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Russo F, Cioppa V, Lazzeri L, Milanesi N, Galluzzo M, D'Erme AM, Schettini N, Cocuroccia B, Sordi D, Panebianco A, Talamonti M, Paganini C, De Pità O, Giampetruzzi AR, Scaglione GL. Evaluating the Clinical Meaning of Dermatology Life Quality Index Scores Between Different Phenotypes of Atopic Dermatitis in Patients Before and After Biologic Therapy With Dupilumab. Dermatitis 2024. [PMID: 38669092 DOI: 10.1089/derm.2023.0357] [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: 04/28/2024]
Abstract
Background and Objective: Atopic Dermatitis (AD) is the most prevalent inflammatory skin disorder resulting in an intense impact on patients quality of life. The aim of this study is to evaluate the clinical meaning of the DLQI scores documented between different phenotypes of AD patients under biologic therapy with Dupilumab. Method: We conducted a retrospective analysis of 209 patients with AD treated with Dupilumab for 2 years. These patients were categorized into different clinical phenotypes. Severity of the disease was assessed by using the Eczema Area and Severity Index (EASI), Numerical Scale Rating (NRS) for sleep (NRS sleep), pruritus (NRS pruritus) and Dermatology Life Quality Index (DLQI) at baseline and subsequently at 4,12 and 24 months. Results: Our results show that the higher DLQI scores (mean: 18.6, range:9-30) achieved at T0 are associated with a prurigo nodularis AD pattern, while after 24 months (T3) of therapy with Dupilumab, the worst quality of life index results were reported in Flexural and Head-Neck combined clinical phenotypes. Conclusions: Quality of life is probably what matters most as an overall endpoint in AD. Assessing the clinical meaning of DLQI scores across different AD phenotypes could be a further aid when considering decision making factors in patient management.
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Affiliation(s)
- Filomena Russo
- From the Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Vittoria Cioppa
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Laura Lazzeri
- Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Nicola Milanesi
- Section of Dermatology, Azienda USL Toscana Centro, Pistoia-Prato, Italy
| | - Marco Galluzzo
- Dermatology Unit, Fondazione Policlinico "Tor Vergata," Rome, Italy
- Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy
| | | | - Natale Schettini
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Barbara Cocuroccia
- From the Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Donatella Sordi
- From the Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | | | - Marina Talamonti
- Dermatology Unit, Fondazione Policlinico "Tor Vergata," Rome, Italy
| | - Claudia Paganini
- Dermatology Unit, Fondazione Policlinico "Tor Vergata," Rome, Italy
- Department of Systems Medicine, University of Rome "Tor Vergata," Rome, Italy
| | - Ornella De Pità
- From the Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Anna Rita Giampetruzzi
- From the Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Giovanni Luca Scaglione
- From the Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
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Russo F, Giampetruzzi AR, Pilla MA, De Pità O, Camela E. Revolutionizing the management of patients with atopic dermatitis: practical considerations. Expert Opin Biol Ther 2024; 24:213-215. [PMID: 38523270 DOI: 10.1080/14712598.2024.2334380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Filomena Russo
- Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | | | | | - Ornella De Pità
- Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Elisa Camela
- Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
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Camela E, Giampetruzzi AR, De Pità O, Pallotta S, Russo F. Dupilumab in real-life settings: a review of adverse events and their pathogenesis. Expert Opin Drug Saf 2024; 23:439-447. [PMID: 38470213 DOI: 10.1080/14740338.2024.2326480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/29/2024] [Indexed: 03/13/2024]
Abstract
INTRODUCTION Dupilumab is a safe and effective biological drug that revolutionized the treatment of atopic dermatitis (AD). Concerning adverse events (AEs), the most commonly reported included ocular involvement, nasopharyngitis, and injection site reactions in clinical trials. Anyway, its use in daily practice is revealing novel dupilumab-induced manifestations. AREAS COVERED Relevant English literature (real-life studies, case series, reviews, and meta-analyses) regarding real-life adverse events induced by dupilumab were searched for up to 10 June 2023. EXPERT OPINION Dupilumab is an effective treatment for AD, showing favorable safety profile since no routine laboratory monitoring is recommended. However, several cutaneous and extracutaneous AEs have been reported in real-life setting expanding the pool emerged from clinical trials. In detail, dupilumab may determine de-novo onset or exacerbation of preexisting conditions, whose pathogenesis is still unclear and seems to involve Th1/Th2 and Th2/Th17 immune-response imbalance. Also, the heterogeneity and the variable onset time of AEs with respect to dupilumab initiation warrant a thorough patients' history collection and strict short- and long-term monitoring. Finally, the most appropriate management of patients with AEs related to dupilumab should take into consideration efficacy for AD as well as severity and nature of the AE, available treatment and patients' preferences.
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Affiliation(s)
- Elisa Camela
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | | | - Ornella De Pità
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | | | - Filomena Russo
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
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Samela T, Cordella G, Antinone V, Sarandrea P, Giampetruzzi AR, Abeni D. The use of SCL-k-9 to measure general psychopathology in women and men with skin conditions. Front Psychol 2022; 13:977264. [PMID: 36337481 PMCID: PMC9632958 DOI: 10.3389/fpsyg.2022.977264] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To measure general psychopathology in dermatologic outpatients using the Symptom-Checklist-K-9 (SCL-K-9); to investigate whether the SCL-K-9 is able to categorize patients with and without significant non-psychotic disorders; and to perform a single-item analysis of the SCL-K-9, with a focus on gender differences. Methods Cross-sectional study on consecutive dermatological patients. We used two self-administered questionnaires to assess general psychopathology symptoms: General Health Questionnaire-12 (GHQ-12) and SCL-K-9. Sociodemographic information was collected with standardized forms. The performance of the SCL-K-9 in classifying patients according to their current emotional distress severity was assessed using a ROC procedure. Finally, we measured differences in scores obtained among women and men in SCL-K-9 single items. Results A total of 292 patients were studied (71.2% women). We observed statistically significant differences in SCL-K-9 total mean scores and in most single items among genders. We found that it would be more appropriate to use gender-specific cut-offs when using SCL-K-9 to screen dermatological patients for general psychopathology. Conclusion The SCL-K-9, with its compact format could provide, in a short time, a wide range of information related to critical areas that challenge the mental health of patients with skin diseases.
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Affiliation(s)
- Tonia Samela
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
- Clinical Psychology Unit, IDI-IRCCS, Rome, Italy
- *Correspondence: Tonia Samela,
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Pennisi A, Bloisi DD, Suriani V, Nardi D, Facchiano A, Giampetruzzi AR. Skin Lesion Area Segmentation Using Attention Squeeze U-Net for Embedded Devices. J Digit Imaging 2022; 35:1217-1230. [PMID: 35505265 PMCID: PMC9582108 DOI: 10.1007/s10278-022-00634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
Melanoma is the deadliest form of skin cancer. Early diagnosis of malignant lesions is crucial for reducing mortality. The use of deep learning techniques on dermoscopic images can help in keeping track of the change over time in the appearance of the lesion, which is an important factor for detecting malignant lesions. In this paper, we present a deep learning architecture called Attention Squeeze U-Net for skin lesion area segmentation specifically designed for embedded devices. The main goal is to increase the patient empowerment through the adoption of deep learning algorithms that can run locally on smartphones or low cost embedded devices. This can be the basis to (1) create a history of the lesion, (2) reduce patient visits to the hospital, and (3) protect the privacy of the users. Quantitative results on publicly available data demonstrate that it is possible to achieve good segmentation results even with a compact model.
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Affiliation(s)
- Andrea Pennisi
- Dept. of Computer Science, University of Antwerp, Antwerpen, Belgium
| | - Domenico D Bloisi
- Dept. of Mathematics, Computer Science, and Economics, University of Basilicata, Potenza, Italy.
| | - Vincenzo Suriani
- Dept. of Computer Science, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
| | - Daniele Nardi
- Dept. of Computer Science, Control, and Management Engineering, Sapienza University of Rome, Rome, Italy
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Pennisi A, Bloisi DD, Nardi D, Giampetruzzi AR, Mondino C, Facchiano A. Skin lesion image segmentation using Delaunay Triangulation for melanoma detection. Comput Med Imaging Graph 2016; 52:89-103. [DOI: 10.1016/j.compmedimag.2016.05.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 05/03/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
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Napolitano M, Giampetruzzi AR, Didona D, Papi M, Didona B. Toxic epidermal necrolysis-like acute cutaneous lupus erythematosus successfully treated with a single dose of etanercept: report of three cases. J Am Acad Dermatol 2014; 69:e303-5. [PMID: 24238188 DOI: 10.1016/j.jaad.2013.07.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 07/22/2013] [Accepted: 07/23/2013] [Indexed: 01/28/2023]
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De Simone C, Guerriero C, Giampetruzzi AR, Costantini M, Di Gregorio F, Amerio P, Giampietruzzi AR. Achilles tendinitis in psoriasis: clinical and sonographic findings. J Am Acad Dermatol 2003; 49:217-22. [PMID: 12894068 DOI: 10.1067/s0190-9622(03)00904-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Involvement of the Achilles tendon is frequent in psoriatic arthritis, but it is easily missed at clinical examination. OBJECTIVE To seek evidence of Achilles tendon abnormalities by means of sonography in psoriatic patients and to correlate sonographic findings with clinical symptoms (tendon and soft-tissue swelling, pain, and difficulty in walking). METHODS Fifty-nine patients with plaque-type psoriasis (Psoriasis Area and Severity Index score, 3.7-34.7) and 50 healthy, aged-matched volunteers underwent clinical and sonographic evaluation of Achilles tendons and peritendinous structures. RESULTS Eighteen (30.5%) of the 59 patients had clinical symptoms of Achilles tendinitis. Thirty-five (59.3%) of the patients had sonographic abnormalities. Of these, 13 patients had clinically symptomatic abnormalities, and 11 had psoriatic arthritis. Degenerative tendinitis was the most frequent sonographic finding (76.9%) among patients with symptomatic conditions. Five patients with symptoms did not have sonographic alterations. None of the controls had clinical or sonographic changes. CONCLUSIONS In psoriatic patients Achilles tendon abnormalities cannot be excluded even when they are clinically absent.
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Affiliation(s)
- Clara De Simone
- Department of Dermatology, Università Carrolica del Sacro Cuore, Rome, Italy.
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De Simone C, Giampetruzzi AR, Guerriero C, De Masi M, Amerio P, Cina G. Squamous cell carcinoma arising in a venous ulcer as a complication of the Klippel-Trenaunay syndrome. Clin Exp Dermatol 2002; 27:209-11. [PMID: 12072010 DOI: 10.1046/j.1365-2230.2002.01009.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Klippel-Trenaunay (KT) syndrome is a vascular malformation characterized by a port-wine stain, varicose veins and hypertrophy of the affected limb. Ulceration is considered an uncommon complication of KT syndrome and occurrence of skin cancer has been previously reported only in one case. We observed a case of KT syndrome in a 48-year-old woman who developed a large ulcer and a squamous cell carcinoma on the affected leg.
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Affiliation(s)
- C De Simone
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
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