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Marino A, Baffa ME, Grandi V, Salvini C, Tinunin L, Difonzo EM, Francalanci S. Elephantiasis nostras verrucosa of a limb stump: is there room for dermoscopy? Clin Exp Dermatol 2024:llae098. [PMID: 38494783 DOI: 10.1093/ced/llae098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/27/2024] [Accepted: 03/15/2024] [Indexed: 03/19/2024]
Abstract
Elephantiasis nostras verrucosa (ENV) is a rare and dramatic sequela of chronic non-filarial lymphoedema. Here we would like to share a case of ENV appeared as a late complication of limb amputation.
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Affiliation(s)
- Andrea Marino
- Department of Health Sciences, Section of Dermatology, University of Florence
| | | | - Vieri Grandi
- Department of Health Sciences, Section of Dermatology, University of Florence
| | - Camilla Salvini
- Department of Health Sciences, Section of Dermatology, University of Florence
| | - Luca Tinunin
- Department of Health Sciences, Section of Anatomic Pathology, University of Florence
| | | | - Stefano Francalanci
- Department of Health Sciences, Section of Dermatology, University of Florence
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Maglie R, Baldi S, Nannini G, Di Gloria L, Pallecchi M, Bartolucci G, Ramazzotti M, Niccolai E, Baffa ME, Camilla B, Solimani F, Antiga E, Amedei A. Alterations of circulating free fatty acids in patients with pemphigus vulgaris. Exp Dermatol 2024; 33:e15063. [PMID: 38532568 DOI: 10.1111/exd.15063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/20/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Abstract
Free fatty acids (FFA) have gained research interest owing to their functions in both local and systemic immune regulation. Changes in the serum levels of anti-inflammatory short chain fatty acids (SCFA), primarily derived from the gut microbiota, and pro-inflammatory medium (MCFA) and long (LCFA) chain fatty acids, derived from either the gut microbiota or the diet, have been associated with autoimmunity. Circulating FFA were retrospectively analysed by a gas chromatography-mass spectrometry method in the serum of 18 patients with pemphigus vulgaris (PV) at the baseline and 6 months (n = 10) after immunosuppressive treatments, and 18 healthy controls (HC). Circulating FFA were correlated with the Pemphigus Disease Area Index (PDAI) and serum concentrations of interferon-gamma (IFN-γ), Interleukin (IL)-17A, IL-5, IL-10 and IL-21. Principal Component analysis computed on FFA abundances revealed significant differences in the profile of SCFA (p = 0,012), MCFA (p = 0.00015) and LCFA (p = 0,035) between PV patients and HC, which were not significantly changed by immunosuppressive treatments. PV patients showed a significantly lower serum concentration of propionic (p < 0.0005) and butyric (p < 0.0005) acids, SCFA with anti-inflammatory functions, while hexanoic (p < 0.0005) and hexadecanoic (p = 0.0006) acids, pro-inflammatory MCFA and LCFA respectively, were over-represented. Treatments induced a significant decrease of hexanoic (p = 0.035) and a further increase of hexadecanoic (p = 0.046) acids. Positive correlations emerged between IFN-γ and acetic acid (Rho = 0.60), IFN-γ and hexanoic acid (Rho = 0.46), IL-5 and both hexadecanoic acid (Rho = 0.50) and octadecanoic acid (Rho = 0.53), butyric acid and PDAI (Rho = 0.53). PV was associated with a remarked imbalance of circulating FFA compared to HC. The serum alterations of SCFA, MCFA, and LCFA may contribute to promoting inflammation in PV. Deeper insights into the immunomodulatory functions of these molecules may pave the way for personalized dietary interventions in PV patients.
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Affiliation(s)
- Roberto Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Simone Baldi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giulia Nannini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Leandro Di Gloria
- Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, Florence, Italy
| | - Marco Pallecchi
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - Gianluca Bartolucci
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - Matteo Ramazzotti
- Department of Neuroscience, Psychology, Drug Research and Child Health NEUROFARBA, University of Florence, Florence, Italy
| | - Elena Niccolai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maria Efenesia Baffa
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Biagioni Camilla
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Amedeo Amedei
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Interdisciplinary Internal Medicine Unit, Careggi University Hospital, Florence, Italy
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Maglie R, Baffa ME, Senatore S, Pipitò C, Caproni M, Solimani F, Antiga E. Rapid and sustained response to tralokinumab in a patient with severe bullous pemphigoid and end-stage kidney disease. Clin Exp Dermatol 2024; 49:161-163. [PMID: 37757836 DOI: 10.1093/ced/llad331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
Tralokinumab as a novel therapeutic approach for bullous pemphigoid.
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Affiliation(s)
- Roberto Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Maria Efenesia Baffa
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Stefano Senatore
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Carlo Pipitò
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Marzia Caproni
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
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Maglie R, De Almeida CV, Baffa ME, Bianchi B, Caproni M, Di Zenzo G, Li X, Hirako Y, Hashimoto T, Tusa I, Lulli M, Rovida E, Antiga E. Anti-β4 integrin autoantibodies in patients with mucous membrane pemphigoid: A retrospective analysis from a tertiary centre in Italy. J Eur Acad Dermatol Venereol 2023; 37:e249-e251. [PMID: 36166640 DOI: 10.1111/jdv.18617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/21/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Roberto Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Carolina Vieira De Almeida
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Maria Efenesia Baffa
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Beatrice Bianchi
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Marzia Caproni
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Giovanni Di Zenzo
- Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | - Xiaoguang Li
- Chronic Disease Research Center, Medical College, Dalian University, Dalian, China
| | - Yoshiaki Hirako
- Division of Biological Science, Graduate School of Science, Nagoya University, Nagoya, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Osaka Metropolitan University School of Medicine, Osaka, Japan
| | - Ignazia Tusa
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Matteo Lulli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Elisabetta Rovida
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
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Maglie R, Baffa ME, Montefusco F, Pipitò C, Senatore S, Capassoni M, Maio V, Cerinic MM, Antiga E, Guiducci S. Case Report: Bullous Pemphigoid Associated With Morphea and Lichen Sclerosus: Coincidental Diseases or Pathogenetic Association? Front Immunol 2022; 13:887279. [PMID: 35592319 PMCID: PMC9110700 DOI: 10.3389/fimmu.2022.887279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/05/2022] [Indexed: 11/23/2022] Open
Abstract
Bullous pemphigoid (BP) represents the most common autoimmune bullous disease and is characterized by IgG autoantibodies targeting collagen XVII (BP180). BP has reportedly been occurred in association with other inflammatory skin diseases. Here, we describe the unusual occurrence of BP in a female patient with a concomitant history of generalized morphea (localized scleroderma, LoS) and cutaneous and genital lichen sclerosus (LiS). The occurrence of BP was associated with elevated serum levels of anti-BP180 IgG autoantibodies, which decreased upon clinical remission. Autoimmune bullous diseases and sclerosing dermatitis are immunologically distinct entities, whose association has been rarely described. In this study, we provide a literature review on cases of BP developed in patients with either LoS or LiS. Further, we discussed immunological mechanisms which may have favored the emergence of BP in our patient.
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Affiliation(s)
- Roberto Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Maria Efenesia Baffa
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Francesca Montefusco
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Carlo Pipitò
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Stefano Senatore
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Marco Capassoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Department of Geriatric Medicine, Division of Rheumatology and Scleroderma Unit Azienda Ospedaliera Universitaria Careggi (AOUC), Florence, Italy
| | - Vincenza Maio
- Department of Health Sciences, Division of Pathological Anatomy, University of Florence, Florence, Italy
| | - Marco Matucci Cerinic
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Department of Geriatric Medicine, Division of Rheumatology and Scleroderma Unit Azienda Ospedaliera Universitaria Careggi (AOUC), Florence, Italy
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - Serena Guiducci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Department of Geriatric Medicine, Division of Rheumatology and Scleroderma Unit Azienda Ospedaliera Universitaria Careggi (AOUC), Florence, Italy
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Maglie R, Senatore S, Di Stefano G, Barzacchi M, Maio V, Montefusco F, Baffa ME, Bianchi B, Santucci M, Antiga E. Myelodysplasia cutis as the presenting sign of chronic myelomonocytic leukemia. Clin Exp Dermatol 2021; 47:773-775. [PMID: 34888907 DOI: 10.1111/ced.15055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Affiliation(s)
- R Maglie
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - S Senatore
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - G Di Stefano
- Pathology Unit, Careggi University Hospital, Florence, Italy.,Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - M Barzacchi
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - V Maio
- Pathology Unit, Careggi University Hospital, Florence, Italy.,Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - F Montefusco
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - M E Baffa
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - B Bianchi
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
| | - M Santucci
- Pathology Unit, Careggi University Hospital, Florence, Italy.,Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - E Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, Florence, Italy
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