1
|
Garg S, Vashisht KR, Garg D, Oberoi B, Sharma G. Advancements in Laser Therapies for Dermal Hyperpigmentation in Skin of Color: A Comprehensive Literature Review and Experience of Sequential Laser Treatments in a Cohort of 122 Indian Patients. J Clin Med 2024; 13:2116. [PMID: 38610881 PMCID: PMC11012689 DOI: 10.3390/jcm13072116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/08/2024] [Accepted: 02/19/2024] [Indexed: 04/14/2024] Open
Abstract
The heightened awareness of ethnic dermatology aligns with the growing prevalence of skin of color communities globally, where hyperpigmentation disorders pose a common dermatological challenge. Effectively addressing dermal pigmentation is challenging due to its resistance to conventional therapies and its association with impaired quality of life. This underscores the need for effective treatments and a thorough grasp of laser advancements. A relevant literature search spanning the last 7 years across the PubMed database reveals core studies, challenges, and the evolution of laser technologies tailored for various forms of congenital and acquired dermal hyperpigmentation in skin of color. This comprehensive review explores the mechanisms, applications, and recommendations for pigmentary laser technologies, highlighting the key role of Q-switched lasers in their established millisecond/ nanosecond forms and emerging picosecond lasers, fractional non-ablative and ablative lasers, Intense Pulsed Light, etc. The summary of evidence includes studies on dermal melanocytosis (nevus of Ota and Hori's nevus), tattoos, acquired dermal macular hyperpigmentation, etc., and also entities with mixed epidermal-dermal components, such as melasma and post-inflammatory hyperpigmentation. The review offers valuable insights for clinicians to make informed decisions based on diagnosis, skin type, and the latest technologies to optimize results and minimize complications, especially in darker Fitzpatrick skin types. In their five-year study with 122 Indian patients, the authors applied specific laser combinations for diverse dermal melanoses, including tattoos, dermal/mixed melasma, acquired dermal macular hyperpigmentation, and dermal nevi. Substantial pigmentation reduction, subjectively assessed by both physicians and patients, was observed across all groups. A one-way ANOVA indicated a significant difference in mean improvement scores across various pigmentary conditions (F = 3.39, p = 0.02), with melasma patients exhibiting a significantly higher improvement score than tattoos (p = 0.03). The results affirmed the safety and efficacy of sequential laser therapy for dermal pigmentation in skin of color, advocating for flexibility in approach while maintaining the rationale behind the laser sequences. Despite advancements, challenges persist, and gaps in the current literature are identified. In conclusion, this summary highlights the ongoing pursuit of optimal protocols in dermatological laser treatments for dermal melanoses, offering valuable insights for future research and clinical practice.
Collapse
Affiliation(s)
| | - Kanya Rani Vashisht
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India
| | - Diksha Garg
- Aura Skin Institute, Chandigarh 160009, India
| | | | | |
Collapse
|
2
|
Andrade LF, Lalama MJ, Choragudi S, Maisonet J, Ayala J, Figueroa C, Lopez LC, Tavarez L, Kirsner RS, Strasswimmer J. Knowledge, Attitudes, and Perceptions of Skin Cancer Clinical Trials in the Hispanic Population. Cureus 2024; 16:e57480. [PMID: 38707098 PMCID: PMC11065540 DOI: 10.7759/cureus.57480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 05/07/2024] Open
Abstract
OBJECTIVE To determine the factors that might limit Hispanic patients from participating in dermatological clinical trials. METHODS From January 2022 to July 2022, we administered a 31-item, in-person questionnaire to patients recruited in the waiting area of the Caridad Center, one of the largest free clinics in the United States with a predominately Hispanic population, and a nearby private primary care clinic. RESULTS Overall, Hispanic patients agreed significantly more with statements in the domain of attitude and behavioral beliefs compared to non-Hispanic survey respondents. The Hispanic ethnicity was associated with increased odds of agreeing with the following statements: "My community would really benefit from skin cancer clinical trials" (OR=0.52; 95% CI 0.30, 0.92), "My participation in a skin cancer study would be very good" (OR=0.59; 95% CI 0.35, 0.99), and "I like to do good for others" (OR=0.41; 95% CI 0.22, 0.77). CONCLUSION While the United States population is composed of 18.5% Hispanics, they only account for 1% of patients enrolled in clinical trials. This study helps identify potential motivational factors for Hispanic patients to participate in skin cancer clinical trials.
Collapse
Affiliation(s)
- Luis F Andrade
- Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Maria J Lalama
- Medicine, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - Siri Choragudi
- Medicine, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | | | - Juan Ayala
- Dermatology, Caridad Center, Boynton Beach, USA
| | - Cesar Figueroa
- Internal Medicine, Cesar Figueroa Clinic, Delray Beach, USA
| | - Liz C Lopez
- Dermatology, Florida Atlantic University, Boca Raton, USA
| | - Lauren Tavarez
- Dermatology, Florida Atlantic University, Boca Raton, USA
| | - Robert S Kirsner
- Dermatology, Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, USA
| | - John Strasswimmer
- Dermatology, Florida Atlantic University, Boca Raton, USA
- Surgery, Strasswimmer Dermatology, Delray Beach, USA
| |
Collapse
|
3
|
Zhang J, Wang Y, Zhang W, Cai L, Feng J, Zhu Y, Lu H. Clinical Misdiagnosis of Cutaneous Malignant Tumors as Melanocytic Nevi or Seborrheic Keratosis: A Retrospective Analysis of a Chinese Population. Clin Cosmet Investig Dermatol 2024; 17:465-476. [PMID: 38435843 PMCID: PMC10906670 DOI: 10.2147/ccid.s451288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/18/2024] [Indexed: 03/05/2024]
Abstract
Purpose The rising incidence and mortality associated with cutaneous malignant tumours highlight the importance of early diagnosis of these tumors. In clinical practice, these tumors are often misdiagnosed as benign skin lesions such as melanocytic nevi (MN) and seborrheic keratosis (SK) because of their similar morphologic features. The incidence and clinicopathological subtypes of cutaneous malignancies in East Asia populations significantly differ from those in fair-skinned groups. However, studies on misdiagnoses in Eastern countries are lacking. Therefore, this study focused on the clinical and pathological features of cutaneous malignant tumors misdiagnosed as MN or SK in a Chinese population. Patients and Methods A total of 4592 samples clinically diagnosed as MN (n = 3503) or SK (n = 1089) from July 2014 to June 2022 were collected and evaluated retrospectively. The clinical and pathological data were analyzed to identify associated factors. Results Pathological assessments showed that 2.5% (86/3503) of the specimens clinically diagnosed as MN were malignancies, predominantly basal cell carcinoma (BCC, 84.9%, 73/86), followed by malignant melanoma (MM, 8.1%, 7/86) and squamous cell carcinoma (SCC, 7.0%, 6/86). Similarly, 5.7% (62/1089) of the specimens clinically diagnosed as SK were malignant tumors, of which BCC (50.0%, 31/62) was the most common, followed by SCC (41.9%, 26/62) and MM (8.1%, 5/62). In both types of specimens, advanced age and facial lesions were risk factors for malignancy misdiagnosis. The malignancy rate, mean age, and proportion of SCC in the specimens clinically diagnosed as SK were higher than those in the specimens clinically diagnosed as MN. Dermoscopy significantly reduced the rate of misdiagnosis of these tumors as MN or SK. Conclusion In China, cutaneous malignant tumors misdiagnosed as MN or SK are not uncommon in clinical practice, and active introduction of noninvasive diagnostic techniques is essential to distinguish them.
Collapse
Affiliation(s)
- Jun Zhang
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| | - Yu Wang
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| | - Wei Zhang
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| | - Linglong Cai
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| | - Jianglong Feng
- Department of Pathology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| | - Yiwei Zhu
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| | - Hongguang Lu
- Department of Dermatology, the Affiliated Hospital of Guizhou Medical University, Guiyang, People’s Republic of China
| |
Collapse
|
4
|
Benedetti S, Frosolini A, Catarzi L, Marsiglio A, Gennaro P, Gabriele G. Impact of the COVID-19 Pandemic on the Diagnosis and Management of Non-Melanoma Skin Cancer in the Head and Neck Region: A Retrospective Cohort Study. Healthcare (Basel) 2024; 12:501. [PMID: 38391876 PMCID: PMC10888473 DOI: 10.3390/healthcare12040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/30/2024] [Accepted: 02/03/2024] [Indexed: 02/24/2024] Open
Abstract
The present study investigates the impact of the COVID-19 pandemic on the management of Non-Melanoma Skin Cancer (NMSC) in the head and neck region. Conducted at the University Hospital "Le Scotte" in Siena, Italy, the research includes 111 patients treated from 2018 to 2021. The study aims to understand how pandemic-related healthcare changes affected NMSC treatment, focusing on differences in diagnosis and management before and during the pandemic. Methods involved retrospective analysis of patient demographics, clinical characteristics, lesion details, and treatment modalities, using Jamovi software (version 1.6) for statistical analysis. Results revealed the scalp as the most common NMSC site, with Squamous Cell Carcinoma (SCC) being the predominant histotype. A significant rise in Basal Cell Carcinoma (BCC) cases and a reduction in surgery duration were noted during the pandemic. The shift to local anesthesia was more pronounced, reflecting the necessity to adapt to healthcare limitations. Despite the disruptions caused by the pandemic, there was no significant drop in NMSC cases, which is attributed to the noticeable nature of head and neck lesions. In conclusion, this study highlights that the COVID-19 pandemic significantly influenced surgical practices in NMSC management, emphasizing the need for effective healthcare strategies that balance quality patient care with public health safety measures.
Collapse
Affiliation(s)
- Simone Benedetti
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Andrea Frosolini
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Lisa Catarzi
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Agnese Marsiglio
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Paolo Gennaro
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Guido Gabriele
- Maxillofacial Surgery Unit, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| |
Collapse
|
5
|
Karampinis E, Papadopoulou MM, Chaidaki K, Georgopoulou KE, Magaliou S, Roussaki Schulze AV, Bogdanos DP, Zafiriou E. Plaque Psoriasis Exacerbation and COVID-19 Vaccination: Assessing the Characteristics of the Flare and the Exposome Parameters. Vaccines (Basel) 2024; 12:178. [PMID: 38400161 PMCID: PMC10892964 DOI: 10.3390/vaccines12020178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
The diverse patient population and widespread vaccination in the COVD-19 era make vaccine-triggered episodes of psoriasis an ideal model of exposome research. This scenario explores the fine balance between protective and exacerbating factors, providing insights into the complex relationship between environmental exposure and psoriasis immunopathogenesis when a trigger appears, such as that of the hyperinflammatory state induced by the COVID-19 vaccine. Analyzing interactions between vaccine-induced phenomena and exposome parameters may provide clinically relevant information important for personalized medicine decision-making. We performed a literature review seeking patients with plaque psoriasis flares or new onset or change in plaque psoriasis into another psoriasis subtype, such as pustular or erythrodermic flare, focusing on the inner and external exposome traits of patients. We identified 71 patients with plaque psoriasis flares, 12 patients with new-onset psoriasis, and 17 with plaque psoriasis subtype change, and assessed the COVID-19 vaccine-induced plaque psoriasis in terms of clinical presentation, post-vaccination flare period and treatment status, as well as inner exposome parameters (genomics, oxidative stress, hormonal impact due to gender, aging, skin color) and external parameters (UV, infectomics). Novel data on psoriasis flares following COVID-19 vaccination are primarily obtained by combining exposome and vaccine-triggered episode features and characteristics and comparing them with similar psoriasis flares unrelated to COVID-19 vaccination.
Collapse
Affiliation(s)
- Emmanouil Karampinis
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (K.C.); (A.V.R.S.)
| | | | - Kleoniki Chaidaki
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (K.C.); (A.V.R.S.)
| | - Konstantina-Eirini Georgopoulou
- Department of Dermatology, General Hospital of Nikaia Pireus “Agios Panteleimon”—General Hospital of West Attica “Agia Varvara”, 12351 Athens, Greece
| | - Stavroula Magaliou
- Department of Internal Medicine, General Hospital of Trikala, 42100 Trikala, Greece
| | - Angeliki Viktoria Roussaki Schulze
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (K.C.); (A.V.R.S.)
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece;
| | - Efterpi Zafiriou
- Department of Dermatology, Faculty of Medicine, School of Health Sciences, University General Hospital of Larissa, University of Thessaly, 41110 Larissa, Greece; (E.K.); (K.C.); (A.V.R.S.)
| |
Collapse
|
6
|
Caraban BM, Aschie M, Deacu M, Cozaru GC, Pundiche MB, Orasanu CI, Voda RI. A Narrative Review of Current Knowledge on Cutaneous Melanoma. Clin Pract 2024; 14:214-241. [PMID: 38391404 PMCID: PMC10888040 DOI: 10.3390/clinpract14010018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/21/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Cutaneous melanoma is a public health problem. Efforts to reduce its incidence have failed, as it continues to increase. In recent years, many risk factors have been identified. Numerous diagnostic systems exist that greatly assist in early clinical diagnosis. The histopathological aspect illustrates the grim nature of these cancers. Currently, pathogenic pathways and the tumor microclimate are key to the development of therapeutic methods. Revolutionary therapies like targeted therapy and immune checkpoint inhibitors are starting to replace traditional therapeutic methods. Targeted therapy aims at a specific molecule in the pathogenic chain to block it, stopping cell growth and dissemination. The main function of immune checkpoint inhibitors is to boost cellular immunity in order to combat cancer cells. Unfortunately, these therapies have different rates of effectiveness and side effects, and cannot be applied to all patients. These shortcomings are the basis of increased incidence and mortality rates. This study covers all stages of the evolutionary sequence of melanoma. With all these data in front of us, we see the need for new research efforts directed at therapies that will bring greater benefits in terms of patient survival and prognosis, with fewer adverse effects.
Collapse
Affiliation(s)
- Bogdan Marian Caraban
- Clinical Department of Plastic Surgery, Microsurgery-Reconstructive, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania
| | - Mariana Aschie
- Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania
- Clinical Service of Pathology, Departments of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Academy of Medical Sciences of Romania, 030171 Bucharest, Romania
- The Romanian Academy of Scientists, 030167 Bucharest, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), "Ovidius" University of Constanta, 900591 Constanta, Romania
| | - Mariana Deacu
- Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania
- Clinical Service of Pathology, Departments of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
| | - Georgeta Camelia Cozaru
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), "Ovidius" University of Constanta, 900591 Constanta, Romania
- Clinical Service of Pathology, Departments of Genetics, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
| | - Mihaela Butcaru Pundiche
- Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania
- Clinical Department of General Surgery, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
| | - Cristian Ionut Orasanu
- Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania
- Clinical Service of Pathology, Departments of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), "Ovidius" University of Constanta, 900591 Constanta, Romania
| | - Raluca Ioana Voda
- Faculty of Medicine, "Ovidius" University of Constanta, 900470 Constanta, Romania
- Clinical Service of Pathology, Departments of Pathology, "Sf. Apostol Andrei" Emergency County Hospital, 900591 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), "Ovidius" University of Constanta, 900591 Constanta, Romania
| |
Collapse
|
7
|
Alma A, Pongetti L, Clementi A, Chester J, Toccaceli M, Ciardo S, Zappia E, Manfredini M, Pellacani G, Greco M, Bennardo L, Farnetani F. Combined Carbon Dioxide Laser with Photodynamic Therapy for Nodular Basal Cell Carcinoma Monitored by Reflectance Confocal Microscopy. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:30. [PMID: 38256291 PMCID: PMC10821002 DOI: 10.3390/medicina60010030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
Introduction: Basal cell carcinoma (BCC) represents around 80% of all malignant skin cancers worldwide, constituting a substantial burden on healthcare systems. Due to excellent clearance rates (around 95%), surgery is the current gold-standard treatment. However, surgery is not always possible or preferred by patients. Numerous non-surgical therapies, sometimes combined, have been associated with promising tumor free survival rates (80-90%) in non-melanoma skin cancers (NMSCs). Most research has enrolled superficial basal cell carcinomas (sBCCs), with limited recent studies also involving low-risk nodular BCCs (nBCCs). Given lower efficacy rates compared to surgery, close monitoring during the follow-up period is essential for patients treated with non-surgical therapies. Monitoring with dermoscopy is constrained by low sensitivity rates. Reflectance confocal microscopy (RCM) is more sensitive in monitoring non-surgically treated NMSCs. Case presentation: A 41-year-old woman with a single nBCC relapse following photodynamic therapy (PDT) located on the dorsum of the nose presented to our center. Given the aesthetically sensitive location of the lesion and the patient's preference for a non-surgical approach, a combined treatment of CO2 laser and PDT was prescribed. A superpulsed CO2 laser (power: 0.5-3 W, frequency: 10 Hz, spot size 2 mm) with two PDT sessions (2 weeks apart) were conducted. At 6 weeks follow-up, monitoring performed with RCM revealed a reduction but not eradication of basaloid tumor islands. Another 2 sessions of PDT were recommended. At 3, 12 and 30 months of follow-up, the nasal dorsum area of the previous nBBC lesion was noted to be slightly hypopigmented (observed clinically), with a mild erythematous background (observed by dermoscopy). RCM evaluation confirmed the absence of RCM BCC criteria. The cosmetic outcome was very much improved. Conclusions: Combined CO2 laser and PDT for the treatment of a localized nBCC on the dorsum of the nose of a 41-year-old proved to offer tumor free survival at 30-month follow-up, as monitored with RCM. RCM is useful for the evaluation of non-surgical therapies as it has comparably higher sensitivity than dermoscopy and is especially useful in cases of suspected late recurrence. Further studies are needed to validate ongoing tumor free survival following this combined nonsurgical approach in the treatment of nBCC.
Collapse
Affiliation(s)
- Antonio Alma
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Linda Pongetti
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Alessandro Clementi
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Johanna Chester
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Matteo Toccaceli
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Silvana Ciardo
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Elena Zappia
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Marco Manfredini
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy;
| | - Maurizio Greco
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| | - Luigi Bennardo
- Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy;
| | - Francesca Farnetani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.A.); (L.P.); (A.C.); (J.C.); (M.T.); (S.C.); (M.M.); (M.G.); (F.F.)
| |
Collapse
|