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Pezzolo E, Ortoncelli M, Ferrucci SM, Guanti MB, Schena D, Napolitano M, Rossi M, Foti C, D’Amico D, Amoruso GF, Morrone P, Ribero S, Barei F, Biagi M, Pascucci E, Patruno C, Calzavara Pinton P, Romita P, Gargiulo L, Narcisi A, Naldi L. Drug Survival of Upadacitinib and Predicting Factors of Discontinuation in Adult Patients Affected by Moderate-to-Severe Atopic Dermatitis: An Italian Multicenter Analysis. J Clin Med 2024; 13:553. [PMID: 38256686 PMCID: PMC10816142 DOI: 10.3390/jcm13020553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/12/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Background: Limited real-world data are available on upadacitinib drug survival in patients with atopic dermatitis (AD). Objectives: To investigate upadacitinib drug survival, and the reasons and predictors of drug discontinuation in AD patients. Methods: All consecutive patients aged 18-75 years, affected by moderate-to-severe AD, and treated with upadacitinib for more than 1 month at dermatological clinics were included during November 2020-August 2023. Upadacitinib survival was investigated through Kaplan-Meier survival analysis and the predictors through multivariable logistic regression analysis. Results: Overall, 325 adult AD patients (mean (SD) age, 38.6(15.6) years) had a 1-year and 1.5-year upadacitinib drug survival of 91.5% and 80.2%, respectively. The main reasons for drug discontinuation (25/325, 7.7%) were adverse events (4.9%), including cutaneous or infectious diseases (1.5%), such as acne and herpes zoster; blood test changes (1.2%), including hypercholesterolemia, creatine phosphokinase or liver enzyme elevation, and lymphopenia; urinary or respiratory infections (0.9%); deep venous thrombosis (0.3%); malignancies (0.3%); loss of consciousness (0.3%); and arthralgias (0.3%); followed by ineffectiveness (0.6%). No specific characteristic was significantly associated with an increased risk of upadacitinib discontinuation. Conclusions: Our findings show that upadacitinib was effective in moderate-to-severe AD after more than 1 year of continuous treatment but point to the need for clinical and laboratory monitoring of patients.
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Affiliation(s)
- Elena Pezzolo
- Dermatology Unit, Ospedale San Bortolo, 36100 Vicenza, Italy
- Study Centre of the Italian Group for Epidemiologic Research in Dermatology (GISED), 24128 Bergamo, Italy
| | - Michela Ortoncelli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Silvia Mariel Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Bruno Guanti
- Department of Dermatology, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37100 Verona, Italy
| | - Maddalena Napolitano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
| | | | - Caterina Foti
- Unit of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Domenico D’Amico
- UOC Dermatologia, AOU “R. Dulbecco”, Ospedale ‘A. Pugliese’, 88100 Catanzaro, Italy
| | | | - Pietro Morrone
- UOC Dermatologia, Azienda Ospedaliera Cosenza, 87100 Cosenza, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Francesca Barei
- Dermatology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Matteo Biagi
- Department of Dermatology, University of Modena and Reggio Emilia, 41100 Modena, Italy
| | - Enrico Pascucci
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37100 Verona, Italy
| | - Cataldo Patruno
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy;
| | | | - Paolo Romita
- Unit of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari Aldo Moro, 70121 Bari, Italy
| | - Luigi Gargiulo
- Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy;
| | - Alessandra Narcisi
- Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy;
| | - Luigi Naldi
- Dermatology Unit, Ospedale San Bortolo, 36100 Vicenza, Italy
- Study Centre of the Italian Group for Epidemiologic Research in Dermatology (GISED), 24128 Bergamo, Italy
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Pezzolo E, Schena D, Gambardella A, Rossi M, Barei F, Calzavara Pinton P, Girolomoni G, Naldi L, Ferrucci SM. Survival, efficacy and safety of tralokinumab after 32 and 52 weeks of treatment for moderate-to-severe atopic dermatitis in adults: A multicentre real-world study. J Eur Acad Dermatol Venereol 2024; 38:e11-e13. [PMID: 37483150 DOI: 10.1111/jdv.19382] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/20/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Elena Pezzolo
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
- A Study Centre of the Italian Group for the Epidemiologic Research in Dermatology (GISED), Bergamo, Italy
| | - Donatella Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Alessio Gambardella
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Mariateresa Rossi
- Section of Dermatology, Department of Medicine, University of Brescia, Brescia, Italy
| | - Francesca Barei
- Dermatology Unit, Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | | | - Giampiero Girolomoni
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - Luigi Naldi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
- A Study Centre of the Italian Group for the Epidemiologic Research in Dermatology (GISED), Bergamo, Italy
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Wollenberg A, Kinberger M, Arents B, Aszodi N, Barbarot S, Bieber T, Brough HA, Pinton PC, Christen-Zaech S, Deleuran M, Dittmann M, Fosse N, Gáspár K, Gerbens LAA, Gieler U, Girolomoni G, Gregoriou S, Mortz CG, Nast A, Nygaard U, Rehbinder EM, Ring J, Rossi M, Roxburgh C, Serra-Baldrich E, Simon D, Szalai ZZ, Szepietowski JC, Torrelo A, Werfel T, Flohr C. First update of the living European guideline (EuroGuiDerm) on atopic eczema. J Eur Acad Dermatol Venereol 2023; 37:e1283-e1287. [PMID: 37328919 DOI: 10.1111/jdv.19269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Affiliation(s)
- A Wollenberg
- Department of Dermatology and Allergy, LMU Munich, Munich, Germany
- Department of Dermatology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - M Kinberger
- Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - B Arents
- European Federation of Allergy and Airways Diseases Patients' Associations (EFA), Brussels, Belgium
| | - N Aszodi
- Department of Dermatology and Allergy, LMU Munich, Munich, Germany
| | - S Barbarot
- Department of Dermatology, Nantes Université, CHU Nantes, UMR 1280 PhAN, INRAE, Nantes, France
| | - T Bieber
- Department of Dermatology and Allergy, University Hospital of Bonn, Bonn, Germany
| | - H A Brough
- Children's Allergy Service, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
- Department of Women and Children's Health, School of Life Course Sciences, Paediatric Allergy Group, King's College London, London, UK
| | - P C Pinton
- Dermatology Department, University of Brescia, Brescia, Italy
| | | | - M Deleuran
- Department of Dermatology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
| | - M Dittmann
- Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - N Fosse
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - K Gáspár
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - L A A Gerbens
- Department of Dermatology, Amsterdam UMC (University Medical Centers), Amsterdam, The Netherlands
| | - U Gieler
- Department of Dermatology, Univ. Giessen, Giessen, Germany
| | - G Girolomoni
- Dermatology and Venereology Section, Department of Medicine, University of Verona, Verona, Italy
| | - S Gregoriou
- Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - C G Mortz
- Department of Dermatology and Allergy Centre, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - A Nast
- Division of Evidence-Based Medicine (dEBM), Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - U Nygaard
- Department of Dermato-Venerology, Aarhus University Hospital, Aarhus, Denmark
| | - E M Rehbinder
- Dermatology Department, Oslo University Hospital, Oslo, Norway
| | - J Ring
- Department of Dermatology Allergology Biederstein, Technical University Munich, Munich, Germany
| | - M Rossi
- Dermatology Department, University of Brescia, Brescia, Italy
| | - C Roxburgh
- Eczema Outreach Support (UK), Linlithgow, UK
| | | | - D Simon
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Z Z Szalai
- Pediatric Dermatology Unit, Heim Pál National Children's Institute Budapest, Budapest, Hungary
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - A Torrelo
- Hospital Infantil Niño Jesús, Madrid, Spain
| | - T Werfel
- Hannover Medical School, Hannover, Germany
| | - C Flohr
- St John's Institute of Dermatology, King's College London, London, UK
- Guy's & St Thomas' NHS Foundation Trust, London, UK
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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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Pezzolo E, Rossi M, Caroppo F, Bianchelli T, Belloni Fortina A, Giacchetti A, Calzavara Pinton P, Naldi L. Long-term drug survival of dupilumab and associated predictors in moderate-to-severe atopic dermatitis: A real-world prospective cohort study. J Eur Acad Dermatol Venereol 2023; 37:e757-e759. [PMID: 36662631 DOI: 10.1111/jdv.18889] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Affiliation(s)
- Elena Pezzolo
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy.,Study Centre of the Italian Group for the Epidemiologic Research in Dermatology (GISED), Bergamo, Italy
| | | | | | - Tommaso Bianchelli
- Dermatology Unit, Istituto Nazionale di Riposo e Cura per Anziani, INRCA-IRCCS Hospital, Ancona, Italy
| | | | - Alfredo Giacchetti
- Dermatology Unit, Istituto Nazionale di Riposo e Cura per Anziani, INRCA-IRCCS Hospital, Ancona, Italy
| | | | - Luigi Naldi
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy.,Study Centre of the Italian Group for the Epidemiologic Research in Dermatology (GISED), Bergamo, Italy
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Monari P, Gualdi G, Rovaris S, Venturuzzo A, Rovati C, Calzavara Pinton P. Etiology of Chronic Leg Ulcers in a Dermatologic Wound Clinic: A Retrospective Observational Study. Wound Manag Prev 2022. [DOI: 10.25270/wmp.2022.8.1215] [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] [Indexed: 11/05/2022]
Abstract
BACKGROUND: Chronic leg ulcers affect approximately 1% to 2% of the European population, with an increasing prevalence. The treatment of chronic wounds is a socioeconomical problem worldwide. PURPOSE: The main purpose of the current investigation was to detect the etiology of leg ulcers treated in a dermatologic wound clinic from January 1, 2010, to December 31, 2019. METHODS: This retrospective observational study was performed at the Dermatologic Clinic of Spedali Civili in Brescia, Italy. The authors enrolled 465 patients with chronic leg ulcers. RESULTS: The 3 most represented causes of ulcers were vascular (238 patients, 51.2%), inflammatory (71 patients, 15.3%) and traumatic (43 patients, 9.3%). Altogether, a total of 13 different entities were identified as a cause of leg ulcer. CONCLUSION: Vascular genesis was the most common etiology of leg ulcers in this population, even though uncommon causes were also represented. These findings are in agreement with other studies reported in the literature.
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Monari P, Gualdi G, Rovaris S, Venturuzzo A, Rovati C, Pinton PC. Etiology of Chronic Leg Ulcers in a Dermatologic Wound Clinic: A Retrospective Observational Study. Wound Manag Prev 2022; 68:12-15. [PMID: 35926144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Chronic leg ulcers affect approximately 1% to 2% of the European population, with an increasing prevalence. The treatment of chronic wounds is a socioeconomical problem worldwide. PURPOSE The main purpose of the current investigation was to detect the etiology of leg ulcers treated in a dermatologic wound clinic from January 1, 2010, to December 31, 2019. METHODS This retrospective observational study was performed at the Dermatologic Clinic of Spedali Civili in Brescia, Italy. The authors enrolled 465 patients with chronic leg ulcers. RESULTS The 3 most represented causes of ulcers were vascular (238 patients, 51.2%), inflammatory (71 patients, 15.3%) and traumatic (43 patients, 9.3%). Altogether, a total of 13 different entities were identified as a cause of leg ulcer. CONCLUSION Vascular genesis was the most common etiology of leg ulcers in this population, even though uncommon causes were also represented. These findings are in agreement with other studies reported in the literature.
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Affiliation(s)
- Paola Monari
- Department of Dermatology, University of Brescia, Spedali Civili Brescia, Brescia, Italy
| | - Giulio Gualdi
- Clinic of Dermatology, Department of Medicine and Aging Sciences, University G. D'Annunzio, Chieti, Italy
| | - Sara Rovaris
- Department of Dermatology, University of Brescia, Spedali Civili Brescia, Brescia, Italy
| | - Anna Venturuzzo
- Department of Dermatology, University of Brescia, Spedali Civili Brescia, Brescia, Italy
| | - Chiara Rovati
- Department of Dermatology, University of Brescia, Spedali Civili Brescia, Brescia, Italy
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Bonamonte D, Hansel K, Romita P, Belloni Fortina A, Girolomoni G, Fabbrocini G, Patruno C, Napolitano M, Patrizi A, Argenziano G, Micali G, Pinton PC, Foti C, Stingeni L. Contact allergy in children with and without atopic dermatitis: an Italian multicenter study. Contact Dermatitis 2022; 87:265-272. [PMID: 35451136 PMCID: PMC9541036 DOI: 10.1111/cod.14130] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
Background Contact allergy and atopic dermatitis (AD) are both common inflammatory T cell‐mediated diseases and many factors may influence the prevalence of contact allergy in AD patients. In children, their possible correlation was debated with conflicting results. Objectives The present study aimed to assess the prevalence of contact sensitivity in children and to investigate the association with AD. Materials and methods A retrospective multicentre study on children aged from 0 to 14 years patch tested between January 2017 and December 2018 was performed. Children were consecutively patch tested with the SIDAPA (Società Italiana Dermatologia Allergologica Professionale Ambientale) baseline series. Results Among the 432 children investigated for contact allergy, 125 (28.9%) showed a positive reaction to at least one of the allergens tested, with a higher prevalence of positive patch test reactions in girls (32.3%) than in boys (25.0%). The most frequent contact allergens were nickel sulphate (10.2%), cobalt chloride (6.7%), methylisothiazolinone (3.7%), fragrance mix‐2 (3.2%), potassium dichromate (2.8%), fragrance mix‐1 (2.1%) and methylchloroisothiazolinone/methylisothiazolinone (2.1%). One‐hundred‐three children (23.8%) suffered from AD showing a higher prevalence of positive patch test (36.9%) compared to children without AD (26.4%). Conclusions Despite the topic being still controversial, the present study suggests a consistent prevalence of contact allergy among children with higher sensitivity rate among children with AD than without AD.
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Affiliation(s)
- Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Katharina Hansel
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - Paolo Romita
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Anna Belloni Fortina
- Unit of Pediatric Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Annalisa Patrizi
- Unit of Dermatology, IRCS Azienda Ospedaliero Universitaria, University of Bologna, Bologna, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | | | | - Caterina Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Luca Stingeni
- Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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9
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Argenziano G, Brancaccio G, Moscarella E, Dika E, Fargnoli MC, Ferrara G, Longo C, Pellacani G, Peris K, Pimpinelli N, Quaglino P, Rongioletti F, Simonacci M, Zalaudek I, Calzavara Pinton P. Management of cutaneous melanoma: comparison of the leading international guidelines updated to the 8th American Joint Committee on Cancer staging system and workup proposal by the Italian Society of Dermatology. GIORN ITAL DERMAT V 2021; 155:126-145. [PMID: 32394673 DOI: 10.23736/s0392-0488.19.06383-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Giuseppe Argenziano
- Unit of Dermatology, Luigi Vanvitelli University of Campania, Naples, Italy -
| | | | - Elvira Moscarella
- Unit of Dermatology, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Emi Dika
- Unit of Dermatology (DIMES), University of Bologna, Bologna, Italy
| | - Maria C Fargnoli
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
| | - Gerardo Ferrara
- Unit of Anatomic Pathology, Hospital of Macerata, Area Vasta 3 ASUR Marche, Macerata, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy.,Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Ketty Peris
- Institute of Dermatology, Sacred Heart Catholic University, Rome, Italy.,A. Gemelli University Polyclinic, IRCCS and Foundation, Rome, Italy
| | - Nicola Pimpinelli
- Unit of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin Medical School, Turin, Italy
| | - Franco Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marco Simonacci
- Unit of Dermatology, Hospital of Macerata, Area Vasta 3 ASUR Marche, Macerata, Italy
| | - Iris Zalaudek
- Department of Dermatology, University Hospital of Trieste, Trieste, Italy
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10
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Brambilla L, Genovese G, Berti E, Peris K, Rongioletti F, Micali G, Ayala F, Della Bella S, Mancuso R, Calzavara Pinton P, Tourlaki A. Diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma: Italian recommendations. Ital J Dermatol Venerol 2020; 156:356-365. [PMID: 33179877 DOI: 10.23736/s2784-8671.20.06703-6] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Kaposi's sarcoma (KS) is a lymphangioproliferative disorder associated with Human herpesvirus 8 (HHV8) infection. Four clinical subtypes are recognized: classic, endemic, epidemic (HIV-related) and iatrogenic. KS diagnosis is based on clinical features, histopathological assessment, and HHV8 serology. Classic KS is usually skin-limited and has a chronic course, while the iatrogenic variant may show mucosal, nodal or visceral involvement. Clinical staging is fundamental to guide the management. Localized disease may be treated with different local therapies, even if there are no randomized trials comparing these different modalities. Aggressive, disseminated KS and cases with visceral involvement usually require systemic chemotherapy, most commonly vinblastine, bleomycin or paclitaxel. Iatrogenic KS needs immunosuppression tapering/withdrawal and, if possible, switch to m-TOR inhibitors in post-transplant KS. The present work by a panel of Italian experts provides guidelines on KS diagnosis and management based on a critical review of the literature and a long and extensive personal experience.
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Affiliation(s)
- Lucia Brambilla
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Genovese
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Emilio Berti
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Ketty Peris
- Unit of Dermatology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Unit of Dermatology, Sacred Heart Catholic University, Rome, Italy
| | - Franco Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuseppe Micali
- Clinic of Dermatology, University of Catania, Catania, Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Silvia Della Bella
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy
| | | | | | - Athanasia Tourlaki
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
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11
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Brambilla L, Genovese G, Berti E, Peris K, Rongioletti F, Micali G, Ayala F, Della Bella S, Mancuso R, Calzavara Pinton P, Tourlaki A. Diagnosis and treatment of classic and iatrogenic Kaposi's sarcoma: Italian recommendations. Ital J Dermatol Venerol 2020. [PMID: 33179877 DOI: 10.23736/s0392-0488.20.06703-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Kaposi's sarcoma (KS) is a lymphangioproliferative disorder associated with Human herpesvirus 8 (HHV8) infection. Four clinical subtypes are recognized: classic, endemic, epidemic (HIV-related) and iatrogenic. KS diagnosis is based on clinical features, histopathological assessment, and HHV8 serology. Classic KS is usually skin-limited and has a chronic course, while the iatrogenic variant may show mucosal, nodal or visceral involvement. Clinical staging is fundamental to guide the management. Localized disease may be treated with different local therapies, even if there are no randomized trials comparing these different modalities. Aggressive, disseminated KS and cases with visceral involvement usually require systemic chemotherapy, most commonly vinblastine, bleomycin or paclitaxel. Iatrogenic KS needs immunosuppression tapering/withdrawal and, if possible, switch to m-TOR inhibitors in post-transplant KS. The present work by a panel of Italian experts provides guidelines on KS diagnosis and management based on a critical review of the literature and a long and extensive personal experience.
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Affiliation(s)
- Lucia Brambilla
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Genovese
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Emilio Berti
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Medical-Surgical Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Ketty Peris
- Unit of Dermatology, IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy.,Unit of Dermatology, Sacred Heart Catholic University, Rome, Italy
| | - Franco Rongioletti
- Unit of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giuseppe Micali
- Clinic of Dermatology, University of Catania, Catania, Italy
| | - Fabio Ayala
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Silvia Della Bella
- Unit of Clinical and Experimental Immunology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy.,Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy
| | | | | | - Athanasia Tourlaki
- Unit of Dermatology, Maggiore Polyclinic Hospital, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
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12
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Maione V, Caravello S, Cozzi C, Venturini M, Incardona P, Frassi M, Calzavara Pinton P. Erfolgreiche Therapie eines refraktären eosinophilen anulären Erythems mit
Dupilumab. J Dtsch Dermatol Ges 2020; 18:1031-1033. [PMID: 32985820 DOI: 10.1111/ddg.14254_g] [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: 11/28/2022]
Affiliation(s)
- Vincenzo Maione
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Simone Caravello
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Chiara Cozzi
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marina Venturini
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy.,Faculty of Medicine and Surgery, University of Brescia, Brescia, Italy
| | - Paolo Incardona
- Department of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Micol Frassi
- Department of Rheumatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Piergiacomo Calzavara Pinton
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy.,Faculty of Medicine and Surgery, University of Brescia, Brescia, Italy
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13
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Maione V, Caravello S, Cozzi C, Venturini M, Incardona P, Frassi M, Pinton PC. Refractory eosinophilic annular erythema treated successfully with dupilumab. J Dtsch Dermatol Ges 2020; 18:1031-1032. [PMID: 32909389 DOI: 10.1111/ddg.14254] [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: 11/30/2022]
Affiliation(s)
- Vincenzo Maione
- Association with Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Simone Caravello
- Association with Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Chiara Cozzi
- Association with Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Marina Venturini
- Association with Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy.,Faculty of Medicine and Surgery, University of Brescia, Brescia, Italy
| | - Paolo Incardona
- Department of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Micol Frassi
- Department of Rheumatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Piergiacomo Calzavara Pinton
- Association with Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy.,Faculty of Medicine and Surgery, University of Brescia, Brescia, Italy
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14
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Maione V, Perantoni M, Errichetti E, Borra T, Pinton PC. Porocarcinoma From Preexisting Hidroacanthoma Simplex: Dermoscopic Findings. Dermatol Pract Concept 2020; 10:e2020036. [PMID: 32363098 DOI: 10.5826/dpc.1002a36] [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] [Accepted: 12/10/2019] [Indexed: 10/31/2022] Open
Affiliation(s)
- Vincenzo Maione
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Martina Perantoni
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Enzo Errichetti
- Institute of Dermatology, University of Udine, Department of Experimental & Clinical Medicine, Udine, Italy
| | - Tiziana Borra
- Department of Pathology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Piergiacomo Calzavara Pinton
- Department of Dermatology, ASST Spedali Civili di Brescia, Brescia, Italy.,University of Brescia, Faculty of Medicine and Surgery, Brescia, Italy
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15
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Ribero S, Dapavo P, Casalegno C, Alaibac M, Argenziano G, Arpaia NG, Bagnoni G, Berti E, Bianchi L, Bianchini D, Calzavara Pinton P, Cannavò SP, Congedo M, Corrao S, Costanzo A, Cusano F, Dattola S, Dattoli S, Deledda S, Donini M, Fabbrocini G, Teresa Fierro M, Foti C, Galluccio AG, Gatti A, René Girardelli C, Girolomoni G, Lemme G, Malagoli P, Malara G, Mercuri SR, Micali G, Montesu MA, Offidani A, Papini M, Parodi A, Patrizi A, Pellacani G, Peris K, Piccirillo A, Pigatto P, Pimpinelli N, Potenza C, Provenzano E, Romanelli M, Rongioletti F, Savoia P, Simonacci M, Sirna R, Stinco G, Valenti G, Zalaudek I. Improving the disease awareness: how a communication campaign brings hidradenitis suppurativa to the light. J Eur Acad Dermatol Venereol 2019; 33 Suppl 6:7-9. [DOI: 10.1111/jdv.15828] [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: 04/07/2019] [Accepted: 05/17/2019] [Indexed: 11/30/2022]
Affiliation(s)
- S. Ribero
- Department of Medical Sciences Dermatologic Clinic University of Turin Turin Italy
| | - P. Dapavo
- Department of Medical Sciences Dermatologic Clinic University of Turin Turin Italy
| | - C. Casalegno
- Department of Management University of Turin Turin Italy
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16
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Lacarrubba F, Dini V, Napolitano M, Venturini M, Caposiena Caro D, Molinelli E, Passoni E, Monfrecola G, Argenziano G, Berti E, Bianchi L, Calzavara Pinton P, Cannavò SP, Costanzo A, Donini M, Fabbrocini G, Fierro MT, Micali G, Offidani A, Parodi A, Patrizi A, Pellacani G, Peris K, Pimpinelli N, Potenza C, Romanelli M, Rongioletti F, Solivetti F. Ultrasonography in the pathway to an optimal standard of care of hidradenitis suppurativa: the Italian Ultrasound Working Group experience. J Eur Acad Dermatol Venereol 2019; 33 Suppl 6:10-14. [DOI: 10.1111/jdv.15847] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 07/24/2019] [Indexed: 02/07/2023]
Affiliation(s)
- F. Lacarrubba
- Dermatology Clinic University of Catania Catania Italy
| | - V. Dini
- Department of Dermatology University of Pisa Pisa Italy
| | - M. Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio University of Molise Campobasso Italy
| | - M. Venturini
- Department of Dermatology University of Brescia Brescia Italy
| | | | - E. Molinelli
- Dermatology Unit Polytechnic Marche University Ancona Italy
| | - E. Passoni
- Dermatology Unit Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico Milan Italy
| | - G. Monfrecola
- Section of Dermatology University of Naples Federico II Naples Italy
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17
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Gorga E, Scodro M, Valentini F, D'Ortona R, Arisi M, Sciatti E, Bonadei I, Regazzoni V, Vizzardi E, Metra M, Calzavara Pinton P. Echocardiographic evaluation of diastolic dysfunction in young and healthy patients with psoriasis: A case-control study. Monaldi Arch Chest Dis 2018; 88:934. [PMID: 30183154 DOI: 10.4081/monaldi.2018.934] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 11/23/2022] Open
Abstract
Psoriasis is a systemic inflammatory disease with a great prevalence in general population. The inappropriate activation of the cellular immune system has been hypothesized to be an independent cardiovascular risk factor, given the higher incidence of cardiovascular disorders in psoriatic patients. Echocardiographic abnormalities have been demonstrated too: the aim of our study was to evaluate the presence of preclinical cardiac dysfunction in a cohort of psoriatic patients without cardiovascular risk factors. We enrolled 52 patients with the diagnosis of chronic plaque psoriasis, compared with a control group not affected by any relevant systemic diseases and inflammatory disorders. In all patients and control group, echocardiographic conventional and tissue Doppler (TDI) studies were conducted. The analysis of echocardiographic parameters revealed normal dimension, mass and systolic function of the left ventricle. Left ventricular diastolic dysfunction was found in 36.5% patients in the psoriasis group versus 0% in control group, and significant reduction of the E/A ratio was found also for the right ventricle. A significant increase of mitral regurgitation has been found in psoriatic patients (p=0.005). The early recognition of cardiovascular pre-clinic disease in psoriatic patients may guide a strict follow up and an early treatment, potentially improving cardiovascular prognosis.
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Affiliation(s)
- Elio Gorga
- University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health.
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18
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Gualdi G, Cammalleri D, Monari P, Calzavara Pinton P, Lougaris V. Glossotillomania as cause of Riga-Fede syndrome. Ital J Dermatol Venerol 2018; 153:576-577. [PMID: 29767483 DOI: 10.23736/s0392-0488.17.05570-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giulio Gualdi
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Daniele Cammalleri
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy -
| | - Paola Monari
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | | | - Vassilios Lougaris
- Department of Pediatrics, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
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19
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Magoni M, Apostoli P, Donato F, Manganoni A, Comba P, Fazzo L, Speziani F, Leonardi L, Orizio G, Scarcella C, Calzavara Pinton P. Plasma levels of polychlorinated biphenyls and risk of cutaneous malignant melanoma: A hospital-based case-control study. Environ Int 2018; 113:20-25. [PMID: 29421403 DOI: 10.1016/j.envint.2018.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/15/2018] [Accepted: 01/20/2018] [Indexed: 05/20/2023]
Abstract
Polychlorinated biphenyls (PCB) have been classified by the International Agency for Research on Cancer (IARC) in Group 1 as carcinogenic to human, based on sufficient evidence in humans of an increased risk of cutaneous malignant melanoma (CMM), however few studies have been done in the general population. This study examined the relationship between PCB plasma levels and risk of CMM adjusting for sun sensitivity and sun exposure in a province of Northern Italy (Brescia), where a chemical factory produced PCBs from 1938 to 1984 causing human contamination. A case-control study of 205 CMM patients and 205 control subjects was conducted. Cases and controls were assayed for plasma levels of 33 PCB congeners. No associations was found between risk of CMM and plasma levels of total PCB (OR = 0.81; 95% CI: 0.34-1.96 for highest vs lowest quartile) or specific congeners. The study confirmed the association with light skin colour (OR = 3.00; 95% CI: 1.91-4.73), cumulative lifetime UV exposure (OR = 2.56; 95% CI: 1.35-4.85) and high level of education (OR = 1.45; 95% CI: 1.03-2.05). This case-control study does not support the hypothesis of an association between current plasma levels of PCBs and CMM development in the general population.
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Affiliation(s)
- Michele Magoni
- ATS Brescia (Brescia Health Protection Agency), Brescia, Italy.
| | - Pietro Apostoli
- Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Institute of Occupational Health and Industrial Hygiene, University of Brescia, Italy
| | - Francesco Donato
- Department of Medical and Surgical Specialties Radiological Sciences and Public Health, Unit of Hygiene, Epidemiology, and Public Health, University of Brescia, Italy
| | - Ausilia Manganoni
- Section of Dermatology, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
| | | | - Lucia Leonardi
- ATS Brescia (Brescia Health Protection Agency), Brescia, Italy
| | - Grazia Orizio
- ATS Brescia (Brescia Health Protection Agency), Brescia, Italy
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20
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Calzavara Pinton P, Cristaudo A, Foti C, Canonica GW, Balato N, Costanzo A, DE Pità O, DE Simone C, Patruno C, Pellacani G, Peris K, Girolomoni G. Diagnosis and management of moderate to severe adult atopic dermatitis: a Consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Italian Association of Hospital Dermatologists (ADOI), the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC), and the Italian Society of Allergological, Environmental and Occupational Dermatology (SIDAPA). G Ital Dermatol Venereol 2017. [PMID: 29237258 DOI: 10.23736/s0392-0488.17.05892-8.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atopic dermatitis (AD) is a chronic immune-mediated inflammatory skin disease, currently recognized as a systemic disease possibly burdened by various comorbidities, including, but not limited to, other allergic conditions. Management guidelines issued by American and European dermatology and allergy scientific societies are available. However, some discrepancies exist in these guidelines, and some aspects of the management process, including diagnosis and severity assessment, as well as therapy duration and switch criteria, are not fully clarified by existing guidelines. Moreover, biologics such as dupilumab have now entered the therapeutic scenario of moderate-to-severe AD, offering a great opportunity to treat effectively and safely in need AD patients. For all these reasons, four Italian dermatology and allergy scientific societies joined to provide practical guidance for the management of moderate-to-severe adult AD suitable for the Italian clinical practice. Through a modified Delphi procedure, consensus was reached by 63 Italian dermatologists and allergists experienced in the management of adult AD on 14 statements covering five AD areas of interest, i.e. diagnosis, severity definition, current systemic therapies, eligibility criteria to biologic treatments, and comorbidities, with the aim to define treatment goals and improve adult AD management. The potential usefulness of a multidisciplinary approach is also underlined, given the complexity of AD and its comorbidities.
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Affiliation(s)
| | | | - Caterina Foti
- Unit of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Giorgio W Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University, Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Nicola Balato
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy: 6 Unit of Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Antonio Costanzo
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Clinical Pathology, Cristo Re Hospital, Rome, Italy
| | - Ornella DE Pità
- Department of Dermatology, Sacro Cuore Catholic University, Rome, Italy
| | - Clara DE Simone
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy: 6 Unit of Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giovanni Pellacani
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Ketty Peris
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Calzavara Pinton P, Cristaudo A, Foti C, Canonica GW, Balato N, Costanzo A, DE Pità O, DE Simone C, Patruno C, Pellacani G, Peris K, Girolomoni G. Diagnosis and management of moderate to severe adult atopic dermatitis: a Consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Italian Association of Hospital Dermatologists (ADOI), the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC), and the Italian Society of Allergological, Environmental and Occupational Dermatology (SIDAPA). Ital J Dermatol Venerol 2017; 153:133-145. [PMID: 29237258 DOI: 10.23736/s0392-0488.17.05892-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Atopic dermatitis (AD) is a chronic immune-mediated inflammatory skin disease, currently recognized as a systemic disease possibly burdened by various comorbidities, including, but not limited to, other allergic conditions. Management guidelines issued by American and European dermatology and allergy scientific societies are available. However, some discrepancies exist in these guidelines, and some aspects of the management process, including diagnosis and severity assessment, as well as therapy duration and switch criteria, are not fully clarified by existing guidelines. Moreover, biologics such as dupilumab have now entered the therapeutic scenario of moderate-to-severe AD, offering a great opportunity to treat effectively and safely in need AD patients. For all these reasons, four Italian dermatology and allergy scientific societies joined to provide practical guidance for the management of moderate-to-severe adult AD suitable for the Italian clinical practice. Through a modified Delphi procedure, consensus was reached by 63 Italian dermatologists and allergists experienced in the management of adult AD on 14 statements covering five AD areas of interest, i.e. diagnosis, severity definition, current systemic therapies, eligibility criteria to biologic treatments, and comorbidities, with the aim to define treatment goals and improve adult AD management. The potential usefulness of a multidisciplinary approach is also underlined, given the complexity of AD and its comorbidities.
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Affiliation(s)
| | | | - Caterina Foti
- Unit of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - Giorgio W Canonica
- Personalized Medicine Asthma & Allergy Clinic, Humanitas University, Clinical and Research Hospital, Rozzano, Milan, Italy
| | - Nicola Balato
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy: 6 Unit of Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Antonio Costanzo
- Unit of Dermatology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.,Clinical Pathology, Cristo Re Hospital, Rome, Italy
| | - Ornella DE Pità
- Department of Dermatology, Sacro Cuore Catholic University, Rome, Italy
| | - Clara DE Simone
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Cataldo Patruno
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy: 6 Unit of Dermatology, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giovanni Pellacani
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Ketty Peris
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Colombo D, Chimenti S, Grossi PA, Marchesoni A, Foti R, Calzavara Pinton P, Zagni E, Ori A, Bellia G. Efficacy of cyclosporine A as monotherapy in patients with psoriatic arthritis: a subgroup analysis of the SYNERGY Study. Ital J Dermatol Venerol 2017; 152:297-301. [DOI: 10.23736/s0392-0488.16.05301-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Girolomoni G, Calzavara Pinton P, Cristaudo A, Cicchetti A. Back to the future: a new topical approach for mild-to-moderate psoriasis. Ital J Dermatol Venerol 2016; 153:375-382. [PMID: 27982547 DOI: 10.23736/s0392-0488.16.05516-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Psoriasis is a chronic-relapsing skin disorder which requires long-term treatments. Therapeutic options for psoriasis include topical treatments, phototherapy and systemic therapy. However, those treatments, and particularly the topical drug therapies, may present some limitations, including poor efficacy/tolerability ratio and lack of adherence. Recently, the supersaturated aerosol foam formulation of the fixed combination calcipotriene plus betamethasone dipropionate (Cal/BD) has gained major attention because it overcomes some of the limitations associated with other topical treatments. This fixed-combination has increased efficacy compared with its individual components. Moreover, the alcohol-free aerosol foam formulation allows a higher penetration of the active ingredients into the skin, resulting in enhanced bioavailability and, consequently, in better clinical outcomes than other products with the same components. Given the short duration of therapy course and the fast onset of action, a reduced amount of Cal/BD foam formulation would be required for the treatment of psoriasis patients, resulting also in cost saving. Therefore this novel formulation could represent an alternative to other topical agents and a first-line therapy in the treatment of mild and mild-to-moderate psoriasis.
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Affiliation(s)
- Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy -
| | | | | | - Americo Cicchetti
- Postgraduate School of Health Economics and Management, Catholic University of the Sacred Heart, Rome, Italy
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Calzavara Pinton P, Licitra L, Peris K, Santoro A, Ascierto PA. Vismodegib in the treatment of basal cell carcinoma: indications for clinical practice. Future Oncol 2016; 11:1429-35. [PMID: 25952787 DOI: 10.2217/fon.15.20] [Citation(s) in RCA: 8] [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] [Indexed: 11/21/2022] Open
Abstract
Basal cell carcinoma (BCC) is a frequent skin cancer which can cause substantial morbidity due to its location on the face, its frequency of relapse and its capacity to invade local tissues. The primary treatment of BCC usually involves surgery or radiotherapy. In patients who have exhausted surgical and radiotherapy options or with metastatic BCC, guidelines recommend the use of the Hedgehog pathway inhibitor vismodegib. This molecule is indicated for the treatment of adults with metastatic BCC, or with locally advanced BCC which has recurred following surgery or who are not eligible to surgery or radiation. This paper aims to provide suggestions on the optimal management of BCC patients treated with vismodegib in clinical practice, according to the large experience gained by a group of Italian dermatologists and oncologists. In particular, the focus of this paper will be on the monitoring of patients and the management of adverse events.
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DI Lernia V, Neri I, Calzavara Pinton P, DI Nuzzo S, Stingeni L, Guarneri C, Belloni Fortina A, Bonamonte D, Cambiaghi S, Lasagni C, Panzone M, Corazza M, Offidani A, Gisondi P. Treatment patterns with systemic antipsoriatic agents in childhood psoriasis: an Italian database analysis. Ital J Dermatol Venerol 2016; 152:327-332. [PMID: 26761766 DOI: 10.23736/s0392-0488.16.05287-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The majority of available systemic therapies have never been systematically investigated in moderate to severe childhood plaque psoriasis. For this reason, treatment preferences for moderate to severe psoriasis in childhood are still unknown. The aim of this study was to investigate the systemic treatment patterns of moderate to severe psoriasis in children and adolescents aged 18 or older in Italy. Additional secondary outcomes were duration of treatment and reasons for discontinuation. METHODS In order to define differences in treatment patterns, we performed a chart review of all consecutive patients treated with systemic drugs during an index period of 5 years. Consecutive sampling of all patients with psoriasis aged ≤18 years, who had been treated with at least one systemic drug over a 5-year period, was made. RESULTS The records of 58 consecutive patients, 27 males, 31 females. with moderate to severe psoriasis treated with at least one systemic therapy were reviewed. The median age (standard deviation) at the start of the first systemic treatment was 11.7±3.7 years. The most preferred first-line systemic treatment was cyclosporine, which was administered as first systemic treatment in 53.4% of patients, followed by acitretin in 22.4% of patients, etanercept and PUVA respectively in 8.6%, methotrexate in 6.8%. 48.2% of patients received a second systemic treatment due to inefficacy or side effects of the first-line therapy during the index period. Because of the small sample, and voluntary contribution, selection bias may have occurred. CONCLUSIONS A considerable variation in the management of the first-line systemic therapy in children with moderate to severe psoriasis was observed. Cyclosporine was most commonly preferred as a first-line treatment. The availability of new therapeutic agents could change the scenario of treatment patterns in childhood psoriasis.
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Affiliation(s)
- Vito DI Lernia
- Dermatology Unit, Department of Internal Medicine, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy -
| | - Iria Neri
- Dermatology Unit, Department of Specialist, Diagnostic and Experimental Medicine, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | | | - Sergio DI Nuzzo
- Section of Dermatology, Department of Clinical and Experimental Medicine, Parma University Hospital, Parma, Italy
| | - Luca Stingeni
- Section of Clinical Dermatology, Allergology and Venereology, Department of Medicine, University of Perugia, Perugia, Italy
| | - Claudio Guarneri
- Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
| | - Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Domenico Bonamonte
- Section of Dermatology, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - Stefano Cambiaghi
- Pediatric Dermatology Unit, Department of Pathophysiology and Transplantation, Maggiore Hospital, Polyclinic Hospital of Milan, Milan, Italy
| | - Claudia Lasagni
- Dermatology Unit, Department of Head and Neck Surgery, University of Modena, Modena, Italy
| | - Michele Panzone
- Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Monica Corazza
- Department of Medical Sciences, Section of Dermatology, University of Ferrara, Ferrara, Italy
| | - Annamaria Offidani
- Dermatology Unit, Department of Clinical and Molecular Sciences, Marche Polytechnic University, Ancona, Italy
| | - Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
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Cugno M, Marzano AV, Bucciarelli P, Balice Y, Cianchini G, Quaglino P, Calzavara Pinton P, Caproni M, Alaibac M, De Simone C, Patrizi A, Cozzani E, Papini M, Tedeschi A, Berti E, Rosendaal FR. Increased risk of venous thromboembolism in patients with bullous pemphigoid. The INVENTEP (INcidence of VENous ThromboEmbolism in bullous Pemphigoid) study. Thromb Haemost 2015; 115:193-9. [PMID: 26245987 DOI: 10.1160/th15-04-0309] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/19/2015] [Indexed: 01/24/2023]
Abstract
Activation of blood coagulation has been demonstrated in bullous pemphigoid (BP), a rare autoimmune blistering disease, potentially leading to a prothrombotic state. In order to evaluate the incidence of venous thromboembolism (VTE) in BP, a cohort study was carried out on 432 BP patients (59% females; median age 76 years, interquartile range [IQR]: 68-82). At diagnosis, autoimmune bullous skin disorder intensity score (ABSIS) was calculated. VTE incidence was standardised with rates of the general population. Multivariable Cox proportional hazard model was used to estimate the hazard ratio of VTE according to ABSIS and concomitant risk factors. During a median follow-up of 4.2 years, 31 objectively-diagnosed VTE events were recorded. The incidence rate of VTE (per 1000 patient-years) was 17.2 overall (95% confidence interval [CI]: 11.1-23.2), 56.7 (95%CI: 33.0-80.4) during acute phase (22 VTE) and 6.3 (95%CI: 2.8-11.3) during remission (9 VTE). The standardised incidence ratio was 4.06 (95%CI: 2.73-5.65), higher during the acute phase (14.86, 95%CI: 9.20-21.88) than during remission (1.48, 0.66-2.63). The adjusted hazard ratio of VTE was 2.74 (95%CI: 1.07-7.04) for ABSIS > 48 vs ABSIS < 28, and 2.56 (95%CI: 1.00-6.70) in patients with ≥ 2 concomitant risk factors. In conclusion, BP patients have a 15-fold increased VTE risk during acute phase, proportional to disease severity and heightened by concomitant risk factors.
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Affiliation(s)
- Massimo Cugno
- Massimo Cugno, MD, Internal Medicine, Department of Pathophysiology and Transplantation, University of Milan, Via Pace 9, 20122 Milano, Italy, Tel.: +39 02 55036340, Fax: +39 02 50320742, E-mail:
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Spandonaro F, Ayala F, Berardesca E, Chimenti S, Girolomoni G, Martini P, Peserico A, Polistena B, Guerra AP, Vena GA, Altomare G, Pinton PC. Reply to Scalone and Cortesi: "Cost-utility analysis of biologic therapies to treat chronic plaque psoriasis in Italy: the importance of using updated and adequate social tariffs to calculate QALYs". BioDrugs 2015; 29:71-2. [PMID: 25647521 DOI: 10.1007/s40259-015-0118-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Girolomoni G, Altomare G, Ayala F, Berardesca E, Calzavara Pinton P, Chimenti S, Martini P, Peserico A, Puglisi Guerra A, Antonio Vena G. Differential management of mild-to-severe psoriasis with biologic drugs: An Italian Delphi consensus expert panel. J DERMATOL TREAT 2014; 26:128-33. [DOI: 10.3109/09546634.2014.907466] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Monari P, Gualdi G, Arisi M, Crotti S, Pinton PC. Letter: onychocryptosis of the toenail: the effectiveness of surgical matricectomy. Dermatol Surg 2012; 38:1413. [PMID: 22861063 DOI: 10.1111/j.1524-4725.2012.02465.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Pasolini G, Ghidini P, Arisi M, Pedretti A, Ungari M, Pinton PC. Pseudolymphoma tattoo-induced. Dermatol Reports 2011; 3:e47. [PMID: 25386299 PMCID: PMC4211496 DOI: 10.4081/dr.2011.e47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Revised: 10/14/2011] [Accepted: 10/24/2011] [Indexed: 11/22/2022] Open
Abstract
Tattooing has become more and more popular in today's society. The most common dermatological tattoo complications are represented by hypersensitivity reaction to tattoo pigments like irritant and allergical contact dermatitis, development of lichenoid areas and granulomatous responses, such as sarcoid granulomas or foreign body granulomas. Less frequently patients developing discoid lupus erythematous have been reported. Pseudolymphoma is an uncommon reactive lymphocytic proliferation mimicking the histological and clinical features of a malignant skin lymphoma. We herein report a pseuldoymphoma limited to the red area of a multicolour tattoo of the leg.
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Affiliation(s)
| | | | | | | | - Marco Ungari
- Department of Pathology, Spedali Civili di Brescia, University of Brescia, Italy
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de Portu S, Del Giglio M, Altomare G, Arcangeli F, Berardesca E, Calzavara-Pinton P, Pinton PC, Lotti T, Martini P, Peserico A, Simonacci M, Vena GA, Girolomoni G. Cost-effectiveness analysis of TNF-alpha blockers for the treatment of chronic plaque psoriasis in the perspective of the Italian health-care system. Dermatol Ther 2010; 23 Suppl 1:S7-13. [PMID: 20136921 DOI: 10.1111/j.1529-8019.2009.01280.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The cost-effectiveness of biological treatments for psoriasis is not well determined and may vary from country to country. The objectives of this study was to perform a cost-effectiveness analysis of infliximab compared with other anti-tumor necrosis factor-alpha agents for the treatment of psoriasis in Italy. The incremental cost-effectiveness ratio per patients achieving at least 75% improvement in the psoriasis area and severity index assessed over 24- and 48-50-week periods was calculated. Efficacy data were drawn from randomized controlled trials when available or from open label studies. Considering patients achieving psoriasis area and severity index at week 24 and 48-50, infliximab was dominant (more effective and less costly) over etanercept given at 50 mg twice weekly. In contrast, infliximab was not dominant over etanercept at other dosages or over adalimumab. When considering the impact of therapy on quality of life at Week 12 using the Dermatology Life Quality Index equal to zero, infliximab resulted more effective and less costly than etanercept. Therefore, infliximab seems to be cost-effective in the therapy of psoriasis. Further cost-efficacy evaluations based on head-to-head trials are necessary to address health economic considerations.
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Affiliation(s)
- Simona de Portu
- CIRFF, Faculty of Pharmacy, University of Naples, Federico II, Italy
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Venturini A, Zane C, Rodella R, Leali C, Calzavara Pinton P, Zorzi F. Syringotropic cutaneous T cell lymphoma treated with PUVA therapy. Eur J Dermatol 2005; 15:262-4. [PMID: 16048754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2005] [Indexed: 05/03/2023]
Abstract
Syringotropic cutaneous T cell Lymphoma (SCTCL) is a rare localized variant of CTCL. It is characterized by erythematous papules that, at histological examination, show dense dermal infiltrates of atypical T cells, that are preferentially located around hyperplastic eccrine sweat glands and ducts, with absent or minimal epidermotropism. Its relationship with mycosis fungoides and other CTCLs is not clarified and is still under discussion. Several treatment approaches have been suggested, but therapeutic results are often disappointing. We report the case of a patient with typical clinical and histopathological features of SCTCL and an excellent response to PUVA therapy.
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Affiliation(s)
- Alessandro Venturini
- Department of Dermatology, Spedali Civili, p.le Spedali Civili, 1 25123 Brescia, Italy.
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Calzavara Pinton P, Porta F, Izzi T, Venturini M, Capezzera R, Zane C, Notarangelo LD. Prospects for ultraviolet A1 phototherapy as a treatment for chronic cutaneous graft-versus-host disease. Haematologica 2003; 88:1169-75. [PMID: 14555314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Standard or investigative immunosuppressive therapies for cutaneous chronic graft-versus-host disease (GVHD) may prove not only ineffective but also cause serious adverse effects. Repeated exposure of the skin to ultraviolet radiation in the wavelength range 340-400 nm (so-called ultraviolet A1) was recently reported to have a strong local (intracutaneous) immunomodulatory activity. This study was undertaken to evaluate efficacy and safety of this phototherapy. DESIGN AND METHODS Nine patients with cutaneous (4 lichenoid and 5 sclerodermoid) GVHD and mild or no other organ involvement were enrolled. All patients had developed serious drug toxicity and/or opportunistic infections. Phototherapy was administered three times a week. RESULTS Complete remission was seen in 5 (2 lichenoid and 3 sclerodermoid) cases and a partial improvement in 4 (2 lichenoid and 2 sclerodermoid) after having received 15.8+/-3.8 (lichenoid GVHD) or 21.6+/-8.0 (sclerodermoid GVHD) sessions of phototherapy. Adverse effects were not registered. At follow-up (range: 6-25 months), two patients with sclerodermoid lesions relapsed after 5 months but responded to another treatment cycle. Patients with lichenoid GVHD showed relapses within one month and prolonged maintenance phototherapy was needed. Problems of drug toxicity and opportunistic infections improved as phototherapy allowed the reduction or interruption of systemic drug therapies. INTERPRETATION AND CONCLUSIONS Ultraviolet A1 phototherapy may be considered as an appropriate therapeutic approach for sclerodermoid GVHD with no or mild involvement of internal organs. Patients with lichenoid GVHD should be treated only if they develop serious adverse effects to immunosuppressive therapies and opportunistic infections because of the carcinogenic hazard of high cumulative doses of ultraviolet A1 radiation.
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Pinton PC, Capezzera R, Zane C, De Panfilis G. Medium-dose ultraviolet A1 therapy for pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica. J Am Acad Dermatol 2002; 47:410-4. [PMID: 12196751 DOI: 10.1067/mjd.2002.122199] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Ultraviolet A1 (340-400 nm) was found to be effective in the treatment of cutaneous T-cell-mediated diseases. OBJECTIVE The purpose of the present study was to assess the efficacy of UVA1 phototherapy for pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). METHODS Eight patients (3 with PLEVA and 5 with PLC) received 60 J/cm(2) UVA1 daily until remission. Four patients also had lesions inaccessible to UVA1 that were used as control lesions. Immunocytologic studies of skin infiltrates and circulating T cells were done. RESULTS Six patients showed complete clinical and histologic recovery. Two patients with PLC had a partial improvement. Unirradiated control lesions never improved. Serious short-term adverse effects were not encountered. No effects on circulating lymphocytes were reported. CONCLUSION UVA1 therapy is an effective and well-tolerated treatment for PLEVA and PLC. The therapeutic activity seems to be related to direct effects on cutaneous inflammatory infiltrates because the lesions in nonexposed cutaneous areas did not respond.
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Zane C, Leali C, Airò P, De Panfilis G, Pinton PC. "High-dose" UVA1 therapy of widespread plaque-type, nodular, and erythrodermic mycosis fungoides. J Am Acad Dermatol 2001; 44:629-33. [PMID: 11260537 DOI: 10.1067/mjd.2001.110896] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND UVA1 (340 to 400 nm) was found to be effective in the treatment of early-stage mycosis fungoides (MF). OBJECTIVE The purpose of this study was to assess the efficacy of UVA1 phototherapy for widespread plaque-type, nodular, and erythrodermic MF. METHODS Thirteen patients (8 with stage IB, 4 with IIB, and 1 with III MF) received 100 J/cm(2) UVA1 daily until remission. Four patients also had lesions inaccessible by UVA1 that were considered control lesions. Immunocytologic studies of skin infiltrates and circulating T cells were done before and after the therapy. RESULTS Eleven patients showed complete clinical and histologic responses. Two patients had a partial improvement. Unirradiated control lesions never improved. Serious short-term side effects were not recorded. Circulating CD4(+)/CD45RO(+) and CD4(+)/CD95(+) lymphocytes were significantly reduced by the therapy. CONCLUSION UVA1 therapy is an effective and well-tolerated treatment for advanced MF. The therapeutic relevance of the effects on circulating lymphocytes remains to be established because lesions in nonexposed cutaneous areas did not respond.
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Affiliation(s)
- C Zane
- Dermatology Department, Azienda Spedali Civili di Brescia, University of Brescia, Italy
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