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Lobato-Berezo A, Escolà-Rodríguez A, Courtney A, Chim I, Ruiz-Villaverde R, Imbernón-Moya A, Velasco-Tamariz V, Vañó-Galván S, Gil-Redondo R, Del Boz J, Garnacho Saucedo G, Starace M, Saceda-Corralo D, Quadrelli F, Piraccini BM, Pujol RM. Acne keloidalis nuchae: An international multicentric review of 79 patients. J Eur Acad Dermatol Venereol 2024; 38:e342-e345. [PMID: 37909243 DOI: 10.1111/jdv.19609] [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: 07/27/2023] [Accepted: 10/24/2023] [Indexed: 11/02/2023]
Affiliation(s)
| | - Alba Escolà-Rodríguez
- Pharmacy Service, Division of Medicines, Hospital Clinic, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | | | - Ivana Chim
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | | | | | | | - Sergio Vañó-Galván
- Department of Dermatology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rocío Gil-Redondo
- Department of Dermatology, Hospital Universitario La Paz, Madrid, Spain
| | - Javier Del Boz
- Department of Dermatology, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Gloria Garnacho Saucedo
- Department of Dermatology, Hospital Universitario Reina Sofía, Córdoba, Spain
- Unidad Tricología Clínica Garnacho, Córdoba, Spain
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
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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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Vañó-Galván S, Egeberg A, Piraccini BM, Marwaha S, Reed C, Johansson E, Durand F, Bewley A. Characteristics and Management of Patients with Alopecia Areata and Selected Comorbid Conditions: Results from a Survey in Five European Countries. Dermatol Ther (Heidelb) 2024; 14:1027-1037. [PMID: 38509379 DOI: 10.1007/s13555-024-01133-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Alopecia areata (AA) is an autoimmune condition that causes non-scarring hair loss and can impose a high psychosocial burden on patients. The presence of comorbid conditions may impact the management of AA in clinical practice. This analysis aims to describe disease characteristics and management of AA in patients with concomitant atopic, autoimmune, and psychiatric comorbid conditions. METHODS Data were collected from the Adelphi Disease Specific Programme™, a cross-sectional survey of physicians and their adult patients with AA conducted in France, Germany, Italy, Spain, and the UK between October 2021 and June 2022. Patients' disease severity was based on physician's definition. Physician-reported data on demographics, AA clinical characteristics, comorbid conditions, and information related to AA therapies were analyzed. Analyses were descriptive. RESULTS Overall, 239 dermatologists provided data for 2083 patients, of which 558 patients (27%) had at least one atopic, autoimmune, or psychiatric comorbid conditions. The most common comorbid conditions were atopic dermatitis, autoimmune thyroid disease, and anxiety. The mean (standard deviation) patient age for the three comorbidity groups was 37.6 years (12.1) and 56% of the patients were women (n = 313). In the three comorbidity groups, 51%, 50%, and 55% of patients with atopic, autoimmune, and psychiatric comorbidities had severe AA with disease progression reported as worsening in 30%, 28%, and 30%, respectively, whereas in the group with no comorbidities, 37% were described as having severe AA and 21% getting worse. Scalp hair loss was the primary sign reported across the three groups of comorbid conditions (atopic, 91%; autoimmune, 91%; psychiatric, 88%). Patients with preselected comorbidities presented more frequently AA-related signs and symptoms beyond scalp hair loss than patients without comorbid conditions. These patients were also more likely to receive topical calcineurin inhibitors, topical immunotherapy, conventional systemic immunosuppressants, and oral Janus kinase inhibitors for the treatment of their AA. CONCLUSION This analysis provided insights into the burden and management of AA in patients presenting with atopic, autoimmune, and psychiatric comorbid conditions in five European countries.
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Affiliation(s)
- Sergio Vañó-Galván
- Department of Dermatology, Ramón y Cajal University Hospital, IRYCIS, University of Alcala, Madrid, Spain.
| | - Alexander Egeberg
- Department of Dermatology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bianca Maria Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine Alma Mater, Studiorum University of Bologna, Bologna, Italy
| | | | | | | | | | - Anthony Bewley
- Barts Health NHS Trust and Queen Mary University, London, UK
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Starace M, Pampaloni F, Lazaridou E, Kyrmanidou E, Stratigos A, Lallas A, Katoulis A, Sgouros D, Quadrelli F, Rapparini L, Cedirian S, Bruni F, Ala L, Rossi A, Piraccini BM, Apalla Z. Current Diagnostic and Therapeutic Practices in Alopecia Areata in Two Mediterranean Countries: A Survey-Based Study. Dermatol Ther (Heidelb) 2024; 14:953-970. [PMID: 38598171 DOI: 10.1007/s13555-024-01141-z] [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: 01/29/2024] [Accepted: 03/11/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Alopecia areata (AA) affects approximately 2% of the general population and is associated with significant psychosocial morbidity and poor health-related quality of life. Despite the high incidence of the disease the available clinical practice guidelines to help clinicians and improve patients' care are very poor and of a low methodological quality, as compared to other high-burden dermatoses. The aim of this survey is to capture the current clinical practice in AA management, as performed by dermatologists, in two Mediterranean countries to identify potential disparities and gaps in diagnosis and treatment. METHODS A 50-item questionnaire was created in the English language and then translated into Greek and Italian language and sent to the Greek and Italian dermatologists via email. RESULTS A total of 490 dermatologists from Italy and 234 from Greece participated in the survey. The diagnosis of AA is usually based on history and clinical examination, supported by trichoscopy. The rate of use of severity scores and scales to evaluate impact on quality of life by dermatologists was low. Treatment of patchy AA, in both adult and pediatric populations, is based on use of topical steroids as first-line treatment. Results on special site involvement (eyebrows, beard, and ophiasis), chronic cases, and the pediatric population highlight extreme heterogeneity in treatment approach. CONCLUSIONS Our results highlight that management of AA, in terms of diagnosis and treatment, is still challenging.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Pampaloni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elisabeth Lazaridou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eirini Kyrmanidou
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "A. Sygros" Hospital for Skin and Venereal Diseases, Athens, Greece
| | - Aimilios Lallas
- 1st Department of Dermatology and Venereology, Medical School, Aristotle University of Thessaloniki, Thessaloníki, Greece
| | - Alexander Katoulis
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attiko" General Hospital, Athens, Greece
| | - Dimitrios Sgouros
- 2nd Department of Dermatology and Venereology, Medical School, National and Kapodistrian University of Athens, "Attiko" General Hospital, Athens, Greece
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Ala
- Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Alfredo Rossi
- Dermatologic Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, La Sapienza University of Rome, Rome, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Massarenti 1, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Zoe Apalla
- Second Dermatology Department, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Rudnicka L, Arenbergerova M, Grimalt R, Ioannides D, Katoulis AC, Lazaridou E, Olszewska M, Ovcharenko YS, Piraccini BM, Prohic A, Rakowska A, Reygagne P, Richard MA, Soares RO, Starace M, Vañó-Galvan S, Waskiel-Burnat A. European expert consensus statement on the systemic treatment of alopecia areata. J Eur Acad Dermatol Venereol 2024; 38:687-694. [PMID: 38169088 DOI: 10.1111/jdv.19768] [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: 10/07/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
Alopecia areata is an autoimmune form of non-scarring hair loss. It is usually characterized by limited areas of hair loss. However, the disease may progress to complete scalp and body hair loss (alopecia totalis, alopecia universalis). In patients with alopecia areata hair loss significantly impacts the quality of life. Children and adolescents with alopecia areata often experience bullying, including physical aggression. The disease severity evaluation tools used in clinical practice are: the Severity of Alopecia Tool (SALT) score and the Alopecia Areata Scale (AAS). A SALT score equal to or greater than 20 constitutes a commonly accepted indication for systemic therapy in alopecia areata. When using the AAS, moderate to severe alopecia areata should be considered a medical indication for systemic treatment. Currently, the only two EMA-approved medications for alopecia areata are baricitinib (JAK 1/2 inhibitor) for adults and ritlecitinib (JAK 3/TEC inhibitor) for individuals aged 12 and older. Both are EMA-approved for patients with severe alopecia areata. Other systemic medications used off-label in alopecia areata include glucocorticosteroids, cyclosporine, methotrexate and azathioprine. Oral minoxidil is considered an adjuvant therapy with limited data confirming its possible efficacy. This consensus statement is to outline a systemic treatment algorithm for alopecia areata, indications for systemic treatment, available therapeutic options, their efficacy and safety, as well as the duration of the therapy.
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Affiliation(s)
- L Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - M Arenbergerova
- Department of Dermatovenereology, Third Faculty of Medicine, Charles University and Královské Vinohrady University Hospital, Prague, Czech Republic
| | - R Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - D Ioannides
- 1st Department of Dermatology-Venereology, Aristotle University Medical School, Thessaloniki, Greece
| | - A C Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - E Lazaridou
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, "Attikon" General University Hospital, Athens, Greece
| | - M Olszewska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Y S Ovcharenko
- Department of Infectious Diseases and Clinical Immunology of the V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Italy School of Specialization Dermatology and Venereology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - A Prohic
- Department of Dermatovenerology, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - A Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - P Reygagne
- Centre de Santé Sabouraud, Hopital Saint Louis, Paris, France
| | - M A Richard
- CEReSS-EA 3279, Research Centrer in Health Services and Quality of Life Aix Marseille University, Dermatology Department, Universitary Hospital Timone, Assistance Publique Hôpitaux de Marseille, APHM, Marseille, France
| | - R O Soares
- CUF Descobertas Hospital, Lisbon, Portugal
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Italy School of Specialization Dermatology and Venereology, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - S Vañó-Galvan
- Department Ramon y Cajal Hospital, IRYCIS, Grupo Pedro Jaén Clinic, TricoHRC Research Group, University of Alcala, Madrid, Spain
| | - A Waskiel-Burnat
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Patruno C, Guarneri F, Nettis E, Bonzano L, Filippi F, Ribero S, Foti C, Rubegni P, Balato A, Miniello A, Motolese A, Piraccini BM, Quaglino P, Romita P, Lazzeri L, Buononato D, Dastoli S, Raia F, Napolitano M. Safety of omalizumab in chronic urticaria during pregnancy: a real-life study. Clin Exp Dermatol 2024; 49:344-347. [PMID: 37956096 DOI: 10.1093/ced/llad386] [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: 10/05/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Managing a pregnant patient with chronic spontaneous urticaria (CSU) is often challenging. Recent data have shown that most CSU treatments in pregnant patients are second-generation H1 antihistamines (sgAHs), while data on the safety of omalizumab are scant. OBJECTIVES To evaluate, in a routine clinical practice setting, the efficacy and safety of omalizumab in patients with severe CSU refractory to sgAHs who either became pregnant during treatment or who started the drug during pregnancy. METHODS We conducted a retrospective study of women aged ≥ 18 years who were pregnant, who received one or more doses of omalizumab at any time during their pregnancy or who were taking omalizumab at the time of, or in the 8 weeks before, conception. RESULTS Twenty-nine pregnant patients were evaluated: 23 (79%) conceived a child while taking omalizumab (group A), while 6 (21%) started omalizumab treatment during pregnancy (group B). Among patients in group A, we observed 23 births (21 liveborn singletons and 1 liveborn twin pair) and 1 miscarriage. Fifteen (65%) patients discontinued omalizumab after confirming their pregnancy, while eight (35%) were exposed to omalizumab during their entire pregnancy. In group B, omalizumab was introduced at a mean (SD) 10.83 (3.60) weeks' gestation and all patients were exposed to it until the end of pregnancy. In this group, there were seven liveborn infants (five singletons and one twin pair). No adverse events, pregnancy complications or congenital anomalies in newborns were recorded in either group. CONCLUSIONS Omalizumab for CSU treatment before and during pregnancy does not appear to have negative effects on maternal or fetal outcomes.
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Affiliation(s)
- Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Fabrizio Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Eustachio Nettis
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Policlinico di Bari, Bari, Italy
| | - Laura Bonzano
- Dermatology Unit, Azienda USL - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Federica Filippi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Simone Ribero
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Caterina Foti
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Pietro Rubegni
- Department of Medical, Surgical Science and Neruroscience, University of Siena, Siena, Italy
| | - Anna Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Andrea Miniello
- Department of Emergency and Organ Transplantation, School of Allergology and Clinical Immunology, University of Bari Aldo Moro, Policlinico di Bari, Bari, Italy
| | - Alfonso Motolese
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Paolo Romita
- Section of Dermatology and Venereology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Laura Lazzeri
- Department of Medical, Surgical Science and Neruroscience, University of Siena, Siena, Italy
| | - Dario Buononato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stefano Dastoli
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Flavia Raia
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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7
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Starace M, Rapparini L, Quadrelli F, Cedirian S, Pampaloni F, Piraccini BM. When onychoscopy makes the difference in a longitudinal furrow on the nail plate: Myxoid pseudocyst versus ungual fibrokeratoma. J Eur Acad Dermatol Venereol 2024. [PMID: 38459785 DOI: 10.1111/jdv.19945] [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: 12/19/2023] [Accepted: 02/19/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Pampaloni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Moussa A, Bennett M, Wall D, Meah N, York K, Bokhari L, Asfour L, Rees H, Abraham LS, Asz-Sigall D, Basmanav FB, Bergfeld W, Betz RC, Bhoyrul B, Blume-Peytavi U, Callender V, Chitreddy V, Combalia A, Cotsarelis G, Craiglow B, Dhurat R, Donovan J, Doroshkevich A, Eisman S, Farrant P, Ferrando J, Gadzhigoroeva A, Green J, Grimalt R, Harries M, Hordinsky M, Irvine A, Jolliffe V, Kaiumov S, King B, Lee J, Lee WS, Li J, Lortkipanidze N, McMichael A, Mesinkovska NA, Messenger A, Mirmirani P, Olsen E, Orlow SJ, Ovcharenko Y, Piraccini BM, Pirmez R, Rakowska A, Reygagne P, Rudnicka L, Corralo DS, Senna M, Shapiro J, Sharma P, Siliuk T, Starace M, Suchonwanit P, Takwale A, Tosti A, Vañó-Galván S, Visser WI, Vogt A, Wade M, Yip L, Zhou C, Sinclair R. The Alopecia Areata Severity and Morbidity Index (ASAMI) Study: Results From a Global Expert Consensus Exercise on Determinants of Alopecia Areata Severity. JAMA Dermatol 2024; 160:341-350. [PMID: 38324292 DOI: 10.1001/jamadermatol.2023.5869] [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] [Indexed: 02/08/2024]
Abstract
Importance Current measures of alopecia areata (AA) severity, such as the Severity of Alopecia Tool score, do not adequately capture overall disease impact. Objective To explore factors associated with AA severity beyond scalp hair loss, and to support the development of the Alopecia Areata Severity and Morbidity Index (ASAMI). Evidence Review A total of 74 hair and scalp disorder specialists from multiple continents were invited to participate in an eDelphi project consisting of 3 survey rounds. The first 2 sessions took place via a text-based web application following the Delphi study design. The final round took place virtually among participants via video conferencing software on April 30, 2022. Findings Of all invited experts, 64 completed the first survey round (global representation: Africa [4.7%], Asia [9.4%], Australia [14.1%], Europe [43.8%], North America [23.4%], and South America [4.7%]; health care setting: public [20.3%], private [28.1%], and both [51.6%]). A total of 58 specialists completed the second round, and 42 participated in the final video conference meeting. Overall, consensus was achieved in 96 of 107 questions. Several factors, independent of the Severity of Alopecia Tool score, were identified as potentially worsening AA severity outcomes. These factors included a disease duration of 12 months or more, 3 or more relapses, inadequate response to topical or systemic treatments, rapid disease progression, difficulty in cosmetically concealing hair loss, facial hair involvement (eyebrows, eyelashes, and/or beard), nail involvement, impaired quality of life, and a history of anxiety, depression, or suicidal ideation due to or exacerbated by AA. Consensus was reached that the Alopecia Areata Investigator Global Assessment scale adequately classified the severity of scalp hair loss. Conclusions and Relevance This eDelphi survey study, with consensus among global experts, identified various determinants of AA severity, encompassing not only scalp hair loss but also other outcomes. These findings are expected to facilitate the development of a multicomponent severity tool that endeavors to competently measure disease impact. The findings are also anticipated to aid in identifying candidates for current and emerging systemic treatments. Future research must incorporate the perspectives of patients and the public to assign weight to the domains recognized in this project as associated with AA severity.
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Affiliation(s)
- Anthony Moussa
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | | | - Dmitri Wall
- Hair Restoration Blackrock, Dublin, Ireland
- National and International Skin Registry Solutions (NISR), Charles Institute of Dermatology, University College Dublin, Dublin, Ireland
| | - Nekma Meah
- St Helens & Knowsley National Health Service Trust, St Helens, United Kingdom
- Manchester University, Faculty of Biology, Medicine and Health, Manchester, United Kingdom
| | - Katherine York
- Netcare Greenacres Hospital, Port Elizabeth, South Africa
| | - Laita Bokhari
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Leila Asfour
- Salford Royal Foundation Trust, Northern Care Alliance, Manchester, United Kingdom
| | - Huw Rees
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | | | - Daniel Asz-Sigall
- Trichology Clinic, Dermatology Department, Dr Manuel Gea Gonzalez General Hospital, Mexico City, Mexico
| | - Fitnat Buket Basmanav
- Institute of Human Genetics, University Hospital of Bonn & University of Bonn, Bonn, Germany
| | | | - Regina C Betz
- Institute of Human Genetics, University Hospital of Bonn & University of Bonn, Bonn, Germany
| | - Bevin Bhoyrul
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | | | - Andrea Combalia
- Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - George Cotsarelis
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
| | - Brittany Craiglow
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | | | - Jeff Donovan
- Donovan Hair Clinic, University of British Columbia, Whistler, British Columbia, Canada
| | | | - Samantha Eisman
- Sinclair Dermatology, East Melbourne, Victoria, Australia
- Australasian Hair and Wool Research Society, Melbourne, Victoria, Australia
| | - Paul Farrant
- Brighton and Sussex University Hospitals National Health Service Trust, Brighton, United Kingdom
| | - Juan Ferrando
- Dermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Aida Gadzhigoroeva
- Moscow Scientific & Practical Center of Dermatology, Venereology and Cosmetology, Russian Federation
| | - Jack Green
- Department of Dermatology, Saint Vincent's Hospital, Victoria, Australia
| | - Ramon Grimalt
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain
| | - Matthew Harries
- Salford Royal Hospital, Northern Care Alliance National Health Service Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
- Centre for Dermatology Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Maria Hordinsky
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Alan Irvine
- Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| | - Victoria Jolliffe
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Spartak Kaiumov
- Clinic of Trichology and Cosmetology Nautilus, Saint-Petersburg, Russia
| | - Brett King
- Yale School of Medicine, New Haven, Connecticut
| | | | - Won-Soo Lee
- Department of Dermatology, Yonsei University, Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon-do, Republic of Korea
| | - Jane Li
- Department of Dermatology, Saint Vincent's Hospital, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
- Department of Dermatology, Eastern Health, Melbourne, Victoria, Australia
- Skin Health Institute, Carlton, Melbourne, Victoria, Australia
| | | | - Amy McMichael
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | - Andrew Messenger
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | | | - Elise Olsen
- Duke Dermatology Clinic, Durham, North Carolina
| | - Seth J Orlow
- Grossman School of Medicine, New York University, New York, New York
| | - Yuliya Ovcharenko
- Department of Infectious Diseases and Clinical Immunology, V. N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Bologna, Italy
| | - Rodrigo Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay-Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Pascal Reygagne
- Centre de Santé Sabouraud, Hopital Saint Louis, Vellefaux, Paris, France
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - David Saceda Corralo
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maryanne Senna
- Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Jerry Shapiro
- Disorders of the Hair and Scalp, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York
| | - Pooja Sharma
- Sinclair Dermatology, East Melbourne, Victoria, Australia
| | - Tatiana Siliuk
- Hair Treatment and Transplantation Center, Saint Petersburg, Russian Federation
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Poonkiat Suchonwanit
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Anita Takwale
- Editorial Advisory Board, Indian Journal of Dermatology Venereology Leprosy
| | - Antonella Tosti
- Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Sergio Vañó-Galván
- Dermatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Universidad de Alcalá, Madrid, Spain
- Trichology Unit, #TricoHRC Research Group, Madrid, Spain
| | - Willem I Visser
- Division of Dermatology, Stellenbosch University, Cape Town, South Africa
| | - Annika Vogt
- Department of Dermatology, Venerology and Allergology, Clinical Research Center for Hair and Skin Science, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Martin Wade
- The London Skin and Hair Clinic, London, United Kingdom
| | - Leona Yip
- Skin Partners Specialist Dermatologists, Brisbane, Australia
| | - Cheng Zhou
- Department of Dermatology, Peking University People's Hospital, Xicheng District, Beijing, China
| | - Rodney Sinclair
- Sinclair Dermatology, East Melbourne, Victoria, Australia
- Australasian Hair and Wool Research Society, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
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Piraccini BM. A new era for alopecia areata: New treatments and improved knowledge of the condition. J Eur Acad Dermatol Venereol 2024; 38:458-459. [PMID: 38391214 DOI: 10.1111/jdv.19741] [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: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 02/24/2024]
Affiliation(s)
- Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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10
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Gupta AK, Wang T, Cooper EA, Summerbell RC, Piguet V, Tosti A, Piraccini BM. A comprehensive review of nondermatophyte mould onychomycosis: Epidemiology, diagnosis and management. J Eur Acad Dermatol Venereol 2024; 38:480-495. [PMID: 38010049 DOI: 10.1111/jdv.19644] [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: 05/10/2023] [Accepted: 10/09/2023] [Indexed: 11/29/2023]
Abstract
Nondermatophyte moulds (NDMs) are widely distributed and can be detected in association with mycotic nails; however, sometimes it can be challenging to establish the role of NDMs in the pathogenesis of onychomycosis (i.e. causative vs. contaminant). In studies where the ongoing invasive presence of NDMs is confirmed through repeat cultures, the global prevalence of NDMs in onychomycosis patients is estimated at 6.9% with the 3 most common genus being: Aspergillus, Scopulariopsis and Fusarium. NDM onychomycosis can, in many cases, appear clinically indistinguishable from dermatophyte onychomycosis. Clinical features suggestive of NDMs include proximal subungual onychomycosis with paronychia associated with Aspergillus spp., Fusarium spp. and Scopulariopsis brevicaulis, as well as superficial white onychomycosis in a deep and diffused pattern associated with Aspergillus and Fusarium. Longitudinal streaks seen in patients with distal and lateral onychomycosis may serve as an additional indicator. For diagnosis, light microscopic examination should demonstrate fungal filaments consistent with an NDM with at least two independent isolations in the absence of a dermatophyte; the advent of molecular testing combined with histological assessment may serve as an alternative with improved sensitivity and turnover time. In most instances, antifungal susceptibility testing has limited value. Information on effective treatments for NDM onychomycosis is relatively scarce, unlike the situation in the study of dermatophyte onychomycosis. Terbinafine and itraconazole therapy (continuous and pulsed) appear effective to varying extents for treating onychomycosis caused by Aspergillus, Fusarium or Scopulariopsis. There is scant literature on oral treatments for Neoscytalidium.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Mediprobe Research Inc., London, Ontario, Canada
| | - Tong Wang
- Mediprobe Research Inc., London, Ontario, Canada
| | | | - Richard C Summerbell
- Sporometrics, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Piguet
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada
| | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology, University of Miami, Miami, Florida, USA
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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11
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Starace M, Rapparini L, Cedirian S, Evangelista V, Pampaloni F, Bruni F, Misciali C, Rubino D, Zamagni C, Pileri A, Piraccini BM. Management of cutaneous adverse events caused by antineoplastic therapies: a single-center experience. Support Care Cancer 2024; 32:200. [PMID: 38421520 DOI: 10.1007/s00520-024-08407-4] [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: 11/05/2023] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Cutaneous adverse events can occur in patients treated with antineoplastic treatments, albeit their incidence has not been defined yet. The clinical presentation of CAEs related to anticancer treatments can vary. The purpose of our study is to characterize skin toxicities during oncological treatments, manage such adverse events to improve patients' quality of life, and ensure therapeutic adherence. METHODS We conducted a single-center prospective study which provided the enrollment of all patients referred to the Skin Toxicity Outpatient Clinic for the occurrence of cutaneous adverse events secondary to an ongoing antineoplastic treatment, between July 2021 and June 2023. We analyzed clinical features, and we described our therapeutic approach. RESULTS Based on the type of drug assumed, chemotherapy-induced skin toxicity in 24 (38.7%) of the 62 evaluated patients, target therapies in 18 (29.0%), CDK4/6 cyclin inhibitors in 12 (19.4%), and immunotherapy in 6 (9.7%), while skin adverse events secondary to hormone therapy were seen in two patients. The most common cutaneous adverse event in our experience was rosaceiform rash of the face, followed by eczematous rash, hand-foot syndrome, and folliculitis. CONCLUSION The present study is aimed at describing the variability and heterogeneity of clinical manifestations of different pharmacological classes used in oncological patients, as well as the different pathogenesis of skin damage. Chemotherapy very frequently causes skin toxicities that are often underestimated by clinicians. Their adequate recognition and optimal treatment lead to total recovery and allow better adhesion to chemotherapy.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Valeria Evangelista
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Pampaloni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Daniela Rubino
- Oncologic Unit, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Bologna, Italy
| | - Claudio Zamagni
- Oncologic Unit, IRCCS Azienda Ospedaliero Universitaria Di Bologna, Bologna, Italy
| | - Alessandro Pileri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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12
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Buzatto BC, Lemes LR, Cortez de Almeida RF, Machado CJ, Starace M, Piraccini BM, Alessandrini A, Quadrelli F, Marti M, Rudnicka L, Wáskiel Burnat A, Doroshkevich A, Silyuk T, Iorizzo M, Rigatti M, Tosti A, Vincenzi C, Mercau S, Sánchez-Dueñas LE, Asz Sigall D, Dos Santos Lima C, Baptista E, de Carvalho R, Faro GBDA, Doche I, Melo DF. Diffuse pattern of alopecia areata in children: A multicentre retrospective study with 67 patients. J Eur Acad Dermatol Venereol 2024. [PMID: 38407450 DOI: 10.1111/jdv.19915] [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: 12/05/2023] [Accepted: 02/13/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Brenda Costa Buzatto
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luciana Rodino Lemes
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, 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
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Miguel Marti
- Centro de Tricologia y Transplante Capilar Dr Miguel Marti, Buenos Aires, Argentina
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warszawa, Poland
| | | | - Andrei Doroshkevich
- Private Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russia
| | - Tatiana Silyuk
- Private Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russia
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona, Lugano, Switzerland
| | - Marcelo Rigatti
- Department of Dermatology, Hair, and Nail Clinic, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | | | - Sebastian Mercau
- Dermatology Department, Trichology Unit, Hospital Centenario, and Clínica de la Piel, Rosario, Argentina
| | | | - Daniel Asz Sigall
- Trichology Clinic, Department of Dermatology, Dr. Manuel Gea Gonzalez General Hospital, Mexico City, Mexico
| | - Caren Dos Santos Lima
- Department of Dermatology, University of State of Pará - UEPA, Belém, Brazil
- Department of Dermatology, University Center of Pará - CESUPA, Belém, Brazil
| | - Erica Baptista
- Department of Dermatology, University of State of Pará - UEPA, Belém, Brazil
| | | | - Gustavo Baptista de Almeida Faro
- Department of Dermatology, Hospital of the Public Servants of São Paulo - HSPM, São Paulo, Brazil
- Federal University of Sergipe - UFS, Aracaju, Brazil
| | - Isabella Doche
- Department of Dermatology, Universidade de São Paulo, Sao Paulo, Brazil
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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13
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Starace M, Loi C, Cedirian S, Bruni F, Filippi F, La Placa M, Piraccini BM, Bardazzi F. Trichoscopy as a monitoring tool in assessing treatment response in scalp pemphigus. J Eur Acad Dermatol Venereol 2024. [PMID: 38372382 DOI: 10.1111/jdv.19869] [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: 06/22/2023] [Accepted: 01/31/2024] [Indexed: 02/20/2024]
Affiliation(s)
- M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - C Loi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Filippi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M La Placa
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Guglielmo A, Pileri A, Toniutto P, Bardazzi F, Potena L, Russo A, Masetti M, Maria Piraccini B, Stinco G. Biologic treatment of psoriasis in solid organ transplant recipients. J Dtsch Dermatol Ges 2024; 22:283-287. [PMID: 38066381 DOI: 10.1111/ddg.15291] [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: 04/13/2023] [Accepted: 09/28/2023] [Indexed: 12/20/2023]
Affiliation(s)
- Alba Guglielmo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandro Pileri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Pierluigi Toniutto
- Internal Medicine, Department of Medical Area, University of Udine, Udine, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Luciano Potena
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Russo
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Masetti
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giuseppe Stinco
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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Guglielmo A, Pileri A, Toniutto P, Bardazzi F, Potena L, Russo A, Masetti M, Piraccini BM, Stinco G. Biologikatherapie der Psoriasis in organtransplantierten Patienten: Biologic treatment of psoriasis in solid organ transplant recipients. J Dtsch Dermatol Ges 2024; 22:283-287. [PMID: 38361191 DOI: 10.1111/ddg.15291_g] [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: 04/13/2023] [Accepted: 09/28/2023] [Indexed: 02/17/2024]
Affiliation(s)
- Alba Guglielmo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Alessandro Pileri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Pierluigi Toniutto
- Internal Medicine, Department of Medical Area, University of Udine, Udine, Italy
| | - Federico Bardazzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Luciano Potena
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Antonio Russo
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Masetti
- Cardiology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Giuseppe Stinco
- Institute of Dermatology, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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Iorizzo M, Sirtoli Marcondes MT, Sechi A, Therianou A, Piraccini BM, Starace M. Female diffuse non-cicatricial alopecia-The diagnostic value of trichoscopy. J Eur Acad Dermatol Venereol 2024; 38:e142-e144. [PMID: 37702248 DOI: 10.1111/jdv.19493] [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: 02/20/2023] [Accepted: 08/30/2023] [Indexed: 09/14/2023]
Affiliation(s)
- M Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
| | | | - A Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - A Therianou
- Imperial College, NHS Healthcare Trust, London, UK
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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17
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Curti N, Merli Y, Zengarini C, Starace M, Rapparini L, Marcelli E, Carlini G, Buschi D, Castellani GC, Piraccini BM, Bianchi T, Giampieri E. Automated Prediction of Photographic Wound Assessment Tool in Chronic Wound Images. J Med Syst 2024; 48:14. [PMID: 38227131 DOI: 10.1007/s10916-023-02029-9] [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: 08/12/2023] [Accepted: 12/22/2023] [Indexed: 01/17/2024]
Abstract
Many automated approaches have been proposed in literature to quantify clinically relevant wound features based on image processing analysis, aiming at removing human subjectivity and accelerate clinical practice. In this work we present a fully automated image processing pipeline leveraging deep learning and a large wound segmentation dataset to perform wound detection and following prediction of the Photographic Wound Assessment Tool (PWAT), automatizing the clinical judgement of the adequate wound healing. Starting from images acquired by smartphone cameras, a series of textural and morphological features are extracted from the wound areas, aiming to mimic the typical clinical considerations for wound assessment. The resulting extracted features can be easily interpreted by the clinician and allow a quantitative estimation of the PWAT scores. The features extracted from the region-of-interests detected by our pre-trained neural network model correctly predict the PWAT scale values with a Spearman's correlation coefficient of 0.85 on a set of unseen images. The obtained results agree with the current state-of-the-art and provide a benchmark for future artificial intelligence applications in this research field.
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Affiliation(s)
- Nico Curti
- Department of Physics and Astronomy, University of Bologna, 40127, Bologna, Italy
- Data Science and Bioinformatics Laboratory, IRCCS Institute of Neurological Sciences of Bologna, 40139, Bologna, Italy
| | - Yuri Merli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Corrado Zengarini
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy.
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Luca Rapparini
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Emanuela Marcelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
- eDIMESLab, Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Gianluca Carlini
- Data Science and Bioinformatics Laboratory, IRCCS Institute of Neurological Sciences of Bologna, 40139, Bologna, Italy
| | - Daniele Buschi
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Gastone C Castellani
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
| | | | - Enrico Giampieri
- Department of Medical and Surgical Sciences, University of Bologna, 40138, Bologna, Italy
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Chessa MA, Maltoni L, Robuffo S, Savoia F, Piraccini BM, Neri I. A Rare Case of Angiolymphoid Hyperplasia With Eosinophilia: A Dermoscopic and Therapeutic Teaching Point. Dermatol Pract Concept 2024; 14:dpc.1401a5. [PMID: 38364438 PMCID: PMC10868895 DOI: 10.5826/dpc.1401a5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Marco Adriano Chessa
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Lorenzo Maltoni
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Silvia Robuffo
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesco Savoia
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori," Skin Cancer Unit, Meldola, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Iria Neri
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Sechi A, Starace M, Piraccini BM, Wortsman X. Ultrasound Features of Onychopapilloma at High-Frequency and Ultra-High Frequency. J Ultrasound Med 2024; 43:71-76. [PMID: 37750808 DOI: 10.1002/jum.16338] [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] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE This study aimed to identify the sonographic features of pathologically confirmed onychopapilloma cases. METHODS High-frequency up to 24 MHz and ultra-high frequency-ultrasound up to 71 MHz examinations were performed and correlated with their clinical and pathologic presentations. RESULTS Twenty-two cases met the criteria. Clinical presentations revealed longitudinal erythronychia in 63.3% of cases. The ultrasound examinations identified a hypoechoic band in the nail bed (86.3%), nail plate abnormalities including upward displacement (68.2%) and thickening (68.1%), focal hyperechoic focal spots on the nail plate (50%) and irregularities of the ventral plate (33.3%). Color Doppler imaging showed no hypervascularity of the nail bed in all studies. These findings correlate with histological characteristics of onychopapilloma, including nail bed acanthosis, papillomatosis, and layered hyperkeratosis. Recurrence occurred in two cases after surgery, with tumors showing proximal extension in the matrix region on ultrasound not evident during clinical examination. CONCLUSION High-frequency and ultra-high-frequency can provide anatomical information in onychopapilloma that could enhance understanding and management.
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Affiliation(s)
- Andrea Sechi
- Dermatology Unit, San Bortolo Hospital of Vicenza, Veneto, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Bologna, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S'Orsola, Bologna, Italy
| | - Ximena Wortsman
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
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20
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Starace M, Milan E, Summa G, Alessandrini AM, Sechi A, Iorizzo M, Di Chiacchio NG, Di Chiacchio N, Piraccini BM. Onychoscopic characteristics of Trichophyton rubrum and Trichophyton interdigitalis fungal infections: A multicentric study. Mycoses 2024; 67:e13673. [PMID: 37966016 DOI: 10.1111/myc.13673] [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: 07/19/2023] [Revised: 09/23/2023] [Accepted: 10/30/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Trichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, which often results unfeasible. OBJECTIVES The aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway. PATIENTS AND METHODS We conducted an observational retrospective study on 54 patients with a culture proven diagnosis of distal subungual onychomycosis of the toenail, caused by Trichophyton rubrum or Trichophyton mentagrophytes variant interdigitalis. Using a videodermatoscope we collected data on nail colour (white, yellow, orange, brown, dark) and on dermoscopic patterns (aurora, spikes, jagged, ruin, linear edge, dots, striae). RESULTS Fifty-four patients, with a total of 72 nails, were eligible for this study. Analysing the association between discoloration of the nail plate and type of infection (T. rubrum or T. interdigitalis), no correlation turned out to be statistically significant. Instead, significant associations between spikes and T. rubrum infection and striae and infection from T. interdigitalis were identified. Finally, a 100% specificity was identified for white colour and ruin pattern for T. rubrum infection, and brown colour, jagged border and aurora pattern for T. interdigitalis. CONCLUSIONS Trying to find relationships between specific pathogens and dermoscopic patterns, we found out an association between spikes and striae and T. rubrum and T. interdigitalis respectively. Further larger studies are however necessary to evaluate our preliminary findings.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Elisa Milan
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Giovanni Summa
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Andrea Sechi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | | | - Nilton Gioia Di Chiacchio
- Faculdade de Medicina do ABC, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Nilton Di Chiacchio
- Head of Dermatology Clinic - Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
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21
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Starace M, Cedirian S, Gurioli C, Chessa MA, Piraccini BM, Neri I. Spotted Lunula in Alopecia Areata: Clinical and Onychoscopic Features of an Unusual Sign. Dermatol Pract Concept 2024; 14:dpc.1401a2. [PMID: 38364419 PMCID: PMC10868956 DOI: 10.5826/dpc.1401a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Stephano Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Carlotta Gurioli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Marco Adriano Chessa
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Iria Neri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
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Sarkis A, Cortez de Almeida RF, Lemes LR, Obadia DL, Machado CJ, Müller-Ramos P, Pedretti M, Starace M, Quadrelli F, Piraccini BM, Alessandrini A, Rossi A, Saceda-Corralo D, Khobzei K, Iorizzo M, Vañó-Galván S, Silyuk T, Tosti A, Vincenzi C, Fechine COC, Anzai A, Rigatti M, Minotto R, D'Atri G, Kakizaki P, Mercau S, Oliveira-Soares R, Navarro Tuculet C, Cappetta ME, Alves LD, Pinto GM, Lima CDS, Frattini S, Melo DF. Folliculitis decalvans in women: A retrospective multicentre study of 150 patients. J Eur Acad Dermatol Venereol 2024; 38:e66-e70. [PMID: 37594799 DOI: 10.1111/jdv.19434] [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: 02/07/2023] [Accepted: 08/09/2023] [Indexed: 08/19/2023]
Affiliation(s)
- Aline Sarkis
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | | | - Luciana Rodino Lemes
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Daniel Lago Obadia
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Carla Jorge Machado
- Preventive and Social Medicine Department, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Paulo Müller-Ramos
- Department of Dermatology and Radiotherapy, Universidade Estadual Paulista - UNESP, Botucatu, Brazil
| | - Manuela Pedretti
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Federico Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, 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
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alfredo Rossi
- Department of Internal Medicine and Medical Specialties, University of Rome "La Sapienza", Rome, Italy
| | - David Saceda-Corralo
- Dermatology Department, Trichology Unit, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | | | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Sergio Vañó-Galván
- Dermatology Department, Trichology Unit, Ramón y Cajal University Hospital, Instituto Ramón y Cajal de Investigación Sanitaria, University of Alcalá, Madrid, Spain
| | - Tatiana Silyuk
- Private Practice, Hair Treatment and Transplantation Center, Saint Petersburg, Russian Federation
| | - Antonella Tosti
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, Miami, Florida, USA
| | | | | | - Alessandra Anzai
- Department of Dermatology, Universidade de São Paulo - USP, São Paulo, Brazil
| | - Marcelo Rigatti
- Department of Dermatology, Hair and Nail Clinic - Federal University of Santa Catarina, Florianópolis, Brazil
| | - Renan Minotto
- Department of Dermatology, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil
| | - Gisela D'Atri
- Grupo MCI (Integral Hair Medicine), Private Dermatology Practice, Buenos Aires, Argentina
| | - Priscila Kakizaki
- Department of Dermatology, Hospital do Servidor Público Municipal de São Paulo, São Paulo, Brazil
| | - Sebastian Mercau
- Dermatology Department, Trichology Unit, Hospital Centenario, and Clínica de la Piel, Rosario, Argentina
| | | | | | | | - Lorena Dourado Alves
- Department of Tropical Medicine and Dermatology, Federal University of Goiás, Goiânia, Brazil
| | | | - Caren Dos Santos Lima
- Department of Dermatology, University of State of Pará - UEPA, Belém, Brazil
- Department of Dermatology, University Center of Pará - CESUPA, Belém, Brazil
| | - Simone Frattini
- Public Health Services, The City of Hamilton, Hamilton, Ontario, Canada
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro - UERJ, Rio de Janeiro, Brazil
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Chessa MA, Rapparini L, Filippi F, Baraldi C, Piraccini BM, Neri I. Paradoxical Psoriasis: A Dermoscopic and Histopathologic Teaching Point. Dermatol Pract Concept 2024; 14:dpc.1401a13. [PMID: 38364375 PMCID: PMC10868953 DOI: 10.5826/dpc.1401a13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Marco Adriano Chessa
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Federica Filippi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carlotta Baraldi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Iria Neri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Piraccini BM, Ohyama M, Craiglow B, Bewley A, Ding Y, Chen YF, Dutronc Y, Pierce E, Durand F, Mostaghimi A. Scalp hair regrowth is associated with improvements in health-related quality of life and psychological symptoms in patients with severe alopecia areata: results from two randomized controlled trials. J DERMATOL TREAT 2023; 34:2227299. [PMID: 37381691 DOI: 10.1080/09546634.2023.2227299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
INTRODUCTION This post hoc analysis assessed association between scalp hair regrowth and improvements in health-related quality of life (HRQoL) and psychological burden in patients with severe alopecia areata (AA). METHODS Data were pooled from two phase-3 trials (N = 1200). Patients randomized to once-daily placebo, baricitinib 2-mg, or 4-mg were analyzed independently of treatment allocation, and categorized according to scalp hair regrowth (at Week 36): meaningful regrowth (Severity of Alopecia Tool (SALT) score ≤20); intermediate regrowth (≥30% SALT improvement [SALT30] at any post-baseline visit to Week 36, but SALT score > 20 at Week 36); no/minimal regrowth (never achieved SALT30). Skindex-16 for AA score change-from-baseline and proportion of patients with baseline Hospital Anxiety and Depression Scale (HADS) scores ≥8 that shifted to <8 (normal) were assessed. RESULTS Patients with meaningful regrowth achieved greater improvements in all Skindex-16 AA domains versus no/minimal regrowth. More patients with meaningful versus no/minimal regrowth shifted from HADS ≥8 to <8 (anxiety:46.8% versus 26.4%; depression:52.3% versus 24.0%). Improvements occurred with intermediate regrowth but to a lesser extent versus meaningful regrowth. CONCLUSIONS Patients with severe AA and scalp hair regrowth at Week 36 experienced greater improvements in HRQoL and anxiety and depression versus patients with no/minimal regrowth. The highest benefit was observed in patients with meaningful regrowth (SALT score ≤20).ClinicalTrials.gov listing: NCT03570749 and NCT03899259.
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Affiliation(s)
- Bianca Maria Piraccini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University, Tokyo, Japan
| | - Brittany Craiglow
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
| | - Anthony Bewley
- Department of Dermatology, Barts Health NHS Trust, London, and Queen Mary University of London, London, UK
| | - Yuxin Ding
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | | | | | - Arash Mostaghimi
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Starace M, Cedirian S, Alessandrini A, Bruni F, Piraccini BM, Iorizzo M. Self-induced nail disorders (SINDs): What do we know so far? Ann Dermatol Venereol 2023; 150:253-259. [PMID: 37813711 DOI: 10.1016/j.annder.2023.05.005] [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: 01/29/2023] [Revised: 03/17/2023] [Accepted: 05/09/2023] [Indexed: 10/11/2023]
Abstract
Self-induced nail disorders are a broad group of different clinical manifestations that share the common trait of being caused more or less voluntarily by the patient. These are distinct conditions within the clinical spectrum of onychotillomania. Most patients diagnosed with these disorders have psychiatric co-morbidities, and a multidisciplinary approach is thus highly recommended. The purpose of this review is to describe the most common clinical features encountered during daily nail consultations and to provide useful diagnostic tools and therapeutic tips for the best approach to these conditions.
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Affiliation(s)
- M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy.
| | - A Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum University, Bologna, Italy
| | - M Iorizzo
- Private Dermatology Practice, Lugano/Bellinzona, Switzerland
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Gupta AK, Polla Ravi S, Wang T, Talukder M, Starace M, Piraccini BM. Systematic review of mesotherapy: a novel avenue for the treatment of hair loss. J DERMATOL TREAT 2023; 34:2245084. [PMID: 37558233 DOI: 10.1080/09546634.2023.2245084] [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: 07/06/2023] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
Mesotherapy is a technique by which lower doses of therapeutic agents and bioactive substances are administered by intradermal injections to the skin. Through intradermal injections, mesotherapy can increase the residence time of therapeutic agents in the affected area, thus allowing for the use of lower doses and longer intervals between sessions which may in turn improve the treatment outcome and patient compliance. This systematic review aims to summarize the current literature that evaluates the efficacy of this technique for the treatment of hair loss and provides an overview of the results observed. Of the 416 records identified, 27 articles met the inclusion criteria. To date, mesotherapy using 6 classes of agents and their combinations have been studied; this includes dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions/multivitamins. While several studies report statistically significant improvements in hair growth after treatment, there is currently a lack of standardized regimens. The emergence of adverse effects after mesotherapy has been reported. Further large-scale and controlled clinical trials are warranted to evaluate the utility of mesotherapy for hair loss disorders.
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Affiliation(s)
- Aditya K Gupta
- Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Canada
- Mediprobe Research Inc, London, Canada
| | | | - Tong Wang
- Mediprobe Research Inc, London, Canada
| | - Mesbah Talukder
- Mediprobe Research Inc, London, Canada
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy
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Lanzoni A, Rapparini L, Pagliara A, Misciali C, Starace M, Piraccini BM. Chromoblastomycosis, A Neglected Fungal Infection. Mycopathologia 2023; 188:1103-1105. [PMID: 37856009 DOI: 10.1007/s11046-023-00803-4] [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: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/20/2023]
Affiliation(s)
- Anna Lanzoni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy.
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Andrea Pagliara
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Vañó-Galván S, Blume-Peytavi U, Farrant P, Reygagne P, Johansson E, Reed C, Marwaha S, Durand F, Piraccini BM. Physician- and Patient-Reported Severity and Quality of Life Impact of Alopecia Areata: Results from a Real-World Survey in Five European Countries. Dermatol Ther (Heidelb) 2023; 13:3121-3135. [PMID: 37889388 PMCID: PMC10689682 DOI: 10.1007/s13555-023-01057-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/09/2023] [Indexed: 10/28/2023] Open
Abstract
INTRODUCTION Alopecia areata (AA) can negatively affect quality of life (QoL) and is associated with increased prevalence of anxiety and depression (vs people without AA). This study compared physician-assessed and patient self-rated severity of AA in a European sample and described the patient-reported burden of AA stratified by physician-assessed severity. METHODS Real-world data were collected from the Adelphi Real World AA Disease Specific Programme™, a retrospective point-in-time cross-sectional survey of dermatologists and their adult patients with AA in five European countries (France, Germany, Italy, Spain, UK). Physicians provided clinical data and an AA severity assessment, according to their own definition of 'mild', 'moderate' and 'severe'. Patients were invited to provide their perception of AA severity and completed patient-reported outcome (PRO) questionnaires, including Skindex-16 for AA (Skindex-16 AA), EuroQol-5-dimension questionnaire 5-level (EQ-5D-5L), Hospital Anxiety and Depression Scale and the Work Productivity and Activity Impairment Questionnaire. RESULTS Data for 2083 patients were collected by 239 physicians; 561 of these patients completed PRO questionnaires. In 78.5% of cases with available data (N = 549), there was alignment between patient and physician-rated AA severity (severity was rated higher by physicians in 15.7% of cases, by patients in 5.8% of cases). Data from all PRO instruments showed an increase in patient-reported burden and work and activity impairment with increasing physician-rated AA severity. For the Skindex-16 AA, the Emotions scale had the worst scores; anxiety/depression was the EQ-5D-5L dimension with the highest percentages of patients reporting any perceived problem. CONCLUSIONS These data highlight the significant impact that AA can have beyond hair loss, especially for patients with severe AA. There was substantial physician-patient alignment on severity assessment. Higher physician-rated AA severity was associated with higher levels of patient-reported disease burden, including anxiety and depression, and work and activity impairment. These data may help inform appropriate treatment strategies.
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Affiliation(s)
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venerology and Allergology, Charité-Universitätsmedizin, Berlin, Germany
| | - Paul Farrant
- Department of Dermatology, Brighton General Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | | | | | | | | | | | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Via Albertoni 15, 40138, Bologna, Italy.
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 1, 40138, Bologna, Italy.
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Galván SV, Piraccini BM, Reygagne P, Farrant P, Reed C, Johansson E, Marwaha S, Durand F, Blume-Peytavi U. A description of alopecia areata in European patients based on real-world survey data: physician-reported characterization of severity and associated treatment utilization. Eur J Dermatol 2023; 33:648-656. [PMID: 38465546 DOI: 10.1684/ejd.2023.4578] [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: 03/12/2024]
Abstract
Alopecia areata (AA), an autoimmune disease -affecting the hair of the scalp, face, and/or body, can entail substantial psychological and physical burden for patients. There is currently no international agreement on how to treat AA and the approach may vary across countries. This study investigated the management of AA in clinical practice. Data from a point-in-time survey conducted in France, Germany, Italy, Spain, and the United Kingdom, between October 2021-June 2022, were analysed for adults with mild, moderate, and severe AA, based on physician assessment. Dermatologists were surveyed about factors used to assess disease severity, physician-reported treatment goals, and treatment patterns for AA, including the use of wigs. In total, 239 dermatologists reported on 2,083 patients. Physicians' severity assessment and treatment goals were predominantly driven by scalp hair loss. Topical and intralesional corticosteroids were the most prescribed treatments for mild and moderate AA. Conventional immunosuppressants, oral Janus kinase inhibitors, and topical immunotherapy use generally increased with AA severity and therapy line. Wig use was greatest for severe AA. The primary reasons for the last treatment change in the moderate and severe groups were worsening of condition, lack of initial efficacy, and loss of response, and for mild group were improvement in condition, lack of initial efficacy, and worsening of condition. Findings were generally similar across countries. This analysis provides insights into the management of AA in five European countries and confirms the need for more effective therapies, especially for patients with severe AA.
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Affiliation(s)
- Sergio Vañó Galván
- Ramón y Cajal University Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - Bianca Maria Piraccini
- Dermatology Unit- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy, Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum University of Bologna, Italy
| | | | - Paul Farrant
- University Hospitals Sussex NHS Trust, Brighton, United Kingdom
| | | | | | - Simran Marwaha
- Adelphi Real World, Macclesfield, Cheshire, United Kingdom
| | | | - Ulrike Blume-Peytavi
- Department of Dermatology and Allergology, Venerology, Charité-Universitätsmedizin, Berlin, Germany
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Gupta AK, Talukder M, Shemer A, Piraccini BM, Tosti A. Low-Dose Oral Minoxidil for Alopecia: A Comprehensive Review. Skin Appendage Disord 2023; 9:423-437. [PMID: 38376087 PMCID: PMC10806356 DOI: 10.1159/000531890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/06/2023] [Indexed: 02/21/2024] Open
Abstract
Low-dose oral minoxidil (LDOM) has demonstrated a promising safety and efficacy profile in the treatment of various hair disorders, including male androgenetic alopecia (AGA) and female-pattern hair loss (FPHL); however, it lacks FDA approval. The usual LDOM starting dose for male AGA is 1-5 mg/day, depending on physician preference and the patient's condition. For FPHL, it is 0.5-1 mg/day. The maximum dose is generally 5 mg/day. If patients respond well without major side effects, the dose may be gradually increased since the LDOM's efficacy appears to be dose-dependent. Patients may use LDOM long term if the treatment outcome is satisfactory. The common side effects of LDOM are hypertrichosis and cardiovascular symptoms. Females are more prone to hypertrichosis than males. The side effects of LDOM can be categorized as (a) dose-dependent type A side effects (hypertrichosis and cardiovascular symptoms) and (b) idiosyncratic type B side effects (pericardial effusion). Minoxidil acts via multiple pathways. Although minoxidil has a relatively short half-life of around 4 h, its hypotensive effect may last approximately 72 h. Effective treatments for alopecia are limited. Therefore, LDOM could be an important addition to the available therapies for managing some hair disorders, including AGA.
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Affiliation(s)
- Aditya K. Gupta
- Mediprobe Research Inc., London, ON, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Mesbah Talukder
- Mediprobe Research Inc., London, ON, Canada
- School of Pharmacy, BRAC University, Dhaka, Bangladesh
| | - Avner Shemer
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Antonella Tosti
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Cedirian S, Bruni F, Quadrelli F, Caro G, Fortuna M, Rossi A, Piraccini BM, Starace M. Clinical study on the efficacy and tolerability of a topical regenerative treatment in patients with telogen effluvium and mild androgenetic alopecia. J Cosmet Dermatol 2023; 22:3347-3351. [PMID: 37415302 DOI: 10.1111/jocd.15873] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/19/2023] [Revised: 05/19/2023] [Accepted: 06/04/2023] [Indexed: 07/08/2023]
Abstract
Hair loss may change the quality of life since modern society considers hair an essential element in beauty definition. The most common causes of hair loss are androgenetic alopecia (AGA) and telogen effluvium (TE). AGA requires a lifetime use of minoxidil or finasteride (and sometimes they lose efficacy over the years), whereas TE has no standardized therapy available. Our study focuses on a novel topical regenerative preparation that, by mimicking autologous PRP, can safely and efficiently improve hair loss in patients affected by TE and AGA.
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Affiliation(s)
- S Cedirian
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Bruni
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F Quadrelli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G Caro
- Dermatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - M Fortuna
- Dermatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - A Rossi
- Dermatology Unit, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - B M Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - M Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Gaspari V, Djusse ME, Morselli S, Rapparini L, Foschi C, Ambretti S, Lazzarotto T, Piraccini BM, Marangoni A. Non-pathogenic Neisseria species of the oropharynx as a reservoir of antimicrobial resistance: a cross-sectional study. Front Cell Infect Microbiol 2023; 13:1308550. [PMID: 38076458 PMCID: PMC10703147 DOI: 10.3389/fcimb.2023.1308550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/02/2023] [Indexed: 12/18/2023] Open
Abstract
Commensal Neisseria species of the oropharynx represent a significant reservoir of antimicrobial resistance determinants that can be transferred to Neisseria gonorrhoeae. This aspect is particularly crucial in 'men having sex with men' (MSM), a key population in which pharyngeal co-colonization by N. gonorrhoeae and non-pathogenic Neisseria species is frequent and associated with the emergence of antimicrobial resistance. Here, we explored the antimicrobial susceptibility of a large panel of non-pathogenic Neisseria species isolated from the oropharynx of two populations: a group of MSM attending a 'sexually transmitted infection' clinic in Bologna (Italy) (n=108) and a group of males representing a 'general population' (n=119). We collected 246 strains, mainly belonging to N. subflava (60%) and N. flavescens (28%) species. Their antimicrobial susceptibility was evaluated assessing the minimum inhibitory concentrations (MICs) for azithromycin, ciprofloxacin, cefotaxime, and ceftriaxone using E-test strips. Overall, commensal Neisseria spp. showed high rates of resistance to azithromycin (90%; median MICs: 4.0 mg/L), and ciprofloxacin (58%; median MICs: 0.12 mg/L), whereas resistance to cephalosporins was far less common (<15%). Neisseria strains from MSM were found to have significantly higher MICs for azithromycin (p=0.0001) and ciprofloxacin (p<0.0001) compared to those from the general population. However, there was no significant difference in cephalosporin MICs between the two groups. The surveillance of the antimicrobial resistance of non-pathogenic Neisseria spp. could be instrumental in predicting the risk of the spread of multi-drug resistant gonorrhea. This information could be an early predictor of an excessive use of antimicrobials, paving the way to innovative screening and prevention policies.
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Affiliation(s)
- Valeria Gaspari
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marielle Ezekielle Djusse
- Section of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Sara Morselli
- Section of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Luca Rapparini
- Section of Dermatology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Claudio Foschi
- Section of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Microbiology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Simone Ambretti
- Section of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Microbiology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Tiziana Lazzarotto
- Section of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Microbiology Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Section of Dermatology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Antonella Marangoni
- Section of Microbiology, Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
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King B, Shapiro J, Ohyama M, Egeberg A, Piraccini BM, Craiglow B, Sinclair R, Chen YF, Wu WS, Ding Y, Somani N, Dutronc Y. When to expect scalp hair regrowth during treatment of severe alopecia areata with baricitinib: insights from trajectories analyses of patients enrolled in two phase III trials. Br J Dermatol 2023; 189:666-673. [PMID: 37708254 DOI: 10.1093/bjd/ljad253] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/13/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Baricitinib is approved for the treatment of adults with severe alopecia areata (AA). In the absence of robust data on the patterns of regrowth during treatment of severe AA, there is a gap in the knowledge regarding treatment expectations. OBJECTIVES To examine whether different clinical response subgroups could be identified in baricitinib-treated patients with severe AA and factors that contribute to these subgroups. METHODS The BRAVE-AA1 and BRAVE-AA2 phase III trials enrolled patients with severe AA [Severity of Alopecia Tool (SALT) score ≥ 50 (≥ 50% scalp hair loss)]. Patients randomized to baricitinib 4 mg or 2 mg retained their treatment allocation for 52 weeks. Based on patterns identified through growth mixture modelling (GMM), patients were categorized into responder subgroups according to when they first achieved ≥ 30% improvement from baseline in SALT score (SALT30). For each responder subgroup, trajectories of response (i.e. achievement of a SALT score ≤ 20, SALT score ≤ 10 and ≥ 50% change from baseline in SALT score) and baseline disease characteristics are reported. RESULTS Respectively, 515 and 340 patients were randomized to once-daily baricitinib 4 mg and 2 mg at baseline; 69% and 51%, respectively, achieved SALT30 at least once by week 52. Based on GMM findings, we identified three responder subgroups: early (SALT30 by week 12), gradual (SALT30 after week 12-week 36) and late (SALT30 after week 36-week 52). The proportions of early, gradual and late responders and nonresponders were, respectively, 33%, 28%, 8% and 31% among patients treated with baricitinib 4 mg, and 20%, 23%, 9% and 49%, respectively, among those treated with baricitinib 2 mg. Early responders had a shorter trajectory to maximal clinical outcomes (e.g. > 78% achieved a SALT score ≤ 20 by week 36) vs. gradual or late responders. Early responders were more frequent among patients with baseline severe AA (SALT score 50 to < 95) vs. very severe AA (SALT score 95-100). Overall, responders (early to late) were more frequent in patients with short (< 4 years) episodes of hair loss. CONCLUSIONS These analyses identified early, gradual and late responder subgroups for scalp hair regrowth in baricitinib-treated patients with severe AA, and that these subgroups are influenced by baseline characteristics. Findings from these analyses will help to inform treatment expectations for scalp hair regrowth.
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Affiliation(s)
- Brett King
- Yale School of Medicine, New Haven, CT, USA
| | - Jerry Shapiro
- New York University Langone Health, New York City, NY, USA
| | - Manabu Ohyama
- Department of Dermatology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences University of Bologna, Bologna, Italy
| | | | | | | | - Wen-Shuo Wu
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Yuxin Ding
- Eli Lilly and Company, Indianapolis, IN, USA
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Rayinda T, McSweeney SM, Fenton D, Stefanato CM, Harries M, Palamaras I, Tidman A, Holmes S, Koutalopoulou A, Ardern-Jones M, Williams G, Papanikou S, Chasapi V, Vañó-Galvan S, Saceda-Corralo D, Melián-Olivera A, Azcarraga-Llobet C, Lobato-Berezo A, Bustamante M, Sunyer J, Starace MVR, Piraccini BM, Wiss IP, Senna MM, Singh R, Hilmann K, Kanti-Schmidt V, Blume-Peytavi U, Simpson M, McGrath JA, Dand N, Tziotzios C. Shared Genetic Risk Variants in Both Male and Female Frontal Fibrosing Alopecia. J Invest Dermatol 2023; 143:2311-2314.e5. [PMID: 37211199 DOI: 10.1016/j.jid.2023.04.022] [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: 02/08/2023] [Revised: 04/04/2023] [Accepted: 04/22/2023] [Indexed: 05/23/2023]
Affiliation(s)
- Tuntas Rayinda
- St John's Institute of Dermatology, School of Basic & Medical Sciences, King's College London, London, United Kingdom; Department of Dermatology and Venereology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Sheila M McSweeney
- St John's Institute of Dermatology, School of Basic & Medical Sciences, King's College London, London, United Kingdom
| | - David Fenton
- St John's Institute of Dermatology, School of Basic & Medical Sciences, King's College London, London, United Kingdom
| | - Catherine M Stefanato
- St John's Institute of Dermatology, School of Basic & Medical Sciences, King's College London, London, United Kingdom
| | - Matthew Harries
- Centre for Dermatology Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom; Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Ioulios Palamaras
- Barnet and Chase Farm Hospitals, Royal Free NHS Foundation Trust, London, United Kingdom
| | - Alice Tidman
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Susan Holmes
- Alan Lyell Centre for Dermatology, Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Anastasia Koutalopoulou
- Department of Dermatology, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Michael Ardern-Jones
- Department of Dermatology, University Hospitals Southampton NHS Foundation Trust, Southampton, United Kingdom
| | | | - Sofia Papanikou
- Department of Dermatology and Venereology of NHS, Andreas Syggros Hospital of Skin and Venereal Diseases, Athens, Greece
| | - Vasiliki Chasapi
- Department of Dermatology and Venereology of NHS, Andreas Syggros Hospital of Skin and Venereal Diseases, Athens, Greece
| | - Sergio Vañó-Galvan
- Trichology Unit, Dermatology Department, Ramon Y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - David Saceda-Corralo
- Trichology Unit, Dermatology Department, Ramon Y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - Ana Melián-Olivera
- Trichology Unit, Dermatology Department, Ramon Y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - Carlos Azcarraga-Llobet
- Trichology Unit, Dermatology Department, Ramon Y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | | | | | - Jordi Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Michela Valeria Rita Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences, Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Isabel Pupo Wiss
- Harvard Medical School and Lahey Hospital and Medical Center, Boston, Massachusetts
| | | | - Rashmi Singh
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kathrin Hilmann
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Varvara Kanti-Schmidt
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Dermatology, Venerology, Allergology and Phlebology, Johannes Wesling Medical Centre, University Hospital of the Ruhr University of Bochum, Minden, Germany
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Simpson
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - John A McGrath
- St John's Institute of Dermatology, School of Basic & Medical Sciences, King's College London, London, United Kingdom
| | - Nick Dand
- Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Christos Tziotzios
- St John's Institute of Dermatology, School of Basic & Medical Sciences, King's College London, London, United Kingdom.
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Starace M, Milan E, Alessandrini A, Bruni F, Piraccini BM. Minoxidil and vitamin E therapy for nail growth disorders: A retrospective study. J Eur Acad Dermatol Venereol 2023; 37:e1226-e1228. [PMID: 37194654 DOI: 10.1111/jdv.19213] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/11/2023] [Indexed: 05/18/2023]
Affiliation(s)
- Michela Starace
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Elisa Milan
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Aurora Alessandrini
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Francesca Bruni
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES) Alma Mater Studiorum University of Bologna, Bologna, Italy
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Gnesotto L, Mioso G, Starace M, Piraccini BM, Naldi L, Sechi A. Nail Lichen Striatus Affecting Adjacent Nails: A Sign of Blaschko Lines. Dermatol Pract Concept 2023; 13:dpc.1304a208. [PMID: 37992341 PMCID: PMC10656183 DOI: 10.5826/dpc.1304a208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Laura Gnesotto
- Department of Medicine-DIMED, Unit of Dermatology, University of Padova, Padova, Italy
| | - Guido Mioso
- Department of Medicine-DIMED, Unit of Dermatology, University of Padova, Padova, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Luigi Naldi
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
- Dermatology Unit, San Bortolo Hospital, Vicenza, Italy
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Gurioli C, Misciali C, Robuffo S, Baraldi C, Boling LB, Piraccini BM. Papular Granuloma Annulare Mimicking Viral Warts. Dermatol Pract Concept 2023; 13:dpc.1304a207. [PMID: 37992393 PMCID: PMC10656127 DOI: 10.5826/dpc.1304a207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Carlotta Gurioli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Cosimo Misciali
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Silvia Robuffo
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Carlotta Baraldi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Lindsay Brooke Boling
- Allergy and Clinical Immunology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
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Neri I, Rapparini L, Salamone FP, Leuzzi M, Gurioli C, Piraccini BM. Hemorrhagic Blister in an Infant. Dermatol Pract Concept 2023; 13:dpc.1304a200. [PMID: 37992366 PMCID: PMC10656160 DOI: 10.5826/dpc.1304a200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 11/24/2023] Open
Affiliation(s)
- Iria Neri
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Luca Rapparini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Francesco Paolo Salamone
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Miriam Leuzzi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Carlotta Gurioli
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
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Sechi A, Iorizzo M, Piraccini BM, Cannata G. CO 2 Laser-Assisted Avulsion of the Proximal Nail Plate as a New Treatment Strategy in Patients Affected by Retronychia. Dermatol Surg 2023; 49:976-977. [PMID: 37584464 DOI: 10.1097/dss.0000000000003890] [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: 08/17/2023]
Affiliation(s)
- Andrea Sechi
- San Bortolo Hospital of Vicenza, Dermatology Unit Vicenza, Veneto, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
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Fagotto L, Gnesotto L, Vincenzi C, Piraccini BM, Naldi L, Sechi A. Wickham striae on skin appendages: a helpful dermoscopic feature. Dermatol Reports 2023; 15:9698. [PMID: 37908602 PMCID: PMC10614556 DOI: 10.4081/dr.2023.9698] [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: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 11/02/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disease, clinically characterized by purpuric, itchy papules that typically spread on the trunk and extremities. Other body sites can also be affected, including mucosal membranes, nails, and the scalp. The use of dermoscopy is essential in determining the diagnosis of LP, as it may highlight pathognomonic features such as Wickham striae (WS). WS are thin, pearly white structures arranged in a reticular pattern that is observed over LP lesions and histologically correspond to epidermal hypergranulosis. WS is usually most visible on the oral mucosa but can also cover almost every active LP papule. Here, we report two cases of biopsy-proven LP that show WS on dermoscopy in two specific sites: the scalp and proximal nail fold.
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Affiliation(s)
- Laura Fagotto
- Dermatology Unit, Department of Medicine, University of Padova
| | - Laura Gnesotto
- Dermatology Unit, Department of Medicine, University of Padova
| | - Colombina Vincenzi
- Dermatology Division, IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna
| | - Bianca Maria Piraccini
- Dermatology Division, IRCCS University Hospital of Bologna S. Orsola-Malpighi Polyclinic, Bologna
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna
| | - Luigi Naldi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy
| | - Andrea Sechi
- Dermatologic Unit, San Bortolo Hospital, Vicenza, Italy.
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Lambertini M, Ricci C, Hrvatin Stancic B, Mussi M, Corti B, Misciali C, Piraccini BM, Dika E. Colocalizing paraneoplastic alopecia areata and nodular basal cell carcinoma. Acta Dermatovenerol Alp Pannonica Adriat 2023; 32:127-128. [PMID: 37749974] [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: 09/27/2023]
Affiliation(s)
- Martina Lambertini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Costantino Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Bor Hrvatin Stancic
- Dermatovenerology Department, Ljubljana University Medical Center, Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Martina Mussi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Barbara Corti
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Cosimo Misciali
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emi Dika
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Dermatology Unit, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
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Longo C, Pampena R, Moscarella E, Chester J, Starace M, Cinotti E, Piraccini BM, Argenziano G, Peris K, Pellacani G. Dermoscopy of melanoma according to different body sites: Head and neck, trunk, limbs, nail, mucosal and acral. J Eur Acad Dermatol Venereol 2023; 37:1718-1730. [PMID: 37210653 DOI: 10.1111/jdv.19221] [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: 12/28/2022] [Accepted: 04/21/2023] [Indexed: 05/22/2023]
Abstract
Effective cancer screening detects early-stage tumours, leading to a lower incidence of late-stage disease over time. Dermoscopy is the gold standard for skin cancer diagnosis as diagnostic accuracy is improved compared to naked eye examinations. As melanoma dermoscopic features are often body site specific, awareness of common features according to their location is imperative for improved melanoma diagnostic accuracy. Several criteria have been identified according to the anatomical location of the melanoma. This review provides a comprehensive and contemporary review of dermoscopic melanoma criteria according to specific body sites, including frequently observed melanoma of the head/neck, trunk and limbs and special site melanomas, located on the nail, mucosal and acral region.
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Affiliation(s)
- Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
| | - Riccardo Pampena
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
- Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Skin Cancer Center, Reggio Emilia, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania L.Vanvitelli, Naples, Italy
| | - Johanna Chester
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Michela Starace
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Elisa Cinotti
- Dermatology Section, Department of Medical, Surgical and Neurological Sciences, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy
| | - Bianca Maria Piraccini
- Dermatology - IRCCS Policlinico di Sant'Orsola - Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | | | - Ketty Peris
- Institute of Dermatology, Catholic University of Rome and Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
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Zengarini C, Baruffaldi G, Piraccini BM, Bardazzi F, Mussi M, Hrvatin Stancic B, Pileri A. Nb-UVB and PUVA therapy in treating early stages of Mycosis Fungoides: A single-center cross-sectional study. Photodermatol Photoimmunol Photomed 2023; 39:435-440. [PMID: 36974002 DOI: 10.1111/phpp.12873] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Mycosis fungoides (MF) and Sezary Syndrome are the most common forms of cutaneous T-cell lymphoma. Early-stage MF is known to have an indolent behavior, and the EORTC guidelines recommend treating patients with skin-directed therapies, such as phototherapy, instead of systemic therapies. Phototherapy is a popular therapeutic option, with two commonly used light sources-PUVA and narrow band-nb UVB. PUVA is less commonly used due to its potential carcinogenic role, but it has systemic effects, while nb-UVB has mostly skin-limited effects. There is ongoing debate regarding the role of UVB light, and in 2021, the Cutaneous Lymphoma Italian Study Group reached a consensus on technical schedules for NB-UVB and PUVA for MF. This study aims to analyze and compare the efficacy of the two phototherapy options in treating early-MF patients. MATERIALS AND METHODS The study included patients diagnosed with stage IA/B MF in the last 10 years, who had at least 12 months of follow-up data and a minimum of 24 phototherapy sessions (PUVA or nb UVB) and treated with topical steroids apart from phototherapy. RESULTS Results showed that the two phototherapy options were similarly effective in treating early MF, with no significant differences in clinical response, although PUVA was associated with more adverse effects. CONCLUSIONS The study provides valuable insights into the use of phototherapy in early MF, and the results can be used to guide treatment decisions and improve patient outcomes.
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Affiliation(s)
- Corrado Zengarini
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Gregorio Baruffaldi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Bardazzi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Martina Mussi
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
| | | | - Alessandro Pileri
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Bruni L, Cassio A, Di Natale V, Baronio F, Ortolano R, Pession A, Piraccini BM, Neri I. A Case of Acrodermatitis Dysmetabolica in a Child Affected by Citrullinemia Type I: When Early Diagnosis and Timely Treatment Are Not Enough. Children (Basel) 2023; 10:1491. [PMID: 37761452 PMCID: PMC10529868 DOI: 10.3390/children10091491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
An infant with a prenatal diagnosis of citrullinemia, who started standard treatment at birth (L-arginine; sodium benzoate and a personalized diet characterized by a low protein intake and supplementation of essential nutrients and amino acids), presented at 4 months of age with extended, progressive, and severe skin lesions consistent with acrodermatitis dysmetabolica. Guidelines for the diagnosis and management of urea cycle disorders underline that a low-protein diet places patients at risk of essential fatty acids, trace elements, and vitamin deficiency. At hospital admission, our patient had normal levels of zinc and alkaline phosphatases. The plasmatic amino acid profile revealed a severe and generalized deficiency. In particular, the serum levels of arginine, valine, and isoleucine were very low and the dermatitis did not improve until the blood levels of these amino acids increased. In our patient, skin lesions happened despite an early diagnosis of citrullinemia and timely treatment due to compliance issues as a consequence of linguistic barriers.
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Affiliation(s)
- Laura Bruni
- Specialty School of Pediatrics-Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy;
| | - Alessandra Cassio
- Department of Medical & Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (V.D.N.); (F.B.); (R.O.); (A.P.)
| | - Valeria Di Natale
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (V.D.N.); (F.B.); (R.O.); (A.P.)
| | - Federico Baronio
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (V.D.N.); (F.B.); (R.O.); (A.P.)
| | - Rita Ortolano
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (V.D.N.); (F.B.); (R.O.); (A.P.)
| | - Andrea Pession
- Pediatric Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (V.D.N.); (F.B.); (R.O.); (A.P.)
| | - Bianca Maria Piraccini
- Unit of Dermatology, IRCCS di Policlinico S. Orsola, 40126 Bologna, Italy;
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy
| | - Iria Neri
- Unit of Dermatology, IRCCS di Policlinico S. Orsola, 40126 Bologna, Italy;
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May Lee M, Naldi L, Piraccini BM, Starace M, Alessandrini A, Sechi A. Trichoscopy as a Tool to Evaluate Early Dissecting Cellulitis in Patients Affected by Hidradenitis Suppurativa: A Prospective Monocentric Observational Study. Skin Appendage Disord 2023; 9:275-279. [PMID: 37564688 PMCID: PMC10410102 DOI: 10.1159/000530630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/13/2023] [Indexed: 08/12/2023] Open
Abstract
Background Dissecting cellulitis (DC) is a rare neutrophilic dermatosis that leads to cicatricial alopecia. Although DC and Hidradenitis suppurativa (HS) have similar characteristics, their association remains poorly understood. Objectives In this prospective observational study, we used trichoscopy to identify subclinical signs of DC in male patients aged 18 years or older, presenting with HS. The objective of this study was to use trichoscopy to identify subclinical signs of DC in patients with confirmed diagnosis of HS. Method In this prospective, monocentric, observational study, we used trichoscopy to identify subclinical signs of DC in male patients aged 18 years or older, presenting with HS for their initial visit at our HS outpatient clinic from February 1, 2022, to January 31, 2023. Results Of the 23 male patients with HS, 8 (35%) had subclinical trichoscopy findings consistent with DC. The most frequent location was the vertex (6/8), and the majority of patients had early/inflammatory trichoscopic signs of DC (5/8). Additionally, patients with trichoscopic findings consistent with DC had a higher Hurley stage and the International Hidradenitis Suppurativa Severity Score System (IHS4). Among the cases with trichoscopic findings compatible with DC, the majority (6/8) were classified as having a "follicular" HS according to the Canoui-Poitrine classification. Patients were treated according to European S1 guidelines on HS. Conclusions This is the first study to evaluate subclinical DC findings in HS patients using trichoscopy. Although the trichoscopic findings of DC are heterogeneous, the use of this non-invasive technique, in conjunction with clinical evaluation, can improve diagnostic accuracy and lead to earlier diagnosis. These findings suggest a potential association between HS and DC, indicating the need for further studies to evaluate this relationship.
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Affiliation(s)
- Marco May Lee
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - Luigi Naldi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
| | - Bianca Maria Piraccini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Michela Starace
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Aurora Alessandrini
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
| | - Andrea Sechi
- Dermatology Unit, Ospedale San Bortolo, Vicenza, Italy
- Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Bologna, Italy
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Waśkiel-Burnat A, Rakowska A, Zaremba M, Maciejewska M, Blicharz L, Starace M, Iorizzo M, Piraccini BM, Olszewska M, Rudnicka L. Markers of Venous Thromboembolism Risk in Patients with Alopecia Areata: Is There Anything to Worry about? Dermatol Ther (Heidelb) 2023:10.1007/s13555-023-00971-7. [PMID: 37423962 PMCID: PMC10366048 DOI: 10.1007/s13555-023-00971-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Numerous studies have indicated that alopecia areata is associated with a chronic systemic inflammation, which is considered as a risk factor for venous thromboembolism. The aim of the study was to evaluate the following markers of venous thromboembolism risk: soluble fibrin monomer complex (SFMC), thrombin-antithrombin complex (TATC), and prothrombin fragment 1 + 2 (F1 + 2) in patients with alopecia areata and compare them with healthy controls. METHODS In total, 51 patients with alopecia areata [35 women and 16 men; mean age: 38 (19-54) years] and 26 controls [18 women and 8 men; mean age: 37 (29-51) years] were enrolled in the study. The serum concentrations of thromboembolism markers were measured using an enzyme-linked immunosorbent assay (ELISA) kit. RESULTS An increased level of SFMC was detected in patients with alopecia areata compared with the controls [25.66 (20-34.86) versus 21.46 (15.38-29.48) µg/ml; p < 0.05)]. In addition, a higher level of F1 + 2 was observed in patients with alopecia areata in comparison with the control group [70150 (43720-86070) versus 38620 (31550-58840) pg/ml; p < 0.001]. No significant correlation was detected among SFMC or F1 + 2 and the Severity of Alopecia Tool (SALT) score, disease duration, or the number of the hair loss episodes. CONCLUSION Alopecia areata may be associated with an increased risk of venous thromboembolism. Regular screening and preventive management of venous thromboembolism may be beneficial in patients with alopecia areata, especially before and during systemic Janus kinase (JAK) inhibitors or glucocorticoid therapy.
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Affiliation(s)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Michał Zaremba
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | | | - Leszek Blicharz
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico S. Orsola Malpighi, Bologna, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
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Starace M, Piraccini BM, Carpanese MA, Iorizzo M, Apalla Z. Folliculitis-Decalvans Like Alopecia During Treatment with EGFR Inhibitors for Lung Cancer: A Case Series of 6 Patients. Dermatol Pract Concept 2023; 13:e2023180. [PMID: 37557165 PMCID: PMC10412076 DOI: 10.5826/dpc.1303a180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Michela Starace
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, 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
| | - Miriam Anna Carpanese
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Greece
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Starace M, Yamagata JP, Cortez de Almeida RF, Frattini S, Bruni F, Alessandrini A, Iorizzo M, Melo DF, Neri I, Piraccini BM. A Practical Algorithm for the Management of Superficial Folliculitis of the Scalp: 10 Years of Clinical and Dermoscopy Experience. Dermatol Pract Concept 2023; 13:e2023131. [PMID: 37557142 PMCID: PMC10412046 DOI: 10.5826/dpc.1303a131] [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] [Accepted: 01/17/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Superficial folliculitis of the scalp (SFS) is a common complaint in clinical practice, and initial presentation may be difficult to differentiate as they may appear very similar to each other. OBJECTIVES The aim of this thesis is to describe the pathologies that occur clinically as folliculitis of the scalp, identify their causes and characteristics and create a standardized classification. METHODS This is a retrospective clinical, dermoscopic and histopathological study over 10 years of dermatologic consultations. Only individuals with a confirmed diagnosis of SFS (updated diagnostic criteria or biopsy) were included. RESULTS In this review, we describe the various clinical features of different causes of SFS in ninety-nine cases and divided into infectious due to fungus, bacteria, or virus and inflammatory conditions such as rosacea, acneiform eruption and Ofuji syndrome. CONCLUSIONS The clinician must differentiate SFS from other underlying scarring disorders to prevent poorer outcomes. We created an algorithm to help the clinician reach a proper diagnosis.
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Affiliation(s)
- Michela Starace
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - João Paulo Yamagata
- Department of Dermatology, State University of Rio de Janeiro – UERJ, Rio de Janeiro – RJ, Brazil
| | | | - Simone Frattini
- Mental Health Department, Guelph General Hospital, Guelph, ON, Canada
| | - Francesca Bruni
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | - Daniel Fernandes Melo
- Department of Dermatology, State University of Rio de Janeiro – UERJ, Rio de Janeiro – RJ, Brazil
| | - Iria Neri
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology - IRCCS Azianda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Iorizzo M, Waśkiel-Burnat A, Anedda J, Piraccini BM, Apalla Z, Rudnicka L, Starace M. Persistent Chemotherapy-Induced Alopecia Treated With Low Dose Oral Minoxidil: A Multicenter Retrospective Case Series of 15 Patients. Dermatol Pract Concept 2023; 13:e2023152. [PMID: 37557121 PMCID: PMC10412018 DOI: 10.5826/dpc.1303a152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| | | | - Jasmine Anedda
- Dermatology Clinic, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit - IRCCS Policlinico Sant’Orsola - Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Zoe Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Warsaw, Poland
| | - Michela Starace
- Dermatology Unit - IRCCS Policlinico Sant’Orsola - Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
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Zengarini C, Orioni G, Cedirian S, Bardazzi F, Ferrari T, Piraccini BM, Raone B. Is Ultrasound more Helpful than Microbiological Testing to Diagnose Atypical Mycobacteriosis Infection? Indian J Dermatol 2023; 68:327-328. [PMID: 37529463 PMCID: PMC10389154 DOI: 10.4103/ijd.ijd_779_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2023] Open
Affiliation(s)
- Corrado Zengarini
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
| | - Gionathan Orioni
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
| | - Stephano Cedirian
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
| | - Federico Bardazzi
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
| | - Tiziano Ferrari
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
| | - Bianca Maria Piraccini
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
| | - Beatrice Raone
- From the Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Italy E-mail:
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