1
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DI Michele E, Giacalone S, Silvio M, Morini N, Ramoni S, Cusini M, Marzano AV. Gonococcal conjunctivitis: a severe extragenital manifestation of Neisseria gonorrheae. Ital J Dermatol Venerol 2024:S2784-8671.24.07824-1. [PMID: 38619200 DOI: 10.23736/s2784-8671.24.07824-1] [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: 04/16/2024]
Affiliation(s)
- Eleonora DI Michele
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
- Department of Medical-Surgical Pathophysiology of Transplants, University of Milan, Milan, Italy -
| | - Serena Giacalone
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Medical-Surgical Pathophysiology of Transplants, University of Milan, Milan, Italy
| | - Martina Silvio
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Medical-Surgical Pathophysiology of Transplants, University of Milan, Milan, Italy
| | - Nicole Morini
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Medical-Surgical Pathophysiology of Transplants, University of Milan, Milan, Italy
| | - Stefano Ramoni
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo V Marzano
- Section of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Medical-Surgical Pathophysiology of Transplants, University of Milan, Milan, Italy
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2
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Maronese CA, Ramoni S, Avallone G, Giacalone S, Quattri E, Gaspari V, Rapparini L, Robuffo S, Delmonte S, Merli M, Tutone M, Facci G, Carugno A, Parietti M, Latini A, Giuliani E, Sena P, Ribero S, Quaglino P, Piraccini BM, Marzano AV. Monkeypox: An Italian, multicentre study of 104 cases. J Eur Acad Dermatol Venereol 2024; 38:e312-e316. [PMID: 37888494 DOI: 10.1111/jdv.19587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/20/2023] [Indexed: 10/28/2023]
Affiliation(s)
- Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Avallone
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Serena Giacalone
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Quattri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Valeria Gaspari
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Silvia Robuffo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Sergio Delmonte
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Martina Merli
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Marco Tutone
- Ce.Mu.S.S., Department of Prevention - ASL Città di Torino, Turin, Italy
| | - Giulia Facci
- Ce.Mu.S.S., Department of Prevention - ASL Città di Torino, Turin, Italy
| | - Andrea Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
- Ph.D. Program in Molecular and Translational Medicine (DIMET), University of Milan-Bicocca, Milan, Italy
| | - Michele Parietti
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Alessandra Latini
- STI/HIV Unit, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Eugenia Giuliani
- Scientific Direction, San Gallicano Dermatological Institute IRCCS, Rome, Italy
| | - Paolo Sena
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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3
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Valtellini L, Ramoni S, Benardon S, Rogari F, Licandro A, Carrera CG, Marzano AV. New small outbreak of Mpox in Italy: A single-centre case series. Int J STD AIDS 2024:9564624241238815. [PMID: 38492208 DOI: 10.1177/09564624241238815] [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: 03/18/2024]
Affiliation(s)
- Luca Valtellini
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Susanna Benardon
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesco Rogari
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Andrea Licandro
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Carlo G Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
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4
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Giacalone S, Barberi F, Ramoni S, Casazza G, Cusini M, Marzano AV. Sexualised drug use and chemsex in Italy: A questionnaire study based on a cohort of clients attending a STI outpatient service in Milan. Int J STD AIDS 2023; 34:1034-1041. [PMID: 37608639 DOI: 10.1177/09564624231193055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND Chemsex is a heterogeneous phenomenon with differences in distribution, setting, motivations and type of substances consumed between countries. The lack of data at national level of the Italian situation creates a perception of reduced need for intervention. METHODS Anonymous paper questionnaires were distributed to patients who had registered themselves at the STI Department IRCCS Ca' Granda Policlinico in Milan. RESULTS A significant association was demonstrated between use of sexualised drugs, chemsex and the following variables: (1). Number of partners: in the group of clients with more than five partners, sexualised drug users were more than twice compared with those in the group with less than five partners (35.2% vs 16.2%) p<0.0001. (2). Use of dating apps: more than one out of two persons who used drugs during sex affirmed looking for partners on internet, p = 0.0059. (3). Low condom uses with occasional partners: percentage of individuals who declared not to use condoms or devices during their sexual encounters with occasional partners is more than twice as high in the sexualised drug users group with respect to controls (44.6% vs 21.4%); p = 0.0006). (4). Use of post exposure prophylaxis (PEP): among the PEP users, more than half participants belonged to the sexualised drug users' group; p = 0.0021. CONCLUSIONS Sexualised drug use and chemsex are frequently practiced in Milan. This survey identified a specific population with higher-risk sexual behaviours and increased incidence of acute bacterial STIs.
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Affiliation(s)
- Serena Giacalone
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Francesco Barberi
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Casazza
- Dipartimento di Scienze Cliniche e di Comunità, Universita' degli Studi di Milano, Milan, Italy
| | - Marco Cusini
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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5
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Maronese CA, Avallone G, Aromolo IF, Spigariolo CB, Quattri E, Ramoni S, Carrera CG, Marzano AV. Mpox: an updated review of dermatological manifestations in the current outbreak. Br J Dermatol 2023; 189:260-270. [PMID: 37146166 DOI: 10.1093/bjd/ljad151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 05/07/2023]
Abstract
Mpox is a disease caused by a double-stranded DNA orthopoxvirus discovered in 1958. In 2022, an outbreak on an unprecedented scale marked its transition from neglected, zoonotic disease circulating almost exclusively within African borders to sexually transmitted infection (STI) of international concern. Although phylogenetic evidence suggests progressive evolution from the strain associated with the 2018 outbreak in Nigeria, epidemiological links with previous cases have still not been completely elucidated. Clinically, mpox presents with systemic symptoms, such as fever, headache, malaise and a characteristic cutaneous eruption, similar to that of cognate viruses (e.g. smallpox). Mpox pseudopustules evolve through several stages, including umbilication and crusting, and resolve in the span of 2-3 weeks. The hallmarks that set the 2022 outbreak apart from classic mpox were a disproportionate number of cases occurring in men who have sex with men, an often localized cutaneous picture and a significant burden in terms of concomitant STIs. Investigations into the disease pathogenesis, related immune response, clinical and dermoscopic features, in addition to studies aimed at defining novel management strategies, have advanced mpox knowledge considerably. Herein, recent findings on mpox are reviewed, with a keen focus on dermatological manifestations and their implications in the current diagnostic scenario, reinforcing the pivotal role of dermatologists in managing suspect cases and preventing further spread of the contagion.
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Affiliation(s)
- Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Avallone
- Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Italo Francesco Aromolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Cristina Beatrice Spigariolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Quattri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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6
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Quattri E, Giacalone S, Morini N, Ramoni S, Boggio FL, Carrera C, Cusini M, DI Benedetto A, Pini M, Marzano AV. Secondary syphilis simulating cutaneous lymphomatous infiltration. Ital J Dermatol Venerol 2023; 158:275-276. [PMID: 37278507 DOI: 10.23736/s2784-8671.23.07555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Eleonora Quattri
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy -
| | - Serena Giacalone
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Nicole Morini
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano Ramoni
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Francesca L Boggio
- Unit of Pathology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Carrera
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandra DI Benedetto
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Pini
- Unit of Dermatology, Foundation IRCCS San Gerardo dei Tintori, Monza, Monza-Brianza, Italy
| | - Angelo V Marzano
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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7
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Avallone G, Maronese CA, Quattri E, Roccuzzo G, Mastorino L, Alberti-Violetti S, Ramoni S, Lucchini A, Delmonte S, Quaglino P, Marzano AV, Ribero S. Maculopapular rash: An overlooked monkeypox diagnostic clue? J Eur Acad Dermatol Venereol 2023; 37:e553-e556. [PMID: 36308513 DOI: 10.1111/jdv.18695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 10/26/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy.,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Quattri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Gabriele Roccuzzo
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Luca Mastorino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Silvia Alberti-Violetti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Lucchini
- CEMUSS - Dip. di Prevenzione - ASL "Cittá di Torino", Torino, Italy
| | - Sergio Delmonte
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
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8
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Giacalone S, Morini N, Quattri E, Ramoni S, Carrera C, Cusini M, Marzano AV. Herpes simplex virus viral shedding in patients diagnosed of monkeypox. J Eur Acad Dermatol Venereol 2023. [PMID: 36883798 DOI: 10.1111/jdv.19014] [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: 10/27/2022] [Accepted: 02/24/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Serena Giacalone
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Nicole Morini
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Eleonora Quattri
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Carrera
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
| | - Angelo Valerio Marzano
- UOC Dermatologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy
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9
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Aromolo IF, Maronese CA, Avallone G, Beretta A, Boggio FL, Murgia G, Marletta DA, Barei F, Carrera CG, Ramoni S, Di Benedetto A, Marzano AV. Clinical spectrum of human monkeypox: An Italian single-centre case series. J Eur Acad Dermatol Venereol 2023; 37:e368-e371. [PMID: 36166329 DOI: 10.1111/jdv.18612] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Italo F Aromolo
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carlo A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Gianluca Avallone
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy
| | - Andrea Beretta
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesca L Boggio
- Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Murgia
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Dario A Marletta
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Francesca Barei
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Carlo G Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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10
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Maronese CA, Beretta A, Avallone G, Boggio FL, Marletta DA, Murgia G, Cusini M, Gori A, Carrera CG, Di Benedetto A, Ramoni S, Marzano AV. Clinical, dermoscopic and histopathological findings in localized human monkeypox: a case from northern Italy. Br J Dermatol 2022; 187:822-823. [PMID: 35822390 PMCID: PMC9804155 DOI: 10.1111/bjd.21773] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 01/05/2023]
Abstract
Abstract
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Affiliation(s)
- Carlo A. Maronese
- Dermatology Unit
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | - Andrea Beretta
- Dermatology Unit
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | - Gianluca Avallone
- Department of Medical SciencesUniversity of Turin, Dermatology ClinicTurinItaly
| | | | - Dario A. Marletta
- Dermatology Unit
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | - Giulia Murgia
- Dermatology Unit
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
| | | | - Andrea Gori
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
- Infectious Diseases UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | | | | | | | - Angelo V. Marzano
- Dermatology Unit
- Department of Pathophysiology and TransplantationUniversità degli Studi di MilanoMilanItaly
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11
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Barei F, Murgia G, Ramoni S, Cusini M, Marzano AV. Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature. Int J STD AIDS 2022; 33:1022-1028. [DOI: 10.1177/09564624221124710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Syphilis is known as the “great imitator” because of its polymorphic clinical manifestations. Condyloma lata are an uncommon mucocutaneous manifestation of secondary syphilis, generally localized in intertriginous areas, such as the genitals and anus. Extragenital localization of condyloma lata is considered unusual. Methods A case study of extra-genital condylomata is presented. To contextualise the case, a literature review of extra-genital condylomata lata was subsequently undertaken. The authors searched MEDLINE/PubMed, Scopus and Excerpta Medica/EMBASE English-language sources using the following keywords: “condyloma lata”, “condylomata lata”, and “condyloma latum”. Results Thirty-five papers (from 1940 to 2021) describing an extra-anogenital localization of condyloma lata were found and are summarized in Table 1. Patients were mainly males (82.1%), with a mean age of 31.9 years. Most of them showed other manifestations of secondary syphilis (53.9%). In a minority of cases (39.0%), concomitant anogenital condyloma lata were present, thus making the diagnosis easier. The toe web localization was the most documented (26.2%) followed by the oral cavity (23.8%). Conclusion In the presence of extra-genital condyloma lata, the differential diagnosis is not always clear, especially when no other muco-cutaneous lesions are observed. In the case of eroded or wet lesions involving any cutaneous fold, associated or not with other cutaneous manifestations, a sexual history should be obtained, and syphilis must be considered.
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Affiliation(s)
- Francesca Barei
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulia Murgia
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Stefano Ramoni
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angelo V Marzano
- Unit of Dermatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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Ramoni S, Maronese CA, Morini N, Avallone G, Quattri E, Carrera CG, Boggio FL, Marzano AV. Syphilis and monkeypox co-infection: Coincidence, synergy or asymptomatic carriage? Travel Med Infect Dis 2022; 50:102447. [PMID: 36067937 DOI: 10.1016/j.tmaid.2022.102447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 08/30/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Alberto Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Nicole Morini
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Gianluca Avallone
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Eleonora Quattri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy
| | - Carlo Giovanni Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Milan, Italy.
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Quattri E, Avallone G, Maronese CA, Cusini M, Carrera CG, Marzano AV, Ramoni S. Unilesional monkeypox: A report of two cases from Italy. Travel Med Infect Dis 2022; 49:102424. [PMID: 35961491 PMCID: PMC9533888 DOI: 10.1016/j.tmaid.2022.102424] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/06/2022] [Indexed: 11/02/2022]
Affiliation(s)
- Eleonora Quattri
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Gianluca Avallone
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Carlo A Maronese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marco Cusini
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo G Carrera
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Angelo V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ramoni S, Riva D, Spigariolo CB, Cusini M. Primary syphilis of the finger: report of four cases. Int J STD AIDS 2022; 33:728-730. [PMID: 35487222 DOI: 10.1177/09564624221097221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although primary syphilis generally involves the genitalia, literature reports that 12% of chancres are extragenital, with the anus and oral cavity as the most frequent locations. We present hereby a case series of four chancres of the finger observed at the sexually transmitted infection centre of Milan between 2010 and 2021.
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Affiliation(s)
- Stefano Ramoni
- Dermatology Unit, 9339Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Riva
- Dermatology Unit, 9339Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, 9304Università degli Studi di Milano, Milan, Italy
| | - Cristina B Spigariolo
- Dermatology Unit, 9339Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, 9304Università degli Studi di Milano, Milan, Italy
| | - Marco Cusini
- Dermatology Unit, 9339Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ramoni S, Benardon S, Spigariolo CB, Süss L, Veraldi S. Ticks on the external male genital structures. Parasitol Int 2021; 83:102336. [PMID: 33785462 DOI: 10.1016/j.parint.2021.102336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/15/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
Penis and scrotum are very rarely affected by tick bites. We present four cases of involvement of male genitals by ticks belonging to the family Ixodidae. Dermatological examination showed an apparently healthy skin around the tick. Anti-Borrelia burgdorferi antibodies were negative. In all patients the entire body of the tick was delicately removed by means of pliers. Antibiotic therapy was unnecessary.
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Affiliation(s)
- Stefano Ramoni
- UO Dermatologia, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Susanna Benardon
- UO Dermatologia, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Beatrice Spigariolo
- UO Dermatologia, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.
| | - Luciano Süss
- Past Full Professor of Entomology, Università degli Studi, Milan, Italy
| | - Stefano Veraldi
- UO Dermatologia, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Ramoni S, Genovese G, Pastena A, Casazza G, Lunghi G, Marzano AV, Cusini M. Clinical and laboratory features of 244 men with primary syphilis: a 5-year single-centre retrospective study. Sex Transm Infect 2021; 97:479-484. [PMID: 33431607 DOI: 10.1136/sextrans-2020-054705] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/13/2020] [Accepted: 12/22/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Syphilis incidence has exponentially increased in recent decades, particularly among men who have sex with men (MSM). Primary syphilis is characterised by a chancre appearing at the site of Treponema pallidum (TP) inoculation. Atypical morphological variants of syphilitic chancre are frequent. Clinical suspicion must be confirmed either by the demonstration of TP within the lesion through direct tests, such as dark field microscopy (DFM) or T. pallidum nucleic acid amplification technique (TP-NAAT), or by serological tests. OBJECTIVES To analyse the clinical features, the sexual behaviour and the role of diagnostic tests in a cohort of men with primary syphilis in Milan. METHODS Epidemiological, clinical and laboratory data of male patients with primary syphilis seen at the STI Center of the University of Milan between 2015 and 2019 were retrospectively evaluated. Diagnosis was confirmed by at least one positive diagnostic test of either DFM, TP-NAAT or serology. RESULTS Among a total of 244 patients, 160 (65.6%) were MSM and 32 (13.1%) were living with HIV. One hundred twenty-four (50.8%) patients had a clinically atypical chancre. Chancres were exclusively extragenital in 30 (12.3%) patients, with MSM being more commonly affected (MSM vs heterosexuals: 16.3% vs 4.8%, respectively; p=0.012), and anal region the most frequently involved site. Chancres were multiple in 68/242 (28.1%) patients and morphologically atypical in 76/244 (31.1%). Diagnosis was obtained by (1) both serology and direct methods in 158/244 patients (64.7%), (2) serology solely in 47/244 (19.3%) and (3) direct methods solely in 39/244 (16%). DFM yielded positive results in 83/139 (59.7%) patients, while TP-NAAT gave positive results in 114/121 (94.2%) patients. CONCLUSIONS Patients with primary syphilis frequently present with morphologically atypical chancres. Furthermore, MSM commonly exhibit extragenital involvement. A combined diagnostic approach including both direct and indirect tests is needed.
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Affiliation(s)
- Stefano Ramoni
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Genovese
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Andrea Pastena
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Casazza
- Department of Biomedical and Clinical Sciences "L. Sacco", Universita' degli Studi di Milano, Milan, Italy
| | - Giovanna Lunghi
- Microbiology and Virology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore di Milano Policlinico, Milan, Italy
| | - Angelo Valerio Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Marco Cusini
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Pontini P, Mastorino L, Gaspari V, Granger C, Ramoni S, Delmonte S, Evangelista V, Cusini M. A Multicentre, Randomised Clinical Trial to Compare a Topical Nitrizinc ® Complex Solution Versus Cryotherapy for the Treatment of Anogenital Warts. Dermatol Ther (Heidelb) 2020; 10:1063-1073. [PMID: 32734366 PMCID: PMC7477018 DOI: 10.1007/s13555-020-00430-7] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Anogenital warts (AGW) are a relevant clinical issue in the field of sexually transmitted disease, and to date no treatment provides a satisfactory clearance rate. Treatment can be both medical and surgical, and be provided by a healthcare provider or by the patient. Cryotherapy (CRYO) is among the most common treatments for AGW. Nitrizinc® Complex solution (NZCS) is a solution containing organic acids, nitric acid and zinc and copper salts that is applied topically to warts, producing mummification of the damaged tissue. It is considered to be an effective and well-tolerated treatment for genital and common warts. The aim of our study was to compare NZCS to CRYO in the treatment of AGW. METHODS We performed a prospective, multicentre, single-blind, randomised, superiority clinical study involving 120 patients, aged 18-55 years, diagnosed with a first episode of AGW, with each patient having from three to ten AGW. The patients were treated either with NZCS or CRYO for a maximum of four treatments. Primary endpoints were: (1) comparison of the clinical efficacy of CRYO and NZCS, based on response to treatment (clearance of AGW) within four treatment sessions; and (2) tolerability, assessed via a short questionnaire at the end of each treatment session. Secondary endpoints were: (1) number of treatments needed for clearance; and (2) recurrence at 1 and 3e months after confirmed clearance. The results were analysed on an intention-to-treat basis. RESULTS A complete response was achieved in 89.7% of the NZCS group and in 75.4% of the CRYO group (p = 0.0443). NZCS was found to be better tolerated. There was no difference between the NZCS and CRYO treatment arms in the number of sessions needed to clear the lesions. Recurrence occurred after 1 month in 18.4% of the NZCS group and 38.1% of the CRYO group (p = 0.0356), and after 3 months in 25 and 40.6% of these groups, respectively (p = 0.1479). CONCLUSIONS Nitrizinc® Complex solution can be considered to be as effective as CRYO for the treatment of small (< 5 mm) external AGW, with a better tolerability profile and lower rate of recurrence. TRIAL REGISTRATION ISRCTN identifier, ISRCTN36102369.
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Affiliation(s)
- Paolo Pontini
- Unit of Dermatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy.
| | - Luca Mastorino
- Dermatology Clinic, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza-University of Turin, Turin, Italy
| | - Valeria Gaspari
- Unit of Dermatology, Head and Neck Department, Sant'Orsola Malpighi University Hospital, Bologna, Italy
| | | | - Stefano Ramoni
- Unit of Dermatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy
| | - Sergio Delmonte
- Dermatology Clinic, Department of Medical Sciences, Azienda Ospedaliera Universitaria Città della Salute e della Scienza-University of Turin, Turin, Italy
| | - Valeria Evangelista
- Unit of Dermatology, Head and Neck Department, Sant'Orsola Malpighi University Hospital, Bologna, Italy
| | - Marco Cusini
- Unit of Dermatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy
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Veraldi S, Benardon S, Ramoni S, Nazzaro G. Escherichia coli urethritis. Ital J Dermatol Venerol 2020; 156:255-256. [PMID: 32348083 DOI: 10.23736/s2784-8671.20.06604-3] [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)
- Stefano Veraldi
- Department of Pathophysiology and Transplantation, University of Milan, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
| | - Susanna Benardon
- Department of Pathophysiology and Transplantation, University of Milan, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Ramoni
- Department of Pathophysiology and Transplantation, University of Milan, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Nazzaro
- Department of Pathophysiology and Transplantation, University of Milan, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Abstract
Anogenital warts (AGWs) are an important issue for public health centers dealing with Sexually Transmitted Infections. They are epidemiologically relevant, with significant morbidity and an established effective treatment is lacking. In this article, we examine the epidemiological, diagnostic, and therapeutic aspect of the problem in order to give an up to date picture of the situation and a practical clue for the management of AGWs.
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Affiliation(s)
- Sergio Delmonte
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy -
| | - Susanna Benardon
- Department of Internal Medicine and Medical Specialties, State University of Milan, Milan, Italy.,Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Caterina Cariti
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy
| | - Simone Ribero
- Clinic of Dermatology, Department of Medical Science, University of Turin, Turin, Italy
| | - Stefano Ramoni
- Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
| | - Marco Cusini
- Unit of Dermatology, Maggiore Polyclinic Hospital, Ca' Granda IRCCS and Foundation, Milan, Italy
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Genovese G, Nazzaro G, Coggi A, Gianotti R, Ramoni S, Cusini M. Secondary syphilis masquerading as lupus vulgaris in an HIV-infected patient: A diagnosis suggested by histology. Int J STD AIDS 2018; 29:1454-1456. [PMID: 30170530 DOI: 10.1177/0956462418795590] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of secondary syphilis mimicking lupus vulgaris in an HIV-infected patient. A 21-year-old Brazilian man presented with a two-month history of asymptomatic cutaneous lesions accompanied by fever and fatigue. Dermatological evaluation revealed an erythematous, crusted, large plaque on the neck with the 'apple jelly' sign on diascopy and two smaller scaly elements on the trunk and left palm. Bacteriological examinations for bacteria and mycobacteria gave negative results. Histology revealed psoriasiform epidermal hyperplasia and dermal lymphoplasmacytic infiltrate. Serology for syphilis was positive, and immunohistochemistry confirmed the presence of Treponema pallidum in lesional skin. A diagnosis of secondary syphilis was made, and the patient was successfully treated with benzathine penicillin G. Cutaneous manifestations of secondary syphilis are protean and skin tuberculosis may be considered in the differential diagnosis, especially in HIV-infected patients. In the current case, clinical examination, and particularly, 'apple jelly' sign positivity, was suggestive of lupus vulgaris, but only typical histopathology and immunohistochemistry led to the correct diagnosis of secondary syphilis.
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Affiliation(s)
- Giovanni Genovese
- Dermatology Unit, Department of Physiopathology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Nazzaro
- Dermatology Unit, Department of Physiopathology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonella Coggi
- Dermatology Unit, Department of Physiopathology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Raffaele Gianotti
- Dermatology Unit, Department of Physiopathology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Ramoni
- Dermatology Unit, Department of Physiopathology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Dermatology Unit, Department of Physiopathology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Cusini M, Ramoni S, Boneschi V, Recalcati S. Chronic Nodular Dermatosis: A Quiz. Acta Derm Venereol 2018; 98:299-300. [PMID: 29057426 DOI: 10.2340/00015555-2828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marco Cusini
- Department of Dermatology - STD Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, IT-20122 Milan, Italy.
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Musi G, Russo A, Conti A, Mistretta FA, Di Trapani E, Luzzago S, Bianchi R, Renne G, Ramoni S, Ferro M, Matei DV, Cusini M, Carmignani L, de Cobelli O. Thulium–yttrium–aluminium–garnet (Tm:YAG) laser treatment of penile cancer: oncological results, functional outcomes, and quality of life. World J Urol 2017; 36:265-270. [DOI: 10.1007/s00345-017-2144-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/27/2017] [Indexed: 11/30/2022] Open
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Affiliation(s)
- Stefano Veraldi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rossana Schianchi
- European Institute of Dermatology and Centro Dermatologico Milanese, Milan, Italy
| | - Stefano Ramoni
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Nazzaro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Cusini M, Benardon S, Brena M, Ramoni S, Boneschi V, Gianotti R. Sudden Genital Ulceration in a Young Man: A Quiz. Acta Derm Venereol 2017; 97:995-996. [PMID: 28448097 DOI: 10.2340/00015555-2688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Marco Cusini
- Department of Dermatology - STD Centre, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
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Ramoni S, Boneschi V, Cusini M. Atypical syphilitic chancre of the tongue in a HIV-positive patient: the diagnostic role of NAATS. Ital J Dermatol Venerol 2017; 152:319-320. [PMID: 28409584 DOI: 10.23736/s0392-0488.17.05273-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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)
- Stefano Ramoni
- Department of Dermatology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy -
| | - Vinicio Boneschi
- Department of Dermatology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Cusini
- Department of Dermatology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Damiani G, Loite U, Ramoni S, Marzano AV. Possible new inflammatory side-effect of SGLT2-inhibitors: Fixed drug eruption. J Diabetes Complications 2016; 30:1530-1531. [PMID: 27591031 DOI: 10.1016/j.jdiacomp.2016.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 08/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Giovanni Damiani
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy.
| | - Ulvi Loite
- Department of Dermatology, University of Tartu, Estonia
| | - Stefano Ramoni
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Angelo Valerio Marzano
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Unità Operativa di Dermatologia, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
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Affiliation(s)
- Stefano Veraldi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Nazzaro
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Ramoni
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, I.R.C.C.S. Foundation, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ramoni S, Boneschi V, Cusini M. Syphilis as “the great imitator”: a case of impetiginoid syphiloderm. Int J Dermatol 2015; 55:e162-3. [DOI: 10.1111/ijd.13072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/15/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Stefano Ramoni
- Department of Dermatology; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) (Italian Research Hospital Foundation) Ca' Granda; Ospedale Maggiore Policlinico; Milan Italy
| | - Vinicio Boneschi
- Department of Dermatology; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) (Italian Research Hospital Foundation) Ca' Granda; Ospedale Maggiore Policlinico; Milan Italy
| | - Marco Cusini
- Department of Dermatology; Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) (Italian Research Hospital Foundation) Ca' Granda; Ospedale Maggiore Policlinico; Milan Italy
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Benardon S, Ramoni S, Boneschi V, Cusini M, Veraldi S. Multifocal perigenital cutaneous larva migrans. GIORN ITAL DERMAT V 2014; 149:477-479. [PMID: 25068239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- S Benardon
- Department of Pathophysiology and Transplantation, University of Milan, I.R.C.C.S. Foundation, Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy -
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Cusini M, Ramoni S. P3.369 Acceptability of HPV Tetravalent Vaccine Among Males Attending the STD Clinic of Milan - The Importance of the Costs For Patients. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cusini M, Fanoni D, Ramoni S, Berti E. P1.007 Immune-Response in Lesional Skin of Secondary Syphilis. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
The appearance of facial expression wrinkles is the result of chronic contraction of mimic muscles. Nifedipine is a dihydropyridinic calcium antagonist which blocks muscular cells' calcium channels, therefore inhibiting their contraction. We assumed that topical nifedipine was able to relax mimic muscular fibres in the same way, thus reducing the depth of wrinkles. We performed a clinical and experimental study, enrolling 64 female patients with periocular wrinkles. They applied a cream containing 0.5% nifedipine (Antrox; Bracco, Milan, Italy) once daily for 90 days. The length and depth of wrinkles (measured by a digital profilometer), moisturizing of periocular skin (measured by a corneometer), and trans-epidermal water loss (TEWL; measured by a tewameter), were evaluated. All parameters were measured before the beginning of treatment, and 45 and 90 days later. At the end of the study, topical nifedipine proved statistically effective in reducing the depth of wrinkles. No significant differences in the length of wrinkles were recorded. No significant changes were observed in moisturizing. TEWL gradually improved, although without statistical significance. On the basis of the results of this study, 0.5% nifedipine cream seems to be effective in reducing the depth of periocular wrinkles. Other studies are necessary in order to confirm these results.
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Cusini M, Gaiani F, Girgenti V, Cantoni G, Ramoni S. Perianal Buschke-Löwenstein tumour: progressive growth despite immune restoration in a man positive for human immunodeficiency virus. Clin Exp Dermatol 2010; 35:e163-4. [PMID: 20105191 DOI: 10.1111/j.1365-2230.2009.03759.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ramoni S, Cusini M, Gaiani F, Arancio L, Alessi E. Penile intraepithelial carcinoma treated with imiquimod 1% in an HIV-positive patient. J DERMATOL TREAT 2009; 20:177-8. [PMID: 19016064 DOI: 10.1080/09546630802562435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Marzano AV, Ramoni S, Spinelli D, Alessi E, Berti E. Refractory linear IgA bullous dermatosis successfully treated with mycophenolate sodium. J DERMATOL TREAT 2009; 19:364-7. [DOI: 10.1080/09546630801958246] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Frigerio E, Ramoni S, Franchi C, Garutti C, Garavaglia M, Splnelli M, Capsoni F, Altomare G. Successful Cyclosporine Treatment in a Case of Amicrobial Pustulosis Associated with Immunological Abnormalities. Int J Immunopathol Pharmacol 2009; 22:243-6. [DOI: 10.1177/039463200902200128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Amicrobial pustulosis associated with autoimmune diseases (APAD) is a clinical entity which was described only recently and few cases are reported in the literature. This condition is characterized by recurrent acute onset with pustular lesions predominantly involving skin folds, genitals, scalp and external auditory canals of young women. The etiopathogenesis of APAD is unknown and the most effective therapeutic treatment seems to be systemic corticosteroids. We describe the case of a 16-year old female patient suffering from APAD successfully treated with cyclosporine A.
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Affiliation(s)
| | | | | | | | | | | | - F. Capsoni
- Rheumatology Division, Institute O. Galeazzi, IRCCS, University of Milan, Italy
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Cusini M, Boneschi V, Arancio L, Ramoni S, Venegoni L, Gaiani F, de Vries HJC. Lymphogranuloma venereum: the Italian experience. Sex Transm Infect 2008; 85:171-2. [PMID: 19036777 DOI: 10.1136/sti.2008.032862] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
An epidemic of lymphogranuloma venereum (LGV) has been described in men who have sex with men (MSM) in the western world, particularly in western Europe. The first Italian case was reported by the authors in 2006, and up to March 2008 there have been 13 symptomatic cases, all in MSM. Ten cases had LGV proctitis and three cases had inguinal adenopathy as their clinical presentation. The initial three cases reported receptive anal intercourse in metropolitan areas of northern Europe, Turkey and eastern Europe, whereas the later cases were infections acquired locally. Diagnosis was by LGV-specific real-time PCR in nine cases, by symptoms and PCR for Chlamydia trachomatis in three cases, and in one case clinically and epidemiologically.
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Affiliation(s)
- M Cusini
- Institute of Dermatological Sciences, University of Milan, Via Pace 9, 20122, Milano, Italy.
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Marzano AV, Ramoni S, Del Papa N, Barbareschi M, Alessi E. Leflunomide-induced subacute cutaneous lupus erythematosus with erythema multiforme-like lesions. Lupus 2008; 17:329-31. [DOI: 10.1177/0961203307087189] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Leflunomide is an immunosuppressive agent that acts by inhibiting pyrimidine synthesis in lymphocytes and other rapidly proliferating cells, as well as by suppressing tumor necrosis factor-α–induced cellular responses. A number of leflunomide-related adverse events have been reported. Among cutaneous side effects, a few cases of subacute cutaneous lupus erythematosus have been described. We report a previously undocumented reaction to leflunomide, manifesting as subacute cutaneous lupus erythematosus and erythema multiforme-like lesions, in a young woman treated with this drug for ankylosing spondylitis. Withdrawal of leflunomide combined with a short cycle of systemic corticosteroid led to the resolution of the patient’s rash, indicating this drug as being responsible for the development of the disease. We conclude that leflunomide might have triggered the occurrence of both subacute cutaneous lupus erythematosus and erythema multiforme in a patient with pre-existing autoimmune diathesis. The suppressive effect of this drug on tumor necrosis factor-α–related mechanisms might have played a role in the induction of such a unique reaction to leflunomide.
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Affiliation(s)
- AV Marzano
- Institute of Dermatological Sciences, University of Milan – Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
| | - S Ramoni
- Institute of Dermatological Sciences, University of Milan – Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
| | - N Del Papa
- Department of Rheumatology, H. “G. Pini”, Milan, Italy
| | - M Barbareschi
- Institute of Dermatological Sciences, University of Milan – Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
| | - E Alessi
- Institute of Dermatological Sciences, University of Milan – Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy
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Marzano AV, Ramoni S, Caputo R. Amicrobial Pustulosis of the Folds. Dermatology 2008; 216:305-11. [DOI: 10.1159/000113942] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 06/20/2007] [Indexed: 11/19/2022] Open
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Marzano AV, Ramoni S, Alessi E, Caputo R. Generalized granuloma annulare and eruptive folliculitis in an HIV-positive man: resolution after antiretroviral therapy. J Eur Acad Dermatol Venereol 2007; 21:1114-6. [PMID: 17714140 DOI: 10.1111/j.1468-3083.2006.02103.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Caputo R, Marzano AV, Di Benedetto A, Ramoni S, Cambiaghi S. Juvenile gangrenous vasculitis of the scrotum: Is it a variant of pyoderma gangrenosum? J Am Acad Dermatol 2006; 55:S50-3. [PMID: 16843125 DOI: 10.1016/j.jaad.2005.11.1031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2005] [Revised: 10/05/2005] [Accepted: 11/01/2005] [Indexed: 10/24/2022]
Abstract
Juvenile gangrenous vasculitis of the scrotum was described by Piñol et al in 1974 as a unique variant of scrotal gangrene of unknown origin, occurring exclusively in young individuals. It was characterized by an acute onset of skin ulcers undergoing complete resolution after appropriate therapy, with no relapses. We present a typical case of this extremely rare disease affecting a 16-year-old boy in whom the scrotal ulcerations were preceded by an episode of pharyngitis with fever. The condition promptly regressed after administration of intramuscular betamethasone in combination with oral ciprofloxacin. According to Piñol et al, juvenile gangrenous vasculitis of the scrotum, although poorly known to dermatologists, should be regarded as a distinctive entity within the wide group of scrotal gangrenes. On the other hand, the hypothesis that this condition may well represent a variant of pyoderma gangrenosum is discussed.
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Affiliation(s)
- Ruggero Caputo
- Institute of Dermatological Sciences, University of Milan-Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Italy
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