephano Cedirian
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
| | - Federico Venturi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
| | - Carlotta Baraldi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
| | - Emi Dika
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum University of BolognaBolognaItaly
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Vaccari S, Roda M, Grendele A, Cassini F, Robuffo S, Veronesi G, Venturi F, Balbi T, Dika E. Canaliculitis mimicking cutaneous squamous cell carcinoma of the palpebral rim: A case report. J Eur Acad Dermatol Venereol 2023. [PMID: 38108524 DOI: 10.1111/jdv.19757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Affiliation(s)
- S Vaccari
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - M Roda
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - A Grendele
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - F Cassini
- Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy
| | - S Robuffo
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - G Veronesi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - F Venturi
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - T Balbi
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - E Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Campione E, Rivieccio A, Gaeta Shumak R, Costanza G, Cosio T, Lambiase S, Garofalo V, Artosi F, Lozzi F, Freni C, Romeo A, Dika E, Falconi M, Bianchi L. Preliminary Evidence of Efficacy, Safety, and Treatment Satisfaction with Tirbanibulin 1% Ointment: A Clinical Perspective on Actinic Keratoses. Pharmaceuticals (Basel) 2023; 16:1686. [PMID: 38139813 PMCID: PMC10748142 DOI: 10.3390/ph16121686] [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: 10/23/2023] [Revised: 11/17/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Actinic keratosis is a common precancerous skin lesion that can progress into invasive squamous cell carcinomas. Many topical treatments for actinic keratoses often have poor tolerability and prolonged duration. Tirbanibulin is a novel synthetic drug with potent antitumor and antiproliferative activities. METHODS We conducted a single-center, prospective and observational study using tirbanibulin ointment on a 25 cm2 area for 5 consecutive days on 30 participants with AKs on the face or scalp. They were followed for at least 57 days to assess the safety profile and efficacy of the drug as well as treatment satisfaction. We evaluated six signs of local skin reaction (LSR): erythema, scaling, crusting, swelling, blisters/pustules, and erosions/ulcerations, grading the severity as mild, moderate, or severe. The effectiveness was evaluated both clinically and dermoscopically. The treatment satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). RESULTS On day 57, 70% of the patients showed a complete clinical and dermoscopic response. The highest scores obtained from the TSQM 1.4 were more evident in the convenience and side effects domains. Most LSRs, including erythema (83.3%), scaling (30%), and swelling (3.3%), occurred on day 8 but resolved spontaneously. CONCLUSION Tirbanibulin is a viable therapeutic option with a short regimen treatment and good tolerability, which favors therapy adherence.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Antonia Rivieccio
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Gaetana Costanza
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Terenzio Cosio
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
- Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sara Lambiase
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Virginia Garofalo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Fabio Artosi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Flavia Lozzi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
| | - Claudia Freni
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (C.F.); (A.R.); (M.F.)
| | - Alice Romeo
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (C.F.); (A.R.); (M.F.)
| | - Emi Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, DIMEC, University of Bologna, 40126 Bologna, Italy;
| | - Mattia Falconi
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (C.F.); (A.R.); (M.F.)
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.R.); (R.G.S.); (T.C.); (F.A.); (F.L.); (L.B.)
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17
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Dika E, Lambertini M, Venturi F, Veronesi G, Mastroeni S, Hrvatin Stancic B, Bergant-Suhodolcan A. A Comparative Demographic Study of Atypical Spitz Nevi and Malignant Melanoma. Acta Dermatovenerol Croat 2023; 31:165-168. [PMID: 38439731] [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: 03/06/2024]
Abstract
Spitz tumors are a subset of melanocytic neoplasms characterized by epithelioid or spindled melanocytes(1). The benign nature of the "Spitz nevus" has since been clarified, but the debate regarding Spitzoidtumors (STs) is still ongoing. Spitzoid tumors encompass a wide spectrum of cutaneous lesions ranging from benign Spitz nevus (SN) to Spitzoid melanoma (SM), the latter displaying capacity for widespread metastasis and a potentially lethal outcome (2). The term atypical Spitz tumors (ASTs) refers to melanocytic tumors exhibiting the morphological features of SN, as well as some features associated with malignancy, but not sufficient to classify them as SMs. Currently, histopathology is the gold standard for the diagnosis of STs and cutaneous MM. However, the differential diagnosis between benign and malignant melanocytic lesions with spitzoid features remains challenging (3-6). In order to facilitate the work of clinicians and pathologists, we attempted a comparative clinical and demographic study comparing ASTs and MMs of patients referred to two Italian institutes. Patient data were obtained from two different Italian dermatological centers (Melanoma Registry of the Instituto Dermopaticodell'Immacolata IDI-IRCCS Rome, Lazio and the Skin Cancer Unit of Dermatology, Hospital Sant'Orsola-Malpighi, University of Bologna), from January 2007 to December 2017. Histological reports presenting pre-operative queries of both "atypical Spitz nevi" or "malignant melanoma" and a final diagnosis confirming one of the queries were included in the study. The chi-square test or Mann-Whitney U-test were applied to analyze differences between the groups for categorical variables such as sex, diagnosis, and continuous variables (age). The "anatomic site" variable was classified into three categories as follows: the limbs, trunk, and head/neck. A multivariate binary logistic model was used to investigate if the anatomic site was an independent predictor of MM. Age and sex were considered confounding factors. A total of 504 patients (51.8% men; 48.2% women) met the inclusion study criteria (mean age 52 years, SD = 22.8) (Table 1). 373 were cases of MM and 131 were cases of AST. Mean age of MM cases and AST were 61.2 years old (SD = 17.6) and 25.8 years old (SD = 13.8), respectively. Subjects with MM were predominantly men (58.2% versus 33.6%) (P<0.0001) and older (median age 62 years versus 25 years) (P=0.0001) than subjects with AST. The most frequent anatomic site for MM was the trunk (39.7 %), while the lower limb was the most frequent anatomic site for AST (48.1 %) (P<0.0001). Table 2 shows the multivariable analysis used to assess if anatomic site was an independent predictor of cutaneous melanoma. Multivariate analysis confirmed an increased risk for MM in comparison with AST for both localization on the trunk (OR:2.78; 95 %CI: 1.74-4.45) (P<0.0001) and head/neck (OR:3.20; 95% CI: 1.60-6.38) (P=0.0001). After introducing age (model 1, OR: 2.11; 95% CI: 1.08-4.12) (P=0.003) and sex into the model, the only anatomic site that remained statistically significant was the trunk (model 2, OR: 2.03; 95% CI: 1.0.3-3.99) (P=0.04). The results show that if the lesion was located on the trunk, the probability of being a MM was two times higher than that of AST, independent of sex, age, or center. After stratifying for sex, the effect was stronger for women (OR: 2.72; 95% CI: 1.14-6.50). After stratifying for age, the effect was stronger for younger subjects (<40 years) (OR: 2. 59; 95% CI: 1.20-5.60) (P=0.02). In this study, we focused on the clinical-epidemiological data in an attempt to improve the identification of nodular melanocytic lesions by providing clinicians with further information in order to reduce the rate of misdiagnosis and assist in providing critical clinical information to surgeons and pathologists. Consistently with the literature, ASTs were mainly found in young-adult patients (mean age was 25.8 years), in the female sex (66.4%), and were typically located on the lower limbs (48.1%) (3,7-10). MM were found to be slightly more common in male patients (58.2%) in the overall patient group; the mean age at the time of the diagnosis was 61.2 years old, and the majority of lesions were located on the trunk (39.7%). These data were similar to those reported by other authors (11-13). ASTs cases were mainly women and younger than MM cases, and were typically located on the lower limbs (Figure 3 and Figure 4). Nodules located on the trunk resulted in a two times greater risk of MM in comparison with AST. In summary, distinguishing ASTs from MMs is often challenging, and histopathology remains the diagnostic gold standard for melanocytic neoplasms, but a specific clinical framework may help surgeons, pathologists, and clinicians to correctly diagnose and manage these lesions in children and adults.
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Affiliation(s)
| | - Martina Lambertini
- Martina Lambertini, MD, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti 1, 40100 Bologna, Italy;
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Tognetti L, Cartocci A, Cinotti E, D'Onghia M, Żychowska M, Moscarella E, Dika E, Farnetani F, Guida S, Paoli J, Lallas A, Tiodorovic D, Stanganelli I, Longo C, Suppa M, Zalaudek I, Argenziano G, Perrot JL, Rubegni G, Cataldo G, Rubegni P. Dermoscopy of atypical pigmented lesions of the face: Variation according to facial areas. Exp Dermatol 2023; 32:2166-2172. [PMID: 37770421 DOI: 10.1111/exd.14941] [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: 05/27/2023] [Revised: 08/11/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023]
Abstract
Atypical pigmented facial lesions (aPFLs)-including lentigo maligna (LM) and lentigo maligna melanoma (LMM), solar lentigo (SL), pigmented actinic keratosis (PAK), atypical nevi (AN), seborrheic keratosis (SK) and lichen planus-like keratosis (LPLK)-can exhibit clinical and dermoscopic overlapping features. We aimed to investigate if and how 14 dermoscopic features suggestive for the aforementioned aPFLs vary according to six facial sites among 1197 aPFLs cases (excised to rule out malignancy) along with lesion and patients' metadata. According to distribution and association analysis, aPFLs on the forehead of a male patient aged > 69 years displaying the obliterated follicular openings pattern, appear to be more at risk of malignancy. Of converse, aPFLs of the orbital/cheek/nose area with evident and regular follicular openings with diameter < 10 mm in a female aged below 68 are probably benign. The obliterated follicular openings, keratin plugs, evident and regular follicular openings and target-like pattern features differed significantly among six facial areas in all aPFLs cases. Lesion of the nose may show both features suggestive of malignancy and benignity (e.g. many SL and PAK may display target-like pattern and some LM/LMM cases display keratin plugs and evident and follicular openings), making these features less specific.
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Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Cartocci
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Martina D'Onghia
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Emi Dika
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Ignazio Stanganelli
- Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, IRCCS, IRST, Meldola, Italy
- Department of Dermatology, University of Parma, Parma, 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
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non-Invasive, Société Française de Dermatologie, Paris, France
- Department of Dermatology, Institut Jules Bordet, Brussels, Belgium
| | - Iris Zalaudek
- Dermatology Clinic, Ospedale di Trieste, Trieste, Italy
| | - Giuseppe Argenziano
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | - Giovanni Rubegni
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Gennaro Cataldo
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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19
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Dika E, Lambertini M, Veronesi G, Misciali C, Ricci C, Longo C. Depicting dermoscopic and confocal findings in patients with Gorlin-Goltz Syndrome. Ital J Dermatol Venerol 2023; 158:500-501. [PMID: 38015487 DOI: 10.23736/s2784-8671.23.07623-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Affiliation(s)
- Emi Dika
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Martina Lambertini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Giulia Veronesi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Costantino Ricci
- Department of Medical Science and Surgery (DIMEC), University of Bologna, Bologna, Italy
- Unit of Pathology, Maggiore Hospital, AUSL Bologna, Bologna, Italy
| | - Caterina Longo
- Unit of Dermatology, Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
- Skin Cancer Center, AUSL Reggio Emilia, Reggio Emilia, Italy
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Dika E, Melotti B, Comito F, Tassone D, Baraldi C, Campione E, Mussi M, Venturi F. Neoadjuvant treatment of basosquamous carcinomas with Sonidegib: An innovative approach. Exp Dermatol 2023; 32:2038-2039. [PMID: 37432021 DOI: 10.1111/exd.14882] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Affiliation(s)
- Emi Dika
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna Bologna, Bologna, Italy
| | - Barbara Melotti
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Comito
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Daniela Tassone
- Plastic surgery unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carlotta Baraldi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna Bologna, Bologna, Italy
| | - Elena Campione
- Department of Systems Medicine, Dermatology Unit, University of Rome Tor Vergata, Rome, Italy
| | - Martina Mussi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna Bologna, Bologna, Italy
| | - Federico Venturi
- Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna Bologna, Bologna, Italy
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
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21
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Magnaterra E, Lambertini M, Scarfì F, Gola M, Dika E, De Giorgi V. Unveiling hydrochlorothiazide: Skin cancer risk and hidden interactions. J Am Acad Dermatol 2023; 89:e249-e250. [PMID: 37507051 DOI: 10.1016/j.jaad.2023.06.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 06/08/2023] [Indexed: 07/30/2023]
Affiliation(s)
- Elisabetta Magnaterra
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Martina Lambertini
- IRCCS Istituto di Ricovero e Cura a carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Dermatology Unit, Department of Medical Science and Surgery, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Federica Scarfì
- UOSD Unità Operativa Semplice Dipartimentale, Dermatology, USL Unità sanitaria locale, Toscana Centro-Prato Hospital, Prato, Italy
| | - Massimo Gola
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emi Dika
- IRCCS Istituto di Ricovero e Cura a carattere Scientifico, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Dermatology Unit, Department of Medical Science and Surgery, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy; Cancer Research "Attilia Pofferi" Foundation, Pistoia, Italy.
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22
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Scotti B, Veronesi G, Misciali C, Venturi F, Dika E. Unusual presentation of porokeratotic lichen planus: Histology, dermoscopy and confocal microscopy imaging of a rare condition. Skin Res Technol 2023; 29:e13521. [PMID: 37937416 PMCID: PMC10628351 DOI: 10.1111/srt.13521] [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: 10/17/2023] [Revised: 10/23/2023] [Accepted: 10/26/2023] [Indexed: 11/09/2023]
Affiliation(s)
- Biagio Scotti
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical Sciences Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Giulia Veronesi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical Sciences Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Cosimo Misciali
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical Sciences Alma Mater StudiorumUniversity of BolognaBolognaItaly
| | - Federico Venturi
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Section of DermatologyDepartment of Health SciencesUniversity of FlorenceFlorenceItaly
| | - Emi Dika
- Oncologic Dermatology UnitIRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology, Department of Medical and Surgical Sciences Alma Mater StudiorumUniversity of BolognaBolognaItaly
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23
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Dika E, Dika E, Lambertini M, Dika E, Lambertini M, Veronesi G, Misciali C, Milani M, Bergant-Suhodolcan A, Hrvatin Stancic B, Baraldi C. Folliculotropism in Actinic Keratoses in Patients not Responding to Treatments: A Pilot Study. Acta Dermatovenerol Croat 2023; 31:98-100. [PMID: 38006370] [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: 11/27/2023]
Abstract
Dear Editor, Actinic keratoses (AK) have a high prevalence in the general population, with greater rates in Caucasian patients after the fourth and fifth decades of life (37.5-60.0%) (1,2). Standard histopathologic reporting of AKs does not provide information on the presence of atypical keratinocytes extending to the hair follicle, also defined as folliculotropism (FLC). Commonly, atypical cells in AKs do not present FLC, but this feature can be observed in bowenoid AKs with full-thickness epidermal atypia (3,4). FLC has been considered a possible element enhancing the chances of a progression toward invasive SCC (iSCC). Fernandez-Figueras et al. (3) reported that the depth of FLC in AKs was correlated with the invasiveness of associated iSCC. Pandey et al. (5) reported a positive association between AKs with FLC and history of invasive cutaneous cancer or melanoma, more often in men at an older age. The role of FLC in cutaneous melanoma is still debated, but it is considered a parameter that may correlate with treatment response in lentigo maligna and disease progression or recurrences in invasive tumors (6,7). These studies draw particular attention to the potential role of hair bulge compartment stem cells in favoring tumor progression through the expression of adhesion molecules, cytokines, and growth factor receptors (8). Aks are known to have a high recurrence rate after topical treatment (1). The risk of evolution to an iSCC is not completely clear, but it has been estimated to be around 0.6% at 12 months and up to 2.5% at 48 months (1,3,7). Considering the possible progression and the heavy burden of AK treatments, including the economic burden, it is imperative to focus on histopathologic features associated with treatment failure. The aim of this preliminary study was to assess the histopathologic features, specifically FLC, of AK samples from patients considered "non-responders" to specific topical treatments. A secondary endpoint was to assess the clinical/dermoscopic features. Patients were considered "non-responders" if the lesions persisted after two alternated completed cycles of treatments with ingenol mebutate, imiquimod, diclofenac 3%, or 5-fluoruracil. Patients with a positive history of immunosuppression or genetic diseases were excluded. The study was approved by the local Ethics Committee. Slides of AKs diagnosed at the Laboratory of Dermatopathology, University of Bologna, Italy from January 2016 to October 2018 were reviewed by two dermatopathologists (CM, PAF). 155 "non-responder" AKs of five main histopathologic subtypes were included, classified from grade I to III according to the Roewert-Huber classification (9) (Table 1). The proliferative and atrophic histopathologic subtypes of AKs were detected in 33.6% and 30.4% samples, respectively. FLC was observed in 75.3% of the cases, subdivided into two categories, periadnexal (48.9%) and intraadnexal (26.4%). Periadnexal FLC was detected in 31.0% of atrophic and in 50.3% of proliferative AKs, while intraadnexal FLC was found in 48.7% and 29.2%, respectively (Figure 1, a, b). At dermoscopy, most lesions had been classified as grade I or II (38.8% and 45.8%), and only 15.4% as grade III, showing an unexpected non-response to treatment according to the dermoscopic criteria. In contrast, almost half of the AKs were classified as grade III at histology, revealing a discrepancy between the dermoscopic grading and histological findings in a majority of cases (77.4%) (Figure 2, c, d). Furthermore, atrophic and proliferative AKs accounted for 64.0% of total cases, and these are the variants associated with a higher probability of evolution toward an iSCC (10). The clinical/histological discrepancy has already been reported in the literature (9) and may represent a misleading factor for treatment choice and outcomes. We believe that a comparative analysis with dermoscopy and histology should be performed in non-responding AKs, in order to choose the best therapeutic option. In fact, some superficial treatments (such as cryotherapy) may not provide a good response in deep hair follicles (4). We also suggest encouraging greater focus on FLC and its description in pathology reports. This is a preliminary observational study, but it reinforces the need to further larger clinical studies investigating the role of specific histopathologic parameters in AKs, including FLC, that may correlate with treatment outcomes.
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Affiliation(s)
| | | | - Martina Lambertini
- Martina Lambertini, MD, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Via Massarenti, 1 - 40138 Bologna, Italy;
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Tognetti L, Cartocci A, Żychowska M, Savarese I, Cinotti E, Pizzichetta MA, Moscarella E, Longo C, Farnetani F, Guida S, Paoli J, Lallas A, Tiodorovic D, Stanganelli I, Magi S, Dika E, Zalaudek I, Suppa M, Argenziano G, Pellacani G, Perrot JL, Miracapillo C, Rubegni G, Cevenini G, Rubegni P. A risk-scoring model for the differential diagnosis of lentigo maligna and other atypical pigmented facial lesions of the face: The facial iDScore. J Eur Acad Dermatol Venereol 2023; 37:2301-2310. [PMID: 37467376 DOI: 10.1111/jdv.19360] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 02/02/2023] [Accepted: 07/07/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Due to progressive ageing of the population, the incidence of facial lentigo maligna (LM) of the face is increasing. Many benign simulators of LM and LMM, known as atypical pigmented facial lesions (aPFLs-pigmented actinic keratosis, solar lentigo, seborrheic keratosis, seborrheic-lichenoid keratosis, atypical nevus) may be found on photodamaged skin. This generates many diagnostic issues and increases the number of biopsies, with a subsequent impact on aesthetic outcome and health insurance costs. OBJECTIVES Our aim was to develop a risk-scoring classifier-based algorithm to estimate the probability of an aPFL being malignant. A second aim was to compare its diagnostic accuracy with that of dermoscopists so as to define the advantages of using the model in patient management. MATERIALS AND METHODS A total of 154 dermatologists analysed 1111 aPFLs and their management in a teledermatology setting: They performed pattern analysis, gave an intuitive clinical diagnosis and proposed lesion management options (follow-up/reflectance confocal microscopy/biopsy). Each case was composed of a dermoscopic and/or clinical picture plus metadata (histology, age, sex, location, diameter). The risk-scoring classifier was developed and tested on this dataset and then validated on 86 additional aPFLs. RESULTS The facial Integrated Dermoscopic Score (iDScore) model consisted of seven dermoscopic variables and three objective parameters (diameter ≥ 8 mm, age ≥ 70 years, male sex); the score ranged from 0 to 16. In the testing set, the facial iDScore-aided diagnosis was more accurate (AUC = 0.79 [IC 95% 0.757-0.843]) than the intuitive diagnosis proposed by dermatologists (average of 43.5%). In the management study, the score model reduced the number of benign lesions sent for biopsies by 41.5% and increased the number of LM/LMM cases sent for reflectance confocal microscopy or biopsy instead of follow-up by 66%. CONCLUSIONS The facial iDScore can be proposed as a feasible tool for managing patients with aPFLs.
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Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Cartocci
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszów, Poland
| | - Imma Savarese
- Soc Dermatologia Pistoia-Prato, USL Toscana Centro, Pistoia, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Maria Antonietta Pizzichetta
- Dermatology Clinic, Ospedale di Trieste, Trieste, Italy
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, 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
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Guida
- Vita-Salute San Raffaele University, Milan, Italy
- Dermatology Clinic, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - John Paoli
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
- Department of Dermatology and Venereology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | | | - Ignazio Stanganelli
- Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, IRCCS, IRST, Meldola, Italy
- Department of Dermatology, University of Parma, Parma, Italy
| | - Serena Magi
- Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, IRCCS, IRST, Meldola, Italy
| | - Emi Dika
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Ospedale di Trieste, Trieste, Italy
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non-Invasive, Société Française de Dermatologie, Paris, France
- Department of Dermatology, Institut Jules Bordet, Brussels, Belgium
| | | | - Giovanni Pellacani
- Department of Dermatology, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | - Chiara Miracapillo
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Giovanni Rubegni
- Department of Ophthalmology, University of Catania, Catania, Italy
| | - Gabriele Cevenini
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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Lambertini M, Ricci C, Hrvatin Stancic B, Mussi M, Corti B, Misciali C, Piraccini BM, Dika E. Colocalizing paraneoplastic alopecia areata and nodular basal cell carcinoma. Acta Dermatovenerol Alp Pannonica Adriat 2023; 32:127-128. [PMID: 37749974] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Affiliation(s)
- Martina Lambertini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Costantino Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Bor Hrvatin Stancic
- Dermatovenerology Department, Ljubljana University Medical Center, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Martina Mussi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Barbara Corti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emi Dika
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Lambertini M, Lambertini L, Dika E. The value of art in modern dermatology and medicine. J Eur Acad Dermatol Venereol 2023; 37:1694-1696. [PMID: 37177899 DOI: 10.1111/jdv.19160] [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: 02/11/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023]
Affiliation(s)
- M Lambertini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - L Lambertini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - E Dika
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Tognetti L, Cinotti E, Farnetani F, Lallas A, Paoli J, Longo C, Pampena R, Moscarella E, Argenziano G, Tiodorovic D, Stanganelli I, Magi S, Suppa M, Del Marmol V, Dika E, Zelin E, Zalaudek I, Pizzichetta MA, Pellacani G, Perrot JL, Bertello M, Cataldo G, Cevenini G, Rubegni P, Cartocci A. Development and Implementation of a Web-Based International Registry Dedicated to Atypical Pigmented Skin Lesions of the Face: Teledermatologic Investigation on Epidemiology and Risk Factors. Telemed J E Health 2023; 29:1356-1365. [PMID: 36752711 DOI: 10.1089/tmj.2022.0456] [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] [Indexed: 02/09/2023] Open
Abstract
Background: Atypical pigmented facial lesions (aPFLs) often display clinical and dermoscopic equivocal and/or overlapping features, thus causing a challenging and delayed diagnosis and/or inappropriate excisions. No specific registry dedicated to aPFL paired with clinical data is available to date. Methods: The dataset is hosted on a specifically designed web platform. Each complete case was composed of the following data: (1) one dermoscopic picture; (2) one clinical picture; (3) two lesion data, that is, maximum diameter and facial location (e.g., orbital area/forehead/nose/cheek/chin/mouth); (4) patient's demographics: family history of melanoma, history of sunburns in childhood, phototype, pheomelanine, eyes/hair color, multiple nevi/dysplastic nevi on the body; and (5) acquisition device (videodermatoscope/camera-based/smartphone-based system). Results: A total of 11 dermatologic centers contributed to a final teledermoscopy database of 1,197 aPFL with a distribution of 353 lentigo maligna (LM), 146 lentigo maligna melanoma (LMM), 231 pigmented actinic keratoses, 266 solar lentigo, 125 atypical nevi, 48 seborrheic keratosis, and 28 seborrheic-lichenoid keratoses. The cheek site was involved in half of aPFL cases (50%). Compared with those with the other aPFL cases, patients with LM/LMM were predominantly men, older (69.32 ± 12.9 years on average vs. 62.69 ± 14.51), exhibited larger lesions (11.88 ± 7.74 mm average maximum diameter vs. 9.33 ± 6.46 mm), and reported a positive history of sunburn in childhood. Conclusions: The iDScore facial dataset currently represents a precious source of data suitable for the design of diagnostic support tools based on risk scoring classifiers to help dermatologists in recognizing LM/LMM among challenging aPFL in clinical practice.
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Affiliation(s)
- Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Francesca Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Aimilios Lallas
- First Department of Dermatology, Aristotele University, Thessaloniki, Greece
| | - John Paoli
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unita Sanitaria, Reggio Emilia, Italy
| | - Riccardo Pampena
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unita Sanitaria, Reggio Emilia, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Ignazio Stanganelli
- Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto per La Ricerca Scientifica e Tecnologica (IRST), Meldola, Italy
- Department of Dermatology, University of Parma, Parma, Italy
| | - Serena Magi
- Skin Cancer Unit, Scientific Institute of Romagna for the Study of Cancer, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto per La Ricerca Scientifica e Tecnologica (IRST), Meldola, Italy
| | - Mariano Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
- Department of Dermatology, Institut Jules Bordet, Pizzi Brussels, Belgium
| | - Veronique Del Marmol
- Groupe d'Imagerie Cutanée Non Invasive (GICNI) of the Société Française de Dermatologie (SFD), Paris, France
- Department of Dermatology, Institut Jules Bordet, Pizzi Brussels, Belgium
| | - Emi Dika
- Dermatology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Italy
| | - Enrico Zelin
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Maria Antonietta Pizzichetta
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
- Department of Medical Oncology, Centro di Riferimento Oncologico di Aviano (CRO), (IRCCS), Aviano, Italy
| | - Giovanni Pellacani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Jean Luc Perrot
- Dermatology Unit, University Hospital of St-Etienne, Saint Etienne, France
| | - Martina Bertello
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Gennaro Cataldo
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Gabriele Cevenini
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Cartocci
- Bioengineering and Biomedical Data Science Lab, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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Cosio T, Costanza G, Coniglione F, Romeo A, Iacovelli F, Diluvio L, Dika E, Shumak RG, Rossi P, Bianchi L, Falconi M, Campione E. From In Silico Simulation between TGF- β Receptors and Quercetin to Clinical Insight of a Medical Device Containing Allium cepa: Its Efficacy and Tolerability on Post-Surgical Scars. Life (Basel) 2023; 13:1781. [PMID: 37629638 PMCID: PMC10455185 DOI: 10.3390/life13081781] [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: 07/06/2023] [Revised: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Objective: Keloid and hypertrophic scars are a challenge in clinical management, causing functional and psychological discomfort. These pathological scars are caused by a proliferation of dermal tissue following skin injury. The TGF-β/Smad signal pathway in the fibroblasts and myofibroblasts is involved in the scarring process of skin fibrosis. Today, multiple therapeutic strategies that target the TGF-β/Smad signal pathway are evaluated to attenuate aberrant skin scars that are sometimes difficult to manage. We performed a head-to-head, randomized controlled trial evaluating the appearance of the post-surgical scars of 64 subjects after two times daily topical application to compare the effect of a class I pullulan-based medical device containing Allium cepa extract 5% and hyaluronic acid 5% gel versus a class I medical device silicone gel on new post-surgical wounds. (2) Methods: Objective scar assessment using the Vancouver Scar Scale (VSS), POSAS, and other scales were performed after 4, 8, and 12 weeks of treatment and statistical analyses were performed. The trial was registered in clinicalTrials.gov ( NCT05412745). In parallel, molecular docking simulations have been performed to investigate the role of Allium cepa in TGF-β/Smad signal pathway. (3) Results: We showed that VSS, POSAS scale, itching, and redness reduced significantly at week 4 and 8 in the subjects using devices containing Allium cepa and HA. No statistically significant differences in evaluated scores were noted at 12 weeks of treatment. Safety was also evaluated by gathering adverse events related to the application of the gel. Subject compliance and safety with the assigned gel were similar between the two study groups. Molecular docking simulations have shown how Allium cepa could inhibit fibroblasts proliferation and contraction via TGF-β/Smad signal pathway. (4) Conclusions: The topical application of a pullulan-based medical device containing Allium cepa and HA showed a clear reduction in the local inflammation, which might lead to a reduced probability of developing hypertrophic scars or keloids.
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Affiliation(s)
- Terenzio Cosio
- Post Graduate School of Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy;
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.D.); (R.G.S.); (L.B.)
| | - Gaetana Costanza
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.D.); (R.G.S.); (L.B.)
- Virology Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Filadelfo Coniglione
- Department of Surgical Sciences, University Nostra Signora del Buon Consiglio, 1000 Tirana, Albania;
| | - Alice Romeo
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (A.R.); (F.I.); (M.F.)
| | - Federico Iacovelli
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (A.R.); (F.I.); (M.F.)
| | - Laura Diluvio
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.D.); (R.G.S.); (L.B.)
| | - Emi Dika
- Dermatology, Department of Medical and Surgical Sciences Alma Mater Studiorum, University of Bologna, 40138 Bolog, Italy;
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Ruslana Gaeta Shumak
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.D.); (R.G.S.); (L.B.)
| | - Piero Rossi
- Department of Surgical Sciences, University of Rome Tor Vergata, 00133 Rome, Italy;
- Minimally Invasive Unit, Tor Vergata Hospital, 00133 Rome, Italy
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.D.); (R.G.S.); (L.B.)
| | - Mattia Falconi
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica, 00133 Rome, Italy; (A.R.); (F.I.); (M.F.)
| | - Elena Campione
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (G.C.); (L.D.); (R.G.S.); (L.B.)
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Chousakos E, Zugna D, Dika E, Boada A, Podlipnik S, Carrera C, Malvehy J, Puig S, Requena C, Manrique-Silva E, Nagore E, Quaglino P, Senetta R, Ribero S. Topographical and Chronological Analysis of Thin Cutaneous Melanoma's Progressions: A Multicentric Study. Cancers (Basel) 2023; 15:3989. [PMID: 37568805 PMCID: PMC10416930 DOI: 10.3390/cancers15153989] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
A great portion of cutaneous melanoma's diagnoses nowadays is attributed to thin tumors with up to 1 mm in Breslow thickness (hereafter thin CMs), which occasionally metastasize. The objective of this study was to identify thin CM's metastatic patterns from a topographical and chronological standpoint. A total of 204 cases of metastatic thin CMs from five specialized centers were included in the study, and corresponding data were collected (clinical, epidemiological, histopathological information of primary tumor and the number, anatomical site, and time intervals of their progressions). First progressions occurred locally, in regional lymph nodes, and in a distant site in 24%, 15% and 61% of cases, respectively, with a median time to first progression of 3.10 years (IQR: 1.09-5.24). The median elapsed time between the first and second progression and between the second and third progression was 0.82 (IQR: 0.34-1.97) and 0.49 (IQR: 0.21-2.30) years, respectively, while the median survival time was about 4 years since first progression. Furthermore, the sequences of locations and time intervals of the progressions were associated with the clinicopathological and demographic features of the primary tumors along with the features of the preceding progressions. In conclusion, the findings of this study describe the natural history of thin CMs, thus highlighting the necessity to identify subgroups of thin CMs at a higher risk for metastasis and contributing to the optimization of the management and follow-up of thin CM patients.
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Affiliation(s)
- Emmanouil Chousakos
- 1st Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Daniela Zugna
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, 10126 Turin, Italy;
| | - Emi Dika
- Oncologic Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, 40138 Bologna, Italy
| | - Aram Boada
- Dermatology Department, Hospital Universitari Germans Trias i Pujol, Institut d’Investigació Germans Trias i Pujol, 08916 Badalona, Spain;
| | - Sebastian Podlipnik
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (C.C.); (J.M.); (S.P.)
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Cristina Carrera
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (C.C.); (J.M.); (S.P.)
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Josep Malvehy
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (C.C.); (J.M.); (S.P.)
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic, Universitat de Barcelona, Institut d’ Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; (S.P.); (C.C.); (J.M.); (S.P.)
- CIBER de Enfermedades Raras, Instituto de Salud Carlos III, 28029 Barcelona, Spain
| | - Celia Requena
- Dermatology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain; (C.R.); (E.M.-S.); (E.N.)
| | - Esperanza Manrique-Silva
- Dermatology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain; (C.R.); (E.M.-S.); (E.N.)
| | - Eduardo Nagore
- Dermatology Department, Instituto Valenciano de Oncología, 46009 Valencia, Spain; (C.R.); (E.M.-S.); (E.N.)
| | - Pietro Quaglino
- Dermatology Clinic, Medical Sciences Department, University of Turin, 10126 Turin, Italy; (P.Q.); (S.R.)
| | - Rebecca Senetta
- Pathology Unit, Department of Oncology, University of Turin, 10124 Turin, Italy;
| | - Simone Ribero
- Dermatology Clinic, Medical Sciences Department, University of Turin, 10126 Turin, Italy; (P.Q.); (S.R.)
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30
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Rossi AN, Veronesi G, Dika E. The role of confocal microscopy in recurrent cutaneous angiosarcoma. Skin Res Technol 2023; 29:e13423. [PMID: 37632190 PMCID: PMC10390705 DOI: 10.1111/srt.13423] [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: 07/05/2023] [Accepted: 07/17/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Alice Nadia Rossi
- Section of Dermatology, Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum, University of BolognaBolognaItaly
| | - Giulia Veronesi
- Section of Dermatology, Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum, University of BolognaBolognaItaly
| | - Emi Dika
- Section of Dermatology, Department of Medical and Surgical Sciences (DIMEC)Alma Mater Studiorum, University of BolognaBolognaItaly
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
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Merli M, Accorinti M, Romagnuolo M, Marzano A, Di Zenzo G, Moro F, Antiga E, Maglie R, Cozzani E, Parodi A, Gasparini G, Sollena P, De Simone C, Caproni M, Pisano L, Fattore D, Balestri R, Sena P, Vezzoli P, Teoli M, Ardigò M, Vassallo C, Michelerio A, Satta RR, Dika E, Melotti B, Ribero S, Quaglino P. Autoimmune bullous dermatoses in cancer patients treated by immunotherapy: a literature review and Italian multicentric experience. Front Med (Lausanne) 2023; 10:1208418. [PMID: 37547602 PMCID: PMC10400335 DOI: 10.3389/fmed.2023.1208418] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Cutaneous immune-related adverse events are frequently associated with immune checkpoint inhibitors (ICIs) administration in cancer patients. In fact, these monoclonal antibodies bind the cytotoxic T-lymphocyte antigen-4 and programmed cell death-1/ligand 1 leading to a non-specific activation of the immune system against both tumoral cells and self-antigens. The skin is the most frequently affected organ system appearing involved especially by inflammatory manifestations such as maculopapular, lichenoid, psoriatic, and eczematous eruptions. Although less common, ICI-induced autoimmune blistering diseases have also been reported, with an estimated overall incidence of less than 5%. Bullous pemphigoid-like eruption is the predominant phenotype, while lichen planus pemphigoides, pemphigus vulgaris, and mucous membrane pemphigoid have been described anecdotally. Overall, they have a wide range of clinical presentations and often overlap with each other leading to a delayed diagnosis. Achieving adequate control of skin toxicity in these cases often requires immunosuppressive systemic therapies and/or interruption of ICI treatment, presenting a therapeutic challenge in the context of cancer management. In this study, we present a case series from Italy based on a multicenter, retrospective, observational study, which included 45 patients treated with ICIs who developed ICI-induced bullous pemphigoid. In addition, we performed a comprehensive review to identify the cases reported in the literature on ICI-induced autoimmune bullous diseases. Several theories seeking their underlying pathogenesis have been reported and this work aims to better understand what is known so far on this issue.
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Affiliation(s)
- Martina Merli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Martina Accorinti
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Maurizio Romagnuolo
- Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Angelo Marzano
- Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Giovanni Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Francesco Moro
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata (IDI)-IRCCS, Rome, Italy
| | - Emiliano Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Roberto Maglie
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cozzani
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Dermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Dermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giulia Gasparini
- Section of Dermatology, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Dermatology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Pietro Sollena
- Dermatology Unit, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Clara De Simone
- Dermatology Unit, Department of Surgical and Medical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Dermatology Unit, University Department of Medicine and Translational Surgery, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Marzia Caproni
- Immunopathology and Rare Skin Diseases Unit, Section of Dermatology, Department of Health Sciences, Azienda Unità Sanitaria Locale Toscana Centro, University of Florence, Florence, Italy
| | - Luigi Pisano
- Section of Dermatology, Department of Health Sciences, Azienda Unità Sanitaria Locale Toscana Centro, University of Florence, Florence, Italy
| | - Davide Fattore
- Section of Dermatology, Department of Clinical Medicine and Surgery, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - Riccardo Balestri
- Division of Dermatology, Outpatient Consultation for Rare Diseases, APSS, Trento, Italy
| | - Paolo Sena
- Dermatology Unit ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Pamela Vezzoli
- Dermatology Unit ASST-Papa Giovanni XXIII, Bergamo, Italy
| | - Miriam Teoli
- Porphyria and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Marco Ardigò
- Porphyria and Rare Diseases, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Camilla Vassallo
- Dermatology Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Michelerio
- Dermatology Unit, Ospedale Cardinal Massaia, Asti, Italy
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Rosanna Rita Satta
- Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Emi Dika
- Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Unit of Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Barbara Melotti
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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32
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Dika E, Mussi M, Lambertini M, Vaccari S, Baraldi C, Campione E, Scotti B, Stancic BH, Zengarini C. Postsurgical hypertrophic scars after nonmelanoma skin cancer surgical excision: clinical and confocal microscopy outcomes of topical 5-fluorouracil in an adjuvant setting. Clin Exp Dermatol 2023; 48:800-802. [PMID: 37017028 DOI: 10.1093/ced/llad110] [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: 01/09/2023] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 04/06/2023]
Abstract
Postsurgical hypertrophic scars management after skin cancer surgical excision can be challenging. In this work we evaluated clinically and with confocal microscopy the outcomes after using topical fluorouracil in an adjuvant setting.
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Affiliation(s)
- Emi Dika
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Martina Mussi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Martina Lambertini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Carlotta Baraldi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elena Campione
- Dermatologic Unit, University of Rome Tor Vergata, Roma, Italy
| | - Biagio Scotti
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bor Hrvatin Stancic
- Department of Dermatovenerology, University Medical Centre Ljubljana, Slovenia
| | - Corrado Zengarini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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33
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Mannino M, Piccerillo A, Fabbrocini G, Quaglino P, Argenziano G, Dika E, Ascierto PA, Pellacani G, Longo C, Fargnoli MC, Bianchi L, Calzavara-Pinton P, Zalaudek I, Fava P, Scalvenzi M, Bocchino E, Di Stefani A, Peris K. Clinical Characteristics of an Italian Patient Population with Advanced BCC and Real-Life Evaluation of Hedgehog Pathway Inhibitor Safety and Effectiveness. Dermatology 2023; 239:868-876. [PMID: 37311439 DOI: 10.1159/000531280] [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: 03/01/2023] [Accepted: 05/22/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Advanced basal cell carcinoma (aBCC) represents a complex and clinically heterogeneous group of lesions for which curative surgery and/or radiotherapy is unlikely. Systemic therapy with hedgehog pathway inhibitors (HHIs) changed the treatment landscape for this complex patient population. OBJECTIVES The aims of the present study are to describe the clinical characteristics of a real-life Italian cohort diagnosed with aBCC and to investigate effectiveness and safety of HHI. METHODS A multicenter observational study was performed by twelve Italian centers in the period January 1, 2016 - October 15, 2022. Patients aged ≥18 years and diagnosed with aBCC (locally advanced [laBCC] and metastatic BCC [mBCC]) were eligible for the study. Methods for investigating tumor response to HHI included clinical and dermatoscopic evaluation, radiological imaging, and histopathology. For HHI safety assessment, therapy-related adverse events (AEs) were reported and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. RESULTS We enrolled 178 patients under treatment with HHI: 126 (70.8%) and 52 patients (29.2%) received sonidegib and vismodegib, respectively. Comprehensive data on HHI effectiveness and disease outcome were available for 132 (74.1%) of 178 patients: 129 patients had a diagnosis of laBCC (n = 84, sonidegib; n = 45, vismodegib) and 3 patients of mBCC (n = 2, vismodegib; n = 1, sonidegib, off-label). Objective response rate was 76.7% (95% confidence interval [CI]: 82.3-68.7) and 33.3% (95% CI: 88.2-1.7) for laBCC (complete response [CR]: 43/129; PR: 56/129) and mBCC (CR: 0/3; PR: 1/3), respectively. High-risk aBCC histopathological subtypes and occurrence of >2 therapy-related AEs were significantly associated with nonresponse to HHI therapy ([OR: 2.61; 95% CI: 1.09-6.05; p: 0.03] and [OR: 2.74; 95% CI: 1.03-7.9; p: 0.04]), respectively. Majority of our cohort (54.5%) developed at least 1 therapy-related AE, most of which were mild-moderate in severity. CONCLUSIONS Our results demonstrate the effectiveness and safety profile of HHI and confirm the reproducibility of pivotal trial results in real-life clinical setting.
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Affiliation(s)
- Maria Mannino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy,
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy,
| | | | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | | | - Emi Dika
- Dermatology - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Paolo Antonio Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Pascale, Naples, Italy
| | | | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Luca Bianchi
- Dermatology Unit, Tor Vergata University Hospital, Rome, Italy
| | | | - Iris Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - Paolo Fava
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Enrico Bocchino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandro Di Stefani
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominali ed Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
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Ricci C, Dika E, Corti B, Lambertini M, Ambrosi F, Cappilli S, Grillini M, Filippo GD, Franchini E, Maloberti T, Fiorentino M, Tallini G, Biase DD. "Paradoxical" p16 overexpression in cutaneous melanoma: Molecular and immunohistochemical analysis of a rare phenomenon with a focus on cell cycle regulatory molecules. Pathol Res Pract 2023; 247:154564. [PMID: 37235909 DOI: 10.1016/j.prp.2023.154564] [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: 05/08/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND One of the most relevant genetic alterations in cutaneous melanoma (CM) is the biallelic inactivation/loss-of-heterozygosis (LOH) of cyclin-dependent kinase inhibitor 2 A (CDKN2A), which results in the immunohistochemical loss of p16 frequently found in CM. However, we recently described a rare case of dermal/deep-seated melanoma arising in giant congenital nevus (DDM-GCN) with p16 overexpression combined with p53 loss and tumor protein 53 (TP53) mutation. Herein, we reported a case series of CM with p16 overexpression and analyzed their clinicopathologic features, immunohistochemical expression of the cell cycle regulatory molecules (CCRM: p53, p21, Cyclin D1, Rb), and mutational landscape. METHODS We retrospectively tested for p16 all cases of CM diagnosed at our institution between January 1st 2019-April 1st 2022. In CM with p16 overexpression, we reported clinicopathologic features, immunohistochemical results for melanocytic markers and CCRM, and mutational landscape investigated with a next-generation sequencing (NGS) panel. In cases with zonal p16 overexpression, the immunohistochemical assessment for melanocytic markers and CCRM, as well as the NGS analysis have been performed in both components {with and without p16 overexpression [p16(+)c and p16(-)]}. RESULTS Overexpression of p16 was found in 10/2879 (0.35%) CM [5/10 (50%) diffuse and 5/10 (50%) zonal]. We combined the immunohistochemical results for CCRM and molecular data to classify the cases as follows: a) Group 1 with altered expression of at least one CCRM but no TP53 mutations [3/10 (30%), all with Rb altered/lost]; b) Group 2 with altered expression of at least one CCRM and TP53 mutations [4/10 (40%), all with p53 altered]; c) Group 3 with normal expression of CCRM and no TP53 mutations [3/10 (30%), all with mutations in MAPK pathway genes (NRAS and BRAF)]. In CM with zonal p16 overexpression, the histologic appearance of p16(+)c was heterogeneous, whereas combining CCRM profiles and molecular data the cases could be categorized as follows: a) cases with the same CCRM and molecular profiles in both p16(+)c and p16(-)c; b) cases with p16(+)c showing additional genetic mutations and/or modifications of CCRM expression. CONCLUSIONS p16 overexpression is a rare event, occurring in advanced-stage, clinically- and histologically-heterogeneous CM. These lesions may be classified into three different groups based on CCRM expression and mutational profiles (including TP53 mutation). The analysis of CM with zonal p16 overexpression suggests that, at least in a subset of cases, this phenomenon could represent a sign of "molecular progression" due to the acquisition of additional genetic mutations and/or modifications of the CCRM profile.
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Affiliation(s)
- Costantino Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Emi Dika
- IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy; Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Barbara Corti
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Martina Lambertini
- IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy; Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Francesca Ambrosi
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Simone Cappilli
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Marco Grillini
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | | | | | - Thais Maloberti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
| | - Giovanni Tallini
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy; Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Dario de Biase
- Solid Tumor Molecular Pathology Laboratory, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
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Dika E, Venturi F, Veronesi G. Reflectance confocal microscopy of large penis pigmentation: A clue for detection of genital melanosis. Skin Res Technol 2023; 29:e13347. [PMID: 37231933 PMCID: PMC10172735 DOI: 10.1111/srt.13347] [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: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/27/2023]
Affiliation(s)
- Emi Dika
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology Unit, Department of Medical Science and Surgery (DIMEC)Alma Mater Studiorum, University of BolognaBolognaItaly
| | - Federico Venturi
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology Unit, Department of Medical Science and Surgery (DIMEC)Alma Mater Studiorum, University of BolognaBolognaItaly
- Section of Dermatology, Department of Health SciencesUniversity of FlorenceFlorenceItaly
| | - Giulia Veronesi
- IRCCS Azienda Ospedaliero‐Universitaria di BolognaBolognaItaly
- Dermatology Unit, Department of Medical Science and Surgery (DIMEC)Alma Mater Studiorum, University of BolognaBolognaItaly
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Ribero S, Lambertini M, Ferracin M, Dika E. Non-Coding RNA Investigations in Cutaneous Melanoma: A Step forward in Discovering Novel Biomarkers. J Invest Dermatol 2023; 143:531-532. [PMID: 36841674 DOI: 10.1016/j.jid.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 02/27/2023]
Affiliation(s)
- Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Martina Lambertini
- Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Manuela Ferracin
- Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy; IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Emi Dika
- Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Collatuzzo G, Boffetta P, Dika E, Visci G, Zunarelli C, Mastroeni S, Antonelli G, Fortes C. Occupational exposure to arsenic, mercury and UV radiation and risk of melanoma: a case-control study from Italy. Int Arch Occup Environ Health 2023; 96:443-449. [PMID: 36378322 DOI: 10.1007/s00420-022-01935-8] [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: 09/07/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Melanoma is mainly caused by sunlight radiation, but other environmental risk factors are not well known. We investigated the association between cutaneous melanoma and occupational exposure to arsenic, mercury and UV radiation. METHODS A hospital-based case-control study was conducted in the inpatient wards of IDI-San Carlo Rome, Italy, including 304 incident cases of cutaneous melanoma and 305 frequency-matched controls. Detailed sociodemographic, clinical and host-related factors were collected, and all participants were physically examined using dermoscopy and following standard protocol for recording pigmented lesions. Four experts assessed exposure to arsenic, mercury and UV radiation based on occupational history. A multidimensional variable was created for each risk factor, by combining intensity and probability of exposure. Multivariable logistic regression models were run to calculate odds ratios (OR) and 95% confidence intervals (CI) of the association between exposure to these agents and melanoma. RESULTS A total of 5.4% of the cases vs 2.4% of the controls were exposed to arsenic (OR = 3.12; 95% CI = 1.10-8.86 for high probability and high exposure to arsenic) after controlling for sex, age, smoking status, number of nevi, phototype and history of sunburns in childhood/adolescence. Occupational exposure to mercury and UV radiation was not associated with the risk of melanoma. CONCLUSIONS Subjects exposed to arsenic at the workplace may be at increased risk of developing cutaneous melanoma in comparison to subjects not exposed to this agent. Further studies should be designed to investigate occupational exposure to arsenic and mercury and melanoma and confirm the findings are warranted.
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Affiliation(s)
- Giulia Collatuzzo
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. .,Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Emi Dika
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Simona Mastroeni
- Epidemiology Unit, Istituto Dermopatico dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
| | - Gianluca Antonelli
- Dermatology Department, Istituto Dermopatico dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
| | - Cristina Fortes
- Epidemiology Unit, Istituto Dermopatico dell'Immacolata Concezione, IDI-IRCCS, Rome, Italy
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Dika E, Starace M, Alessandrini A, Patrizi A, Baraldi C, Misciali C, Fanti PA, Waśkiel-Burnat A, Rudnicka L, Piraccini BM. The Histopathologic Evaluation of Diagnostic Procedures in Nail Melanoma. Dermatol Pract Concept 2023; 13:dpc.1302a92. [PMID: 37196263 DOI: 10.5826/dpc.1302a92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION The diagnostic delay in nail melanoma (NM) has been repeatedly emphasized. It may be related to both clinical misinterpretations and to errors in the bioptic procedure. OBJECTIVES To assess the efficacy of histopathologic examination in different diagnostic biopsies in NM. METHODS We retrospectively investigated the diagnostic procedures and histopathologic specimens referred to the Laboratory of Dermatopathology for the clinical suspicion of NM from January 2006 to January 2016. RESULTS Eighty-six nail histopathologic specimens were analyzed consisting in 60 longitudinal, 23 punch and 3 tangential biopsies. A diagnosis of NM was performed in 20 cases, benign melanocytic activation in 51 cases and melanocytic nevi in 15 patients. Longitudinal and tangential biopsy were diagnostic in all cases, regardless of the clinical suspicion. Nail matrix punch biopsy instead was not diagnostic in most of the cases (13/23 specimens). CONCLUSIONS In the presence of an NM clinical suspicion, longitudinal biopsy is recommended (lateral or median) because it provides exhaustive information on the characteristics of melanocytes morphology and distribution in all the components of the nail unit. Tangential biopsy, recently encouraged by expert authors due to the optimal surgical outcome, in our experience gives incomplete information on tumor extension. Punch matrix biopsy gives limited evidence in the diagnosis of NM.
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Affiliation(s)
- Emi Dika
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Annalisa Patrizi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Carlotta Baraldi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pier Alessandro Fanti
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Anna Waśkiel-Burnat
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Lidia Rudnicka
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Mannino M, Piccerillo A, Dika E, Vaccari S, Quaglino P, Rubatto M, Longo C, Borsari S, Pellacani G, Fargnoli MC, Caponio C, Argenziano G, Briatico G, Bianchi L, Di Raimondo C, Calzavara Pinton PG, Zalaudek I, Di Stefani A, Peris K. Advanced Cutaneous Squamous Cell Carcinoma: Italian Multicentric Retrospective Analysis of Patient Profiles and Therapeutic Approaches. Dermatology 2023; 239:422-428. [PMID: 36921583 DOI: 10.1159/000528555] [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: 06/22/2022] [Accepted: 11/11/2022] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Advanced cutaneous squamous cell carcinoma (aCSCC) represents an area of unmet clinical need, with no standardized treatments until the recent approval of immune checkpoint inhibitors (ICIs). OBJECTIVES The aim of the study was to describe clinical characteristics and therapeutic strategies of a real-life Italian cohort of aCSCC patients managed at the beginning of cemiplimab approval as compassionate use in Italy. METHODS A multicenter retrospective study was performed by 10 Italian centers in the period January 1, 2018-May 31, 2020. Patients aged ≥18 years and diagnosed with aCSCC (locally aCSCC and metastatic CSCC) were eligible for the study. Analysis of patients' characteristics and treatment strategies was performed. RESULTS 239 patients were initially recruited in the study: 19 patients were excluded due to incomplete data collection, yielding a final cohort of 220 patients, of which 191 and 220 were included for patients' clinical characteristics and therapeutic intervention analysis, respectively. Median age at the time of diagnosis was 81 years (range: 72-86); nodal metastases were detected in 64/220 (29%) patients, and distant metastatic spread was reported in 33/220 (15%) patients. Most of our patients referred chronic occupational and/or recreational sun exposure, experienced ≥1 sunburn during their lifetime, never wore hats or used photoprotective filters, and presented with signs of cumulative sun damage (solar lentigines and/or actinic keratosis). Majority of our cohort received at least one intervention directed to the primary tumor (n = 212, 96.3%); surgery and radiotherapy were the most common therapeutic choices. Immunotherapy was administered to a small number of patients as compassionate use, especially in the metastatic setting. CONCLUSIONS Our study outlines the complex and heterogeneous clinical and therapeutic landscape of aCSCC patients at the beginning of ICI era, highlighting the need of a standardized care for this fragile and high-need patient population.
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Affiliation(s)
- Maria Mannino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy,
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy,
| | - Alfredo Piccerillo
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Emi Dika
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Marco Rubatto
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Borsari
- Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Chiara Caponio
- Unit of Dermatology, Ospedale San Salvatore, L'Aquila, Italy
| | | | | | - Luca Bianchi
- UOSD di Dermatologia, Policlinico Tor Vergata, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cosimo Di Raimondo
- UOSD di Dermatologia, Policlinico Tor Vergata, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Iris Zalaudek
- Department of Dermatology and Venerology, University of Trieste, Trieste, Italy
| | - Alessandro Di Stefani
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
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Starace M, Waśkiel-Burnat A, Bruni F, Alessandrini A, Dika E, Piraccini MB, Iorizzo M. Combination of topical fluorouracil and salicylic acid as a therapeutic option for recalcitrant warts of the nail unit. J Eur Acad Dermatol Venereol 2023; 37:e410-e411. [PMID: 36164812 DOI: 10.1111/jdv.18591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 09/13/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Michela Starace
- Dermatology IRCCS Policlinico Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Anna Waśkiel-Burnat
- Dermatology IRCCS Policlinico Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy.,Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Francesca Bruni
- Dermatology IRCCS Policlinico Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology IRCCS Policlinico Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emi Dika
- Dermatology IRCCS Policlinico Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maria Bianca Piraccini
- Dermatology IRCCS Policlinico Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
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Cosio T, Coniglione F, Flaminio V, Gaziano R, Coletta D, Petruccelli R, Dika E, Bianchi L, Campione E. Pyodermitis during Nivolumab Treatment for Non-Small Cell Lung Cancer: A Case Report and Review of the Literature. Int J Mol Sci 2023; 24:ijms24054580. [PMID: 36902013 PMCID: PMC10003408 DOI: 10.3390/ijms24054580] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/30/2023] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 03/03/2023] Open
Abstract
Immunotherapy in oncology is replacing traditional therapies due to it specific action and limited side effects. Despite the high efficacy of immunotherapy, side effects such as bacterial infection have been reported. Bacterial skin and soft tissue infections represent one of the most important differential diagnoses in patients presenting with reddened and swollen skin and soft tissue. Among these infections, cellulitis (phlegmon) and abscesses are the most frequent. In most cases, these infections occur locally with possible contiguous spread, or as a multifocal manifestation, especially in immunocompromised patients. Herein, we report a case of pyodermitis in an immunocompromised district in a patient treated with nivolumab for non-small cell lung cancer. A 64-year-old, smoker male patient showed cutaneous lesions at a different evolution level in the left arm, all in a tattooed area, with one phlegmon and two ulcerated lesions. Microbiological cultures and gram staining revealed an infection caused by a methicillin-susceptible but erythromycin-resistant (ER-R), clindamycin-resistant (CL-R), and gentamicin-resistant (GE-R) Staphylococcus aureus strain. Despite immunotherapy becoming a milestone in oncologic treatment, more than the spectrum of immune-mediated toxicities of these agents needs to be investigated. This report highlights the importance of considering lifestyle and cutaneous background before starting immunotherapy for cancer treatment, with an emphasis on pharmacogenomics and the possibility of modified skin microbiota predisposing to cutaneous infections in patients treated with PD-1 inhibitors.
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Affiliation(s)
- Terenzio Cosio
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Filadelfo Coniglione
- Department of Surgical Sciences, University Nostra Signora del Buon Consiglio, 1000 Tirana, Albania
| | - Valeria Flaminio
- Medical Oncology Unit, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Roberta Gaziano
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Deborah Coletta
- Medical Oncology Unit, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Rosalba Petruccelli
- Laboratory of Microbiology, Microbiology and Virology Lab, Tor Vergata University Hospital, V. le Oxford, 81, 00133 Rome, Italy
| | - Emi Dika
- Melanoma Center, Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- Unit of Dermatology, Department of Medical and Surgical Sciences, DIMEC, Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy
| | - Luca Bianchi
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
| | - Elena Campione
- Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Viale Oxford, 81, 00133 Rome, Italy
- Correspondence:
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Lambertini M, Ricci C, Corti B, Veronesi G, Quaglino P, Ribero S, Pellacani G, Hrvatin Stancic B, Campione E, Dika E. Follicular colonization in melanocytic nevi and melanoma: A literature review. J Cutan Pathol 2023. [PMID: 36820529 DOI: 10.1111/cup.14415] [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: 11/22/2022] [Revised: 02/11/2023] [Accepted: 02/21/2023] [Indexed: 02/24/2023]
Abstract
The lentiginous spread of melanocytes into the hair follicle can be observed in a number of benign melanocytic neoplasms such as in nevi but also in sun-induced melanocytic hyperplasia and melanoma. The follicular colonization by melanocytes in melanoma is classified into three distinct patterns: primary follicular melanoma, melanoma with folliculotropism, and invasive melanoma arising from melanoma in situ with folliculotropism. The role of follicular colonization in melanoma pathologic staging is still a matter of debate though the description of the latter has been recommended by the International Collaboration on Cancer Reporting. In this review, we will discuss the role of follicular colonization in melanoma and melanocytic nevi as well as the facts and controversies regarding this topic.
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Affiliation(s)
- Martina Lambertini
- Melanoma Centre, Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Costantino Ricci
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy
| | - Barbara Corti
- Pathology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
| | - Giulia Veronesi
- Melanoma Centre, Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, Rome, Italy
| | - Bor Hrvatin Stancic
- Dermatovenerology Department, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emi Dika
- Melanoma Centre, Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Dermatology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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43
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Comito F, Gagliano A, Sperandi F, Dika E, Savoia F, Melotti B. Retreatment with sonidegib in a patient with multiple basal cell carcinomas and multiple comorbidities: a complex real-life scenario. Ital J Dermatol Venerol 2023; 158:150-152. [PMID: 36799006 DOI: 10.23736/s2784-8671.23.07281-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- Francesca Comito
- Unit of Medical Oncology, University Hospital of Bologna, Bologna, Italy - .,Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Bologna, Italy -
| | - Ambrogio Gagliano
- Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Bologna, Italy
| | - Francesca Sperandi
- Unit of Medical Oncology, University Hospital of Bologna, Bologna, Italy
| | - Emi Dika
- Unit of Dermatology, University Hospital of Bologna, Bologna, Italy
| | - Francesco Savoia
- Unit of Skin Cancer, Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" - IRST IRCCS, Meldola, Forlì-Cesena, Italy
| | - Barbara Melotti
- Unit of Medical Oncology, University Hospital of Bologna, Bologna, Italy
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44
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Lambertini M, Zengarini C, Ravaioli GM, Veronesi G, Mussi M, Ferrari T, Braschi G, Campione E, Dika E. Multiple primary melanomas: Is there a correlation between dermoscopic features and germline mutations? Australas J Dermatol 2023; 64:e182-e185. [PMID: 36774630 DOI: 10.1111/ajd.14007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 02/13/2023]
Affiliation(s)
- Martina Lambertini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Corrado Zengarini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giulia Maria Ravaioli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giulia Veronesi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Martina Mussi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Tiziano Ferrari
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emi Dika
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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45
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Lambertini M, Comito F, Melotti B, Baracca MF, Dika E. Drug-induced photosensitivity during tebentafusp treatment for metastatic uveal melanoma: A newly described occurrence. J Eur Acad Dermatol Venereol 2023; 37:e207-e208. [PMID: 36177547 DOI: 10.1111/jdv.18625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/23/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Martina Lambertini
- Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Francesca Comito
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Barbara Melotti
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maria Francesca Baracca
- Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Emi Dika
- Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.,Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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46
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Querzoli G, Veronesi G, Corti B, Nottegar A, Dika E. Basic Elements of Artificial Intelligence Tools in the Diagnosis of Cutaneous Melanoma. Crit Rev Oncog 2023; 28:37-41. [PMID: 37968992 DOI: 10.1615/critrevoncog.2023050220] [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] [Indexed: 11/17/2023]
Abstract
Cutaneous melanoma (CM) incidence has dramatically increased in the last years. Early diagnosis is of paramount importance in terms of prognosis. Artificial Intelligence (AI) tools are being proposed for clinicians and pathologists as an adjunct support in the diagnostic process. We described herein an overview of the most important parameters that a potential AI tool should take into consideration in histopathology to evaluate a skin lesion. First of all, recognition of a melanocytic or non-melanocytic nature. Furthermore, melanocytic lesions should be stratified according to at least four parameters: silhouette and asymmetry; identification and spatial distribution of the cells; mitosis count; presence of ulceration. According to the number of parameters the AI tools might stratify the risk of CM and prioritize the pathologist's work.
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Affiliation(s)
- Giulia Querzoli
- Pathology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy
| | - Giulia Veronesi
- Division of Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy; Alma Mater Studiorum, University of Bologna, Italy
| | - Barbara Corti
- Pathology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy
| | | | - Emi Dika
- Division of Dermatology, IRCCS Azienda Ospedaliero Universitaria di Bologna, Italy; Alma Mater Studiorum, University of Bologna, Italy
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47
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Alessandrini A, Evangelista V, Barisani A, Vaccari S, Dika E, Piraccini BM, Starace M. Recurrent microinvasive subungueal squamous cell carcinoma in an HIV patient: a case of good response to photodynamic therapy. Dermatol Pract Concept 2022; 12:e2022136. [DOI: 10.5826/dpc.1204a136] [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] [Accepted: 02/21/2022] [Indexed: 11/06/2022] Open
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48
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Curti N, Veronesi G, Dika E, Misciali C, Marcelli E, Giampieri E. Breslow thickness: Geometric interpretation, potential pitfalls, and computer automated estimation. Pathol Res Pract 2022; 238:154117. [PMID: 36126452 DOI: 10.1016/j.prp.2022.154117] [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: 07/15/2022] [Revised: 08/28/2022] [Accepted: 08/31/2022] [Indexed: 11/19/2022]
Abstract
Breslow thickness is one of most important prognostic factor for cutaneous melanoma. To quantify the positions of the melanocytes, the Breslow thickness is defined on a distance metric that is reliable and easy to use in a clinical setting. In this letter, we want to highlight some pitfalls in this distance measurement arising from geometrical issues related to section bending and curling, and their consequences on computer automated estimation.
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Affiliation(s)
- Nico Curti
- eDIMESLab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Giulia Veronesi
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Emi Dika
- Dermatology Unit, IRCCS Azienda OspedalieraUniversitaria di Bologna, Sant'Orsola Hospital, Bologna, Italy; Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy.
| | - Cosimo Misciali
- Dermatology Unit, IRCCS Azienda OspedalieraUniversitaria di Bologna, Sant'Orsola Hospital, Bologna, Italy
| | - Emanuela Marcelli
- eDIMESLab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Enrico Giampieri
- eDIMESLab, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
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49
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Campione E, Di Prete M, Di Raimondo C, Costanza G, Palumbo V, Garofalo V, Mazzilli S, Franceschini C, Dika E, Bianchi L, Orlandi A. Topical Treatment of Actinic Keratosis and Metalloproteinase Expression: A Clinico-Pathological Retrospective Study. Int J Mol Sci 2022; 23:ijms231911351. [PMID: 36232651 PMCID: PMC9569516 DOI: 10.3390/ijms231911351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Actinic keratosis is an intraepithelial proliferation of atypical keratinocytes that could progress into invasive squamous cell carcinoma. Most evidence suggests an important role of the dermal matrix metalloproteinases in the progression of atypical skin epithelial lesions. We evaluated the clinical efficacy of three different therapeutic modalities (a medical device containing 0.8% piroxicam cream and 50+ sunscreen, photodynamic therapy, and ingenol mebutate gel) to treat suspicious actinic keratoses, which were biopsied for histopathological examination and then analyzed for the expression of matrix metalloproteinases by immunohistochemistry. Clinical, dermoscopic, and reflectance confocal microscopy evaluations revealed a gradual decrease in all standard scores validated for actinic keratosis assessment at the end of the treatments. From a histopathological point of view, we documented the substantial restoration of normal skin architecture, while the immunohistochemical evaluation of matrix metalloproteinases showed a reduction in expression in the treated skin lesions compared to the baseline. As actinic keratoses are considered the precursors of squamous cell carcinoma, their treatment is crucial to prevent the development of a more aggressive disease. Our study monitored the evolution of actinic keratoses subjected to three different topical therapies, with the value of correlating clinical and histopathological findings. Moreover, as the matrix metalloproteinases are largely recognized factors involved in the pathogenesis and evolution of actinic keratosis to squamous cell carcinoma, the demonstration by immunohistochemistry of a reduction in their expression after the treatments adds new valuable concern to the field.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Monia Di Prete
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gaetana Costanza
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenzo Palumbo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Virginia Garofalo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sara Mazzilli
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Chiara Franceschini
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Emi Dika
- Division of Dermatology, Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- Division of Dermatology, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Augusto Orlandi
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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50
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Venturi F, Pellacani G, Farnetani F, Maibach H, Tassone D, Dika E. Non – Invasive diagnostic techniques in the preoperative setting of Mohs micrographic surgery: a review of the literature. Dermatol Ther 2022; 35:e15832. [DOI: 10.1111/dth.15832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/28/2022] [Accepted: 09/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Federico Venturi
- Section of Dermatology, Department of Health Sciences University of Florence Florence Italy
| | - Giovanni Pellacani
- Department of Dermatology, Policlinico Umberto I Sapienza University of Rome Rome Italy
| | | | - Howard Maibach
- Dermatology University of California San Francisco, San Francisco California
| | - Daniela Tassone
- IRCCS di Policlinico Sant'Orsola, via Massarenti 9 Bologna Italia
| | - Emi Dika
- IRCCS di Policlinico Sant'Orsola, via Massarenti 9 Bologna Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) University of Bologna Bologna Italy
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