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Rudnicka L, Arenbergerova M, Grimalt R, Ioannides D, Katoulis AC, Lazaridou E, Olszewska M, Ovcharenko YS, Piraccini BM, Prohic A, Rakowska A, Reygagne P, Richard MA, Soares RO, Starace M, Vañó-Galvan S, Waskiel-Burnat A. European expert consensus statement on the systemic treatment of alopecia areata. J Eur Acad Dermatol Venereol 2024; 38:687-694. [PMID: 38169088 DOI: 10.1111/jdv.19768] [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: 10/07/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
Alopecia areata is an autoimmune form of non-scarring hair loss. It is usually characterized by limited areas of hair loss. However, the disease may progress to complete scalp and body hair loss (alopecia totalis, alopecia universalis). In patients with alopecia areata hair loss significantly impacts the quality of life. Children and adolescents with alopecia areata often experience bullying, including physical aggression. The disease severity evaluation tools used in clinical practice are: the Severity of Alopecia Tool (SALT) score and the Alopecia Areata Scale (AAS). A SALT score equal to or greater than 20 constitutes a commonly accepted indication for systemic therapy in alopecia areata. When using the AAS, moderate to severe alopecia areata should be considered a medical indication for systemic treatment. Currently, the only two EMA-approved medications for alopecia areata are baricitinib (JAK 1/2 inhibitor) for adults and ritlecitinib (JAK 3/TEC inhibitor) for individuals aged 12 and older. Both are EMA-approved for patients with severe alopecia areata. Other systemic medications used off-label in alopecia areata include glucocorticosteroids, cyclosporine, methotrexate and azathioprine. Oral minoxidil is considered an adjuvant therapy with limited data confirming its possible efficacy. This consensus statement is to outline a systemic treatment algorithm for alopecia areata, indications for systemic treatment, available therapeutic options, their efficacy and safety, as well as the duration of the therapy.
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Affiliation(s)
- L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - R Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - D Ioannides
- 1st Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - A C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - E Lazaridou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - M Olszewska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Y S Ovcharenko
- Department of Infectious Diseases and Clinical Immunology of the V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Italy School of Specialization Dermatology and Venereology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - A Prohic
- Department of Dermatovenerology, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - A Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - P Reygagne
- Centre de Santé Sabouraud, Hopital Saint Louis, Paris, France
| | - M A Richard
- CEReSS-EA 3279, Research Centrer in Health Services and Quality of Life Aix Marseille University, Dermatology Department, Universitary Hospital Timone, Assistance Publique Hôpitaux de Marseille, APHM, Marseille, France
| | - R O Soares
- CUF Descobertas Hospital, Lisbon, Portugal
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Italy School of Specialization Dermatology and Venereology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - S Vañó-Galvan
- Department Ramon y Cajal Hospital, IRYCIS, Grupo Pedro Jaén Clinic, TricoHRC Research Group, University of Alcala, Madrid, Spain
| | - A Waskiel-Burnat
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Starace M, Loi C, Cedirian S, Bruni F, Filippi F, La Placa M, Piraccini BM, Bardazzi F. Trichoscopy as a monitoring tool in assessing treatment response in scalp pemphigus. J Eur Acad Dermatol Venereol 2024. [PMID: 38372382 DOI: 10.1111/jdv.19869] [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: 06/22/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Affiliation(s)
- M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - C Loi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Filippi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M La Placa
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Iorizzo M, Sirtoli Marcondes MT, Sechi A, Therianou A, Piraccini BM, Starace M. Female diffuse non-cicatricial alopecia-The diagnostic value of trichoscopy. J Eur Acad Dermatol Venereol 2024; 38:e142-e144. [PMID: 37702248 DOI: 10.1111/jdv.19493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Affiliation(s)
- M Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
| | | | - A Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - A Therianou
- Imperial College, NHS Healthcare Trust, London, UK
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Starace M, Cedirian S, Alessandrini A, Bruni F, Piraccini BM, Iorizzo M. Self-induced nail disorders (SINDs): What do we know so far? Ann Dermatol Venereol 2023; 150:253-259. [PMID: 37813711 DOI: 10.1016/j.annder.2023.05.005] [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: 01/29/2023] [Revised: 03/17/2023] [Accepted: 05/09/2023] [Indexed: 10/11/2023]
Abstract
Self-induced nail disorders are a broad group of different clinical manifestations that share the common trait of being caused more or less voluntarily by the patient. These are distinct conditions within the clinical spectrum of onychotillomania. Most patients diagnosed with these disorders have psychiatric co-morbidities, and a multidisciplinary approach is thus highly recommended. The purpose of this review is to describe the most common clinical features encountered during daily nail consultations and to provide useful diagnostic tools and therapeutic tips for the best approach to these conditions.
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Affiliation(s)
- M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy.
| | - A Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - M Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
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Cedirian S, Bruni F, Quadrelli F, Caro G, Fortuna M, Rossi A, Piraccini BM, Starace M. Clinical study on the efficacy and tolerability of a topical regenerative treatment in patients with telogen effluvium and mild androgenetic alopecia. J Cosmet Dermatol 2023; 22:3347-3351. [PMID: 37415302 DOI: 10.1111/jocd.15873] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/19/2023] [Accepted: 06/04/2023] [Indexed: 07/08/2023]
Abstract
Hair loss may change the quality of life since modern society considers hair an essential element in beauty definition. The most common causes of hair loss are androgenetic alopecia (AGA) and telogen effluvium (TE). AGA requires a lifetime use of minoxidil or finasteride (and sometimes they lose efficacy over the years), whereas TE has no standardized therapy available. Our study focuses on a novel topical regenerative preparation that, by mimicking autologous PRP, can safely and efficiently improve hair loss in patients affected by TE and AGA.
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Affiliation(s)
- S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Caro
- Dermatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - M Fortuna
- Dermatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - A Rossi
- Dermatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Sechi A, Song J, Dell'Antonia M, Heidemeyer K, Piraccini BM, Starace M, Naldi L. Adverse events in patients treated with Jak-inhibitors for alopecia areata: a systematic review. J Eur Acad Dermatol Venereol 2023. [PMID: 37013725 DOI: 10.1111/jdv.19090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
Recently, the impressive efficacy of JAK-inhibitors (JAK-I) in alopecia areata (AA) has been described in several studies; however, to date, there is limited information on the safety of JAK-I in AA patients. For this reason, on the August 18th 2022, a systematic review was performed to collect the pre-marketing and post-marketing data on the safety of JAK-I in patients treated for AA, evaluating for each molecule the reported adverse events (AEs) in indexed literature and their frequency. The keywords "alopecia areata" AND "Jak-inhibitors OR Janus-kinase Inhibitors" were searched on PubMed, Embase, and Cochrane databases. Of 407 studies retrieved, 28 papers met the requirements and were used in our review, including 5 RCTs and 23 case series, overall 1719 patients were included and the safety of 6 JAK-I was assessed (baricitinib, brepocitinib, deuruxolitinib, ritlecitinib, ruxolitinib, tofacitinib). Systemic JAK-I were well tolerated, most of the AEs were mild, and the withdrawal rate for AEs was very low and inferior to placebo in controlled studies (1.6% vs. 2.2%). Laboratory abnormalities represented 40.1% of AEs associated with oral JAK-I, which mostly included the rise in cholesterol, transaminase, triglycerides, creatine phosphokinase (CPK), and sporadic cases of neutro/lymphocytopenia. The remaining AEs involved the respiratory tract (20.8%), the skin (17.2%), the urogenital (3.8%), or the gastroenterological (3.4%) tract. Increased rates of infections involved not only the upper (19.0%) and lower (0.3%) respiratory tract, but also the urogenital system (3.6%), and the skin (4.6%). Isolated cases of grade 3 to 4 AEs have been reported, including myocardial infarction, hypertensive urgencies, cellulitis, rhabdomyolysis, neutropenia, and high elevation of creatinine kinase. No fatal outcomes were reported. AEs reported with topical formulation included scalp irritation and folliculitis. The main limit of this review is the lack of data related to post-marketing surveillance, which should be maintained on a long-term basis.
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Affiliation(s)
- A Sechi
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine
| | - J Song
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
- University of Padua Faculty of Medicine and Surgery, Department of Medicine DIMED, Padova, Veneto, Italy
| | - M Dell'Antonia
- University of Cagliari, Dermatology Clinic, Department of Medical Sciences and Public Health
| | - K Heidemeyer
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
- Bern University Hospital Clinic for Dermatology, Department of Dermatology, Inselspital, Bern, Switzerland
| | - B M Piraccini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine
| | - M Starace
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine
| | - L Naldi
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
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Starace M, Viviani F, Carpanese MA, Alessandrini A, Sechi A, Patrizi A, Bianchi T. Diagnosis and Management of Intravenous Drug Users' Chronic Wounds: A Case Series Collection of a Single Center. INT J LOW EXTR WOUND 2022:15347346221121465. [PMID: 36036366 DOI: 10.1177/15347346221121465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Intravenous drug users (IVDUs) represent a very small group of patients affected by chronic wounds (CWs). Objectives: To assess the risk factors for CWs in IVDUs, to improve their treatment. Methods: A retrospective review of 7 IVDUs with CWs was performed at the Dermatology of the University of Bologna. Results: A history of 10 years of the most frequent injection was heroin in the gaiter area. The most observed comorbidities were HIV, HCV and HBV. They were treated most with an alginate with silver dressing with an average follow-up of 2.8 years. Conclusions: We would like to highlight the importance of clinical history in this type of patients and that in our experience specialized skin wounds risk assessment and management could be useful, aside from traditional compression therapy.
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Affiliation(s)
- M Starace
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - F Viviani
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - M A Carpanese
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - A Alessandrini
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - A Sechi
- 198202UOC Dermatologia - Ospedale San Bortolo, Vicenza, Italy
| | - A Patrizi
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), 18508University of Bologna, Bologna, Italy
| | - T Bianchi
- Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italia
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de Marsillac PF, Cortez de Almeida RF, Machado CJ, Piraccini BM, Starace M, Tosti A, Vincenzi C, Kobzei K, Iorizzo M, Alves LD, Blanco A, Coelho C, Saceda-Corralo D, D'Atri G, Benez M, Ramos PM, Baja S, Tortelly VD, Frattini S, Melo DF. Clinical, epidemiological, trichoscopic and histopathological features of linear morphea on the scalp. J Eur Acad Dermatol Venereol 2022; 36:e892-e895. [PMID: 35694874 DOI: 10.1111/jdv.18323] [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: 03/30/2022] [Accepted: 06/03/2022] [Indexed: 11/29/2022]
Affiliation(s)
- P F de Marsillac
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - R F Cortez de Almeida
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - C J Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - B M Piraccini
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - A Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | - C Vincenzi
- Department of Dermatology, Private Hospital Nigrisoli, Bologna, Italy
| | - K Kobzei
- Kyiv Medical University, Kyiv, Ukraine
| | - M Iorizzo
- Private Dermatology Practice, Bellinzona, Lugano, Switzerland
| | - L D Alves
- Department of Tropical Medicine and Dermatology, Federal University of Goiás, Goiânia, GO, Brazil
| | - A Blanco
- Department of Dermatology, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - C Coelho
- Department of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - D Saceda-Corralo
- Dermatology Department, Trichology Unit, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | - G D'Atri
- GrupoMCI (Integral Hair Medicine), Private Dermatology Practice, Buenos Aires, Argentina
| | - M Benez
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - P M Ramos
- Department of Dermatology and Radiotherapy, São Paulo State University, Botucatu, SP, Brazil
| | - S Baja
- Private Dermatology Practice, Resende, RJ, Brazil
| | - V D Tortelly
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - S Frattini
- Mental Health Department, Guelph General Hospital, Guelph, Ontario, Canada
| | - D F Melo
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Starace M, Alessandrini A, Piraccini BM. Onychodynia: a new term of painful sensation and paresthesia of the nails. J Eur Acad Dermatol Venereol 2022; 36:e809-e810. [PMID: 35648440 DOI: 10.1111/jdv.18286] [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: 01/28/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Affiliation(s)
- M Starace
- Dermatology Unit- IRCCS Azienda Ospedaliero, Universitaria di Bologna.,Department of Experimental, Diagnostic and Specialty Medicine Alma Mater, Studiorum University of Bologna, Italy
| | - A Alessandrini
- Dermatology Unit- IRCCS Azienda Ospedaliero, Universitaria di Bologna.,Department of Experimental, Diagnostic and Specialty Medicine Alma Mater, Studiorum University of Bologna, Italy
| | - B M Piraccini
- Dermatology Unit- IRCCS Azienda Ospedaliero, Universitaria di Bologna.,Department of Experimental, Diagnostic and Specialty Medicine Alma Mater, Studiorum University of Bologna, Italy
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Kolla A, Starace M, Svigos K, Yin L, Rich P, Krueger L, Adotama P, Shapiro J, Piraccini B, Lo Sicco K. Dermatologists' Knowledge of Dermoscopic Features in Hair and Nail Disorders. J Eur Acad Dermatol Venereol 2022; 36:e684-e686. [PMID: 35148453 DOI: 10.1111/jdv.18000] [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: 09/24/2021] [Revised: 01/07/2022] [Accepted: 02/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- A Kolla
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York
| | - M Starace
- IRCCS Azienda Ospedaliero, Universitaria di Bologna.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum, Università di Bologna, Italy
| | - K Svigos
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York
| | - L Yin
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York
| | - P Rich
- Department of Dermatology, Oregon Health & Science University, Portland OR
| | - L Krueger
- Department of Dermatology, Emory University, Atlanta GA
| | - P Adotama
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York
| | - J Shapiro
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York
| | - B Piraccini
- IRCCS Azienda Ospedaliero, Universitaria di Bologna.,Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum, Università di Bologna, Italy
| | - K Lo Sicco
- The Ronald O. Perelman Department of Dermatology, NYU Langone Health, New York
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11
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Starace M, Orlando G, Bruni F, Alessandrini A, Piraccini BM. Anagen effluvium and the role of trichoscopy. Clin Exp Dermatol 2021; 47:589-591. [PMID: 34642956 DOI: 10.1111/ced.14982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M Starace
- Dermatology Division, IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Orlando
- Department of Medicine (DIMED), Unit of Dermatology, University of Padua, Padua, Italy
| | - F Bruni
- Dermatology Division, IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - A Alessandrini
- Dermatology Division, IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - B M Piraccini
- Dermatology Division, IRCCS Policlinico Sant'Orsola, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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12
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Starace M, Iorizzo M, Mandel VD, Bruni F, Misciali C, Apalla Z, Silyuk T, Pellacani G, Patrizi A, Piraccini BM, Alessandrini A. Scalp dysaesthesia and lichen simplex chronicus: diagnostic and therapeutic update with literature review. Clin Exp Dermatol 2021; 47:3-8. [PMID: 34137059 PMCID: PMC9290567 DOI: 10.1111/ced.14808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/28/2022]
Abstract
Scalp dysaesthesia, considered a variant of the cutaneous dysaesthesia syndrome, is characterized by chronic sensory symptoms, including pruritus, pain, burning and stinging in a well‐defined location, without objective findings. Its aetiology is not well elucidated and treatment options are limited, thus it can be challenging and frustrating for both patient and physician. It can be associated with lichen simplex chronicus. In this paper, we review the literature on the pathogenetic factors, diagnostic methods and therapeutic options in the management of scalp dysaesthesia. Dissociation, cervical spine disease and muscle tension seem to be the most important pathogenetic factors. Trichoscopy, reflectance confocal microscopy and biopsy are all helpful for the diagnosis of the disease. Therapies include high‐potency topical or intralesional corticosteroids, capsaicin and topical anaesthetics, sedative antihistamines, tricyclic antidepressants, transcutaneous electric nerve stimulation, botulinum toxin and vitamin B12.
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Affiliation(s)
- M Starace
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - M Iorizzo
- Private Dermatology Practice, Lugano and Bellinzona, Switzerland
| | - V D Mandel
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatology Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - F Bruni
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - C Misciali
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - Z Apalla
- Dermatology Department, Hippokration Hospital of Thessaloniki, Thessaloniki, Greece
| | - T Silyuk
- Private Dermatology Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russia
| | - G Pellacani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - A Patrizi
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
| | - A Alessandrini
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, IRCCS Policlinico di Sant'Orsola, Bologna, Italy
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13
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Bruni F, Alessandrini A, Starace M, Orlando G, Piraccini BM. Clinical and trichoscopic features in various forms of scalp psoriasis. J Eur Acad Dermatol Venereol 2021; 35:1830-1837. [PMID: 33991148 DOI: 10.1111/jdv.17354] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 04/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Scalp psoriasis is often undiagnosed or inadequately treated. The patient himself underestimates the seriousness of this hair disease and consults too late to a dermatologist. OBJECTIVES The aim of our study was to create a correlation between the clinical patterns and trichoscopy of scalp psoriasis such in a way to help the clinician to make the diagnosis and select the appropriate therapy. MATERIAL AND METHODS We gathered all patients affected of scalp psoriasis afferent to Outpatient's hair consultation of the Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, from January 2012 to December 2018. All patients were evaluated through clinical, trichoscopic examination and a skin biopsy only in doubtful cases. We quantified the severity of the disease with several objective and subjective parameters every 4 months, up to 1 year. We recorded therapies, outcome data and quality of life. RESULTS We collected 156 patients affected by scalp psoriasis, identifying seven clinical patterns with specific trichoscopical correlation. In the order of frequency, the clinical patterns were as follows: plaque psoriasis (with a prevalence of erythema, silver-white scales and twisted red loops vessels and red dots); thin scales (with silvery-white scales, simple red lines and signet red ring vessels); sebopsoriasis (with greasy scales, erythema with red dots, globules and twisted and bushy red loops at high magnification); psoriatic cap (with silver-white scales, erythema and polymorphic vascular pattern); pityriasis amiantacea (with yellowish adherent scales, erythema and simple red loops capillaries); cicatricial psoriatic alopecia (with erythema associated with yellowish, silver-white scales with twisted and bushy red loops capillaries) and pustular psoriasis (with 'flower shape' pustular lesions, erythema simple red loops capillaries). CONCLUSIONS The description of different clinical patterns of scalp psoriasis and its trichoscopical correlations may help the clinician to make the diagnosis also in atypical presentations and to prescribe an adequate therapeutic regimen.
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Affiliation(s)
- F Bruni
- Dermatology -IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - A Alessandrini
- Dermatology -IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology -IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Orlando
- Department of Dermatology, University of Padua, Padua, Italy
| | - B M Piraccini
- Dermatology -IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, Bologna, Italy
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14
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Starace M, Mandel V, Francesca B, Alessandrini A, Misciali C, Apalla Z, Iorizzo M, Pellacani G, Silyuk T, Patrizi A, Piraccini B. Lichen simplex chronicus of the scalp: dermoscopy and reflectance confocal microscopy features. J Eur Acad Dermatol Venereol 2021; 35:e450-e452. [DOI: 10.1111/jdv.17206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/02/2021] [Accepted: 02/11/2021] [Indexed: 11/30/2022]
Affiliation(s)
- M. Starace
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - V.D. Mandel
- Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
- Dermatology Unit Department of Clinical and Experimental Medicine University of Parma Parma Italy
| | - B. Francesca
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - A. Alessandrini
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - C. Misciali
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - Z. Apalla
- State Dermatology Department Hippokratio Hospital of Thessaloniki Thessaloniki Greece
| | - M. Iorizzo
- Private Dermatology Practice Lugano and Bellinzona Switzerland
| | - G. Pellacani
- Dermatology Unit Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine University of Modena and Reggio Emilia Modena Italy
| | - T. Silyuk
- Dermatology Private Practice Hair Treatment and Transplantation Center Saint Petersburg Russia
| | - A. Patrizi
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
| | - B.M. Piraccini
- Dermatology ‐IRCCS Policlinico di Sant'Orsola ‐ Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna Bologna Italy
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15
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Alessandrini A, Bruni F, Piraccini B, Starace M. Common causes of hair loss – clinical manifestations, trichoscopy and therapy. J Eur Acad Dermatol Venereol 2021; 35:629-640. [DOI: 10.1111/jdv.17079] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/27/2020] [Indexed: 12/26/2022]
Affiliation(s)
- A. Alessandrini
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - F. Bruni
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - B.M. Piraccini
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
| | - M. Starace
- Dermatology Department of Experimental, Diagnostic and Specialty Medicine University of Bologna Bologna Italy
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16
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Neri I, Guglielmo A, Virdi A, Gaspari V, Starace M, Piraccini BM. The red half-moon nail sign: a novel manifestation of coronavirus infection. J Eur Acad Dermatol Venereol 2020; 34:e663-e665. [PMID: 32535979 PMCID: PMC7323324 DOI: 10.1111/jdv.16747] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/03/2020] [Indexed: 01/17/2023]
Affiliation(s)
- I Neri
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - A Guglielmo
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - A Virdi
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - V Gaspari
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - B M Piraccini
- Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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17
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Pisaturo M, Starace M, Minichini C, De Pascalis S, Occhiello L, Fraia AD, Messina V, Sangiovanni V, Claar E, Coppola N. Virological patterns of hepatitis C virus patients with failure to the current-generation direct-acting antivirals. Int J Antimicrob Agents 2020; 56:106067. [PMID: 32599227 DOI: 10.1016/j.ijantimicag.2020.106067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/15/2020] [Accepted: 06/21/2020] [Indexed: 12/14/2022]
Abstract
There are few data on the virological characterisation of patients with failure to current-generation direct-acting antivirals (DAAs), namely elbasvir/grazoprevir, sofosbuvir/velpatasvir and glecaprevir/pibrentasvir. This study aimed to characterise virological patterns in patients with failure to current DAA regimens as well as the efficacy of re-treatment. All 61 consecutive hepatitis C virus (HCV) treatment-naïve patients with failure to current DAAs from January 2018 to February 2019 were enrolled. Sanger sequencing of NS3, NS5A and NS5B proteins was performed using homemade protocols. NS5A resistance-associated substitutions (RASs) were more frequent in the 17 patients treated with sofosbuvir/velpatasvir (89.5%) and 33 patients treated with elbasvir/grazoprevir (97%) compared with the 11 patients treated with glecaprevir/pibrentasvir (18.2%) (P = 0.002 and 0.000, respectively). NS3 RASs were more often detected in the 33 patients with failure to elbasvir/grazoprevir (30.3%) than in the 11 patients treated with glecaprevir/pibrentasvir (9.1%). NS3 RASs were also detected in 12% of sofosbuvir/velpatasvir-treated patients. NS5B RASs were infrequently identified. Of the glecaprevir/pibrentasvir-treated patients, 73% did not show RASs in any HCV regions, a prevalence higher than that observed in those treated with elbasvir/grazoprevir (0%; P < 0.05) or sofosbuvir/velpatasvir (12%; P < 0.05). Of the 61 patients, 21 (34.4%) were re-treated with sofosbuvir/velpatasvir and voxilaprevir. All patients achieved sustained virological response at 12 weeks (SVR12). To our knowledge, this is one of the first real-life studies describing patients who failed current-generation DAAs; the prevalence of RASs differed according to the DAA regimen used, and the efficacy of re-treatment was high.
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Affiliation(s)
- M Pisaturo
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - M Starace
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - C Minichini
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - S De Pascalis
- Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - L Occhiello
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - A Di Fraia
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania 'L. Vanvitelli', Napoli, Italy
| | - V Messina
- Infectious Diseases Unit, A.O. S Anna e S Sebastiano, Caserta, Italy
| | - V Sangiovanni
- Third Infectious Diseases Unit, AORN dei Colli, P.O. Cotugno, Naples, Italy
| | - E Claar
- Internal Medicine Unit, Evangelical Hospital Villa Betania, Naples, Italy
| | - N Coppola
- Laboratory for the Identification of Prognostic Factors of Response to the Treatment Against Infectious Diseases, University of Campania 'L. Vanvitelli', Napoli, Italy; Infectious Diseases and Viral Hepatitis, Department of Mental and Physical Health and Preventive Medicine, University of Campania 'L. Vanvitelli', Napoli, Italy.
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18
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Starace M, Iorizzo M, Trüeb RM, Piccolo V, Argenziano G, Camacho FM, Gallyamova Y, Rudnicka L, Umbert I, Lyakhovitsky A, Vañó-Galván S, Goren A, Alessandrini A, Bruni F, Piraccini BM. Erosive pustular dermatosis of the scalp: a multicentre study. J Eur Acad Dermatol Venereol 2020; 34:1348-1354. [PMID: 31954062 DOI: 10.1111/jdv.16211] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/17/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Erosive pustular dermatosis of the scalp (EPDS) is characterized by crusted erosions or superficial ulcerations that lead to scarring alopecia. OBJECTIVES AND METHODS We performed a multicentre retrospective clinical study including 56 patients (29 females and 27 males, mean age 62.7) with a confirmed EPDS in order to describe epidemiology, clinical findings and therapeutic choices of this disease. RESULTS Mechanical/chemical trauma was reported in 28.6%, a previous infection in 10.7%, a previous cryotherapy in 5.4% androgenetic alopecia in 48.2% and severe actinic damage in 25%. Trichoscopy showed absence of follicular ostia, tufted and broken hair, crusts, serous exudate, dilated vessels, pustules and hyperkeratosis. Histopathology revealed three different features, depending on the disease duration. The most prescribed therapy was topical steroids (62.5%), followed by the combination of topical steroids and topical tacrolimus (8.9%), systemic steroids (7.1%) and topical tacrolimus (5.4%). A reduction of inflammatory signs was observed in 28 patients (50%) treated with topical steroids and in all three patients treated with topical tacrolimus. CONCLUSION The relatively high number of patients collected allowed us to identify a better diagnostic approach, using trichoscopy and a more effective therapeutic strategy, with high-potency steroids or tacrolimus, which should be considered as first-line treatment.
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Affiliation(s)
- M Starace
- Department of Experimental, Diagnostic and Specialty Medicine - Division of Dermatology, University of Bologna, Bologna, Italy
| | - M Iorizzo
- Private Dermatology Practice - Lugano & Bellinzona, Bellinzona, Switzerland
| | - R M Trüeb
- Center for Dermatology and Hair Disease Professor Trüeb, Zürich-Wallisellen, Switzerland
| | - V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F M Camacho
- Department of Dermatology, University of Seville, Seville, Spain.,Doctor Honoris Causa from University of Cadiz, Cadiz, Spain
| | - Y Gallyamova
- State Budget Educational Institution of Additional Professional Education "Russian Medical Academy of Postgraduate Education Studies" of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - I Umbert
- Instituto de Dermatologia Ignacio Umbert (Private Research Institute), Barcelona, Spain
| | - A Lyakhovitsky
- Department of Dermatology, Sheba Medical Center, Ramat Gan, Israel
| | - S Vañó-Galván
- Department of Dermatology - Trichology Unit, Ramon y Cajal Hospital, Madrid, Spain
| | - A Goren
- Department of Dermatology, University of Rome G. Marconi, Rome, Italy
| | - A Alessandrini
- Department of Experimental, Diagnostic and Specialty Medicine - Division of Dermatology, University of Bologna, Bologna, Italy
| | - F Bruni
- Department of Experimental, Diagnostic and Specialty Medicine - Division of Dermatology, University of Bologna, Bologna, Italy
| | - B M Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine - Division of Dermatology, University of Bologna, Bologna, Italy
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19
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Starace M, Alessandrini A, Bruni F, Piraccini BM. Trachyonychia: a retrospective study of 122 patients in a period of 30 years. J Eur Acad Dermatol Venereol 2020; 34:880-884. [PMID: 31923322 DOI: 10.1111/jdv.16186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 12/17/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Trachyonychia is a nail disease characterized by longitudinal striations, ridges, fissures and/or pitting. This condition can be both idiopathic and associated with other dermatologic diseases. OBJECTIVE AND METHODS The aim of this retrospective study was to analyse the clinical features, onychoscopy, therapy efficacy and outcome of 122 patients with trachyonychia visited at the Hair Disease Outpatient Consultations of the Dermatology Unit of the Department of Experimental, Diagnostic and Specialty Medicine of the University of Bologna, from 1988 to 2018. RESULTS Opaque trachyonychia was the most observed type while shiny trachyonychia, less common, was present especially in milder cases. Pitting was the most frequently observed feature (80.3%), followed by koilonychia (45%) and hyperkeratosis (19.6%). Nail matrix longitudinal biopsy was performed for diagnosis confirmation in 29 cases, and spongiotic was the most common pattern. Topical therapy was prescribed in 109 patients while systemic treatments were reserved for severe cases (38 patients); 22 patients did not receive any treatment. A marked improvement in the appearance of the nails or even a total resolution was seen in 63 patients. CONCLUSIONS Trachyonychia can occur at any age but is more frequent in children and often associated with alopecia areata. The pathological diagnosis of trachyonychia is not mandatory as the disease has generally a benign outcome. Considering the absence of pain and the high rate of spontaneous resolution, treatment is often prescribed only for cosmetic reasons or reserved for severe cases.
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Affiliation(s)
- M Starace
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
| | - A Alessandrini
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
| | - F Bruni
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
| | - B M Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
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20
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Starace M, Guicciardi F, Alessandrini A, Baraldi C, Ravaioli GM, Bruni F, Piraccini BM. Long-standing patchy alopecia areata along the hairline, a variety of alopecia areata mimicking frontal fibrosing alopecia and other cases of hair loss: case series of 11 patients. J Eur Acad Dermatol Venereol 2019; 34:e186-e188. [PMID: 31758714 DOI: 10.1111/jdv.16105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - A Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - C Baraldi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - G M Ravaioli
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - F Bruni
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - B M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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21
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Pellacani G, Alessandrini A, Mandel VD, Martella A, Brandi N, Chester J, Piraccini BM, Starace M. Onychoscopy with red light for vascular pattern identification: a study of 33 patients. J Eur Acad Dermatol Venereol 2019; 33:2355-2361. [PMID: 31287600 DOI: 10.1111/jdv.15790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/19/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nail dermoscopy (onychoscopy) during physical examination assists in correct diagnosis. Often further magnifications are necessary for an effective differential diagnosis. With the addition of a red light to the dermoscope, important vascular features can be visualized. OBJECTIVE To describe common features observed at onychoscopy with a new device that combines the regular white light with the red light illumination, demonstrating that it is useful for diagnosis of nail disorders. METHODS We enrolled 33 consecutive patients referred to the Nail Diseases Dermatology Unit of the University of Modena and Reggio Emilia and to the Outpatient Consultation for Nail Disease of the Dermatology Unit of the University of Bologna. Patients were assessed with a standard hand-held dermoscope and at the red light dermoscope. Dermoscopic images were collected. RESULTS The new prototype was used during daily clinical practice and allowed a more accurate visualization of some details that classic onychoscopy can miss. In particular, with the help of the red light it was possible to better visualize nail lesions that were characterized by some kind of colour change or vascular alterations. CONCLUSION The new device of red light for vascular pattern onychoscopy can be a new investigation method to observe nail alterations, especially due to vascular pattern, even with low magnification, without the necessity to use higher resolutions.
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Affiliation(s)
- G Pellacani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - A Alessandrini
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - V D Mandel
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | - N Brandi
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - J Chester
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - B M Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.,Department of Experimental, Diagnostic and Specialty Medicine-Division of Dermatology, University of Bologna, Bologna, Italy
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Pileri A, Starace M, Alessandrini A, Casadei B, Zinzani P, Piraccini B. New therapies and old side‐effects in mycosis fungoides treatment: brentuximab vedotin‐induced alopecia. Br J Dermatol 2019; 180:1535-1536. [DOI: 10.1111/bjd.17533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Pileri
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
| | - M. Starace
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
| | - A. Alessandrini
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
| | - B. Casadei
- Hematology Unit Department of Experimental, Diagnostic and Speciality Medicine University of Bologna Via Massarenti 9 Bologna Italy
| | - P.L. Zinzani
- Hematology Unit Department of Experimental, Diagnostic and Speciality Medicine University of Bologna Via Massarenti 9 Bologna Italy
| | - B.M. Piraccini
- Dermatology Unit Department of Experimental Diagnostic and Speciality Medicine University of Bologna Via Massarenti 1 Bologna Italy
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Lencastre A, Iorizzo M, Caucanas M, Cunha N, Trakatelli M, Zaraa I, Henry M, Daniel R, Gregoriou S, Haneke E, Prevezas C, Salphale P, Piraccini B, Starace M, Tosti A, Richert B. Topical steroids for the treatment of retronychia. J Eur Acad Dermatol Venereol 2019; 33:e320-e322. [DOI: 10.1111/jdv.15603] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Lencastre
- Department of Dermatology Centro Hospitalar Universitário de Lisboa Central Lisbon Portugal
| | - M. Iorizzo
- Private Dermatology Practice Bellinzona Switzerland
| | | | - N. Cunha
- Department of Dermatology Centro Hospitalar Universitário de Lisboa Central Lisbon Portugal
| | - M.G. Trakatelli
- Second Department of Dermatology and Venerology Papageorgiou Hospital Aristotle University School of Medicine Thessaloniki Greece
| | - I. Zaraa
- Dermatology Department Hôpital Bichât‐Claude Bernard Paris France
| | - M. Henry
- Private Dermatology Practice Rennes France
| | - R. Daniel
- University of Mississippi Medical Center University of Alabama Birmingham AL USA
| | - S. Gregoriou
- First Department of Dermatology and Venereology University of Athens Medical School Andreas Sygros Hospital Athens Greece
| | - E. Haneke
- Department of Dermatology Inselspital University of Bern Bern Switzerland
| | - C. Prevezas
- Nail Unit Andreas Syggros University Hospital Athens Greece
| | - P. Salphale
- Department of Dermatology RIPAS Hospital Bandar Seri Begawan Brunei
| | - B.M. Piraccini
- Dermatology Department of Specialized, Experimental and Diagnostic Medicine University of Bologna Bologna Italy
| | - M. Starace
- Dermatology Department of Specialized, Experimental and Diagnostic Medicine University of Bologna Bologna Italy
| | - A. Tosti
- Department of Dermatology & Cutaneous Surgery University of Miami South Miami FL USA
| | - B. Richert
- Hôpitaux Universitaires Saint Pierre & Brugmann Hôpital Universitaire des enfants Reine‐Fabiola Université Libre de Bruxelles Bruxelles Belgium
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Starace M, Brandi N, Alessandrini A, Bruni F, Piraccini B. Frontal fibrosing alopecia: a case series of 65 patients seen in a single Italian centre. J Eur Acad Dermatol Venereol 2018; 33:433-438. [DOI: 10.1111/jdv.15372] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/29/2018] [Indexed: 12/19/2022]
Affiliation(s)
- M. Starace
- Dermatology Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - N. Brandi
- Dermatology Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - A. Alessandrini
- Dermatology Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - F. Bruni
- Dermatology Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
| | - B.M. Piraccini
- Dermatology Department of Specialized, Diagnostic and Experimental Medicine University of Bologna Bologna Italy
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25
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Russo P, Fino E, Mancini C, Mazzetti M, Starace M, Piraccini B. HrQoL in hair loss‐affected patients with alopecia areata, androgenetic alopecia and telogen effluvium: the role of personality traits and psychosocial anxiety. J Eur Acad Dermatol Venereol 2018; 33:608-611. [DOI: 10.1111/jdv.15327] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P.M. Russo
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - E. Fino
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - C. Mancini
- Dermatology Unit Sant'Orsola‐Malpighi Hospital Bologna Italy
| | - M. Mazzetti
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
| | - M. Starace
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
- Dermatology Unit Sant'Orsola‐Malpighi Hospital Bologna Italy
| | - B.M. Piraccini
- Department of Experimental, Diagnostic and Speciality Medicine (DIMES) Alma Mater Studiorum Università di Bologna Bologna Italy
- Dermatology Unit Sant'Orsola‐Malpighi Hospital Bologna Italy
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26
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Chessa MA, Alessandrini A, Starace M, Baraldi C, Dahdah M, Andre J, Richert B, Piraccini BM. Erosive lichen planus: beyond the nails. J Eur Acad Dermatol Venereol 2018; 33:e97-e99. [PMID: 30242909 DOI: 10.1111/jdv.15254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M A Chessa
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - A Alessandrini
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - C Baraldi
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Dahdah
- Department of Dermatology, American University of Beirut Medical Center, Beirut, Lebanon
| | - J Andre
- Saint Pierre, Brugmann and Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - B Richert
- Saint Pierre, Brugmann and Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium
| | - B M Piraccini
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
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Starace M, Dika E, Fanti P, Patrizi A, Misciali C, Alessandrini A, Bruni F, Piraccini B. Nail apparatus melanoma: dermoscopic and histopathologic correlations on a series of 23 patients from a single centre. J Eur Acad Dermatol Venereol 2017; 32:164-173. [DOI: 10.1111/jdv.14568] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 07/31/2017] [Indexed: 11/29/2022]
Affiliation(s)
- M. Starace
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - E. Dika
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - P.A. Fanti
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - A. Patrizi
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - C. Misciali
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - A. Alessandrini
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - F. Bruni
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - B.M. Piraccini
- Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
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28
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Manfredini M, Greco M, Farnetani F, Ciardo S, De Carvalho N, Mandel VD, Starace M, Pellacani G. Acne: morphologic and vascular study of lesions and surrounding skin by means of optical coherence tomography. J Eur Acad Dermatol Venereol 2017; 31:1541-1546. [PMID: 28556980 DOI: 10.1111/jdv.14369] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/28/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Acne vulgaris is a disease of the pilosebaceous unit, characterized by hyper-keratinization process, comedos formation and inflammatory reactions. OBJECTIVE The definition of the morphology and the vascularization of acne lesions by means of dynamic optical coherence tomography (D-OCT), to non-invasively define the alterations occurring during the acne development and patient therapeutic management. METHODS A set of standardized clinical pictures and D-OCT images were acquired from 114 acne lesions of 31 volunteers, presenting mild to moderate acne and evaluated by experts. Fifteen patients treated with oral antibiotics were followed during time at 0, 20, 40, and 60 days. RESULTS Optical coherence tomography enabled to identify vascular and morphological aspects characterizing different types of acne lesions. Oral antibiotic treatment improved the morphologic features and decreased the digitally reconstructed vascular signal during time. CONCLUSION The characterization of acne lesions and the identification of vascular pattern in acne lesions through D-OCT, corresponding to blood vessel dilation and inflammatory associated hyper-vascularization, may have important clinical consequences in the assessment of acne severity, therapeutic decisions and treatment efficacy monitoring.
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Affiliation(s)
- M Manfredini
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Greco
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - F Farnetani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Ciardo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - N De Carvalho
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - V D Mandel
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - M Starace
- Division of Dermatology, Department of Specialized, Clinical, and Experimental Medicine, University of Bologna, Bologna, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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29
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Balestri R, Rech G, Rossi E, Starace M, Malavolta N, Bardazzi F, Patrizi A, Piraccini B. Natural history of isolated nail psoriasis and its role as a risk factor for the development of psoriatic arthritis: a single-centre cross-sectional study. Br J Dermatol 2017; 176:1394-1397. [DOI: 10.1111/bjd.15026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. Balestri
- Outpatient Nail Clinic; Division of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - G. Rech
- Outpatient Nail Clinic; Division of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - E. Rossi
- Rheumatology Unit; University of Bologna; Italy
| | - M. Starace
- Outpatient Nail Clinic; Division of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Italy
| | | | - F. Bardazzi
- Outpatient Nail Clinic; Division of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - A. Patrizi
- Outpatient Nail Clinic; Division of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Italy
| | - B.M. Piraccini
- Outpatient Nail Clinic; Division of Dermatology; Department of Experimental, Diagnostic and Specialty Medicine; University of Bologna; Italy
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30
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Benati E, Ribero S, Longo C, Piana S, Puig S, Carrera C, Cicero F, Kittler H, Deinlein T, Zalaudek I, Stolz W, Scope A, Pellacani G, Moscarella E, Piraccini BM, Starace M, Argenziano G. Clinical and dermoscopic clues to differentiate pigmented nail bands: an International Dermoscopy Society study. J Eur Acad Dermatol Venereol 2016; 31:732-736. [PMID: 27696528 DOI: 10.1111/jdv.13991] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/19/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND Longitudinal melanonychia might be difficult to differentiate and the use of dermoscopy can be useful for the preoperative evaluation and management decision. OBJECTIVES The aim of our study was to investigate clinical and dermoscopic criteria of acquired longitudinal melanonychia in adults to identify the best predictors of melanoma using a multivariate analysis and to explore eventual new dermoscopic criteria for nail melanoma diagnosis. METHODS In this retrospective observational study, 82 histopathologically diagnosed, acquired nail pigmented bands were collected and examined. All variables were included in the analysis and examined as possible predictors of nail melanoma. Both univariate and multivariable analyses have been performed. RESULTS Among 82 cases, 25 were diagnosed as nail melanoma and 57 as benign lesions (including 32 melanocytic nevi and 25 benign melanocytic hyperplasia). Melanoma cases were significantly associated with a width of the pigmented band higher than 2/3 of the nail plate, grey and black colours, irregularly pigmented lines, Hutchinson and micro-Hutchinson signs, and nail dystrophy. Granular pigmentation, a newly defined dermoscopic criterion, was found in 40% of melanomas and only in 3.51% of benign lesions. CONCLUSIONS Dermoscopic examination of longitudinal melanonychia provides useful information that could help clinicians to improve melanoma recognition.
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Affiliation(s)
- E Benati
- Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - S Ribero
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - C Longo
- Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - S Piana
- Pathology Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - S Puig
- Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain.,CIBER of Rare Diseases, Instituto de Salud Carlos III, Barcelona, Spain
| | - C Carrera
- Melanoma Unit, Dermatology and Pathology Departments, Hospital Clínic Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - F Cicero
- Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria
| | - H Kittler
- Department of Dermatology, Division of General Dermatology, Medical University of Vienna, Vienna, Austria
| | - T Deinlein
- Non-Melanoma Skin Cancer Unit, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - I Zalaudek
- Non-Melanoma Skin Cancer Unit, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
| | - W Stolz
- Clinic for Dermatology, Allergology, and Environmental Medicine, Klinik Thalkirchner Straße Städt, Klinikum München GmbH, Munich, Germany
| | - A Scope
- Department of Dermatology, Sheba Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Pellacani
- Department of Dermatology, University of Modena, Reggio Emilia, Italy
| | - E Moscarella
- Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - B M Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - M Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - G Argenziano
- Dermatology Unit, Second University of Naples, Naples, Italy
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Piraccini B, Alessandrini A, Dika E, Starace M, Patrizi A, Neri I. Topical propranolol 1% cream for pyogenic granulomas of the nail: open-label study in 10 patients. J Eur Acad Dermatol Venereol 2015; 30:901-2. [DOI: 10.1111/jdv.13071] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B.M. Piraccini
- Department of Experimental; Diagnostic and Specialty Medicine- Division of Dermatology; University of Bologna; Bologna Italy
| | - A. Alessandrini
- Department of Experimental; Diagnostic and Specialty Medicine- Division of Dermatology; University of Bologna; Bologna Italy
| | - E. Dika
- Department of Experimental; Diagnostic and Specialty Medicine- Division of Dermatology; University of Bologna; Bologna Italy
| | - M. Starace
- Department of Experimental; Diagnostic and Specialty Medicine- Division of Dermatology; University of Bologna; Bologna Italy
| | - A. Patrizi
- Department of Experimental; Diagnostic and Specialty Medicine- Division of Dermatology; University of Bologna; Bologna Italy
| | - I. Neri
- Department of Experimental; Diagnostic and Specialty Medicine- Division of Dermatology; University of Bologna; Bologna Italy
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Coppola N, Sagnelli C, Pisaturo M, Minichini C, Messina V, Alessio L, Starace M, Signoriello G, Gentile I, Filippini P, Sagnelli E. Clinical and virological characteristics associated with severe acute hepatitis B. Clin Microbiol Infect 2014; 20:O991-7. [PMID: 24930916 DOI: 10.1111/1469-0691.12720] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 06/08/2014] [Accepted: 06/10/2014] [Indexed: 12/16/2022]
Abstract
To identify early predictors of a severe or fulminant course in patients with acute viral hepatitis B (AVH-B). One hundred and thirty-eight patients with symptomatic acute hepatitis B observed from 1999 to 2012 were enrolled. For each patient, the demographics, risk factors for the acquisition of hepatitis B virus (HBV) infection, clinical, biochemical and virological data (HBV DNA, HBV DNA sequences) were recorded and analysed. The HBV mutants in the polymerase region were sought in 110 (87%) patients by direct sequencing, and the rtM204V/I mutations also by an allele-specific PCR. AVH-B was severe in 13 (9.4%) of the 138 patients enrolled, fulminant in 6 (4.3%) and with a normal clinical course in 119. The 19 patients with severe or fulminant AVH-B more frequently than the 119 with a normal course stated intravenous drug use (63.2% versus 36.1%, p 0.04) and were HBV-DNA negative (31.6% versus 11.8%, p 0.03) and anti-hepatitis C virus (HCV) positive (57.9% versus 19.3%, p 0.0008); the prevalences of different HBV genotypes and of the rtM204V/I mutant were similar in these three forms of AVH-B. A multivariate logistic regression analysis identified a pre-existing HCV chronic infection as the only factor independently associated with a severe or fulminant clinical course of AVH-B (OR 4.89, 95% CI 1.5-15.94, p 0.01). A pre-existing HCV chronic infection was identified as the only factor independently associated with a severe clinical presentation of acute hepatitis B, an association most probably due to the combination of the liver lesions caused by acute hepatitis B and the pre-existing histological abnormalities related to HCV chronic infection.
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Affiliation(s)
- N Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Naples, Italy
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Coppola N, Marrone A, Pisaturo M, Starace M, Signoriello G, Gentile I, Adinolfi LE, Sagnelli E, Zampino R. Role of interleukin 28-B in the spontaneous and treatment-related clearance of HCV infection in patients with chronic HBV/HCV dual infection. Eur J Clin Microbiol Infect Dis 2014; 33:559-67. [PMID: 24081499 DOI: 10.1007/s10096-013-1985-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [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: 07/08/2013] [Accepted: 09/11/2013] [Indexed: 12/27/2022]
Abstract
The purpose of this investigation was to evaluate the role of IL28-B polymorphism in the clearance of hepatitis C virus (HCV) in chronic hepatitis B virus (HBV)/HCV coinfection during a long-term follow-up. Thirty-four consecutive patients with HBV surface antigen (HBsAg)-positive/anti-HCV-positive chronic hepatitis were retrospectively enrolled at their first liver biopsy (LB). For all patients, a documented clinical, serological and virological follow-up of at least 3 years (range 3-16 years) after LB and a sample of whole blood for genetic evaluation were available. Of the 24 patients with detectable serum HBV-DNA and HCV-RNA at their first observation, three cleared both HBV-DNA and HCV-RNA, 12 HCV-RNA and five HBV-DNA. Of the seven HBV DNA-positive/HCV RNA-negative patients at enrolment, three cleared HBV-DNA and one remained HBV DNA-positive and became HCV RNA-positive. All three HBV DNA-negative/HCV RNA-positive patients remained unchanged. Compared with the 12 patients with HCV persistence, the 15 patients who cleared HCV were younger, had lower serum alanine aminotransferase (ALT), HCV load, and histological activity index (HAI) and fibrosis score, more frequently had IL28-B CC variant, had been receiving an interferon-based treatment and less frequently cleared serum HBV-DNA. To investigate the relationship between the IL28-B variants and clearance of HCV, excluding the confounding effect of interferon-based treatment, the Mantel-Haenszel test was used, which indicated an association between HCV clearance and IL28-B variants (p = 0.009). In chronic HBV/HCV coinfection, a long-term follow-up showed a frequent spontaneous or treatment-related clearance of active replication of one or both viruses and identified the IL28-B CC genotype as an independent predictor of HCV clearance.
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Affiliation(s)
- N Coppola
- Department of Mental Health and Public Medicine, Section of Infectious Diseases, Second University of Naples, Via L. Armanni 5, 80133, Naples, Italy,
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Neri I, Piccolo V, Cocchi G, Starace M, Patrizi A, Dika E, Piraccini B. Hair in newborns and infants: clinical and dermoscopic evaluation of 45 cases. Br J Dermatol 2013; 169:896-900. [DOI: 10.1111/bjd.12459] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2013] [Indexed: 12/01/2022]
Affiliation(s)
- I. Neri
- Division of Dermatology; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - V. Piccolo
- Department of Dermatology and Venereology; Second University of Naples; Naples Italy
| | - G. Cocchi
- Department of Medical and Surgical Sciences; Neonatology and Neonatal Intensive Unit; University of Bologna; Bologna Italy
| | - M. Starace
- Division of Dermatology; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - A. Patrizi
- Division of Dermatology; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - E. Dika
- Division of Dermatology; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
| | - B.M. Piraccini
- Division of Dermatology; Department of Experimental; Diagnostic and Specialty Medicine; University of Bologna; Bologna Italy
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Piraccini B, Starace M, Alessandrini A, Guarrera M, Fiorucci MC, Lorenzi S. [Efficacy and tolerability of 5% minoxidil solution (Carexidil®) in male and female androgenetic alopecia: a 6-month open multicentric study]. GIORN ITAL DERMAT V 2011; 146:1-8. [PMID: 22189834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM The aim of the study was to evaluate efficacy and safety of 5% Carexidil solution®, applied twice a day on the scalp, on male and female androgenetic alopecia. METHODS The 6 month-study was performed in three Italian dermatological centers. Evaluation of efficacy was performed with subjective and objective methods, including operator and patient assessments, global photography and videodermoscopy. RESULTS Global photography revealed that after 6 months of treatment with 5% Carexidil solution®, androgenetic alopecia was improved in all 32 females and 16 males. Alopecia stopped to progress in 6 males. Scalp videodermoscopy confirmed the results. Some patients complained of increased hair greasiness, others complained of mild scalp itching. Two female patients developed contact sensitization to minoxidil, confirmed by patch test, 2 a mild malar-temporal hypertrichosis. All patients were satisfied by treatment and continued it after the end of the study. CONCLUSION Our study confirms the data of the literature and the evidence coming from years of clinical experience, that twice a day topical application of 5% minoxidil solution, Carexidil ®, is effective in the treatment of male and female androgenetic alopecia, with evident efficacy already after 6 months.
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Affiliation(s)
- B Piraccini
- Department of Internal Medicine, University of Bologna, Bologna, Italy.
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Abstract
BACKGROUND Distal subungual onychomycosis and traumatic onycholysis are the most common causes of toenail abnormalities, and differential diagnosis is often impossible without mycology. OBJECTIVES To identify and describe dermoscopic signs specific for distal subungual onychomycosis that could facilitate its diagnosis and differentiation from traumatic mycologically negative onycholysis and to determine the sensitivity and specificity of these dermoscopic features. METHODS We performed a retrospective study at the Outpatient Consultation for Nail Diseases of the Department of Dermatology of the University of Bologna. Dermoscopic digital images of 57 consecutive patients who underwent global photography, videodermoscopy and mycological examination for onycholysis of a single toenail between 1 December, 2010 and 30 June, 2011, were evaluated and compared. Digital dermoscopic images of onycholysis of the great toenail were evaluated for the presence of peculiar dermoscopic features. The presumptive dermoscopic diagnosis was compared with results of mycology. RESULTS Evaluation of videodermoscopic images allowed us to identify three recurring peculiar dermoscopic features, two of which were present only in distal subungual onychomycosis (jagged proximal edge with spikes of the onycholytic area and longitudinal striae) and one only in traumatic onycholysis (linear edge - without spikes - of the onycholytic area). CONCLUSIONS We found distinctive dermoscopic signs that are exclusive to distal subungual onychomycosis and to traumatic onycholysis. Detection of these signs is simple and can, in selected cases, help to avoid mycology.
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Affiliation(s)
- B M Piraccini
- Division of Dermatology, Department of Internal Medicine, Aging and Nephrological Diseases, University of Bologna, Bologna, Italy
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Savage RE, Hall T, Bresciano K, Bailey J, Starace M, Chan TCK. Development and validation of a liquid chromatography-tandem mass spectrometry method for the determination of ARQ 501 (beta-lapachone) in plasma and tumors from nu/nu mouse xenografts. J Chromatogr B Analyt Technol Biomed Life Sci 2008; 872:148-53. [PMID: 18706870 DOI: 10.1016/j.jchromb.2008.07.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2008] [Revised: 07/22/2008] [Accepted: 07/27/2008] [Indexed: 10/21/2022]
Abstract
A sensitive and specific LC-MS/MS method employing positive electrospray ionization for the determination of ARQ 501 (beta-lapachone) in (nu/nu) mouse plasma and tumor tissue is described. Samples were processed using protein precipitation with acetonitrile. A d6 analog of ARQ 501 was used as the internal standard (IS). The analytes were separated using a Zorbax SB8 column (30 mm x 2.1 mm i.d. 5 microm particle size) and analyzed in the multiple reaction monitoring (MRM) mode using mass transitions of 243>159 and 249>159 m/z for ARQ 501 and d6-ARQ 501, respectively. The lower limit of quantitation (LLOQ) for ARQ 501 was 3.0 ng/mL. The calibration curve was linear in the range of 3.0-2000 ng/mL with a correlation coefficient better than 0.99. Intra- and inter-batch precisions were within 8.4% for plasma and 11.8% for tumor samples. Accuracy expressed as percentage relative error (%R.E.) ranged from -9.0 to 7.7 for both plasma and tumor samples. Recovery was between 106 and 113% for both ARQ 501 and its d6 analog. Plasma pharmacokinetic data of ARQ 501 in mouse from intraperitoneal (IP) dosing at 60 mg/kg obtained using this validated method is presented along with tumor concentration data. The C(max), AUC(0-infinity), t(1/2), Cl/F, and V(d)/F were determined to be 4016 ng/mL, 4392 h ng/mL, 3.9 h, 13.7 L/h/kg, and 76.5 L/kg, respectively. Tumor tissue concentrations were in the range 1-2 microM for approximately 2 h post-dose.
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Affiliation(s)
- R E Savage
- Preclinical Development Department, ArQule Inc., 19 Presidential Way, Woburn, MA 01801, USA.
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Affiliation(s)
- M Starace
- Department of Dermatology, University of Bologna, Via Massarenti 1, 40138 Bologna, Italy
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Di Nicuolo G, Battisti S, La Porta R, Starace M, Gargiulo M, Viglietti R. CONFRONTO TRA DATABASE ONLINE PER LA SOTTOTIPIZZAZIONE DI SEQUENZE HVI-1. Microbiol Med 2006. [DOI: 10.4081/mm.2006.3217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Di Nicuolo G, Pagliano P, Battisti S, Starace M, Mininni V, Attanasio V, Faella F. INFEZIONI DEL SISTEMA NERVOSO CENTRALE DA TOSCANA VIRUS IN ITALIA MERIDIONALE. Microbiol Med 2005. [DOI: 10.4081/mm.2005.3465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Di Nicuolo G, Starace M, Battisti S, Pizzella T, Busto A, Glielmi G, Battaglia M. PREVALENZA DI SOTTOTIPI NON-B DI HIV-1 IN CAMPANIA. Microbiol Med 2004. [DOI: 10.4081/mm.2004.3998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Di Nicuolo G, Chirianni A, Battisti S, Starace M, Sangiovanni V, Glielmi G. DETERMINAZIONE DELLA FARMACORESISTENZA DI HIV-1 MEDIANTE ANALISI GENOTIPICA: CONFRONTO SULLA PREDITTIVITÀ DEI SAGGI INTERPRETATIVI VIROSEQ TM HIV-1 (APPLIED BIOSYSTEM), HIVSEQ (STANFORD) E VIRTUAL PHENOTYPE (VIRCONET TM). Microbiol Med 2003. [DOI: 10.4081/mm.2003.4361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Di Nicuolo G, Gargiulo M, Starace M, Punzi R, Tarro G, Esposito C, Loiacono L, Liberti A. [Plasma HIV-1 RNA viral load up to one year of follow-up in 64 patients treated with HAART]. Infez Med 2003; 7:85-89. [PMID: 12759586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
The aim of this study was to evaluate efficacy of highly active antiretroviral therapy (HAART) in 64 HIV-1 positive treatment-naive and previously treated patients, with different viral load at baseline. The HAART regimen consisted of one protease inhibitor and two reverse-transcriptase inhibitors. Plasma RNA viral load was measured by RT-PCR (Roche Amplicor Monitor kit) at enrolment and at months 3, 6, 9, and 12 of follow-up. The viral load fell below the threshold of 200 copies/ml in 46.9% of patients at month 6 and this result lasted up to month 12 of follow-up in 42.2% of patients. In these patients the CD4+ cell count increased from a baseline with a median of 194 cells/mmc at month 12. Treatment failure occurred in 35.9% of patients and the proportion was higher among previously treated patients. 7 patients stopped therapy because of poor compliance and 5 because of adverse drug effects. Also in our cases the HAART regimen showed more efficacy in treatment-naive patients, whereas baseline viral load >1x105 was the cause of less efficacy of therapy.
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Affiliation(s)
- G. Di Nicuolo
- Servizio di Virologia e 2a Divisione di Malattie Infettive, Azienda Sanitaria Ospedaliera "D. Cotugno", Napoli, Italy
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Abstract
This article provides practical advice of organising a study day. It is based on the authors' experience of organising a successful event in their own hospital.
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Affiliation(s)
- M Starace
- Neonatal Intensive Care Unit, Rosie Hospital, Addenbrookes NHS Trust, Cambridge
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