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Orsini D, Caldarola G, Dattola A, Campione E, Bernardini N, Frascione P, De Simone C, Richetta AG, Galluzzo M, Skroza N, Assorgi C, Amore E, Falco GM, Gaeta Shumak R, Artosi F, Maretti G, Potenza C, Bianchi L, Pellacani G, Peris K, Bonifati C, Graceffa D. Efficacy and safety of tildrakizumab in elderly patients: real-world multicenter study (ESTER - study). J DERMATOL TREAT 2024; 35:2319304. [PMID: 38413097 DOI: 10.1080/09546634.2024.2319304] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Purpose of the article: Interleukin-23 inhibitors, such as tildrakizumab, have emerged as safe and effective options for the management of psoriasis. Yet their efficacy in elderly patients (aged 65 years or more), particularly in those with difficult-to-treat areas involvement, remains insufficiently explored. We conducted this real-life retrospective multicentric observational study to assess the effectiveness of tildrakizumab in elderly patients with moderate-to-severe psoriasis, with involvement of difficult-to-treat areas.Materials and methods: We enrolled forty-nine patients aged 65 years old or more (mean age 73.1 ± 6.0), all treated with tildrakizumab for at least 28 weeks. The effectiveness of tildrakizumab was assessed by Static Physician's Global Assessment of Genitalia (sPGA-G), fingernail-PGA (f-PGA), palmoplantar PGA (pp-PGA), scalp-specific PGA (sc-PGA), and Psoriasis Area and Severity Index (PASI) scores.Results: Significant improvements in PASI scores were observed within 28 weeks of treatment, with 77.5%, 60%, and 45.2% of patients achieving PASI75, PASI90, and PASI100, respectively. The mean PASI decreased significantly from baseline (13.6 ± 9.9) to 1.3 ± 1.7 at week 28. More than 90% of patients had clear sPGA-G and pp-PGA scores and over 70% had clear f-PGA and sc-PGA scores after 28 weeks.Conclusions: Our findings suggest that tildrakizumab could be a valuable option for the treatment of elderly patients, including those with difficult-to-treat areas involvement.
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Affiliation(s)
- Diego Orsini
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Giacomo Caldarola
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Annunziata Dattola
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicoletta Bernardini
- Dermatology Unit "Daniele Innocenzi" ASL LATINA, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy
| | - Pasquale Frascione
- Oncologic and Preventive Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Clara De Simone
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio G Richetta
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Marco Galluzzo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nevena Skroza
- Dermatology Unit "Daniele Innocenzi" ASL LATINA, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy
| | - Chiara Assorgi
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II Napoli Italy
| | - Emanuele Amore
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Gennaro M Falco
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Fabio Artosi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Maretti
- Dermatology Unit "Daniele Innocenzi" ASL LATINA, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy
- Department of Neurosciences, Mental Health and Sensory Organs, "Sapienza" University of Rome, Rome, Italy
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi" ASL LATINA, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giovanni Pellacani
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Claudio Bonifati
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
| | - Dario Graceffa
- Clinical Dermatology Unit, IFO-San Gallicano Dermatological Institute-IRCCS, Rome, Italy
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Bernardini N, Ambrosio L, Tolino E, Proietti I, Skroza N, Potenza C. Successful Treatment with Bimekizumab of a Psoriatic Patient Undergoing Hemodialysis: A Case Report and Review of the Literature. J Clin Med 2024; 13:2250. [PMID: 38673523 PMCID: PMC11050806 DOI: 10.3390/jcm13082250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objectives: Treating psoriasis patients requires the consideration of potential underlying complications like latent viral infections and chronic kidney disease, which may influence therapy selection. Case presentation: A patient with end-stage kidney disease (ESKD) undergoing hemodialysis (HD) was successfully treated with bimekizumab, an IgG1 humanized monoclonal antibody inhibiting interleukin (IL)-17A and IL-17F. This case appears to be the first documented instance of effective anti-IL-17A/IL-17F antibody treatment in a psoriasis patient undergoing HD, with a sustained positive response for eight months. Discussion: Studies indicate the comparable pharmacokinetics, efficacy, and safety of certain psoriasis drugs in patients with chronic kidney disease (CKD) and those with normal renal function. The positive clinical outcome observed following treatment with bimekizumab aligns with the existing literature on this topic. However, further studies are needed to objectively evaluate the pharmacokinetics, efficacy, and safety of this drug in this specific setting. Conclusions: This documented case represents the first known use of bimekizumab to treat psoriasis in patients undergoing dialysis, suggesting its potential effectiveness and safety in this population.
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Affiliation(s)
- Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, “Sapienza” University of Rome, Polo Pontino, 04100 Latina, Italy; (N.B.); (E.T.); (I.P.); (N.S.); (C.P.)
| | - Luca Ambrosio
- Dermatology Unit, Department of Clinical Internal Anesthesiologic Cardiovascular Sciences, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, “Sapienza” University of Rome, Polo Pontino, 04100 Latina, Italy; (N.B.); (E.T.); (I.P.); (N.S.); (C.P.)
| | - Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, “Sapienza” University of Rome, Polo Pontino, 04100 Latina, Italy; (N.B.); (E.T.); (I.P.); (N.S.); (C.P.)
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, “Sapienza” University of Rome, Polo Pontino, 04100 Latina, Italy; (N.B.); (E.T.); (I.P.); (N.S.); (C.P.)
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, “Sapienza” University of Rome, Polo Pontino, 04100 Latina, Italy; (N.B.); (E.T.); (I.P.); (N.S.); (C.P.)
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Proietti I, Battilotti C, Svara F, Tolino E, Bernardini N, Skroza N, Filippi L, Potenza C. 18F-FDG PET-CT Scans in Oncology Patients Treated with Hyaluronic Acid Filler: Not Always a Pitfall. Case Rep Oncol Med 2024; 2024:5559093. [PMID: 38572350 PMCID: PMC10990642 DOI: 10.1155/2024/5559093] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/09/2024] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
The use of hyaluronic acid (HA) fillers in oncology patients undergoing PET-CT scans is a topic of debate due to potential interference with imaging accuracy. A 54-year-old female, postmelanoma metastasectomy in the parotid region with subsequent facial nerve palsy (FNP), received HA filler injections for facial symmetry and functional restoration. Follow-up PET-CT scans showed no interference or artifacts attributable to HA injection, allowing for accurate imaging results. This case suggests that HA fillers administered in oncology patients may not universally pose challenges or disrupt PET-CT imaging interpretation. Due to the possible false positives induced by fillers, the inclusion of aesthetic treatments in patients' anamnesis is a crucial step to accurately interpret PET-CT images. Although maintaining high level of caution in interpreting PET-CT results after filler injection is essential, our case emphasizes the safety of this procedure in oncology patients undergoing follow-up PET-CT scans.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
| | - Chiara Battilotti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
| | - Francesca Svara
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
| | - Ersilia Tolino
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
| | - Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
| | - Luca Filippi
- Nuclear Medicine Unit, Department of Oncohaematology, Fondazione PTV Policlinico Tor Vergata University Hospital, Viale Oxford 81, 00133 Rome, Italy
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy
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Proietti I, Svara F, Battilotti C, Tolino E, Bernardini N, Skroza N, Potenza C. Extreme makeover filler edition: Non-surgical correction for facial deformities post-trauma. J Cosmet Dermatol 2024. [PMID: 38456485 DOI: 10.1111/jocd.16252] [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: 12/10/2023] [Revised: 01/23/2024] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Ilaria Proietti
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Francesca Svara
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Chiara Battilotti
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Ersilia Tolino
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | | | - Nevena Skroza
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
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Mira NP, Marshall R, Pinheiro MJF, Dieckmann R, Dahouk SA, Skroza N, Rudnicka K, Lund PA, De Biase D. On the potential role of naturally occurring carboxylic organic acids as anti-infective agents: opportunities and challenges. Int J Infect Dis 2024; 140:119-123. [PMID: 38325748 DOI: 10.1016/j.ijid.2024.01.011] [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: 10/26/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
Carboxylic organic acids are intermediates of central carbon metabolic pathways (e.g. acetic, propionic, citric, and lactic acid) long known to have potent antimicrobial potential, mainly at acidic pHs. The food industry has been leveraging those properties for years, using many of these acids as preservatives to inhibit the growth of pathogenic and/or spoilage fungal and bacterial species. A few of these molecules (the most prominent being acetic acid) have been used as antiseptics since Hippocratic medicine, mainly to treat infected wounds in patients with burns. With the growth of antibiotic therapy, the use of carboxylic acids (and other chemical antiseptics) in clinical settings lost relevance; however, with the continuous emergence of multi-antibiotic/antifungal resistant strains, the search for alternatives has intensified. This prospective article raises awareness of the potential of carboxylic acids to control infections in clinical settings, considering not only their previous exploitation in this context (which we overview) but also the positive experience of their safe use in food preservation. At a time of great concern with antimicrobial resistance and the slow arrival of new antimicrobial therapeutics to the market, further exploration of organic acids as anti-infective molecules may pave the way to more sustainable prophylactic and therapeutic approaches.
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Affiliation(s)
- Nuno Pereira Mira
- iBB, Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal; Associate Laboratory i4HB-Institute for Health and Bioeconomy at Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal.
| | - Robert Marshall
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Birmingham, United Kingdom
| | - Maria Joana F Pinheiro
- iBB, Institute for Bioengineering and Biosciences, Department of Bioengineering, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal; Associate Laboratory i4HB-Institute for Health and Bioeconomy at Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Ralf Dieckmann
- German Federal Institute for Risk Assessment, Department of Biological Safety, Berlin, Germany
| | - Sascha Al Dahouk
- German Federal Institute for Risk Assessment, Department of Biological Safety, Berlin, Germany
| | - Nevena Skroza
- Unit of Dermatology, Department of Medico-Surgical Science and Biotechnologies, Sapienza University of Rome, A. Fiorini Hospital, Latina, Italy
| | - Karolina Rudnicka
- Department of Immunology and Infectious Biology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Peter A Lund
- Associate Laboratory i4HB-Institute for Health and Bioeconomy at Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Daniela De Biase
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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Proietti I, Filippi L, Tolino E, Bernardini N, Svara F, Trovato F, Di Cristofano C, Petrozza V, Bagni O, Vizzaccaro A, Skroza N, Potenza C. Supraorbital Basosquamous Carcinoma Treated with Cemiplimab Followed by Sonidegib: A Case Report and Review of the Literature. Biomedicines 2023; 11:2903. [PMID: 38001904 PMCID: PMC10669660 DOI: 10.3390/biomedicines11112903] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023] Open
Abstract
Basal cell carcinoma (BCC) is a skin cancer with low local aggressiveness and a low tendency to metastasize. Basosquamous Carcinoma (BSC) represents an aggressive histological subtype of BCC with intermediate features between Squamous Cell Carcinoma (SCC) and BCC. Cemiplimab is currently approved as first-line therapy in SCC and second-line therapy in BCC patients who have progressed on or are intolerant of a Hedgehog pathway Inhibitor (HHI). Our study describes the case of a 59-year-old man with BSC who was successfully treated with 5 cycles of Cemiplimab as first-line therapy and Sonidegib as second-line therapy. Currently, the efficacy of Cemiplimab against BSC and other histopathological subtypes of BCC has not been fully elucidated, as has the role of sequential or combination therapy with Cemiplimab and HHI in the management of BSC. The aim of this case report is to highlight the need to outline the use of checkpoint inhibitors in BCCs and focus attention on the synergistic role of Cemiplimab and HHIs in such a controversial entity as BSC.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Luca Filippi
- Nuclear Medicine Unit, Department of Oncohaematology, Fondazione PTV Policlinico Tor Vergata University Hospitale, Viale Oxfors 81, 00133 Rome, Italy;
| | - Ersilia Tolino
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Francesca Svara
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Federica Trovato
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Claudio Di Cristofano
- Pathology Unit, Department of Medical-Surgical Sciences and Biotechnologies, ICOT Hospital, Sapienza University of Rome, 04100 Latina, Italy; (C.D.C.); (V.P.)
| | - Vincenzo Petrozza
- Pathology Unit, Department of Medical-Surgical Sciences and Biotechnologies, ICOT Hospital, Sapienza University of Rome, 04100 Latina, Italy; (C.D.C.); (V.P.)
| | - Oreste Bagni
- Department of Nuclear Medicine, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy;
| | - Andrea Vizzaccaro
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (E.T.); (N.B.); (F.S.); (F.T.); (A.V.); (N.S.); (C.P.)
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Proietti I, Tolino E, Bernardini N, Di Fraia M, Skroza N, Potenza C. Efficacy of Cemiplimab in a Patient Affected by Cutaneous Squamous Cell Carcinoma and Myelodysplastic Syndrome. Dermatol Pract Concept 2023; 13:e2023178. [PMID: 37557104 PMCID: PMC10412024 DOI: 10.5826/dpc.1303a178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Ilaria Proietti
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Italy
| | - Ersilia Tolino
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Italy
| | - Nicoletta Bernardini
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Italy
| | - Marco Di Fraia
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Italy
| | - Nevena Skroza
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Italy
| | - Concetta Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Polo Pontino, Sapienza University of Rome, Italy
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Tolino E, Skroza N, Del Giudice E, Maddalena P, Bernardini N, Proietti I, Mambrin A, Marraffa F, Rossi G, Lubrano R, Potenza C. A Case of Psoriatic Disease and Hidradenitis Suppurativa in a Child with Chromosome 17q21.31 Microduplication Syndrome. Children (Basel) 2023; 10:931. [PMID: 37371163 DOI: 10.3390/children10060931] [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] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/02/2023] [Accepted: 04/27/2023] [Indexed: 06/29/2023]
Abstract
Psoriatic disease is a chronic, relapsing inflammatory disorder, characterized mostly by cutaneous erythematous scaly plaques sometimes associated with arthritis. Hidradenitis suppurativa (HS) is a chronic relapsing inflammatory disease of the apocrine glands, characterized clinically by painful abscesses, sinus tracts and scars. It typically occurs after puberty, affecting mainly intertriginous areas of the body. There is a strong association between HS and psoriasis since they share the same pathogenic inflammatory pathway. The patient presented: low birthweight, microcephaly, facial dysmorphisms, lumbar hyperlordosis, walking difficulties, global psychomotor developmental delay and learning disabilities. A genetic evaluation revealed a 2.5 Mb de novo microduplication in the 17q21.31 chromosomal region. Dermatological examination revealed HS (Hurley stage II-HS) distributed in the genital area and inguinal folds, psoriatic plaques on the retroauricolar folds, on the elbows bilaterally and on the lateral aspect of the right ankle and psoriatic arthritis. The patient was treated with adalimumab, with a marked improvement of both conditions. To our best knowledge, we report the first case of coexisting Psoriatic Arthritis Disease and Hidradenitis Suppurativa in a child with chromosome 17q21.31 microduplication syndrome. We hypothesize that gene CRHR1 duplication included in the 17q21.31 chromosomal region might be involved in the pathogenesis of both diseases.
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Affiliation(s)
- Ersilia Tolino
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Nevena Skroza
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Emanuela Del Giudice
- Maternal and Child Health Department, Santa Maria Goretti Hospital, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Patrizia Maddalena
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Nicoletta Bernardini
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Ilaria Proietti
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Alessandra Mambrin
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Federica Marraffa
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Giovanni Rossi
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
| | - Riccardo Lubrano
- Maternal and Child Health Department, Santa Maria Goretti Hospital, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy
| | - Concetta Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Via Firenze, 1, 04019 Terracina, Italy
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9
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Fargnoli MC, Bardazzi F, Bianchi L, Dapavo P, Fabbrocini G, Gisondi P, Micali G, Offidani AM, Pellacani G, Skroza N, Angileri RG, Burlando M, Campanati A, Carrera CG, Chiricozzi A, Conti A, Simone CD, Di Lernia V, Errichetti E, Galluzzo M, Guarneri C, Lasagni C, Lembo S, Loconsole F, Megna M, Musumeci ML, Prignano F, Richetta AG, Trovato E, Venturini M, Peris K, Pinton PC. Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: An Expert Delphi Consensus Statement. J Clin Med 2023; 12:jcm12103545. [PMID: 37240650 DOI: 10.3390/jcm12103545] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = "strongly disagree" to 5 = "strongly agree") using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form "main principles" and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis.
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Affiliation(s)
- Maria Concetta Fargnoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
- Dermatology Unit, Ospedale San Salvatore, 67100 L'Aquila, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, 40126 Bologna, Italy
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
- Dermatology Unit, Azienda Ospedaliera Universitaria "Policlinico Tor Vergata", 00133 Rome, Italy
| | - Paolo Dapavo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical, Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37129 Verona, Italy
| | - Giuseppe Micali
- Department of Dermatology, University of Catania, 95123 Catania, Italy
| | - Anna Maria Offidani
- Department of Clinical and Molecular Sciences, Dermatology Unit, Polytechnic Marche University, 60121 Ancona, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza Medical School, Sapienza University of Rome, 00185 Rome, Italy
| | - Nevena Skroza
- Dermatology Unit "D. Innocenzi", Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome-Polo Pontino, 04100 Latina, Italy
| | | | - Martina Burlando
- Clinica Dermatologica, DissaL, Ospedale Policlinico San Martino-IRCCS, 16132 Genova, Italy
| | - Anna Campanati
- Department of Clinical and Molecular Sciences, Dermatology Clinic, Polytechnic Marche University, 60121 Ancona, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Department of Internal Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Andrea Chiricozzi
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Andrea Conti
- Dermatologic Unit, Department of Surgery, Infermi Hospital, AUSL Romagna, 47923 Rimini, Italy
| | - Clara De Simone
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
| | - Vito Di Lernia
- Dermatology Unit, Arcispedale S. Maria Nuova, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Enzo Errichetti
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), University of Udine, 33100 Udine, Italy
| | - Marco Galluzzo
- Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy
- Dermatology Unit, Azienda Ospedaliera Universitaria "Policlinico Tor Vergata", 00133 Rome, Italy
| | - Claudio Guarneri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
| | - Claudia Lasagni
- Clinica Dermatologica, Dipartimento delle Medicine Specialistiche AOU Policlinico di Modena, 41121 Modena, Italy
| | - Serena Lembo
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, 84084 Fisciano, Italy
| | - Francesco Loconsole
- Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, 70121 Bari, Italy
- Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, 70124 Bari, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical, Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | | | - Francesca Prignano
- Department of Health Sciences, Section of Dermatology, University of Florence, 50125 Florence, Italy
| | - Antonio Giovanni Richetta
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Trovato
- Section of Dermatology, Department of Medical, Surgical and Neurological Science, S. Maria alle Scotte Hospital, University of Siena, 53100 Siena, Italy
| | - Marina Venturini
- Dermatology Department, University of Brescia, 25121 Brescia, Italy
| | - Ketty Peris
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli-IRCCS, 00168 Rome, Italy
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10
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Bianchi L, Caldarola G, Campione E, Dattola A, DE Simone C, Pellacani G, Richetta AG, Skroza N. A multidisciplinary approach for patients with moderate-to-severe psoriasis: an advisable network of management. Ital J Dermatol Venerol 2023:S2784-8671.23.07559-X. [PMID: 37162246 DOI: 10.23736/s2784-8671.23.07559-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Luca Bianchi
- Unit of Dermatology, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Giacomo Caldarola
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Elena Campione
- Unit of Dermatology, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Annunziata Dattola
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy -
| | - Clara DE Simone
- Unit of Dermatology, Department of Medical and Surgical Sciences, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy
- Unit of Dermatology, Department of Translational Medicine and Surgery, Sacred Heart Catholic University, Rome, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, Rome, Italy
| | - Antonio G Richetta
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
| | - Nevena Skroza
- Daniele Innocenzi Dermatology Unit, Department of Medical-Surgical Sciences and Biotechnologies, Fiorini Hospital, Sapienza University, Latina, Italy
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11
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van Straalen KR, Tzellos T, Alavi A, Benhadou F, Cuenca-Barrales C, Daxhelet M, Daoud M, Efthymiou O, Giamarellos-Bourboulis EJ, Guillem P, Gulliver W, Jemec GBE, Katoulis A, Koenig A, Lazaridou E, Lowes MA, Marzano AV, Matusiak Ł, Molina-Leyva A, Moltrasio C, Pinter A, Potenza C, Prens EP, Romaní J, Saunte DML, Sayed CJ, Skroza N, Stergianou D, Szepietowski JC, Trigoni A, Vilarrasa E, Kyrgidis A, Zouboulis CC, van der Zee HH. External validation of the IHS4-55 in a European antibiotic-treated HS cohort. Dermatology 2023:000528968. [PMID: 36630943 DOI: 10.1159/000528968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/09/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Previously, a new dichotomous outcome was developed, calculated as 55% reduction in the International Hidradenitis Suppurativa 4 score (IHS4-55). It was validated in datasets of adalimumab and placebo treated HS patients. External validation is an important aspect of clinical outcomes. OBJECTIVES We aimed to externally validate the novel dichotomous IHS4-55 in a non-biologic treated dataset of HS patients. METHODS Data from a previously published European-wide prospective clinical study of antibiotic treatment of HS patients was used to assess the association of IHS4-55 achievement with individual reduction in inflammatory nodules, abscesses and draining tunnels. Moreover, the associations between IHS4-55 positivity and achievement of the minimal clinically important differences (MCID) for Dermatology Life Quality Index (DLQI), numerical rating scale (NRS) Pain, and NRS Pruritus were analyzed. RESULTS Data was obtained from 283 individual patients, of which 36.4% (103/283) were treated with clindamycin and rifampicin and 63.6% (180/283) with tetracyclines for 12 weeks. Achievers of the IHS4-55 demonstrated a significant reduction the counts of inflammatory nodules, abscesses, and draining tunnels (all p<0.001). Additionally, IHS4-55 achievers had an odds ratio (OR) for achieving the minimal clinically important difference (MCID) of DLQI, NRS Pain and NRS Pruritus of 2.16 (95% CI 1.28-3.65, p<0.01), 1.79 (95% CI 1.10-2.91, p<0.05), and 1.95 (95% CI 1.18-3.22, p<0.01), respectively. CONCLUSIONS This study shows the external validity of the novel IHS4-55 by demonstrating a significant association between IHS4-55 achievement and a reduction in inflammatory lesion counts as well as achievement of MCIDs for DLQI, NRS Pain and NRS Pruritus in an antibiotic-treated cohort. These findings support the use of the IHS4-55 as a novel primary outcome measure in clinical trials.
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12
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Galluzzo M, Talamonti M, Bernardini N, Chiricozzi A, De Simone C, Bonifati C, Bruni P, Diotallevi F, Esposito M, Graceffa D, Hansel K, Loconsole F, Moretta G, Mugheddu C, Papini M, Richetta A, Skroza N, Atzori L, Fargnoli MC, Persechino S, Offidani A, Stingeni L, Peris K, Potenza C, Bianchi L. Real-world outcomes in patients with moderate-to-severe plaque psoriasis treated with guselkumab for up to 1 year. Expert Opin Biol Ther 2022; 22:1585-1592. [PMID: 35708257 DOI: 10.1080/14712598.2022.2090835] [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: 01/25/2023]
Abstract
BACKGROUND Real-world data on guselkumab, especially at times >6 months, are limited. RESEARCH DESIGN AND METHODS We performed a longitudinal, retrospective analysis on 307 patients with moderate-severe chronic plaque psoriasis (Psoriasis Area Severity Index [PASI] >10) treated with guselkumab for up to 12 months. MAIN OUTCOME MEASURES PASI 75, PASI 90, and PASI 100 were assessed at baseline and at 4, 12, 20, 28, 36, 44, and 52 weeks. RESULTS At 12 weeks, PASI 75, PASI 90, and PASI 100 were achieved in 56.4%, 33.6%, and 24.1% of patients, respectively. At 52 weeks, PASI 75, PASI 90, and PASI 100 were achieved in 82.7%, 68.7%, and 51.1% of patients, respectively. Patients without comorbidities and those naïve to previous biological therapy had better responses. The mean Dermatology Life Quality Index score decreased from 14.0 at baseline to 3.1 at 12 weeks and 1.6 at 6 months, which was maintained at later times. Similar improvements were seen in pruritus visual analog scale. CONCLUSIONS Guselkumab maintains its efficacy for up to 12 months among responders in a real-world cohort of patients with moderate-severe plaque psoriasis, confirming data from prior real-world studies with smaller cohorts and shorter duration of follow-up.
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Affiliation(s)
- Marco Galluzzo
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | - Marina Talamonti
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
| | | | - Andrea Chiricozzi
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Clara De Simone
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Claudio Bonifati
- Dermatology Unit, San Gallicano Dermatological Institute - IRCCS, Roma, Italy
| | - Pierluigi Bruni
- Dermatology University of Perugia, Terni Hospital, Terni Italy
| | - Federico Diotallevi
- Dermatology Unit, Dept. of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Maria Esposito
- Dermatology, Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Dario Graceffa
- Dermatology Unit, San Gallicano Dermatological Institute - IRCCS, Roma, Italy
| | - Katharina Hansel
- Dermatology Section, Department of Dermatology and Venereology, University of Perugia, Perugia, Italy
| | - Francesco Loconsole
- Dermatology clinic, University hospital "Policlinico universitario di Bari", Bari, Italy
| | | | | | - Manuela Papini
- Dermatology University of Perugia, Terni Hospital, Terni Italy
| | - Antonio Richetta
- Dermatology, Sapienza University of Rome - Umberto I Hospital, Rome, Italy
| | - Nevena Skroza
- Dermatology, Sapienza University of Rome - Polo Pontino, Rome, Italy
| | - Laura Atzori
- Dermatology, University of Cagliari, Cagliari, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Severino Persechino
- Department of Neuroscienze Salute Mentale e Organi di Senso (NESMOS), Sapienza University of Rome, Rome, Italy
| | - Annamaria Offidani
- Dermatology Unit, Dept. of Clinical and Molecular Sciences, Polytechnic Marche University, Ancona, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Dermatology and Venereology, University of Perugia, Perugia, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Concetta Potenza
- Dermatology, Sapienza University of Rome - Polo Pontino, Rome, Italy
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,Dermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, Italy
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13
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Bernardini N, Skroza N, Rossi G, Mambrin A, Tolino E, Marraffa F, Caviglia M, Guardo AD, Volpe S, Proietti I, Potenza C. Long term efficacy, safety, and tolerability of tildrakizumab in epileptic patient with psoriasis and eczema. Dermatol Reports 2022; 14:9447. [PMID: 36483227 PMCID: PMC9724640 DOI: 10.4081/dr.2022.9447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 09/16/2022] [Indexed: 01/21/2023] Open
Abstract
Psoriasis is a chronic inflammatory disease which mostly affects skin. Tildrakizumab is a specific anti-interleukin -23p19 monoclonal antibody approved for the treatment of plaque psoriasis in adults. Herein, we report about a patient who came to our attention for a moderate-to-severe plaque psoriasis, involving primarily upper limbs, elbow, abdomen and knees (PASI 18 - DLQI 22). His medical history was relevant for epilepsy controlled pharmacologically. In addition, an eczematous and edematous appearance of the tibial area was detected; the histologic findings did not contradict the diagnostic hypothesis of subacute spongiotic dermatitis. The patient was treated with Tildrakizumab. After 12 weeks the clinical lesions improved significantly, and the eczematous component disappeared in the tibial area bilaterally. The clinical improvement was maintained even after one year of therapy. Tildrakizumab showed excellent results in the control of psoriasis, with an excellent safety profile. The promising results of clinical trials have been confirmed in a real-life setting. There are no reports about its safety in epileptic patients. In our case, neurological adverse events did not verify and tildrakizumab managed to control both the psoriatic and eczematous components.
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Affiliation(s)
- Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019, Terracina (LT), Italy. +39.0773.708811.
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14
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Proietti I, Santoro PE, Skroza N, Tieghi T, Bernardini N, Tolino E, Dybala AE, Di Guardo A, Rallo A, Di Fraia M, Rossi MF, Vitiello M, Moscato U, Pellacani G, Lichtner M, Potenza C. A Case Report of Monkeypox in an Adult Patient from Italy: Clinical and Dermoscopic Manifestations, Diagnosis and Management. Vaccines (Basel) 2022; 10:1903. [PMID: 36366410 PMCID: PMC9694441 DOI: 10.3390/vaccines10111903] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/27/2022] [Accepted: 11/07/2022] [Indexed: 01/16/2024] Open
Abstract
Monkeypox infection is an emerging problem and a new challenge for modern medicine. With an increasing number of new cases worldwide, new data regarding the clinical manifestations, characteristics of the patients, risk factors and treatment options are coming to light. Knowing more about the disease will allow to elaborate new helpful methods to facilitate its diagnosis. Special attention should be paid to the careful dermatologic and dermoscopic examination of the patient. The analysis of available data also suggests possible strategies for the prevention of Monkeypox virus spread; the vaccine against Smallpox seems to be an effective solution. This case report describes the diagnostic approach and management of a non-vaccinated adult patient with several risk factors and a history of sexually transmitted disease. The patient had no history of travel abroad. Even though a clinical diagnose of Monkeypox can be challenging due to its similarities with skin rashes caused by other Orthopoxviral infections, there are fine differences between the rashes which can be helpful in their differentiation, although laboratory analysis is required for a definitive identification. A careful study of the characteristics of the rash, such as diameter, its presence on palms and soles and its evolution in time, provided important clues for the diagnosis of Monkeypox infection. The lack of vaccinations in the history of the patient was another crucial finding in the diagnostic process.
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Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Paolo Emilio Santoro
- Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Tiziana Tieghi
- Department of Neurosciences Public Health and Organs of Sense, Infectious Diseases Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Agnieszka Ewa Dybala
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Antonio Di Guardo
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Alessandra Rallo
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Marco Di Fraia
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Maria Francesca Rossi
- Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
| | - Martina Vitiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
| | - Umberto Moscato
- Department of Health Science and Public Health, Catholic University of the Sacred Heart, 00168 Roma, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy
| | - Miriam Lichtner
- Department of Neurosciences Public Health and Organs of Sense, Infectious Diseases Unit, Sapienza University of Rome, Santa Maria Goretti Hospital, 04100 Latina, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, Fiorini Hospital, 04019 Terracina, Italy
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15
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Bernardini N, Skroza N, Prevete E, Marraffa F, Proietti I, Tolino E, Mambrin A, Rossi G, Volpe S, Bersani G, Potenza C. Guselkumab for the treatment of severe plaque psoriasis in a schizophrenia patient: a case report. Dermatol Reports 2022; 14:9476. [DOI: 10.4081/dr.2022.9476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/26/2022] [Indexed: 11/22/2022] Open
Abstract
A wide range of comorbid conditions are associated with psoriasis, many studies have drawn attention to a higher prevalence of psychiatric comorbidities in psoriatic population. Herein, we present a case of a Caucasian 44-years-old man suffering from a severe schizophrenia, who received guselkumab (a human monoclonal antibody targeting the p40 subunit of IL-23) for the treatment of a moderate-to-severe plaque type psoriasis. After 3 months, the patient reached complete resolution of psoriasis without any side effects, maintained at 6 months follow up visit. Some studies have highlighted the hypothesis that an hyperactivation of immune response appears to be one of the main mechanisms underlying the increased risk of this association. In particular, the axis il-17/il-23 plays a central role in the pathogenesis of this disease. Further research will be needed to assess whether anti-IL23 drugs could be a more suitable therapeutic option in psoriatic patients with schizophrenia.
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16
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Proietti I, Bernardini N, Skroza N, Mambrin A, Tolino E, Marchesiello A, Marraffa F, Rossi G, Volpe S, Potenza C. PSSD and biologic therapy: Real-life data in 417 patients with moderate to severe psoriasis. Rev Recent Clin Trials 2022; 17:RRCT-EPUB-124763. [PMID: 35747967 DOI: 10.2174/1574887117666220623161751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/16/2022] [Accepted: 04/06/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Psoriasis is a chronic relapsing immune-mediated disease leading to a strong impact on patient's quality of life. The treatment of psoriasis has undergone a revolution with the advent of biologic therapies. Currently, Psoriasis Area and Severity Index [PASI] and Dermatology Life Quality Index [DLQI] scores are in use to assess the overall severity of pathology. A new self- administered questionnaire, the Psoriasis Symptoms and Signs Diary (PSSD), assesses severity of six psoriasis symptoms (itch, skin tightness, burning, stinging, and pain,) and five signs (dryness, cracking, scaling, shedding/flaking, redness, and bleeding). OBJECTIVE To evaluate and compare the efficacy of biologic therapies through PSSD in patients with moderate to severe psoriasis Methods: The PSSD questionnaire was administered to all the patients at the beginning and after 6 months of biologic therapy (anti-TNFalpha, anti- IL17, anti-IL23, anti-IL12/23 and phhosphodiesterase-4 Inhibitors). RESULTS The study population included 417 adult patients with moderate to severe psoriasis in treatment with biologic drugs. All the drugs contributed to a significant improvement of mean total PSSD at t 24; anti-IL17 and anti-IL23 led to a significantly greater reduction at t 24 mean PSSD when compared to other therapies. CONCLUSION The PSSD, is a new validated instrument useful for capturing psoriasis patient's quality of life and evaluating treatments efficacy. In our study this score has been useful to put in evidence significant differences between biologic drugs.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Nicoletta Bernardini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Nevena Skroza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Alessandra Mambrin
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Ersilia Tolino
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Anna Marchesiello
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Federica Marraffa
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Giovanni Rossi
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Salvatore Volpe
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Concetta Potenza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
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17
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Proietti I, Skroza N, Michelini S, Mambrin A, Anzalone A, Colapietra D, Volpe S, Tolino E, Marchesiello A, Balduzzi V, Maddalena P, Bernardini N, Porta N, Veccia N, Petrozza V, Potenza C. A case of proliferative nodule arising within blue nevus. Clin Ter 2022; 173:214-216. [PMID: 35612332 DOI: 10.7417/ct.2022.2420] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Blue nevi are a heterogeneous group of lesions that can display a variety of different clinicopathological characteristics. Although attempts are made to classify each lesion into defined subtypes, there can be overlap between the subtypes. The clinical , dermoscopic and histolopathologic features of a case of proliferative nodule arising within blue nevus is discussed. Running title: Blue nevi are an heterogeneous group of melanocytic lesions blue tinctorial properties. Proliferative nodules are rare benign lesions often present at birth as a component of a large congenital melanocytic nevi, congenital or acquired nevi. We first report a case of proliferative nodule arising within blue nevus.
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Affiliation(s)
- I Proietti
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - N Skroza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - S Michelini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Mambrin
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Anzalone
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - D Colapietra
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - S Volpe
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - E Tolino
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Marchesiello
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - V Balduzzi
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - P Maddalena
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - N Bernardini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - N Porta
- Pathological Unit, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino I.C.O.T. Hospital, Latina, Italy
| | - N Veccia
- Pathological Unit, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino I.C.O.T. Hospital, Latina, Italy
| | - V Petrozza
- Pathological Unit, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino I.C.O.T. Hospital, Latina, Italy
| | - C Potenza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
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18
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Bernardini N, Skroza N, Tolino E, Marchesiello A, Mambrin A, Balduzzi V, Michelini S, Maddalena P, Volpe S, Proietti I, Potenza C. HIV positive patient treated with ixekizumab. Clin Ter 2022; 173:195-197. [PMID: 35612328 DOI: 10.7417/ct.2022.2416] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Psoriasis is a immune-mediated, chronic, inflammatory skin dis-ease. In HIV positive (HIV+) patients we usually observe more serious clinical features and recalcitrant course. Furthermore, therapeutic man-agement of HIV+ patient is complex and requires collaboration with the infectious disease specialist. We report the case of a patient affected by severe psoriasis who contracted HIV infection during biological therapy and, subsequently, succesfully treated with ixekizumab.
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Affiliation(s)
- N Bernardini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - N Skroza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - E Tolino
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Marchesiello
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Mambrin
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - V Balduzzi
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - S Michelini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - P Maddalena
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - S Volpe
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - I Proietti
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - C Potenza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
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19
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Šola M, Skroza N, Mangino G, Škrtić A, Seiwerth S, Sikirić P. Do We Have a New Psoriasis Drug? FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r5345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marija Šola
- Department of Dermatology and VenereologyUniversity Hospital OsijekOsijek
- University Hospital OsijekOsijek
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20
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Bernardini N, Skroza N, Marraffa F, Prevete E, Mambrin A, Proietti I, Tolino E, Caviglia M, Guardo AD, Rossi G, Volpe S, Bersani G, Potenza C. A case of Twins affected by Psoriasis, Psoriatic Arthritis and Autism: Five years of efficacious and safe treatment with Secukinumab. Dermatol Ther 2022; 35:e15533. [PMID: 35460156 PMCID: PMC9539526 DOI: 10.1111/dth.15533] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Nicoletta Bernardini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Nevena Skroza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Federica Marraffa
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Elisabeth Prevete
- Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy
| | - Alessandra Mambrin
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Ilaria Proietti
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Ersilia Tolino
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Martina Caviglia
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Antonio Di Guardo
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Giovanni Rossi
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Salvatore Volpe
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
| | - Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, Latina, Italy
| | - Concetta Potenza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Italy
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21
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Proietti I, Borrelli I, Skroza N, Santoro PE, Gualano MR, Bernardini N, Mambrin A, Tolino E, Marchesiello A, Marraffa F, Michelini S, Rossi G, Volpe S, Ricciardi W, Moscato U, Potenza C. Adverse skin reactions to personal protective equipment (
PPE
) during
COVID
‐19 pandemic in Italian health care workers. Dermatol Ther 2022; 35:e15460. [PMID: 35306721 PMCID: PMC9111857 DOI: 10.1111/dth.15460] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/07/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
To avoid exposure to SARS‐COV‐2, healthcare professionals must use personal protective equipment (PPE). Their use has been related to a series of adverse effects; the most frequent adverse events were headache, dyspnoea, and pressure injuries. Skin adverse effects are very common, including contact dermatitis, itching, erythema, and acneiform eruptions. The objective of this study is to evaluate the skin problems caused by personal protection equipment (PPE) in health care workers (HCWs) and to individuate eventual risk factors. From May to June 2020 a retrospective observational multi‐centric study conducted by an online survey sent by email, involving 10 hospital centers, was performed. We considered as independent variables gender and age, occupational group and sector, time of utilization, type and material of PPE. We tested 3 types of PPE: gloves, bonnet, and mask for different time of utilization (<1, 1–3, 3–6, >6 h). We performed a multiple logistic regression model to correlate them with skin adverse events occurrence. Among all the 1184 participants, 292 workers reported a dermatological pathology: 45 (15.41%) had psoriasis, 54 (18.49%) eczema, 38 (13.01%) acne, 48 (16.44%) seborrheic dermatitis, and 107 (36.64%) other. In our sample previous inflammatory dermatological conditions, female sex, prolonged use of PPE were significant risk factors for developing skin related adverse events considering all the PPE considered. The use of PPE is still mandatory in the hospital setting and skin adverse reactions still represent a global problem. Although data from Europe are limited, our study highlighted the importance of the problem of PPE skin reactions in a large sample of Italian healthcare professionals.
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Affiliation(s)
- Ilaria Proietti
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Ivan Borrelli
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Nevena Skroza
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Paolo Emilio Santoro
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Maria Rosaria Gualano
- Department of Public Health Sciences and Paediatrics University of Torino Torino Italy
| | - Nicoletta Bernardini
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Alessandra Mambrin
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Ersilia Tolino
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Anna Marchesiello
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Federica Marraffa
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Simone Michelini
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Giovanni Rossi
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Salvatore Volpe
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Walter Ricciardi
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Umberto Moscato
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
- Department of Public Health Sciences and Paediatrics University of Torino Torino Italy
| | - Concetta Potenza
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
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22
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Bernardini N, Skroza N, Marchesiello A, Mambrin A, Proietti I, Tolino E, Maddalena P, Marraffa F, Rossi G, Volpe S, Potenza C. Psoriatic patients with a history of cancer: a real-life experience with Apremilast treatment for 104 weeks. Dermatol Ther 2022; 35:e15306. [PMID: 35100460 DOI: 10.1111/dth.15306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 12/10/2021] [Accepted: 12/28/2021] [Indexed: 11/28/2022]
Abstract
Psoriasis is a multifactorial, chronic, auto- inflammatory disease, with a worldwide prevalence of around 2%, subtended by robust genetic predisposition and autoimmune pathogenic traits. The disease, mainly involving the skin and joints, is featured by erythemato-squamous lesions, with a chronic relapsing course and relevant systemic comorbidities. Apremilast is a novel oral agent that has recently been made available to dermatologists for the treatment of moderate-to-severe plaque psoriasis and psoriatic arthritis. Although it is considered as relatively safe molecule with few contraindications, experience with Apremilast in the real-world setting for cancer patients with moderate-to-severe plaque psoriasis is lacking. Hence, we report the real-life experience in patients with psoriasis and a history of cancer who underwent treatment with Apremilast for 104 weeks.
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Affiliation(s)
- Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Patrizia Maddalena
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Federica Marraffa
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Giovanni Rossi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Salvatore Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
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23
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Santoro PE, Borrelli I, Gualano MR, Proietti I, Skroza N, Rossi MF, Amantea C, Daniele A, Ricciardi W, Potenza C, Moscato U. The Dermatological Effects and Occupational Impacts of Personal Protective Equipment on a Large Sample of Healthcare Workers During the COVID-19 Pandemic. Front Public Health 2022; 9:815415. [PMID: 35141194 PMCID: PMC8818717 DOI: 10.3389/fpubh.2021.815415] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. Materials and Methods An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. Results Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38–2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49–2.78, p < 0.001), which acted as risk factors. Discussion The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.
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Affiliation(s)
- Paolo Emilio Santoro
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ivan Borrelli
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Rosaria Gualano
- Department of Public Health Sciences and Paediatrics, University of Torino, Torino, Italy
- *Correspondence: Maria Rosaria Gualano
| | - Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina, Italy
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina, Italy
| | - Maria Francesca Rossi
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlotta Amantea
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Daniele
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Ricciardi
- Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina, Italy
| | - Umberto Moscato
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
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Proietti I, Skroza N, Mambrin A, Marraffa F, Tolino E, Bernardini N, Marchesiello A, Rossi G, Volpe S, Potenza C. Aesthetic Treatments in Cancer Patients. Clin Cosmet Investig Dermatol 2021; 14:1831-1837. [PMID: 34898993 PMCID: PMC8654687 DOI: 10.2147/ccid.s342734] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/22/2021] [Indexed: 12/02/2022]
Abstract
Cancer patients are experiencing an increase in overall survival as a consequence of earlier diagnosis and newer effective anticancer therapies. However, cancer survivors often face long-term consequences from their original cancer diagnosis and long-term sequelae of anticancer treatment. Maintaining patients’ quality of life is of paramount importance and this can be accomplished by a multidisciplinary treatment approach, including aesthetic treatments to improve patients’ body image and positively impact their quality of life. In this perspective, we will discuss the importance of aesthetic treatments in cancer patients. In addition, we will summarise the data available regarding the use of several aesthetic treatments such as fillers, botulinum toxin and laser use in cancer patients, their safety, their efficacy, and the specific precautions that need to be implemented in this particular subset of cancer patients.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Nevena Skroza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Alessandra Mambrin
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Federica Marraffa
- Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Ersilia Tolino
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Nicoletta Bernardini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Anna Marchesiello
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Giovanni Rossi
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Salvatore Volpe
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy
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Skroza N, Tolino E, Balduzzi V, Bernardini N, Mambrin A, Marchesiello A, Marraffa F, Rossi G, Volpe S, Proietti I, Potenza C. Advantages of Tailored Isotretinoin Treatment in Moderate to Severe Acne: Real-Life Data. Front Pharmacol 2021; 12:733526. [PMID: 34867340 PMCID: PMC8632712 DOI: 10.3389/fphar.2021.733526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/27/2021] [Indexed: 01/28/2023] Open
Abstract
This retrospective single-center study analyzes the efficacy and safety of isotretinoin for the treatment of moderate to severe acne in real-life clinical practice, particularly with regard to acne severity, isotretinoin cumulative dosage, and patients’ gender. The results suggest the opportunity of an early isotretinoin systemic treatment in patients affected by moderate acne and emphasize the importance of an appropriate dose adjustment in order to minimize adverse events.
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Affiliation(s)
- Nevena Skroza
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Ersilia Tolino
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Veronica Balduzzi
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | | | - Alessandra Mambrin
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Anna Marchesiello
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Federica Marraffa
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Giovanni Rossi
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Salvatore Volpe
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Ilaria Proietti
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Terracina, Italy
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Proietti I, Tolino E, Mambrin A, Skroza N, Bernardini N, Marchesiello A, Marraffa F, Michelini S, Rossi G, Volpe S, Del Giudice E, Lubrano R, Potenza C. Non-invasive instrumental examinations of cutaneous, adnexal and mucosal manifestations after SARS-COV-2 infection in adult and children. J Eur Acad Dermatol Venereol 2021; 36:e169-e170. [PMID: 34753203 PMCID: PMC9088730 DOI: 10.1111/jdv.17805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- I Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - E Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - A Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - N Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - N Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - A Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - F Marraffa
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - S Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - G Rossi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - S Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
| | - E Del Giudice
- Maternal and Child Health Department, Sapienza - University of Rome, Polo Pontino, Santa Maria Goretti Hospital, Latina, Italy
| | - R Lubrano
- Maternal and Child Health Department, Sapienza - University of Rome, Polo Pontino, Santa Maria Goretti Hospital, Latina, Italy
| | - C Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino, Italy
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Bernardini N, Skroza N, Proietti I, Mambrin A, Marchesiello A, Tolino E, Balduzzi V, Potenza C. Erythrodermic Psoriasis Successfully Treated with Anti IL-17: A Case Series. Acta Dermatovenerol Croat 2021; 29:191-195. [PMID: 36896689] [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: 03/11/2023]
Abstract
Erythrodermic psoriasis (EP) is a very rare but extremely severe subtype of chronic plaque psoriasis. Its pathogenesis still remains unknown, and current therapeutic strategies frequently end in failure. Erythrodermic psoriasis often requires hospitalization in order to control any kind of possible serious complications. Treatment of EP is a challenge for clinicians because international guidelines are lacking. Nevertheless, Th17 has been shown to be the second-most predominant T-cell type after Th2 in EP lesions. There is a growing body of evidence supporting the safety and efficacy of biologics in rapidly achieving near-total clearance of EP, particularly within the IL-17 class. Herein we report a series of 5 cases of EP successfully treated with anti-interleukines 17: Ixekizumab and Secukinumab.
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Affiliation(s)
| | - Nevena Skroza
- Nevena Skroza, MD, Dermatology Unit "Daniele Innocenzi" Dept. of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome - Polo Pontino (LT),
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Bernardini N, Skroza N, Mambrin A, Proietti I, Marchesiello A, Marraffa F, Rossi G, Volpe S, Tolino E, Potenza C. Herpes zoster ophthalmicus in two women after Pfizer-BioNTech (BNT162b2) vaccine. J Med Virol 2021; 94:817-818. [PMID: 34585774 PMCID: PMC8661555 DOI: 10.1002/jmv.27366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 11/09/2022]
Affiliation(s)
- Nicoletta Bernardini
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nevena Skroza
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Alessandra Mambrin
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ilaria Proietti
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Anna Marchesiello
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Federica Marraffa
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Giovanni Rossi
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Salvatore Volpe
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ersilia Tolino
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Concetta Potenza
- Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
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Fabbrocini G, Ruina G, Giovanardi G, Dini V, Raone B, Venturini M, Caposiena Caro RD, Veraldi S, Cannavò SP, Merlo G, Bertoldi AM, Fiorentini F, Molinelli E, Atzori L, Bongiorno MR, Lo Re M, Skroza N, Lasagni C, Franchi C, Ardigò M, Di Costanzo L, Stingeni L, Amerio P, Sanna F, Pescitelli L, Broganelli P, De Cupis C, Gualberti G, Saragaglia V, Argenziano G. Hidradenitis Suppurativa in a Large Cohort of Italian Patients: Evaluation of the Burden of Disease. Dermatology 2021; 238:487-497. [PMID: 34474409 DOI: 10.1159/000517412] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 05/25/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually occurs after puberty with painful, deep-seated, inflamed nodules and sinus tracts in the apocrine gland-bearing areas of the body, most commonly the axillae and inguinal and anogenital regions, with a relevant impact on patients' quality of life (QoL). OBJECTIVE To evaluate how the burden of HS disease impacts on patient well-being and working activities in a large Italian population over a period of 9 months. METHODS A multicenter, prospective, epidemiologic cohort study was conducted in adult Italian patients with HS. HS severity was assessed through Hurley stage and HS Physician's Global Assessment (HS-PGA), clinical improvement by HS Clinical Response (HiSCR) and partial response, and disease burden through QoL questionnaires (HIDRAdisk, Skindex-16, Dermatology Life Quality Index [DLQI]), and Work Productivity and Activity Impairment - General Health (WPAI:GH). RESULTS A total of 308 patients (56.2% women; mean age 35.2 ± 12.9 years) were enrolled in 27 dermatologic clinics. Men were older (37.4 years vs. 33.5), more smoking addicted (74.1% vs. 60.1%), and alcohol consumer (34.1% vs. 13.9%), while more women were obese (34.10% vs. 22.22%). At baseline, most patients had a Hurley severity stage of 2 (43.9%), a moderate HS-PGA score (57.1%), and poor QoL (HIDRAdisk: 65.7 ± 23.3, Skindex-16: 60.3 ± 26.9, and DLQI: 10.8 ± 8.1). Patients with more severe disease showed worse QoL. Mean values for the variables related to HS severity decreased during the study period. The achievement of HiSCR and partial response increased during the study. CONCLUSION This study offers insight into the disease burden of HS in an Italian population. Our results underline the impact of QoL evaluation, also with the use of the HIDRAdisk, in clinical routine as a support to validated severity clinical and instrumental indexes for a "360-degree" assessment of HS patient's burden of disease.
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Affiliation(s)
- Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico, Naples, Italy
| | - Giulia Ruina
- Royal London Hospital, Barts NHS Trust, London, United Kingdom
| | - Giulia Giovanardi
- Istituto di Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma - Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Beatrice Raone
- Department of Specialized, Diagnostic and Experimental Medicine, Division of Dermatology, University of Bologna, Bologna, Italy
| | - Marina Venturini
- Department of Dermatology, University of Brescia and ASST-Spedali Civili Hospital, Brescia, Italy
| | | | - Stefano Veraldi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Foundation IRCCS Cà Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Giulia Merlo
- Dermatology Unit, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | | | - Elisa Molinelli
- Dermatological Unit, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Laura Atzori
- Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Rita Bongiorno
- U.O.C. Dermatologia e MTS, Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Università di Palermo, Palermo, Italy
| | - Michele Lo Re
- U.O.C di Dermatologia Azienda Ospedaliera Papardo, Messina, Italy
| | - Nevena Skroza
- Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Polo Pontino, Italy
| | - Claudia Lasagni
- Clinica Dermatologica, A.O.U. Policlinico di Modena, Modena, Italy
| | | | | | - Luisa Di Costanzo
- UOC di Dermatologia Azienda Ospedaliera San Pio Presidio G. Rummo, Benevento, Italy
| | - Luca Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Paolo Amerio
- Department of Dermatology, University of Chieti-Pescara, Chieti, Italy
| | | | - Leonardo Pescitelli
- Department Health Science Section of Dermatology, University of Florence, Florence, Italy
| | - Paolo Broganelli
- Dermatologia, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
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Proietti I, Skroza N, Filippi L, Bernardini N, Mambrin A, Tolino E, Rossi G, Marchesiello A, Marraffa F, Volpe S, Bagni O, Potenza C. Long-Term Maintained Response to Selective Internal Radiation Therapy in an Oligometastatic Uveal Melanoma Patient Treated with Concomitant Anti-PD-1 Therapy. Life (Basel) 2021; 11:692. [PMID: 34357064 PMCID: PMC8307638 DOI: 10.3390/life11070692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 12/16/2022] Open
Abstract
Uveal melanoma (UM) is a primary neoplasm of the eye arising from the melanocytes residing in the iris, ciliary body or choroid. It is the most frequent intraocular malignancy and often determines metastases at distant sites, with a peculiar tropism for the liver. Metastatic UM has a poor prognosis, as any treatment affects the natural course of this fatal disease. Herein, we report a case of a UM metastatic to the liver in a 54 year-old female patient, initially treated with nivolumab without success. The patient was then scheduled for selective internal radiation therapy (SIRT) while continuing immunotherapy. This combination led to a complete and durable response and the patient is currently free of disease, two years after the diagnosis of the hepatic metastases. The association between SIRT and immunotherapy (IT) has very promising perspectives for metastatic UM, especially considering the disappointing or contradictory results of classic chemotherapies, IT alone and targeted therapies. Furthermore, this combination has been shown to have a good security profile. However, further studies are needed to confirm the efficacy of associating SIRT and IT and to clarify some unsolved problems, such as the timing of administration of these two therapies.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Luca Filippi
- Department of Nuclear Medicine, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy; (L.F.); (O.B.)
| | - Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Alessandra Mambrin
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Ersilia Tolino
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Giovanni Rossi
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Anna Marchesiello
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Federica Marraffa
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Salvatore Volpe
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
| | - Oreste Bagni
- Department of Nuclear Medicine, “Santa Maria Goretti” Hospital, Via Antonio Canova, 04100 Latina, Italy; (L.F.); (O.B.)
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Via Firenze, 1, 04019 Terracina, Italy; (N.S.); (N.B.); (A.M.); (E.T.); (G.R.); (A.M.); (F.M.); (S.V.); (C.P.)
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Tolino E, Skroza N, Mambrin A, Proietti I, Bernardini N, Balduzzi V, Marchesiello A, Di Fraia M, Michelini S, Potenza C. An Open-label Study Comparing Oral Zinc to Lymecycline in the Treatment of Acne Vulgaris. J Clin Aesthet Dermatol 2021; 14:56-58. [PMID: 34188751 PMCID: PMC8211333] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND: Acne is a chronic multifactorial skin disease with a high prevalence among adolescents. The therapeutic approach for mild to moderate papulopustular acne includes the use of systemic tetracycline. Increased risk of antibiotic resistance necessitates research into alternative therapeutic approaches, such as zinc sulphate. Efficacy of zinc sulphate in acne treatment is widely reported in the literature, but drug comparison studies are lacking. OBJECTIVE: We sought to compare the efficacy and safety of zinc sulphate to lymecycline for the treatment of mild to moderate papulopustular acne. METHODS: One hundred patients were equally randomized to receive either zinc sulphate or lymecycline. Acne severity was evaluated using the subjective Global Acne Grading System (GAGS) and the Acne-specific Quality of Life (AQoL) questionnaire at baseline and after four and 12 weeks. RESULTS: Both zinc sulphate and lymecycline induced a statistically significant reduction in GAGS scores at four and 12 weeks of treatment. The improvements in AQoL scores in patients treated with zinc sulphate were significantly higher than those in the lymecycline group. CONCLUSIONS: Our study suggests that zinc sulphate is a valid alternative therapeutic approach in the treatment of mild to moderate papulopustular acne relative to lymecycline in terms of clinical efficacy, tolerability, and the occurrence of side effects.
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Affiliation(s)
- Ersilia Tolino
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Nevena Skroza
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Alessandra Mambrin
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Ilaria Proietti
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Nicoletta Bernardini
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Veronica Balduzzi
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Anna Marchesiello
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Marco Di Fraia
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Simone Michelini
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
| | - Concetta Potenza
- All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy
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Bernardini N, Skroza N, Spagnoli A, Marchesiello A, Balduzzi V, Tolino E, Mambrin A, Michelini S, Maddalena P, Volpe S, Proietti I, Vestri A, Potenza C. How lockdown measures, during COVID-19 pandemic, matter on psoriatic patient's perception: Study on 600 patients on biologic therapy. J Infect Public Health 2021; 14:878-882. [PMID: 34118738 PMCID: PMC8015377 DOI: 10.1016/j.jiph.2021.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 02/15/2021] [Accepted: 03/17/2021] [Indexed: 01/18/2023] Open
Abstract
Background The outbreak of coronavirus disease-2019 (COVID-19) is a public health crisis of global proportion. In psoriatic patients treated with biologic agents, evidence is not yet available on susceptibility to infection with the novel SARS-CoV-2 coronavirus, and data about the perception of COVID-19 and its impact on these patients are lacking. Aims The aim of this observational, spontaneous study was the evaluation of the impact of anti COVID-19 measures in “fragile population” such as patients with a chronic inflammatory disease. Thus, we evaluated the impact of perceived risk on quality of life of patients with moderate to severe psoriasis, in our outpatient clinic, and how their perceptions changed before and after the adoption of Covid-19 emergency measures following the Italian Ministerial Decree in March 9, 2020. Methods Using a series of questions, our study surveyed adult patients with moderate to severe psoriasis receiving treatment with biologic agents (n = 591), before and after the adoption of COVID-19 emergency measures. Results Most patients (97%) had been sufficiently informed by healthcare staff about COVID-19 spread. A significant change was observed in social activity reduction before and after the adoption of the measures (18% vs. 90% of patients; P < 0.0001). Similarly, patients were more likely to suspend ongoing therapy after the measures were adopted than before (87% vs. 34% of patients; P < 0.0001). Following the measures, older patients were significantly more inclined to suspend therapy and reduce social activities than younger patients. Conclusions Government COVID-19 emergency measures further curtailed already reduced social activities in psoriatic patients, and led to a greater inclination to suspend biologic therapy, more so in older patients, despite there being no evidence to support this suspension. These vulnerable patients may need support from clinicians in order to maintain treatment adherence.
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Affiliation(s)
- N Bernardini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy.
| | - N Skroza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Spagnoli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - A Marchesiello
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - V Balduzzi
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - E Tolino
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Mambrin
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - S Michelini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - P Maddalena
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - S Volpe
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - I Proietti
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Vestri
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - C Potenza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
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Dall’Oglio F, Tedeschi A, Lacarrubba F, Fabbrocini G, Skroza N, Chiodini P, Micali G. A novel azelaic acid formulation for the topical treatment of inflammatory rosacea: A multicentre, prospective clinical trial. J Cosmet Dermatol 2021; 20 Suppl 1:28-31. [PMID: 33934475 PMCID: PMC8252084 DOI: 10.1111/jocd.14098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Topical azelaic acid (AzA) is a common treatment for mild/moderate inflammatory rosacea. AIMS To assess the efficacy and tolerability of a novel formulation cream containing 15% AzA (anti-inflammatory/anti-oxidant/anti-microbial agent) combined with 1% dihydroavenanthramide D (anti-inflammatory/anti-itch) in inflammatory rosacea using clinical/instrumental evaluation. METHODS In this multicentre, prospective, open-label trial, 45 patients with mild/moderate inflammatory rosacea enrolled at the Dermatology Clinic of the University of Catania, Naples, and Rome (Italy) were instructed to apply the cream twice daily for 8 weeks. Clinical evaluation was performed at baseline (T0) and at 8 weeks (T1) by (1) Investigator Global Assessment (IGA) score based on a 5-point scale (from 0 = clear/no erythema/papules/pustules to 4 = severe erythema/several papules/pustules) and (2) inflammatory lesions count. Instrumental evaluation of erythema degree was performed by erythema-directed digital photography (EDDP) by a 5-point scale (from 0 = no redness to 4 = severe redness) at all time points. Tolerability was assessed by a self-administered questionnaire at 8 weeks. Statistical analysis was performed using SAS version 9. RESULTS Forty-four patients completed the study. At week 8, a significant decrease in baseline of IGA scores [median from 3 (T0) to 1 (T1)] and inflammatory lesions count [median from 8 (T0) to 1 (T1)] was recorded along with a significant reduction of erythema scores [median from 2 (T0) to 1 (T1)]. No relevant side effects were recorded. CONCLUSIONS Our results suggest that this new non-irritating product represents a valid therapeutic option for mild/moderate inflammatory rosacea, and EDDP is able to provide a more defined evaluation of erythema changes.
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Affiliation(s)
| | | | | | - Gabriella Fabbrocini
- Section of DermatologyDepartment of Clinical Medicine and SurgeryUniversity Federico II of NaplesNaplesItaly
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”Department of Medical‐Surgical Sciences and Bio‐TechnologiesSapienza University of RomeTerracinaItaly
| | - Paolo Chiodini
- Medical Statistics UnitUniversity of Campania “Luigi Vanvitelli”NaplesItaly
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34
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Ribero S, Ramondetta A, Fabbrocini G, Bettoli V, Potenza C, Chiricozzi A, Licciardello M, Marzano AV, Bianchi L, Rozzo G, Fania L, Marasca C, Odorici G, Mambrin A, Moltrasio C, Caposiena Caro RD, Skroza N, Quaglino P, Siliquini N, Dapavo P. Effectiveness of Secukinumab in the treatment of moderate-severe hidradenitis suppurativa: results from an Italian multicentric retrospective study in a real-life setting. J Eur Acad Dermatol Venereol 2021; 35:e441-e442. [PMID: 33594790 DOI: 10.1111/jdv.17178] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/09/2021] [Indexed: 02/06/2023]
Affiliation(s)
- S Ribero
- Dermatology Clinic, University of Turin, Turin, Italy
| | - A Ramondetta
- Dermatology Clinic, University of Turin, Turin, Italy
| | - G Fabbrocini
- Department of Clinical Medicine and Surgery, Dermatology Unit, University Federico II of Naples, Naples, Italy
| | - V Bettoli
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - C Potenza
- Dermatology Unit "Daniele Innocenzi", Department of Medical Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - A Chiricozzi
- Dermatology Unit, Department of Medical Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - L Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - G Rozzo
- Dermatology Clinic, University of Turin, Turin, Italy
| | - L Fania
- Dermatology Department, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - C Marasca
- Department of Clinical Medicine and Surgery, Dermatology Unit, University Federico II of Naples, Naples, Italy
| | - G Odorici
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - A Mambrin
- Dermatology Unit "Daniele Innocenzi", Department of Medical Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - C Moltrasio
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - R D Caposiena Caro
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - N Skroza
- Dermatology Unit "Daniele Innocenzi", Department of Medical Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy
| | - P Quaglino
- Dermatology Clinic, University of Turin, Turin, Italy
| | - N Siliquini
- Dermatology Clinic, University of Turin, Turin, Italy
| | - P Dapavo
- Dermatology Clinic, University of Turin, Turin, Italy
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35
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van Straalen KR, Tzellos T, Guillem P, Benhadou F, Cuenca-Barrales C, Daxhelet M, Daoud M, Efthymiou O, Giamarellos-Bourboulis EJ, Jemec GBE, Katoulis AC, Koenig A, Lazaridou E, Marzano AV, Matusiak Ł, Molina-Leyva A, Moltrasio C, Pinter A, Potenza C, Romaní J, Saunte DM, Skroza N, Stergianou D, Szepietowski J, Trigoni A, Vilarrasa E, van der Zee HH. The efficacy and tolerability of tetracyclines and clindamycin plus rifampicin for the treatment of hidradenitis suppurativa: Results of a prospective European cohort study. J Am Acad Dermatol 2021; 85:369-378. [PMID: 33484766 DOI: 10.1016/j.jaad.2020.12.089] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/19/2020] [Accepted: 12/29/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Tetracyclines and clindamycin plus rifampicin combination therapy are both considered first-line therapy in current hidradenitis suppurativa guidelines. However, evidence for their efficacy is drawn from small studies, often without validated outcomes. OBJECTIVE To assess the 12-week efficacy of oral tetracyclines and a combination of clindamycin and rifampicin. METHODS A prospective, international cohort study performed between October 2018 and August 2019. RESULTS In total, 63.6% of the included 283 patients received oral tetracyclines, and 36.4% were treated with clindamycin and rifampicin. Both groups showed a significant decrease in International Hidradenitis Suppurativa Severity Score System from baseline (both P < .001). The Hidradenitis Suppurativa Clinical Response (HiSCR) was achieved in 40.1% and 48.2% of patients, respectively (P = .26). Patient characteristics or disease severity were not associated with the attainment of HiSCR or the minimal clinically important differences for the Dermatology Life Quality Index and pain. LIMITATIONS Cohort study. Respectively, 23.9% and 19.4% of patients had to be excluded from the HiSCR analysis for the tetracycline and combination therapy group because of a low abscess and nodule count at baseline. CONCLUSION This study shows significant efficacy of both tetracycline treatment and clindamycin and rifampicin combination therapy after 12 weeks in patients with hidradenitis suppurativa. No significant differences in efficacy were observed between the 2 treatments, regardless of disease severity.
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Affiliation(s)
- Kelsey R van Straalen
- Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands
| | | | - Phillipe Guillem
- Department of Surgery, Clinique du Val d'Ouest, Lyon, France; ResoVerneuil, Paris, France; Groupe de Recherche en Proctologie de la Société Nationale Française de ColoProctologie, Paris, France
| | - Farida Benhadou
- Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium
| | - Carlos Cuenca-Barrales
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group Instituto de Investigación Biosanitaria, Granada, Spain
| | - Mathilde Daxhelet
- Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium
| | - Mathieu Daoud
- Department of Dermatology, Université Libre de Bruxelles, Erasme Hospital, Brussels, Belgium
| | - Ourania Efthymiou
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | | | - Gregor B E Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde and Health Sciences Faculty, University of Copenhagen, Denmark
| | - Alexandros C Katoulis
- Second Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - Anke Koenig
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Germany
| | - Elizabeth Lazaridou
- Second Department of Dermatology and Venereology, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Angelo V Marzano
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Łucas Matusiak
- Department of Dermatology, Venereology and Allergology, Medical University, Wroclaw, Poland
| | - Alejandro Molina-Leyva
- Department of Dermatology, Hospital Universitario Virgen de las Nieves, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group Instituto de Investigación Biosanitaria, Granada, Spain
| | - Chiara Moltrasio
- Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Andreas Pinter
- Department of Dermatology, Venereology and Allergology, University Hospital Frankfurt am Main, Germany
| | - Concetta Potenza
- Dermatology Unit 'Daniele Innocenzi,' Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino-Latina, Italy
| | - Jorge Romaní
- Department of Dermatology, Corporació Sanitaria Parc Taulí, Sabadell, Spain
| | - Ditte M Saunte
- Department of Dermatology, Zealand University Hospital, Roskilde and Health Sciences Faculty, University of Copenhagen, Denmark
| | - Nevena Skroza
- Dermatology Unit 'Daniele Innocenzi,' Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino-Latina, Italy
| | - Dimitra Stergianou
- Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Jacek Szepietowski
- Department of Dermatology, Venereology and Allergology, Medical University, Wroclaw, Poland
| | - Anastasia Trigoni
- Second Department of Dermatology and Venereology, Aristotle University of Thessaloniki, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Eva Vilarrasa
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Hessel H van der Zee
- Erasmus MC, University Medical Center Rotterdam, Department of Dermatology, Rotterdam, the Netherlands.
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36
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Proietti I, Skroza N, Filippi L, Balduzzi V, Michelini S, Bagni O, Bernardini N, Maddalena P, Mambrin A, Marchesiello A, Tolino E, Volpe S, Lichtner M, Porta N, Petrozza V, Potenza C. Metastatic penile squamous cell carcinoma successfully treated with cemiplimab in an HIV patient. Dermatol Ther 2021; 34:e14744. [PMID: 33405367 DOI: 10.1111/dth.14744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Luca Filippi
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Oreste Bagni
- Department of Nuclear Medicine, Santa Maria Goretti Hospital, Latina, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Patrizia Maddalena
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Salvatore Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
| | - Miriam Lichtner
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - Natale Porta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Vincenzo Petrozza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy
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37
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Tolino E, Proietti I, Sarni A, Bernardini N, Mambrin A, Balduzzi V, Maddalena P, Marchesiello A, Michelini S, Volpe S, Skroza N, Potenza C. Success of dupilumab as a monotherapy in an adult patient affected by severe uncontrolled asthma and atopic dermatitis. Dermatol Ther 2020; 34:e14596. [PMID: 33244860 DOI: 10.1111/dth.14596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Ersilia Tolino
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Ilaria Proietti
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Antonella Sarni
- Pneumology UOSD, Department of Medicine, S.M. Goretti Hospital in Latina, Latina, Italy
| | - Nicoletta Bernardini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Alessandra Mambrin
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Veronica Balduzzi
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Patrizia Maddalena
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Anna Marchesiello
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Simone Michelini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Salvatore Volpe
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Nevena Skroza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - Concetta Potenza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
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38
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Tolino E, Skroza N, Proietti I, Mambrin A, Balduzzi V, Marchesiello A, Maddalena P, Michelini S, Volpe S, Bernardini N, Potenza C. Efficacy and safety of systemic isotretinoin treatment for moderate to severe acne (insights from the real‐life clinical setting). Dermatol Ther 2020; 33:e14392. [DOI: 10.1111/dth.14392] [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: 07/22/2020] [Revised: 09/02/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ersilia Tolino
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Alessandra Mambrin
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Veronica Balduzzi
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Anna Marchesiello
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Patrizia Maddalena
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Simone Michelini
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Salvatore Volpe
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, Department of Medical‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino Terracina Italy
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39
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Mangino G, Iuliano M, Carlomagno S, Bernardini N, Rosa P, Chiantore MV, Skroza N, Calogero A, Potenza C, Romeo G. Interleukin-17A affects extracellular vesicles release and cargo in human keratinocytes. Exp Dermatol 2020; 28:1066-1073. [PMID: 31373041 DOI: 10.1111/exd.14015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/09/2019] [Accepted: 07/25/2019] [Indexed: 12/14/2022]
Abstract
Psoriasis is a chronic inflammatory systemic disease caused by deregulation of the interleukin-23/-17 axis that allows the activation of Th17 lymphocytes and the reprogramming of keratinocytes proliferative response, thereby inducing the secretion of cyto-/chemokines and antimicrobial peptides. Beside cell-to-cell contacts and release of cytokines, hormones and second messengers, cells communicate each other through the release of extracellular vesicles containing DNA, RNA, microRNAs and proteins. It has been reported the alteration of extracellular vesicles trafficking in several diseases, but there is scarce evidence of the involvement of extracellular vesicles trafficking in the pathogenesis of psoriasis. The main goal of the study was to characterize the release, the cargo content and the capacity to transfer bioactive molecules of extracellular vesicles produced by keratinocytes following recombinant IL-17A treatment if compared to untreated keratinocytes. A combined approach of standard ultracentrifugation, RNA isolation and real-time RT-PCR techniques was used to characterize extracellular vesicles cargo. Flow cytometry was used to quantitatively and qualitatively analyse extracellular vesicles and to evaluate cell-to-cell extracellular vesicles transfer. We report that the treatment of human keratinocytes with IL-17A significantly modifies the extracellular vesicles cargo and release. Vesicles from IL-17A-treated cells display a specific pattern of mRNA which is undid by IL-17A neutralization. Extracellular vesicles are taken up by acceptor cells irrespective of their content but only those derived from IL-17A-treated cells enable recipient cells to express psoriasis-associated mRNA. The results imply a role of extracellular vesicles in amplifying the pro-inflammatory cascade induced in keratinocyte by pro-psoriatic cytokines.
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Affiliation(s)
- Giorgio Mangino
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Marco Iuliano
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Silvia Carlomagno
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Nicoletta Bernardini
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Dermatology Unit "Daniele Innocenzi", Fiorini Hospital, Terracina, Italy
| | - Paolo Rosa
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | | | - Nevena Skroza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Dermatology Unit "Daniele Innocenzi", Fiorini Hospital, Terracina, Italy
| | - Antonella Calogero
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Istituto Chirurgico Ortopedico Traumatologico, ICOT, Latina, Italy
| | - Concetta Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Dermatology Unit "Daniele Innocenzi", Fiorini Hospital, Terracina, Italy
| | - Giovanna Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,Institute of Molecular Biology and Pathology, Consiglio Nazionale delle Ricerche, Rome, Italy
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Bernardini N, Skroza N, Tolino E, Mambrin A, Balduzzi V, Marchesiello A, Michelini S, Volpe S, Maddalena P, Proietti I, Potenza C. Recurrent erythrodermic psoriasis and polycythemia successfully treated with brodalumab. Dermatol Ther 2020; 33:e14338. [PMID: 32975343 DOI: 10.1111/dth.14338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/02/2020] [Accepted: 09/16/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Salvatore Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Patrizia Maddalena
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
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Proietti I, Skroza N, Bernardini N, Tolino E, Balduzzi V, Marchesiello A, Michelini S, Volpe S, Mambrin A, Mangino G, Romeo G, Maddalena P, Rees C, Potenza C. Mechanisms of Acquired BRAF Inhibitor Resistance in Melanoma: A Systematic Review. Cancers (Basel) 2020; 12:E2801. [PMID: 33003483 PMCID: PMC7600801 DOI: 10.3390/cancers12102801] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 12/18/2022] Open
Abstract
This systematic review investigated the literature on acquired v-raf murine sarcoma viral oncogene homolog B1 (BRAF) inhibitor resistance in patients with melanoma. We searched MEDLINE for articles on BRAF inhibitor resistance in patients with melanoma published since January 2010 in the following areas: (1) genetic basis of resistance; (2) epigenetic and transcriptomic mechanisms; (3) influence of the immune system on resistance development; and (4) combination therapy to overcome resistance. Common resistance mutations in melanoma are BRAF splice variants, BRAF amplification, neuroblastoma RAS viral oncogene homolog (NRAS) mutations and mitogen-activated protein kinase kinase 1/2 (MEK1/2) mutations. Genetic and epigenetic changes reactivate previously blocked mitogen-activated protein kinase (MAPK) pathways, activate alternative signaling pathways, and cause epithelial-to-mesenchymal transition. Once BRAF inhibitor resistance develops, the tumor microenvironment reverts to a low immunogenic state secondary to the induction of programmed cell death ligand-1. Combining a BRAF inhibitor with a MEK inhibitor delays resistance development and increases duration of response. Multiple other combinations based on known mechanisms of resistance are being investigated. BRAF inhibitor-resistant cells develop a range of 'escape routes', so multiple different treatment targets will probably be required to overcome resistance. In the future, it may be possible to personalize combination therapy towards the specific resistance pathway in individual patients.
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Affiliation(s)
- Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Nicoletta Bernardini
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Ersilia Tolino
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Veronica Balduzzi
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Anna Marchesiello
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Simone Michelini
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Salvatore Volpe
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Alessandra Mambrin
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | - Giorgio Mangino
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy; (G.M.); (G.R.)
| | - Giovanna Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy; (G.M.); (G.R.)
- Department of Infectious, Parasitic and Immune-Mediated Diseases, Istituto Superiore di Sanità, 00185 Rome, Italy
- Institute of Molecular Biology and Pathology, Consiglio Nazionale delle Ricerche, 00185 Rome, Italy
| | - Patrizia Maddalena
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
| | | | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy; (N.S.); (N.B.); (E.T.); (V.B.); (A.M.); (S.M.); (S.V.); (A.M.); (P.M.); (C.P.)
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Bernardini N, Skroza N, Tolino E, Marchesiello A, Mambrin A, Balduzzi V, Michelini S, Maddalena P, Volpe S, Proietti I, Potenza C. Benefit of a topic ointment as co-medication with biologic drugs for the management of moderate-severe psoriasis: a prospective, observational real-life study. Clin Ter 2020; 171:e321-e327. [PMID: 32614364 DOI: 10.7417/ct.2020.2234] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Psoriasis is a multifactorial chronic inflammatory skin disease characterized by erythemato-squamous lesions with a chronic relapsing course. The desease clinical activity (PASI) and the patient's quality of life (DLQI) are the main elements to assess for setting up a correct therapeutic management. OBJECTIVES The aim of the study was to evaluate the management of the patient with moderate-severe psoriasis in therapy with biological drugs and to establish the difference in the achievement of PASI 90 and DLQI 0-1 between a group of patients treated with only biological drugs and a group of patients receiving biologic therapy in combination with a topical ointment. METHODS We conducted a prospective, observational real-life study enrolling 60 patients with moderate to severe psoriasis and divided in two groups: Group A patients treated with biological drugs, Group B patiens treated with biological drugs in association with an ointment composed of betamethasone, salicylic acid and ammonium sulpho-ichtyolate, applied 2 times a day. PASI and DLQI were evaluated at study beginning (T0) for both study groups, after 12 weeks (T3) for sample in therapy with biological drugs and after 24 weeks (T6) for sample in co-medication therapy. RESULTS The two-way ANOVA method was used to evaluate the standard deviations (SD): at T3 and T6 Group B obtained a significant PASI reduction and improvement of DLQI (* p value <0.05) compared to Group A. CONCLUSIONS Our study shown that the patients treated with biologics in co-medication with topical therapy reached a significantly higher PASI and DQLI compared with those treated with only biologics. Furthermore we observed that the association with topical oinment showed more efficacy in the treatment of areas such as palm-plantar region, that is often difficult-to-treat region, even for biologic drugs.
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Affiliation(s)
- N Bernardini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - N Skroza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - E Tolino
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Marchesiello
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - A Mambrin
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - V Balduzzi
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - S Michelini
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - P Maddalena
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | - S Volpe
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
| | | | - C Potenza
- Dermatology Unit "D. Innocenzi", Polo Pontino, Sapienza University of Rome, Rome, Italy
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Proietti I, Bernardini N, Tolino E, Mambrin A, Balduzzi V, Marchesiello A, Michelini S, Skroza N, Potenza C. Polymorphic eruption of pregnancy as a possible COVID-19 manifestation. Dermatol Ther 2020; 33:e14117. [PMID: 32737915 PMCID: PMC7436318 DOI: 10.1111/dth.14117] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
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Fragiotta S, Mangino G, Iuliano M, Potenza C, Bernardini N, Skroza N, Vingolo EM, Romeo G. Role of CD 20 + T cells and related cytokines in mediating retinal microvascular changes and ocular complications in chronic-plaque type psoriasis. Cytokine 2020; 136:155253. [PMID: 32858439 DOI: 10.1016/j.cyto.2020.155253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the role of CD3+ CD20+ CD4- CD8- double-negative (DN) or CD3+CD20+ CD4/CD8+ T cells and the related pro-inflammatory cytokines in the humor aqueous, in mediating retinal microvascular changes in patients with chronic plaque-type moderate to severe psoriasis. DESIGN A total of 76 patients (57.6 ± 11.7 years) with chronic plaque-type psoriasis were initially evaluated. Nineteen patients (19 eyes) and 19 healthy volunteers (19 eyes) were subjected to dermatological evaluation with Psoriasis Area Severity Index (PASI) and the Dermatology life quality index (DLQI). Retinal images were processed using an automatized software. On the same day, a venous sample was collected and analyzed using multiparametric flow cytometry. Three out of 6 patients who presented cataract, consented to perform surgery with humor aqueous collection. The samples were analyzed using a Multi-Analyte ELISA kit for the simultaneous quantification of IL1α, IL1β, IL2, IL4, IL6, IL8, IL10, IL12, IL17A, IFNγ, TNF-α, GMCSF. RESULTS The CD3+CD4+/CD8+CD20+CD56- T cells expression was greater in the psoriatic patients (+73.9%, P < 0.001) compared to controls, but not the DN T cells (-8.2%, P = 0.30). Ocular complications were diagnosed in 61.1% of patients, microvascular parameters including artero-venous ratio (P = 0.04), subfoveal choriocapillaris/Sattler's layer, and choroidal thickness (CT, both P < 0.001) were significantly altered in psoriasis subgroup. The increased circulating levels of the CD3+CD4+/CD8+CD20+CD56- T cells were associated with thinning of subfoveal CT (P = 0.03) and Haller's layer (P = 0.01). Instead, the DN T cells presented an inverse relationship with disease duration (P = 0.02), DLQI score (P = 0.02), and the use of biological therapy (P = 0.05). The related cytokine patterns possibly modified in this cellular context have been investigated. No significant differences were observed in cytokines levels between psoriasis and controls, the most significant difference was detected on IL-6, without reaching statistical significance (fold change of 1.4, P = 0.13). CONCLUSION Our findings demonstrated that CD20+ T cell subpopulation is highly represented in psoriasis regardless of the use of immunomodulatory therapies, and the diffuse microvascular alterations suggested possible endothelial damage as mainstream for the genesis of psoriatic-mediated complications as further supported by the comparable concentrations of cytokines, at least as humor aqueous content, with respect to healthy eyes.
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Affiliation(s)
- Serena Fragiotta
- Department of Medico-Surgical Sciences and Biotechnologies, U.O.S.D. Ophthalmology, Sapienza University of Rome, A. Fiorini Hospital, Via Firenze 1, 04019 Terracina, Italy
| | - Giorgio Mangino
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy; Center for Biophotonics, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy
| | - Marco Iuliano
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy
| | - Concetta Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy; Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, A. Fiorini Hospital, Via Firenze 1, 04019 Terracina, Italy
| | - Nicoletta Bernardini
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, A. Fiorini Hospital, Via Firenze 1, 04019 Terracina, Italy
| | - Nevena Skroza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy; Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, A. Fiorini Hospital, Via Firenze 1, 04019 Terracina, Italy
| | - Enzo Maria Vingolo
- Department of Medico-Surgical Sciences and Biotechnologies, U.O.S.D. Ophthalmology, Sapienza University of Rome, A. Fiorini Hospital, Via Firenze 1, 04019 Terracina, Italy
| | - Giovanna Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy; Center for Biophotonics, Sapienza University of Rome, C.so della Repubblica, 79, 04100 Latina, Italy.
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Proietti I, Tolino E, Bernardini N, Mambrin A, Balduzzi V, Marchesiello A, Michelini S, Del Borgo C, Skroza N, Lichtner M, Potenza C. Auricle perniosis as a manifestation of Covid-19 infection. Dermatol Ther 2020; 33:e14089. [PMID: 32720420 DOI: 10.1111/dth.14089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/22/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Cosmo Del Borgo
- Infectious Disease Unit, Sapienza University, S.M. Goretti Hospital, Latina, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
| | - Miriam Lichtner
- Infectious Disease Unit, Sapienza University, S.M. Goretti Hospital, Latina, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy
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Proietti I, Mambrin A, Bernardini N, Tolino E, Balduzzi V, Maddalena P, Marchesiello A, Michelini S, Volpe S, Skroza N, Potenza C. Urticaria in an infant with SARS-CoV-2 positivity. Dermatol Ther 2020; 33:e14043. [PMID: 32697027 PMCID: PMC7404499 DOI: 10.1111/dth.14043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Patrizia Maddalena
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Salvatore Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy
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Bernardini N, Proietti I, Tolino E, Zuber S, Mambrin A, Balduzzi V, Marchesiello A, Anzalone A, Colapietra D, Potenza C, Skroza N. Therapeutic Options for the Treatment of Actinic Keratosis with Scalp and Face Localization. Acta Dermatovenerol Croat 2020; 28:93-101. [PMID: 32876034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Actinic keratosis (AK) is a common skin disease related to ultraviolet chronic exposure, that is now considered a squamous cell carcinoma in situ. Primary skin cancer prevention strategies should be recommended for high risk patients. There is a wide spectrum of treatment options available for AKs, and several variables should be taken into account regarding the best therapeutic choice for each patient. The purpose of this article is to review the current treatment strategies for AKs localized on the face and scalp, with a focus on the practical point of view that could be useful for choosing the best therapeutic option. The two main therapeutic approaches will be distinguished first: lesion-directed and field-directed. Afterwards, the treatment based on clinical type and patient comorbidity will be discussed.
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Affiliation(s)
- Nicoletta Bernardini
- Nicoletta Bernardini, MD, PhD, "Daniele Innocenzi" Dermatology Unit Dept of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome Fiorini Hospital, Via Firenze snc Polo Pontino, 04019 Terracina, Italy;
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48
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Proietti I, Skroza N, Michelini S, Mambrin A, Balduzzi V, Bernardini N, Marchesiello A, Tolino E, Volpe S, Maddalena P, Di Fraia M, Mangino G, Romeo G, Potenza C. BRAF Inhibitors: Molecular Targeting and Immunomodulatory Actions. Cancers (Basel) 2020; 12:cancers12071823. [PMID: 32645969 PMCID: PMC7408709 DOI: 10.3390/cancers12071823] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/19/2020] [Accepted: 06/26/2020] [Indexed: 12/12/2022] Open
Abstract
The BRAF inhibitors vemurafenib, dabrafenib and encorafenib are used in the treatment of patients with BRAF-mutant melanoma. They selectively target BRAF kinase and thus interfere with the mitogen-activated protein kinase (MAPK) signalling pathway that regulates the proliferation and survival of melanoma cells. In addition to their molecularly targeted activity, BRAF inhibitors have immunomodulatory effects. The MAPK pathway is involved in T-cell receptor signalling, and interference in the pathway by BRAF inhibitors has beneficial effects on the tumour microenvironment and anti-tumour immune response in BRAF-mutant melanoma, including increased immune-stimulatory cytokine levels, decreased immunosuppressive cytokine levels, enhanced melanoma differentiation antigen expression and presentation of tumour antigens by HLA 1, and increased intra-tumoral T-cell infiltration and activity. These effects promote recognition of the tumour by the immune system and enhance anti-tumour T-cell responses. Combining BRAF inhibitors with MEK inhibitors provides more complete blockade of the MAPK pathway. The immunomodulatory effects of BRAF inhibition alone or in combination with MEK inhibition provide a rationale for combining these targeted therapies with immune checkpoint inhibitors. Available data support the synergy between these treatment approaches, indicating such combinations provide an additional beneficial effect on the tumour microenvironment and immune response in BRAF-mutant melanoma.
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Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
- Correspondence: ; Tel.: +39-3334684342 or +39-0773708811
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Salvatore Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Patrizia Maddalena
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Marco Di Fraia
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
| | - Giorgio Mangino
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (G.M.); (G.R.)
- Institute of Molecular Biology and Pathology, Consiglio Nazionale delle Ricerche, 00100 Rome, Italy
| | - Giovanna Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (G.M.); (G.R.)
- Institute of Molecular Biology and Pathology, Consiglio Nazionale delle Ricerche, 00100 Rome, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit “Daniele Innocenzi”, Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy; (N.S.); (S.M.); (A.M.); (V.B.); (N.B.); (A.M.); (E.T.); (S.V.); (P.M.); (M.D.F.); (C.P.)
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Proietti I, Michelini S, Skroza N, Mambrin A, Tolino E, Bernardini N, Di Fraia M, Balduzzi V, Marchesiello A, Volpe S, Maddalena P, Calogero A, Romeo G, Porta N, Pacini L, Di Cristofano C, Petrozza V, Potenza C. Melanoma: Double BRAF mutation, double chance to treat? Dermatol Ther 2020; 33:e13820. [PMID: 32530551 DOI: 10.1111/dth.13820] [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: 04/09/2020] [Revised: 05/20/2020] [Accepted: 06/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ilaria Proietti
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Simone Michelini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nevena Skroza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Alessandra Mambrin
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Ersilia Tolino
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Nicoletta Bernardini
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Marco Di Fraia
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Veronica Balduzzi
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Anna Marchesiello
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Salvatore Volpe
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Patrizia Maddalena
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
| | - Antonella Calogero
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Giovanna Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Natale Porta
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Luca Pacini
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Claudio Di Cristofano
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Vincenzo Petrozza
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.,Pathology Unit, I.C.O.T. Hospital, Latina, Italy
| | - Concetta Potenza
- Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy
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50
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Proietti I, Filippi L, Michelini S, Porta N, Bernardini N, Mambrin A, Tolino E, Pacini L, Rosa P, Calogero A, Romeo G, Di Cristofano C, Petrozza V, Bagni O, Skroza N, Potenza C. PET-guided Switch from Immunotherapy to Targeted Therapy in a Metastatic Melanoma Patient: a personalized approach. Clin Ter 2020; 171:e283-e287. [PMID: 32614358 DOI: 10.7417/ct.2020.2228] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
An early identification of non-responders in oncology is of crucial importance to rapidly switch treatment regimens. Here we report a positron emission tomography, (PET)-guided switch from immunotherapy to targeted therapy in a patient affected by metastatic melanoma. We describe the case of a 78-years-old male patient diagnosed with nodular melanoma, submitted to baseline PET/CT with 18fluorodeoxyglucose (18F-FDG) that showed cutaneous and skeletal metastases (stage IV). The patients started immunotherapy with pembrolizumab. A PET/CT performed 3 months after the start of immunotherapy demonstrated progressive metabolic disease both at skeletal and cutaneous level, confirmed also by the biopsy. As patients resulted positive for BRAF V600k mutation, treatment regimen was rapidly switched to combined anti-BRAF/MEK targeted therapy. The PET/CT performed 3 months later, showed almost complete metabolic response. Ten months after the beginning of targeted therapy, the patient continues to present a durable metabolic response. PET/CT with 18F-FDG may help in monitoring the response to treatment in metastatic melanoma thus defining personalized therapeutic pathways.
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Affiliation(s)
- I Proietti
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
| | - L Filippi
- Nuclear Medicine Unit, "Santa Maria Goretti" Hospital, Latina
| | - S Michelini
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
| | - N Porta
- Pathology Unit, I.C.O.T. Hospital, Latina
| | - N Bernardini
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
| | - A Mambrin
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
| | - E Tolino
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
| | - L Pacini
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | - P Rosa
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | - A Calogero
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | - G Romeo
- Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Latina, Italy
| | | | - V Petrozza
- Pathology Unit, I.C.O.T. Hospital, Latina
| | - O Bagni
- Nuclear Medicine Unit, "Santa Maria Goretti" Hospital, Latina
| | - N Skroza
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
| | - C Potenza
- Dermatology Unit Daniele Innocenzi, A. Fiorini Hospital, Polo Pontino, Terracina - Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome
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