1
|
Borradori L, Van Beek N, Feliciani C, Tedbirt B, Antiga E, Bergman R, Böckle BC, Caproni M, Caux F, Chandran NS, Cianchini G, Daneshpazhooh M, De D, Didona D, Di Zenzo GM, Dmochowski M, Drenovska K, Ehrchen J, Goebeler M, Groves R, Günther C, Horvath B, Hertl M, Hofmann S, Ioannides D, Itzlinger-Monshi B, Jedličková J, Kowalewski C, Kridin K, Lim YL, Marinovic B, Marzano AV, Mascaro JM, Meijer JM, Murrell D, Patsatsi K, Pincelli C, Prost C, Rappersberger K, Sárdy M, Setterfield J, Shahid M, Sprecher E, Tasanen K, Uzun S, Vassileva S, Vestergaard K, Vorobyev A, Vujic I, Wang G, Wozniak K, Yayli S, Zambruno G, Zillikens D, Schmidt E, Joly P. Updated S2 K guidelines for the management of bullous pemphigoid initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2022; 36:1689-1704. [PMID: 35766904 DOI: 10.1111/jdv.18220] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or, most frequently, generalized bullous lesions. A subset of patients only develops excoriations, prurigo-like lesions, and eczematous and/or urticarial erythematous lesions. The disease, which is significantly associated with neurological disorders, has high morbidity and severely impacts the quality of life. OBJECTIVES AND METHODOLOGY The Autoimmune blistering diseases Task Force of the European Academy of Dermatology and Venereology sought to update the guidelines for the management of BP based on new clinical information, and new evidence on diagnostic tools and interventions. The recommendations are either evidence-based or rely on expert opinion. The degree of consent among all task force members was included. RESULTS Treatment depends on the severity of BP and patients' comorbidities. High-potency topical corticosteroids are recommended as the mainstay of treatment whenever possible. Oral prednisone at a dose of 0.5 mg/kg/day is a recommended alternative. In case of contraindications or resistance to corticosteroids, immunosuppressive therapies, such as methotrexate, azathioprine, mycophenolate mofetil or mycophenolate acid, may be recommended. The use of doxycycline and dapsone is controversial. They may be recommended, in particular, in patients with contraindications to oral corticosteroids. B-cell-depleting therapy and intravenous immunoglobulins may be considered in treatment-resistant cases. Omalizumab and dupilumab have recently shown promising results. The final version of the guideline was consented to by several patient organizations. CONCLUSIONS The guidelines for the management of BP were updated. They summarize evidence- and expert-based recommendations useful in clinical practice.
Collapse
Affiliation(s)
- L Borradori
- Department of Dermatology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - N Van Beek
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - C Feliciani
- Dermatology Unit, Department of Medicine and Surgery, University Hospital, University of Parma, Italy
| | - B Tedbirt
- Department of Dermatology, Rouen University Hospital, Referral Center for Autoimmune Bullous Diseases, Referral Center for Autoimmune Bullous Diseases, Rouen University Hospital, INSERM U1234, Normandie University, Rouen, France
| | - E Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - R Bergman
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - B C Böckle
- Department of Dermatology, Venereology & Allergology, Innsbruck Medical University, Innsbruck, Austria
| | - M Caproni
- Department of Health Sciences, Section of Dermatology, AUSL Toscana Centro, Rare Diseases Unit, European Reference Network-Skin Member, University of Florence, Italy
| | - F Caux
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and University Paris 13, Bobigny, France
| | - N S Chandran
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - G Cianchini
- Department of Dermatology, Ospedale Classificato Cristo Re, Rome, Italy
| | - M Daneshpazhooh
- Department of Dermatology, Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - D De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - D Didona
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - G M Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - M Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - K Drenovska
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J Ehrchen
- Department of Dermatology, University of Münster, Münster, Germany
| | - M Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - R Groves
- St. John's Institute of Dermatology, Viapath Analytics LLP, St. Thomas' Hospital, London, UK.,Division of Genetics and Molecular Medicine, King's College London, Guy's Hospital, London, UK
| | - C Günther
- Department of Dermatology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - B Horvath
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - M Hertl
- Department of Dermatology and Allergology, Philipps University, Marburg, Germany
| | - S Hofmann
- Department of Dermatology, Allergy and Dermatosurgery, Helios University Hospital Wuppertal, University Witten, Herdecke, Germany
| | - D Ioannides
- 1st Department of Dermatology-Venereology, Hospital of Skin and Venereal Diseases, Aristotle University Medical School, Thessaloniki, Greece
| | - B Itzlinger-Monshi
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria
| | - J Jedličková
- Department of Dermatovenereology, Masaryk University, University Hospital St. Anna, Brno.,Department of Dermatovenereology, University Hospital Brno, Brno, Czech Republic
| | - C Kowalewski
- Department Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland
| | - K Kridin
- National Skin Centre, Singapore, Singapore
| | - Y L Lim
- Department of Dermatology and Venereology, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia
| | - B Marinovic
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - J-M Mascaro
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - J M Meijer
- Department of Dermatology, Center for Blistering Diseases, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - D Murrell
- Department of Dermatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia
| | - K Patsatsi
- 2nd Department of Dermatology, Autoimmune Bullous Diseases Unit, Aristotle University School of Medicine, Papageorgiou General Hospital, Thessaloniki, Greece
| | - C Pincelli
- DermoLab, Institute of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - C Prost
- Department of Dermatology and Referral Center for Autoimmune Bullous Diseases, Groupe Hospitalier Paris Seine-Saint-Denis, AP-HP and University Paris 13, Bobigny, France
| | - K Rappersberger
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria.,Abteilung Dermatologie, Venerologie und Allergologie, Lehrkrankenhaus der Medizinischen Universität Wien, Austria
| | - M Sárdy
- Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany.,Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - J Setterfield
- Department of Oral Medicine, St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Shahid
- Department of Dermatology, Medical University, Sofia, Bulgaria
| | - E Sprecher
- Division of Dermatology, Tel Aviv Sourasky Medical Center and Department of Human Molecular Genetics & Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - K Tasanen
- Department of Dermatology, the PEDEGO Research Unit, University of Oulu and Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - S Uzun
- Department of Dermatology and Venereology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - S Vassileva
- Department of Dermatology, Medical University, Sofia, Bulgaria
| | - K Vestergaard
- Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark
| | - A Vorobyev
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - I Vujic
- Department of Dermatology, Venereology and Allergy, Clinical Center Landstrasse, Academic Teaching Hospital of the Medical University of Vienna, Vienna, Austria.,Medical Faculty, The Sigmund Freud Private University, Vienna, Austria
| | - G Wang
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - K Wozniak
- National Skin Centre, Singapore, Singapore
| | - S Yayli
- Department of Dermatology, School of Medicine, Koç University, Istanbul, Turkey
| | - G Zambruno
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - D Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Center for Research on Inflammation of the Skin, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Referral Center for Autoimmune Bullous Diseases, Referral Center for Autoimmune Bullous Diseases, Rouen University Hospital, INSERM U1234, Normandie University, Rouen, France
| |
Collapse
|
2
|
Stingeni L, Bianchi L, Antonelli E, Caroppo ES, Ferrucci SM, Ortoncelli M, Fabbrocini G, Nettis E, Schena D, Napolitano M, Gola M, Bonzano L, Rossi M, Belloni Fortina A, Balato A, Peris K, Foti C, Guarneri F, Romanelli M, Patruno C, Savoia P, Fargnoli MC, Russo F, Errichetti E, Bianchelli T, Bianchi L, Pellacani G, Feliciani C, Offidani A, Corazza M, Micali G, Milanesi N, Malara G, Chiricozzi A, Tramontana M, Hansel K, Bini V, Buligan C, Caroppo F, Bello GD, Dastoli S, De Brizi EV, Del Giudice MBDF, Diluvio L, Esposito M, Gelmetti A, Giacchetti A, Grieco T, Iannone M, Macchia L, Marietti R, Musumeci ML, Peccerillo F, Pluchino F, Radi G, Ribero S, Romita P, Tavecchio S, Tronconi G, Veronese F. Moderate to severe atopic dermatitis in adolescents treated with dupilumab: a multicenter Italian real-world experience. J Eur Acad Dermatol Venereol 2022; 36:1292-1299. [PMID: 35412683 PMCID: PMC9542087 DOI: 10.1111/jdv.18141] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/12/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Abstract
Background Moderate‐to‐severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side‐effects. Dupilumab was recently approved for treatment of adolescent AD. Objectives A multicentre, prospective, real‐world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate‐to‐severe AD was conducted. The main AD clinical phenotypes were also examined. Methods Data of adolescents with moderate‐to‐severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes. Results One hundred and thirty‐nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait‐like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS‐CoV‐2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty‐eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event. Conclusions Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID‐19 pandemic era.
Collapse
Affiliation(s)
- L Stingeni
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - L Bianchi
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - E Antonelli
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - E S Caroppo
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - S M Ferrucci
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - M Ortoncelli
- Division of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - G Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - E Nettis
- Department of Emergency and Organ Transplantation, Allergology and Clinical Immunology, University of Bari, Bari, Italy
| | - D Schena
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - M Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - M Gola
- Unit of Allergological and Pediatric Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - L Bonzano
- Dermatology Unit, Arcispedale Santa Maria Nuova, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - M Rossi
- Department of Dermatology, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - A Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - A Balato
- Unit of Dermatology, University of Campania Luigi Vanvitelli, Naples, Italy
| | - K Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - C Foti
- Section of Dermatology, Department of Biomedical Science and Human Oncology, University of Bari, Bari, Italy
| | - F Guarneri
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M Romanelli
- Dermatology Unit, University of Pisa, Pisa, Italy
| | - C Patruno
- Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy
| | - P Savoia
- Dermatology Clinic, Department of Health Science, University of Eastern Piedmont, Novara, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - F Russo
- Section of Dermatology, Department of Clinical, Surgical Medicine and Neuroscience, University of Siena, Siena, Italy
| | - E Errichetti
- Institute of Dermatology, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - T Bianchelli
- Dermatology Unit, Istituto Nazionale di Riposo e Cura per Anziani, INRCA-IRCCS Hospital, Ancona, Italy
| | - L Bianchi
- Dermatology Unit, System Medicine Department, University of Tor Vergata, Rome, Italy
| | - G Pellacani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - A Offidani
- Dermatology Clinic, Clinical and Molecular Science Department, Polytechnic Marche University, Ancona, Italy
| | - M Corazza
- Section of Dermatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - N Milanesi
- Allergological and Occupational Dermatology Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - G Malara
- Dermatology Unit, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - A Chiricozzi
- Institute of Dermatology, Catholic University, Rome, Italy
| | - M Tramontana
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | - K Hansel
- Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Caini S, Brusasco M, Niero G, De Giorgi V, Lombardo M, Massone C, Medri M, Palmieri G, Pizzichetta M, Quaglino P, Satta R, Feliciani C, Gandini S, Stanganelli I. Health Care and Safety of Patients with Melanoma during the COVID‐19 Pandemic in Italy. J Eur Acad Dermatol Venereol 2022; 36:e510-e512. [PMID: 35278222 PMCID: PMC9115002 DOI: 10.1111/jdv.18056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S. Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit Institute for Cancer Research, Prevention and Clinical Network (ISPRO) Florence Italy
| | - M. Brusasco
- Section of Dermatology Department of Medicine and Surgery University of Parma Parma Italy
| | - G. Niero
- Italian Association of Melanoma Patients (AIMaMe) Rome Italy
| | - V. De Giorgi
- Department of Dermatology University of Florence Florence Italy
| | - M. Lombardo
- Department of Dermatology Ospedale di Circolo e Fondazione Macchi Varese Italy
| | - C. Massone
- Dermatology Unit Galliera Hospital Genoa Italy
| | - M. Medri
- Skin Cancer Unit Istituto Scientifico Romagnolo per lo Studio dei Tumori (IRST) Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Meldola FC Italy
| | - G. Palmieri
- Immuno‐Oncology & Cancer Biotherapies University of Sassari ‐ Unit of Cancer Genetics, Institute for Genetic and Biomedical Research – National Research Council (IRGB‐CNR) Sassari Italy
| | - M.A. Pizzichetta
- Dermatologic Clinic University of Trieste Trieste Italy
- Department of Medical Oncology Centro di Riferimento Oncologico di Aviano (CRO), (IRCCS) Aviano Italy
| | - P. Quaglino
- Dermatologic Clinic Department of Medical Sciences University of Turin Medical School Turin Italy
| | - R. Satta
- Department of Surgical Microsurgical and Medical Sciences Unit of Dermatology University of Sassari Sassari Italy
| | - C. Feliciani
- Section of Dermatology Department of Medicine and Surgery University of Parma Parma Italy
| | - S. Gandini
- Division of Epidemiology and Biostatistics European Institute of Oncology Milan Italy
| | - I. Stanganelli
- Section of Dermatology Department of Medicine and Surgery University of Parma Parma Italy
- Italian Association of Melanoma Patients (AIMaMe) Rome Italy
- Department of Dermatology University of Florence Florence Italy
- Department of Dermatology Ospedale di Circolo e Fondazione Macchi Varese Italy
- Dermatology Unit Galliera Hospital Genoa Italy
| | | |
Collapse
|
4
|
Schmidt E, Rashid H, Marzano A, Lamberts A, Di Zenzo G, Diercks G, Alberti‐Violetti S, Barry R, Borradori L, Caproni M, Carey B, Carrozzo M, Cianchini G, Corrà A, Dikkers F, Feliciani C, Geerling G, Genovese G, Hertl M, Joly P, Meijer J, Mercadante V, Murrell D, Ormond M, Pas H, Patsatsi A, Rauz S, van Rhijn B, Roth M, Setterfield J, Zillikens D, C.Prost, Zambruno G, Horváth B, Caux F. European Guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology - Part II. J Eur Acad Dermatol Venereol 2021; 35:1926-1948. [PMID: 34309078 PMCID: PMC8518905 DOI: 10.1111/jdv.17395] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/24/2021] [Indexed: 01/21/2023]
Abstract
This guideline has been initiated by the task force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology, including physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline that systematically reviewed the literature on mucous membrane pemphigoid (MMP) in the MEDLINE and EMBASE databases until June 2019, with no limitations on language. While the first part of this guideline addressed methodology, as well as epidemiology, terminology, aetiology, clinical presentation and outcome measures in MMP, the second part presents the diagnostics and management of MMP. MMP should be suspected in cases with predominant mucosal lesions. Direct immunofluorescence microscopy to detect tissue-bound IgG, IgA and/or complement C3, combined with serological testing for circulating autoantibodies are recommended. In most patients, serum autoantibodies are present only in low levels and in variable proportions, depending on the clinical sites involved. Circulating autoantibodies are determined by indirect IF assays using tissue substrates, or ELISA using different recombinant forms of the target antigens or immunoblotting using different substrates. The major target antigen in MMP is type XVII collagen (BP180), although in 10-25% of patients laminin 332 is recognized. In 25-30% of MMP patients with anti-laminin 332 reactivity, malignancies have been associated. As first-line treatment of mild/moderate MMP, dapsone, methotrexate or tetracyclines and/or topical corticosteroids are recommended. For severe MMP, dapsone and oral or intravenous cyclophosphamide and/or oral corticosteroids are recommended as first-line regimens. Additional recommendations are given, tailored to treatment of single-site MMP such as oral, ocular, laryngeal, oesophageal and genital MMP, as well as the diagnosis of ocular MMP. Treatment recommendations are limited by the complete lack of high-quality randomized controlled trials.
Collapse
|
5
|
Rashid H, Lamberts A, Borradori L, Alberti‐Violetti S, Barry R, Caproni M, Carey B, Carrozzo M, Caux F, Cianchini G, Corrà A, Diercks G, Dikkers F, Di Zenzo G, Feliciani C, Geerling G, Genovese G, Hertl M, Joly P, Marzano A, Meijer J, Mercadante V, Murrell D, Ormond M, Pas H, Patsatsi A, Prost C, Rauz S, van Rhijn B, Roth M, Schmidt E, Setterfield J, Zambruno G, Zillikens D, Horváth B. European guidelines (S3) on diagnosis and management of mucous membrane pemphigoid, initiated by the European Academy of Dermatology and Venereology - Part I. J Eur Acad Dermatol Venereol 2021; 35:1750-1764. [PMID: 34245180 PMCID: PMC8457055 DOI: 10.1111/jdv.17397] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 05/17/2021] [Indexed: 12/15/2022]
Abstract
This guideline on mucous membrane pemphigoid (MMP) has been elaborated by the Task Force for Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology (EADV) with a contribution of physicians from all relevant disciplines and patient organizations. It is a S3 consensus-based guideline encompassing a systematic review of the literature until June 2019 in the MEDLINE and EMBASE databases. This first part covers methodology, the clinical definition of MMP, epidemiology, MMP subtypes, immunopathological characteristics, disease assessment and outcome scores. MMP describes a group of autoimmune skin and mucous membrane blistering diseases, characterized by a chronic course and by predominant involvement of the mucous membranes, such as the oral, ocular, nasal, nasopharyngeal, anogenital, laryngeal and oesophageal mucosa. MMP patients may present with mono- or multisite involvement. Patients' autoantibodies have been shown to be predominantly directed against BP180 (also called BPAG2, type XVII collagen), BP230, laminin 332 and type VII collagen, components of junctional adhesion complexes promoting epithelial stromal attachment in stratified epithelia. Various disease assessment scores are available, including the Mucous Membrane Pemphigoid Disease Area Index (MMPDAI), the Autoimmune Bullous Skin disorder Intensity Score (ABSIS), the 'Cicatrising Conjunctivitis Assessment Tool' and the Oral Disease Severity Score (ODSS). Patient-reported outcome measurements (PROMs), including DLQI, ABQOL and TABQOL, can be used for assessment of quality of life to evaluate the effectiveness of therapeutic interventions and monitor disease course.
Collapse
|
6
|
Hébert V, Bastos S, Drenovska K, Meijer J, Ingen-Housz-Oro S, Bedane C, Lunardon L, Debarbieux S, Jedlickova H, Caux F, Chaby G, D'Incan M, Feliciani C, Boulard C, Schumacher N, Schmidt E, Roussel A, Richard MA, Gottlieb J, Ferranti V, Guérin O, Bénichou J, Joly P. International multicentre observational study to assess the efficacy and safety of a 0·5 mg kg -1 per day starting dose of oral corticosteroids to treat bullous pemphigoid. Br J Dermatol 2021; 185:1232-1239. [PMID: 34173243 DOI: 10.1111/bjd.20593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND European guidelines propose a 0·5 mg kg-1 per day dose of oral prednisone as initial treatment for bullous pemphigoid (BP). We assessed the safety and efficacy of this regimen depending on BP extent and general condition of the patients. METHODS In a prospective international study, we consecutively included all patients diagnosed with BP. Patients received a 0·5 mg kg-1 per day dose of prednisone, which was then gradually tapered 15 days after disease control, with the aim of stopping prednisone or maintaining minimal treatment (0·1 mg kg-1 per day) within 6 months after the start of treatment. The two coprimary endpoints were control of disease activity at day 21 and 1-year overall survival. Disease severity was assessed according to the Bullous Pemphigoid Disease Area Index (BPDAI) score. RESULTS In total, 198 patients were included between 2015 and 2017. The final analysis comprised 190 patients with a mean age of 80·9 (SD 9·1) years. Control of disease activity was achieved at day 21 in 119 patients [62·6%, 95% confidence interval (CI) 55·3-69.5]; 18 of 24 patients (75%, 95% CI 53·3-90·2), 75 of 110 patients (68·8%, 95% CI 59·2-77·3) and 26 of 56 patients (46.4%, 95% CI 33·0-60·3) had mild, moderate and severe BP, respectively (P = 0·0218). A total of 30 patients died during the study. The overall Kaplan-Meier 1-year survival was 82·6% (95% CI 76·3-87·4) corresponding to 90·9%, 83·0% and 80·0% rates in patients with mild, moderate and severe BP, respectively (P = 0·5). Thresholds of 49 points for BPDAI score and 70 points for Karnofsky score yielded maximal Youden index values with respect to disease control at day 21 and 1-year survival, respectively. CONCLUSIONS A 0·5 mg kg-1 per day dose of prednisone is a valuable therapeutic option in patients with mild or moderate BP whose general condition allows them to be autonomous.
Collapse
Affiliation(s)
- V Hébert
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | - S Bastos
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | - K Drenovska
- Department of Dermatology, Medical University of Sofia, Sofia, Bulgaria
| | - J Meijer
- Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, Groningen, the Netherlands
| | - S Ingen-Housz-Oro
- Department of Dermatology, Henri Mondor University Hospital, (AP-HP), Creteil, France
| | - C Bedane
- Department of Dermatology, Limoges University Hospital, Limoges, France
| | - L Lunardon
- Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - S Debarbieux
- Department of Dermatology, Hospices Civils de Lyon, Lyon, France
| | - H Jedlickova
- Department of Dermatology, St. Anne's Faculty Hospital, Brno, Czech Republic
| | - F Caux
- Department of Dermatology, Avicenne Hospital, University Paris 13, Bobigny, France
| | - G Chaby
- Department of Dermatology, Amiens University Hospital, Amiens, France
| | - M D'Incan
- Department of Dermatology, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Boulard
- Department of Dermatology, Monod General Hospital, le Havre, France
| | - N Schumacher
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - A Roussel
- Department of Dermatology, Orleans Hospital, Orléans, France
| | - M A Richard
- Department of Dermatology, Hôpital la Timone, Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | - J Gottlieb
- Department of Dermatology, Saint Louis Hospital, (AP-HP), Paris, France
| | - V Ferranti
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - O Guérin
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - J Bénichou
- Department of Biostatistics, Rouen University Hospital, Rouen, France
| | - P Joly
- Department of Dermatology, Rouen University Hospital, Center for Autoimmune Bullous Diseases, and INSERM U1234, Normandie University, Rouen, France
| | | |
Collapse
|
7
|
Görög A, Antiga E, Caproni M, Cianchini G, De D, Dmochowski M, Dolinsek J, Drenovska K, Feliciani C, Hervonen K, Lakos Jukic I, Kinyó Á, Koltai T, Korponay-Szabó I, Marzano AV, Patsatsi A, Rose C, Salmi T, Schmidt E, Setterfield J, Shahid M, Sitaru C, Uzun S, Valitutti F, Vassileva S, Yayli S, Sárdy M. S2k guidelines (consensus statement) for diagnosis and therapy of dermatitis herpetiformis initiated by the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2021; 35:1251-1277. [PMID: 34004067 DOI: 10.1111/jdv.17183] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/14/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Dermatitis herpetiformis (DH) is a chronic, pruritic, gluten-induced skin disorder characterized by subepidermal granular IgA deposition and a variable degree of enteropathy identical to that seen in coeliac disease. So far, there has been no European consensus about the management of DH. METHODS The guidelines were created by small subgroups of a guideline committee consisting of 26 specialists from various medical fields and one patients' representative. The members of the committee then discussed the guidelines and voted for the final version at two consensus meetings. The guidelines were developed under the support of the European Academy of Dermatology and Venereology (EADV) and in collaboration with the European Dermatology Forum (EDF). RESULTS The guidelines summarize evidence-based and expert-based recommendations (S2 level) for the management of DH (see Appendix). CONCLUSION These guidelines will improve the quality of management of DH and support dermatologists in their diagnostic and therapeutic decisions.
Collapse
Affiliation(s)
- A Görög
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary
| | - E Antiga
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - M Caproni
- Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, USL Toscana Centro, European Reference Network-Skin Member, University of Florence, Florence, Italy
| | - G Cianchini
- Department of Dermatology, Cristo Re Hospital, Rome, Italy
| | - D De
- Department of Dermatology, Postgraduate Institute of Medical Education Research, Chandigarh, India
| | - M Dmochowski
- Autoimmune Blistering Dermatoses Section, Department of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
| | - J Dolinsek
- Gastroenterology Unit, Department of Pediatrics, University Medical Center Maribor, Maribor, Slovenia.,Medical Faculty, University of Maribor, Maribor, Slovenia
| | - K Drenovska
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - C Feliciani
- Dermatology Unit Azienda Ospedaliero - Universitaria, Università di Parma, Parma, Italy
| | - K Hervonen
- Coeliac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - I Lakos Jukic
- Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia
| | - Á Kinyó
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School, Pécs, Hungary
| | - T Koltai
- Association of European Coeliac Societies, Brussels, Belgium.,Hungarian Coeliac Society, Budapest, Hungary
| | - I Korponay-Szabó
- Coeliac Disease Centre, Heim Pál National Paediatric Institute, Budapest, Hungary.,Faculty of Medicine, Institute of Paediatrics, University of Debrecen, Debrecen, Hungary
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - A Patsatsi
- Autoimmune Bullous Diseases Unit, 2nd Dermatology Department, Aristotle University School of Medicine, Thessaloniki, Greece
| | - C Rose
- Dermatopathology Laboratory, Lübeck, Germany.,German Coeliac Disease Society e. V., Stuttgart, Germany
| | - T Salmi
- Coeliac Disease Research Center, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Department of Dermatology, Tampere University Hospital, Tampere, Finland
| | - E Schmidt
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - J Setterfield
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Host Microbiome Interactions, Faculty of Dentistry Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Shahid
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - C Sitaru
- Department of Dermatology, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany.,BIOSS Centre for Biological Signalling, University of Freiburg, Freiburg, Germany
| | - S Uzun
- Department of Dermatology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - F Valitutti
- Pediatric Unit, AOU San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - S Vassileva
- Department of Dermatology and Venereology, Medical University, Sofia, Bulgaria
| | - S Yayli
- Department of Dermatology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - M Sárdy
- Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Budapest, Hungary.,Department of Dermatology and Allergy, University Hospital of LMU, Munich, Germany
| |
Collapse
|
8
|
Di Nuzzo S, Bertolani M, Casanova D, Manuguerra R, de Felici Del Giudice MB, Feliciani C. A case of acquired disseminated elastosis perforans serpiginosa in a patient with HIV, hepatitis B and hepatitis C successfully treated with narrowband ultraviolet B therapy. Clin Exp Dermatol 2020; 46:219-222. [PMID: 32931593 DOI: 10.1111/ced.14436] [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: 05/27/2020] [Revised: 07/09/2020] [Accepted: 08/09/2020] [Indexed: 12/01/2022]
Affiliation(s)
- S Di Nuzzo
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - M Bertolani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - D Casanova
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - R Manuguerra
- Department of Pathology, University of Parma, Parma, Italy
| | - M B de Felici Del Giudice
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| |
Collapse
|
9
|
Joly P, Horvath B, Patsatsi Α, Uzun S, Bech R, Beissert S, Bergman R, Bernard P, Borradori L, Caproni M, Caux F, Cianchini G, Daneshpazhooh M, De D, Dmochowski M, Drenovska K, Ehrchen J, Feliciani C, Goebeler M, Groves R, Guenther C, Hofmann S, Ioannides D, Kowalewski C, Ludwig R, Lim Y, Marinovic B, Marzano A, Mascaró J, Mimouni D, Murrell D, Pincelli C, Squarcioni C, Sárdy M, Setterfield J, Sprecher E, Vassileva S, Wozniak K, Yayli S, Zambruno G, Zillikens D, Hertl M, Schmidt E. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the european academy of dermatology and venereology (EADV). J Eur Acad Dermatol Venereol 2020; 34:1900-1913. [DOI: 10.1111/jdv.16752] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/29/2020] [Indexed: 01/21/2023]
|
10
|
Talamonti M, Galluzzo M, Chiricozzi A, Quaglino P, Fabbrocini G, Gisondi P, Marzano AV, Potenza C, Conti A, Parodi A, Belloni Fortina A, Bardazzi F, Argenziano G, Rongioletti F, Stingeni L, Micali G, Loconsole F, Venturini M, Bongiorno MR, Feliciani C, Rubegni P, Amerio P, Fargnoli MC, Pigatto P, Savoia P, Nisticò SP, Giustini S, Carugno A, Cannavò SP, Rech G, Prignano F, Offidani A, Lombardo M, Zalaudek I, Bianchi L, Peris K. Management of biological therapies for chronic plaque psoriasis during COVID-19 emergency in Italy. J Eur Acad Dermatol Venereol 2020; 34:e770-e772. [PMID: 32735716 PMCID: PMC7436412 DOI: 10.1111/jdv.16841] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 01/07/2023]
Affiliation(s)
- M Talamonti
- Dermatology Department, University of Rome 'Tor Vergata', Rome, Italy
| | - M Galluzzo
- Dermatology Department, University of Rome 'Tor Vergata', Rome, Italy
| | - A Chiricozzi
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | - P Quaglino
- Medical Sciences Department, Dermatologic Clinic, University of Turin, Turin, Italy
| | - G Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - P Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - A V Marzano
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - C Potenza
- Department of Medico-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi' Sapienza University of Rome - Polo Pontino, Rome, Italy
| | - A Conti
- Dermatologic Unit, Department of Specialized Medicine, AOU Policlinico di Modena, Modena, Italy
| | - A Parodi
- Ospedale-Policlinico San Martino IRCCS Genova, Clinica Dermatologica DiSSal Università di Genova, Genova, Italy
| | - A Belloni Fortina
- Dermatology Unit - Department of Medicine DIMED, University of Padova, Padova, Italy
| | - F Bardazzi
- Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - F Rongioletti
- Section of Dermatology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - L Stingeni
- Dermatology Section, Department of Medicine, University of Perugia, Perugia, Italy
| | - G Micali
- Dermatology Clinic, University of Catania, Catania, Italy
| | - F Loconsole
- Department of Biomedical Science and Human Oncology, Unit of Dermatology, University of Bari, Bari, Italy
| | - M Venturini
- Department of Dermatology, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - M R Bongiorno
- Section of Dermatology, Department of Health Promotion, Maternal-Infant, Internal Medicine and Specialization, University of Palermo, Palermo, Italy
| | - C Feliciani
- Department of Medicine and Surgery, Section of Dermatology, University of Parma, Parma, Italy
| | - P Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Italy
| | - P Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, G. D'Annunzio University, Chieti, Italy
| | - M C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Pigatto
- Department of Biomedical, Surgical and Dental Sciences, Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, University of Milan, Milan, Italy
| | - P Savoia
- Department of Health Science, Dermatologic Clinic, University of Eastern Piedmont, Novara, Italy
| | - S P Nisticò
- Dermatology Unit, Department of Health Sciences, Università Magna Graecia, Catanzaro, Italy
| | - S Giustini
- Department of Dermatology, Sapienza' University of Rome, Rome, Italy
| | - A Carugno
- Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - S P Cannavò
- Dermatology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - G Rech
- Division of Dermatology, Santa Chiara Hospital, Trento, Italy
| | - F Prignano
- Dermatology Clinic, Department of Health Sciences, University of Florence, Florence, Italy
| | - A Offidani
- Dermatological Clinic, Department of Clinical and Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - M Lombardo
- Unit of Dermatological Diseases, ASST Sette Laghi, Ospedale di Circolo, Varese, Italy
| | - I Zalaudek
- Department of Dermatology, University of Trieste, Trieste, Italy
| | - L Bianchi
- Dermatology Department, University of Rome 'Tor Vergata', Rome, Italy
| | - K Peris
- Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy
| | | |
Collapse
|
11
|
Stanganelli I, De Felici MB, Mandel VD, Caini S, Raimondi S, Corso F, Bellerba F, Quaglino P, Sanlorenzo M, Ribero S, Medri M, Farnetani F, Feliciani C, Pellacani G, Gandini S. The association between pesticide use and cutaneous melanoma: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2020; 34:691-708. [PMID: 31541557 DOI: 10.1111/jdv.15964] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 08/23/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND The incidence of cutaneous melanoma (CM), the deadliest form of skin cancer, has gradually increased in the last decades among populations of European origin. Epidemiological studies suggested that farmers and agricultural workers are at an increased risk of CM because they were exposed to pesticides. However, little is known about the relationship between pesticides and CM. OBJECTIVES To investigate the association between exposure to pesticides and CM by systematically reviewing the literature. Secondary aim was to determine the categories of pesticides mainly involved in CM development. METHODS A systematic review of the literature was performed up to September 2018 using MEDLINE, Embase and Web of Science. Studies assessing CM risk in licensed pesticide applicators were considered. Strict criteria were established to select independent studies and risk estimates; random effect models, taking into account heterogeneity, were applied. A pooled risk estimate for CM was calculated for the use of each type of pesticide and type of exposure. Between-study and estimate heterogeneity was assessed and publication bias investigated. RESULTS A total of nine studies (two case-controls and seven cohorts) comprising 184 389 unique subjects were included. The summary relative risks for the categories 'herbicides - ever exposure', 'insecticides - ever exposure', 'any pesticide - ever exposure' and 'any pesticide - high exposure' resulted 1.85 [95% confidence interval (CI): 1.01, 3.36], 1.57 (95% CI: 0.58, 4.25), 1.31 (95% CI: 0.85, 2.04) and 2.17 (95% CI: 0.45, 10.36), respectively. Herbicides and insecticides had no between-study heterogeneity (I2 = 0%), while a significant heterogeneity (I2 > 50%) was detected for the high exposure to any pesticide. No indication for publication bias was found. CONCLUSIONS Individuals exposed to herbicides are at an increased risk of CM. Future properly designed observational studies are required to confirm this finding.
Collapse
Affiliation(s)
- I Stanganelli
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
- Dermatology Department, University of Parma, Parma, Italy
| | - M B De Felici
- Dermatology Department, University of Parma, Parma, Italy
| | - V D Mandel
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - S Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Raimondi
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - F Corso
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - F Bellerba
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| | - P Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Sanlorenzo
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - S Ribero
- Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy
| | - M Medri
- Skin Cancer Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Meldola, Italy
| | - F Farnetani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - C Feliciani
- Dermatology Department, University of Parma, Parma, Italy
| | - G Pellacani
- Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology (IEO), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
| |
Collapse
|
12
|
Bastos S, Hebert V, Vassileva S, Patsatsi A, Meijer J, Quéreux G, Bedane C, Prost-Squarcioni C, Debardieux S, Oro S, Chaby G, D’Incan M, Litrowski N, Boulard C, Lunardon L, Kiritsi D, Jedlickova H, Feliciani C, Roussel A, Kottler D, Plantin P, Richard MA, Friedrichsen L, Abasq C, Duvert Lehembre S, Gottlieb J, Zebrowska A, Hofmann S, Joly P. Efficacité et tolérance de la prednisone à 0,5 mg/kg/j en traitement initial de la pemphigoïde bulleuse. Ann Dermatol Venereol 2019. [DOI: 10.1016/j.annder.2019.09.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
13
|
Feliciani C, Toto P, Pour SM, Coscione G, Amerio P, Amerio P. A Th2-like Cytokine Response is Involved in Bullous Pemphigoid. The Role of IL-4 and IL-5 in the Pathogenesis of the Disease. Int J Immunopathol Pharmacol 2018. [DOI: 10.1177/205873929901200202] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- C. Feliciani
- Department of Dermatology, University “G.D'Annunzio”, Chieti, Italy
| | - P. Toto
- Department of Dermatology, University “G.D'Annunzio”, Chieti, Italy
| | - S. Mohammad Pour
- Department of Dermatology, University “G.D'Annunzio”, Chieti, Italy
| | - G. Coscione
- Department of Dermatology, University “G.D'Annunzio”, Chieti, Italy
| | - P. Amerio
- Department of Dermatology, University of Ancona, Ancona, Italy
| | - P. Amerio
- Department of Dermatology, Catholic University, Rome, Italy
| |
Collapse
|
14
|
Peccerillo F, Zambito Spadaro F, Fabrizi G, Feliciani C, Pagliarello C, Stanganelli I. Not a simple plantar wart: a case of tungiasis. J Eur Acad Dermatol Venereol 2017; 32:e113-e114. [DOI: 10.1111/jdv.14595] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- F. Peccerillo
- Department of Surgical, Medical, Dental and Morphological Sciences with Interest Transplant, Oncological and Regenerative Medicine; Dermatology Unit; University of Modena and Reggio Emilia; Modena Italy
| | | | - G. Fabrizi
- Istituto Dermopatico dell'Immacolata; Fondazione Luigi Maria Monti IRCCS; Rome Italy
| | - C. Feliciani
- Department of Dermatology; University of Parma; Parma Italy
| | - C. Pagliarello
- Division of Dermatology; UO Multizonale ‘Santa Chiara’ Hospital; Trento Italy
| | - I. Stanganelli
- Department of Dermatology; University of Parma; Parma Italy
| |
Collapse
|
15
|
Pagliarello C, Scrivani S, Fabrizi G, Feliciani C, Di Nuzzo S. An under-recognized, life-threatening complication of atopic dermatitis. Clin Exp Dermatol 2017; 42:831-832. [PMID: 28597997 DOI: 10.1111/ced.13171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2016] [Indexed: 10/19/2022]
Affiliation(s)
- C Pagliarello
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Scrivani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Fabrizi
- Istituto Dermopatico dell'Immacolata, IDI IRCCS, Rome, Italy
| | - C Feliciani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Di Nuzzo
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
16
|
Rovesti M, Satolli F, Zucchi A, Gandolfi M, Fioranelli M, Roccia MG, Boccalari M, França K, Lotti J, Zerbinati N, Lotti T, Feliciani C. Between history and gossip: the state of women relative to syphilis, a traditionally male disease. J BIOL REG HOMEOS AG 2017; 31:187-191. [PMID: 28702981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Despite the new World Health Organization data remind us how syphilis is a disease which affects both sexes equally, this pathology has always been mainly considered a male disease. While several famous men are known to be affected by syphilis, there are very few women affected by this pathology of which we have historical records. Through the lives of Mary Todd Lincoln, Catherine of Aragon, Karen Blixen and Florence Foster Jenkins, this article would like to grant dignity to all the women who contracted syphilis in the wrong historical era where, for a woman, admitting to contracting it was shameful. Through the important women who lived their lives fighting against this disease and its complications, we would like to pay tribute to all those women who still today, in an era of antibiotics and where syphilis is a treatable pathology, they cannot be cured because they are both geographically and socially disadvantaged.
Collapse
Affiliation(s)
- M Rovesti
- Department of Dermatology, University of Parma, Parma, Italy
| | - F Satolli
- Department of Dermatology, University of Parma, Parma, Italy
| | - A Zucchi
- Department of Dermatology, University of Parma, Parma, Italy
| | - M Gandolfi
- Department of Dermatology, University of Parma, Parma, Italy
| | - M Fioranelli
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
| | - M G Roccia
- University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India
| | | | - K França
- Department of Dermatology and Cutaneous Surgery, Department of Psychiatry and Behavioural Sciences, Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL, U.S.A
| | - J Lotti
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
| | - N Zerbinati
- Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - T Lotti
- Chair of Dermatology, University of Rome “G. Marconi”, Rome, Italy
| | - C Feliciani
- Department of Dermatology, University of Parma, Parma, Italy
| |
Collapse
|
17
|
Rovesti M, Satolli F, Zucchi A, Gandolfi M, Fioranelli M, Roccia MG, Boccalari M, França K, Lotti J, Zerbinati N, Lotti T, Feliciani C. A short novel about the spread of two important diseases in history: syphilis and SARS. J BIOL REG HOMEOS AG 2017; 31:183-186. [PMID: 28702980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Throughout the centuries, the undefended nature of man has very often manifested in cases of epidemics, which have determined scenarios of suffering and death. Through “historical” observation lens, it is possible to understand the relationship between the spread of viruses, bacteria and parasites responsible for these epidemics and the displacement of ancient or contemporary travellers. We have analysed two infective diseases, syphilis and SARS, and their role in history and in medicine.
Collapse
Affiliation(s)
- M Rovesti
- Department of Dermatology, University of Parma, Parma, Italy
| | - F Satolli
- Department of Dermatology, University of Parma, Parma, Italy
| | - A Zucchi
- Department of Dermatology, University of Parma, Parma, Italy
| | - M Gandolfi
- Department of Dermatology, University of Parma, Parma, Italy
| | - M Fioranelli
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
| | - M G Roccia
- University B.I.S. Group of Institutions, Punjab Technical University, Punjab, India
| | | | - K França
- Department of Dermatology and Cutaneous Surgery, Department of Psychiatry and Behavioural Sciences, Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL, U.S.A
| | - J Lotti
- Department of Nuclear, Subnuclear and Radiation Physics, University of Rome “G. Marconi”, Rome, Italy
| | - N Zerbinati
- Department of Surgical and Morphological Sciences, University of Insubria, Varese, Italy
| | - T Lotti
- Chair of Dermatology, University of Rome “G. Marconi”, Rome, Italy
| | - C Feliciani
- Department of Dermatology, University of Parma, Parma, Italy
| |
Collapse
|
18
|
Simoncini C, Chico L, Concolino D, Sestito S, Fancellu L, Boadu W, Sechi GP, Feliciani C, Gnarra M, Zampetti A, Salviati A, Scarpelli M, Orsucci D, Bonuccelli U, Siciliano G, Mancuso M. Mitochondrial DNA haplogroups may influence Fabry disease phenotype. Neurosci Lett 2016; 629:58-61. [PMID: 27365132 DOI: 10.1016/j.neulet.2016.06.051] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 06/13/2016] [Accepted: 06/23/2016] [Indexed: 10/21/2022]
Abstract
While the genetic origin of Fabry disease (FD) is well known, it is still unclear why the disease presents a wide heterogeneity of clinical presentation and progression, even within the same family. Emerging observations reveal that mitochondrial impairment and oxidative stress may be implicated in the pathogenesis of FD. To investigate if specific genetic polymorphisms within the mitochondrial genome (mtDNA) could act as susceptibility factors and contribute to the clinical expression of FD, we have genotyped European mtDNA haplogroups in 77 Italian FD patients and 151 healthy controls. Haplogroups H and I, and haplogroup cluster HV were significantly more frequent in patients than controls. However, no correlation with gender, age of onset, organ involvement was observed. Our study seems to provide some evidence of a contribution of mitochondrial variation in FD pathogenesis, at least in Italy.
Collapse
Affiliation(s)
- C Simoncini
- Experimental and Clinical Medicine Department, Neurological Clinic, University of Pisa, Italy
| | - L Chico
- Experimental and Clinical Medicine Department, Neurological Clinic, University of Pisa, Italy
| | - D Concolino
- Department of Pediatrics University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - S Sestito
- Department of Pediatrics University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - L Fancellu
- Department of Clinical and Experimental Medicine, University of Sassari, Italy
| | - W Boadu
- Department of Clinical and Experimental Medicine, University of Sassari, Italy
| | - G P Sechi
- Department of Clinical and Experimental Medicine, University of Sassari, Italy
| | - C Feliciani
- Section of Dermatology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| | - M Gnarra
- Section of Dermatology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| | - A Zampetti
- Rare diseases and Periodic fevers Research Center, Policlinico A. Gemelli, Rome, Italy
| | - A Salviati
- Department of Neurological and Movement Sciences, University of Verona, Italy
| | - M Scarpelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Italy
| | - D Orsucci
- Experimental and Clinical Medicine Department, Neurological Clinic, University of Pisa, Italy
| | - U Bonuccelli
- Experimental and Clinical Medicine Department, Neurological Clinic, University of Pisa, Italy
| | - G Siciliano
- Experimental and Clinical Medicine Department, Neurological Clinic, University of Pisa, Italy
| | - M Mancuso
- Experimental and Clinical Medicine Department, Neurological Clinic, University of Pisa, Italy.
| |
Collapse
|
19
|
Abstract
Pemphigus is a rare autoimmune disease, involving the skin and mucous epithelia, characterized by flaccid blisters and erosions. Histologically, the basic abnormality in all forms of pemphigus is the separation of keratinocytes from one another, a process known as acantholysis. There is direct evidence that autoantibodies against desmoglein, a transmembrane desmosomal component, are critical in its pathogenesis, but the exact mechanism that induces acantholysis is yet unknown. Actually, different studies suggest three possible mechanisms: sterical impedance, intracellular signalling and apoptosis. Understanding these processes should show new therapeutic perspective.
Collapse
Affiliation(s)
- G. Caldarola
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - A. Zampetti
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - P. Amerio
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - C. Feliciani
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
20
|
Feliciani C, Ruocco E, Zampetti A, Toto P, Amerio P, Tulli A, Amerio P, Ruocco V. Tannic Acid Induces in vitro Acantholysis of Keratinocytes via IL-1α and TNF-α. Int J Immunopathol Pharmacol 2016; 20:289-99. [PMID: 17624241 DOI: 10.1177/039463200702000209] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The mechanism of acantholysis in pemphigus vulgaris (PV) is an intriguing argument since several chemical mediators are implicated. We previously reported a central role for IL-1α and TNF-α, both able to regulate complement activation and plasminogen activators. Very little is known about what triggers the disease (drugs, viruses or food). In this study, we evaluate the molecular role of tannins in acantholysis. By HPLC chromatography we measured tannic acid (TA) and gallic acid (GA) in blister fluid of 4 groups of patients divided according to their dietary habits, including a regular diet, a diet rich in tannins, a diet free of tannins, and a group of pemphigus patients. Blister fluid was obtained from patients using a suction blister apparatus. We show that people with a diet rich in tannins have increased tannin metabolites (TA and GA) in the skin in respect to controls (tannin-rich diet: GA = 194.52±2.39 nmol/ml; TA = 348.28±1.4 nmol/ml versus tannin-Mediterranean diet: GA = 15.28±1.63 nmol/ml; TA = 22.81±1.68 nmol/ml). PV patients showed similar values to the Mediterranean diet population (PV patients: GA = 95.8±1.97 nmol/ml; TA = 199.09±4.15 nmol/ml versus Mediterranean diet: GA = 83.53±2.35 nmol/ml; TA = 195.1±2.50 nmol/ml). In an in vitro acantholysis system using TA and PV-IgG we show that TA 0.1 mM in NHEK culture is able to induce acantholysis. This effect was able to amplify the acantholytic action of PV-IgG in vitro. A blocking study using anti IL-1α and anti TNF-α antibodies showed a reduction in TA-induced acantholysis. Taken together, these results suggest that a diet rich in tannins could be a trigger in genetically predisposed patients. If these data are confirmed, a complementary diet poor in tannins may be useful in patients affected by PV.
Collapse
Affiliation(s)
- C Feliciani
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Feliciani C, Amerio P, Pour SM, Allegretti T, Proietto G, Coviello C, Amerio P, Vena G. IL-1α, IL-6 and TNF-α in Cutaneous Lesions of Lupus Erythematosus are Inhibited by Topical Application of Calcipotriol. Int J Immunopathol Pharmacol 2016. [DOI: 10.1177/039463209500800306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Lupus Erythematosus (LE) is an autoimmune disorder with an unknown etiology and pathogenesis. Skin lesions of LE express several cytokines which correlate to histological findings such as IL-1 and IL-6 which are mediators of epidermal growth and proliferation. Skin lesions of LE are generally treated with immunosuppressive agents such as oral or topically applied corticosteroids. Recently a new drug, calcipotriol, a vitamin D3 analogue has been useful in treatment of psoriasis with no ad verse effect on calcium metabolism. This drug shares immunomodulatory effects with vit. D3 by inhibiting several cytokines produced by keratinocytes. In order to test the clinical effectiveness of calcipotriol in cutaneous lesions of LE we have investigated several proinflammatory cytokines such as: IL-1α, IL-1β, IL-4, IL-5, IL-6, IL-8, MCP-1, TNF-α. Using an avidin-biotin immunoperoxidase system we have found IL-1 in both forms, IL-6 and TNF-α in basal keratinocytes in patients affected with LE, after treatment they were reverted to normal. This inhibition is induced at a molecular level as demostrated by reduced IL-1, IL-6 and TNFα mRNA expression. This is the first report showing that calcipotriol is effective in cutaneous lesions of LE and suggesting that this action is due to an inhibition of protein synthesis and mRNA expression for IL-1α, IL-6 and TNFα.
Collapse
Affiliation(s)
| | | | | | | | | | - C. Coviello
- Department of Dermatology, University of Bari, Italy
| | | | - G.A. Vena
- Department of Dermatology, University of Bari, Italy
| |
Collapse
|
22
|
Cavalieri S, Rotoli M, Feliciani C, Amerio P. Expression of the High-Affinity Laminin Receptor (67 kDa) in Normal Human Skin and Appendages. Int J Immunopathol Pharmacol 2016; 18:223-31. [PMID: 15888241 DOI: 10.1177/039463200501800205] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The interaction of cells with extracellular matrix components plays a significant role in the regulation of cell biology. Laminin is a large glycoprotein involved in fundamental interactions between cells and the basement membrane. Several cell surface receptors are responsible for cell-matrix interactions. The 67 kDa high affinity laminin receptor, 67LR, is involved in the adhesion of normal cells to the laminin network and is also associated with the metastatic phenotype of some tumoral cells. We have investigated the expression of laminin and of the 67LR in normal human skin using immunoperoxidase staining. Twenty samples of skin were analyzed. Antibody against laminin reacted in a continuous linear band at the dermal-epidermal junction, as well as basement membranes of hair follicles, sebaceous and eccrine sweat glands, and dermal blood vessels. The epidermis and the follicular epithelium were negative for laminin. The 67LR seemed not to be expressed on the basal surface of basal keratinocytes. The major expression of this receptor may be detected in the upper half of the spinous layer and in the granular layer. The cells of the outer root sheath in hair follicle showed the same immunohistochemical pattern described for epidermis. In sebaceous glands and in eccrine sweat glands the secreting epithelium was positive. Endothelial cells of dermal blood vessels were routinely positive for 67LR. We observed that the expression of the 67LR in normal human skin is mostly located in epidermal areas in which the keratinizing process was particularly advanced.
Collapse
Affiliation(s)
- S Cavalieri
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | | |
Collapse
|
23
|
Boulard C, Duvert Lehembre S, Picard‐Dahan C, Kern J, Zambruno G, Feliciani C, Marinovic B, Vabres P, Borradori L, Prost‐Squarcioni C, Labeille B, Richard M, Ingen‐Housz‐Oro S, Houivet E, Werth V, Murrell D, Hertl M, Benichou J, Joly P, Hofmann S, Camaioni B, Didona B, Fania L, Della Torre R, Caux F, Alexandre M, Paul C, Bulai Livideanu C, Delaporte E, Dupuy A, Avenel‐Audran M, Schmidt E, Schumacher N, Bagot M, Tancrede‐Bohin E, Bouaziz J, D'Incan M, Quereux G, Skowron F, Beylot‐Barry M, Doutre M, Bedane C, Bernard P, Machet L, Jullien ., Debarbieux S, Dereure O, Hünefeld C, Schanz S, Franck N, Maillard H, Misery L, Sassolas B, Abasq C, Bouyeure A, Lagoutte P, Ferranti V. Calculation of cut‐off values based on the Autoimmune Bullous Skin Disorder Intensity Score (
ABSIS
) and Pemphigus Disease Area Index (
PDAI
) pemphigus scoring systems for defining moderate, significant and extensive types of pemphigus. Br J Dermatol 2016; 175:142-9. [DOI: 10.1111/bjd.14405] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2016] [Indexed: 11/27/2022]
Affiliation(s)
- C. Boulard
- Department of Dermatology Rouen University Hospital, and INSERM U905 Institute for Research and Innovation in Biomedicine University of Rouen Rouen France
| | - S. Duvert Lehembre
- Department of Dermatology Rouen University Hospital, and INSERM U905 Institute for Research and Innovation in Biomedicine University of Rouen Rouen France
| | - C. Picard‐Dahan
- Department of Dermatology Bichat University Hospital AP‐HP Paris France
| | - J.S. Kern
- Department of Dermatology Medical Center University of Freiburg Freiburg Germany
| | - G. Zambruno
- Laboratory of Molecular and Cell Biology Istituto Dermopatico dell'Immacolata IRCCS Via Monti di Creta 104 00167 Roma Italy
| | - C. Feliciani
- Policlinico Gemelli – Università Cattolica del ‘Sacro Cuore’ Largo Gemelli 8 00168 Roma Italy
| | - B. Marinovic
- University Hospital Center Zagreb Department of Dermatology and Venereology Salata 4 10000 Zagreb Croatia
| | - P. Vabres
- Department of Dermatology Dijon University Hospital Dijon France
| | - L. Borradori
- Department of Dermatology Universitätsklinik für Dermatologie Inselspital CH‐3010 Bern Switzerland
| | - C. Prost‐Squarcioni
- Department of Dermatology Avicenne Hospital University Paris 13 Bobigny France
| | - B. Labeille
- Department of Dermatology Saint Etienne University Hospital Saint Etienne France
| | - M.A. Richard
- Aix‐Marseille University UMR 911 INSERM CRO2 ‘Centre de Recherche en Oncologie Biologique et Oncophamacologie’ Department of Dermatology Hôpital Timone Assistance Publique des Hôpitaux de Marseille 264 Rue Saint Pierre 13385 Marseille France
| | - S. Ingen‐Housz‐Oro
- Department of Dermatology Henri Mondor University Hospital AP‐HP Créteil France
| | - E. Houivet
- Department of Biostatistics INSERM U657 Rouen University Hospital University of Rouen Rouen France
| | - V.P. Werth
- Department of Dermatology University of Pennsylvania, and Philadelphia VAMC Philadelphia PA U.S.A
| | - D.F. Murrell
- Department of Dermatology St George Hospital University of NSW Sydney Australia
| | - M. Hertl
- Department of Dermatology Philipps University Marburg Marburg Germany
| | - J. Benichou
- Department of Biostatistics INSERM U657 Rouen University Hospital University of Rouen Rouen France
| | - P. Joly
- Department of Dermatology Rouen University Hospital, and INSERM U905 Institute for Research and Innovation in Biomedicine University of Rouen Rouen France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Hebert V, Boulard C, Houivet E, Duvert Lehembre S, Borradori L, Della Torre R, Feliciani C, Fania L, Zambruno G, Camaioni D, Didona B, Marinovic B, Schmidt E, Schumacher N, Hünefeld C, Schanz S, Johannes Steffen Kern J, Hofmann S, Bouyeure A, Picard-Dahan C, Prost-Squarcioni C, Caux F, Alexandre M, Ingen-Housz-Oro S, Bagot M, Tancrede-Bohin E, Bouaziz J, Franck N, Vabres P, Labeille B, Aleth Richard M, Delaporte E, Dupuy A, D’Incan M, Quereux G, Skowron F, Paul C, Bulai Livideanu C, Beylot-Barry M, Doutre M, Avenel-Audran M, Bedane C, Bernard P, Machet L, Maillard H, Jullien D, Debarbieux S, Sassolas B, Misery L, Abasq C, Dereure O, Lagoutte P, Ferranti V, Werth V, Murrell D, Hertl M, Benichou J, Joly P. Reproductibilité inter-observateur des scores de sévérité du pemphigus ABSIS et PDAI. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
25
|
Houivet E, Hebert V, Boulard C, Vaillant M, Duvert Lehembre S, Borradori L, Della Torre R, Feliciani C, Fania L, Zambruno G, Camaioni D, Didona B, Marinovic B, Schmidt E, Schumacher N, Hünefeld C, Schanz S, Johannes Steffen Kern J, Hofmann S, Bouyeure A, Picard-Dahan C, Prost-Squarcioni C, Caux F, Alexandre M, Ingen-Housz-Oro S, Bagot M, Tancrede-Bohin E, Bouaziz J, Franck N, Vabres P, Labeille B, Aleth Richard M, Delaporte E, Dupuy A, D’Incan M, Quereux G, Skowron F, Paul C, Bulai Livideanu C, Beylot-Barry M, Doutre M, Avenel-Audran M, Bedane C, Bernard P, Machet L, Maillard H, Jullien D, Debarbieux S, Sassolas B, Misery L, Abasq C, Dereure O, Lagoutte P, Ferranti V, Werth V, Murrell D, Hertl M, Benichou J, Joly P. Corrélation entre les scores de sévérité clinique (ABSIS, PDAI, PGA), la qualité de vie (DLQI) et les taux d’Ac anti-desmogléine 1 et 3 dans le suivi du pemphigus. Ann Dermatol Venereol 2015. [DOI: 10.1016/j.annder.2015.10.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
26
|
Pagliarello C, Fabrizi G, Ricci R, Tabolli S, Feliciani C, Di Nuzzo S. Side predominance of squamous cell carcinoma: further evidence. J Eur Acad Dermatol Venereol 2015; 30:1226-7. [PMID: 25864957 DOI: 10.1111/jdv.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- C Pagliarello
- Section of Dermatology, Section of Pathology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| | - G Fabrizi
- Section of Dermatology, Section of Pathology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| | - R Ricci
- Section of Dermatology, Section of Pathology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| | - S Tabolli
- Health Services Research Unit, Istituto Dermopatico dell'Immacolata-Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), Rome, Italy
| | - C Feliciani
- Section of Dermatology, Section of Pathology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| | - S Di Nuzzo
- Section of Dermatology, Section of Pathology, Department of Clinical and Experimental Medicine, Parma Medical School, Parma, Italy
| |
Collapse
|
27
|
Feliciani C, Joly P, Jonkman M, Zambruno G, Zillikens D, Ioannides D, Kowalewski C, Jedlickova H, Kárpáti S, Marinovic B, Mimouni D, Uzun S, Yayli S, Hertl M, Borradori L. Management of bullous pemphigoid: the European Dermatology Forum consensus in collaboration with the European Academy of Dermatology and Venereology. Br J Dermatol 2015; 172:867-77. [DOI: 10.1111/bjd.13717] [Citation(s) in RCA: 206] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2014] [Indexed: 12/20/2022]
Affiliation(s)
- C. Feliciani
- Department of Dermatology; University of Parma; Parma Italy
| | - P. Joly
- Department of Dermatology; University of Rouen, INSERM U 905; Rouen France
| | - M.F. Jonkman
- Department of Dermatology; University Medical Centre Groningen; Groningen The Netherlands
| | - G. Zambruno
- Laboratory of Molecular and Cell Biology; Istituto Dermopatico dell'Immacolata, IRCCS; Rome Italy
| | - D. Zillikens
- Department of Dermatology; University of Lübeck; Lübeck Germany
| | - D. Ioannides
- Department of Dermatology; Aristotle University of Thessaloniki; Thessaloniki Greece
| | - C. Kowalewski
- Department of Dermatology; Medical University of Warsaw; Warsaw Poland
| | - H. Jedlickova
- Department of Dermatology; Masaryk University; Brno Czech Republic
| | - S. Kárpáti
- Department of Dermatology; Semmelweis University; Budapest Hungary
| | - B. Marinovic
- Department of Dermatology and Venereology; University Hospital Center Zagreb; University of Zagreb School of Medicine; Zagreb Croatia
| | - D. Mimouni
- Department of Dermatology; Tel-Aviv University; Tel-Aviv Israel
| | - S. Uzun
- Department of Dermatology; Akdeniz University; Antalya Turkey
| | - S. Yayli
- Department of Dermatology; Karadeniz Technical University; Trabzon Turkey
| | - M. Hertl
- Department of Dermatology; Philipps-University Marburg; Marburg Germany
| | - L. Borradori
- Department of Dermatology; University Hospital of Bern - Inselspital, Freiburgstrasse 4; 3010 Bern Switzerland
| |
Collapse
|
28
|
Pagliarello C, Fabrizi G, Cortelazzi C, Boccaletti V, Feliciani C, Di Nuzzo S. Psoriasis and seborrheic dermatitis in infancy and childhood. GIORN ITAL DERMAT V 2014; 149:683-691. [PMID: 25315289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Psoriasis is a common inflammatory dermatosis that may be seen in infants, children, and adolescents. The clinical presentation and course may be quite variable, and while patients with mild disease are often easily managed, those with recalcitrant or more severe disease often present a therapeutic dilemma given the number of therapies available and the relative lack of data on the efficacy and safety of use of these therapies in children. Diagnosis in children can be more difficult, but family history may be helpful. Moreover, sometimes clinical pattern of pediatric psoriasis is very different from its adult counterpart or it could manifests in association with atopic dermatitis, and for these reason it is possibly misdiagnosed and under recognized. We therefore focus on diagnostic patterns and effective treatments of this challenging disease.
Collapse
Affiliation(s)
- C Pagliarello
- Section of Dermatology, Department of Surgical Sciences, Parma Medical School, Parma, Italy -
| | | | | | | | | | | |
Collapse
|
29
|
Garcovich S, Gnarra M, Murabit A, Arena V, Sani I, Feliciani C. First report of hereditary Christ-Siemens-Touraine syndrome and non-segmental vitiligo association in a young adult: contraindication for vitiligo treatment. J Eur Acad Dermatol Venereol 2014; 30:346-8. [PMID: 25339629 DOI: 10.1111/jdv.12756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- S Garcovich
- Institute of Dermatology, Policlinico A. Gemelli, Catholic University, Rome, Italy
| | - M Gnarra
- Institute of Dermatology, Policlinico A. Gemelli, Catholic University, Rome, Italy
| | - A Murabit
- Plastic & Reconstructive Surgery, University of British Columbia, Vancouver, BC, Canada
| | - V Arena
- Institute of Pathology, Policlinico A. Gemelli, Catholic University, Rome, Italy
| | - I Sani
- Genetic and Molecular Medicine Unit, A. Meyer, University of Florence, Florence, Italy
| | - C Feliciani
- Institute of Dermatology, Policlinico A. Gemelli, Catholic University, Rome, Italy
| |
Collapse
|
30
|
Hertl M, Jedlickova H, Karpati S, Marinovic B, Uzun S, Yayli S, Mimouni D, Borradori L, Feliciani C, Ioannides D, Joly P, Kowalewski C, Zambruno G, Zillikens D, Jonkman MF. Pemphigus. S2 Guideline for diagnosis and treatment--guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2014; 29:405-14. [PMID: 25338479 DOI: 10.1111/jdv.12772] [Citation(s) in RCA: 168] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 09/10/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pemphigus encompasses a group of life-threatening autoimmune bullous diseases characterized by blisters and erosions of the mucous membranes and skin. Before the era of immunosuppressive treatment, the prognosis of pemphigus was almost fatal. Due to its rarity, only few prospective controlled therapeutic trials are available. OBJECTIVES For this reason, a group of European dermatologists with a long-standing interest and expertise in basic and clinical pemphigus research has sought to define diagnostic and therapeutic guidelines for the management of patients with pemphigus. RESULTS This group identified the statements of major agreement or disagreement regarding the diagnostic and therapeutic management of pemphigus. The revised final version of the pemphigus guideline was finally passed on to the European Dermatology Forum (EDF) for a final consensus with the European Academy of Dermatology and Venereology (EADV) and the European Union of Medical Specialists (UEMS).
Collapse
Affiliation(s)
- M Hertl
- Department of Dermatology, Philipps-University Marburg, Marburg, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Boccaletti V, Di Nuzzo S, Feliciani C, Fabrizi G, Pagliarello C. An update on juvenile dermatomyositis. GIORN ITAL DERMAT V 2014; 149:519-524. [PMID: 25034096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Juvenile dermatomyositis (JDM) is a rare, severe, autoimmune disease characterized by a small-vessel vasculopathy that primarily affects skin and muscle, but also lung, joints, gut and heart. Nowadays prompt recognition of this entity and aggressive treatment, when needed, improves outcomes and has decreased mortality that, before corticosteroid became a mainstay in therapy, could reach 40%.
Collapse
Affiliation(s)
- V Boccaletti
- Clinica Dermatologica Università degli Studi di Parma, Parma, Italia -
| | | | | | | | | |
Collapse
|
32
|
Manna R, Garcovich S, Giovinale M, Marinaro A, Manganelli C, Zampetti A, Feliciani C. Systemic complications of esophageal lichen planus. Int J Immunopathol Pharmacol 2013; 26:575-8. [PMID: 23755777 DOI: 10.1177/039463201302600235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Lichen planus is an uncommon inflammatory mucocutaneous disorder affecting the skin and its appendages, as well as oral and genital mucosa. Involvement of the esophageal mucosa is rare and causes significant morbidity, with dysphagia and risk of long-term complications, such as esophageal strictures and stenosis. Esophageal lichen planus is an underreported condition in the spectrum of lichenoid tissue reactions, presenting the risk of systemic manifestations. We describe a patient with severe, long-standing esophageal lichen planus, which had led to marked weight-loss, malnutrition syndrome and chronic respiratory distress due to recurrent aspiration pneumonia. Diagnosis was confirmed by the presence of concomitant muco-cutaneous lesions and characteristic endoscopic and histological findings. Systemic therapy with cyclosporine A and micronutrient supplementation led to rapid clinical improvement. Early diagnosis of esophageal lichen planus as well as effective systemic immunosuppressive treatment is crucial in order to prevent short- and long-term complications.
Collapse
Affiliation(s)
- R Manna
- Institute of Internal Medicine, Policlinico A. Gemelli, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
33
|
Boulard C, Bouyeure A, Houivet E, Borradori L, Huenefeld C, Schmidt E, Marinovic B, Zambruno G, Feliciani C, Prost C, Picard-Dahan C, Duvert Lehembre S, Labeille B, Paul C, Richard M, Dalac S, Bernard P, Dupuy A, Caux F, Bouaziz J, Oro S, Avenel-Audran M, Misery L, Sassolas B, Alexandre M, D’Incan M, Delaporte E, Bedane C, Quereux G, Machet L, Vabre P, Dereure O, Skowron F, Franck N, Beylot-Barry M, Beneton Benhard N, Debarbieux S, Jullien D, Benichou J, Ferranti V, Murrell D, Hertl M, Joly P. Qualité de vie chez les patients atteints de pemphigus : corrélation avec le type et la sévérité du pemphigus. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
34
|
Zampetti A, Fania L, Antuzzi D, Giurdanella F, Gnarra M, Bertola F, Lualdi S, Filocamo M, Morrone A, Feliciani C. Mutation identification of Fabry disease in families with other lysosomal storage disorders. Clin Genet 2012; 84:281-5. [DOI: 10.1111/cge.12071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Revised: 11/29/2012] [Accepted: 11/29/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - D Antuzzi
- Department of Pediatric Sciences; Policlinico “A. Gemelli”, Università Cattolica del Sacro Cuore; Rome; Italy
| | | | | | - F Bertola
- Consortium for Human Molecular Genetics; University of Milano-Bicocca; Monza; Italy
| | - S Lualdi
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche; Istituto G. Gaslini; Genova; Italy
| | - M Filocamo
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche; Istituto G. Gaslini; Genova; Italy
| | | | | |
Collapse
|
35
|
Zampetti A, Orteu C, Antuzzi D, Bongiorno M, Manco S, Gnarra M, Morrone A, Cardinali G, Kovacs D, Aspite N, Linder D, Parini R, Feliciani C. Angiokeratoma: decision-making aid for the diagnosis of Fabry disease. Br J Dermatol 2012; 166:712-20. [DOI: 10.1111/j.1365-2133.2012.10742.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
36
|
Zampetti A, Orteu C, Antuzzi D, Bongiorno M, Manco S, Gnarra M, Morrone A, Cardinali G, Kovacs D, Aspite N, Linder D, Parini R, Feliciani C. Angiokeratoma: Decision Making Methodology for the Diagnosis of Fabry Disease. Br J Dermatol 2011. [DOI: 10.1111/j.1365-2133.2011.10742.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
37
|
Ferri L, Guido C, la Marca G, Malvagia S, Cavicchi C, Fiumara A, Barone R, Parini R, Antuzzi D, Feliciani C, Zampetti A, Manna R, Giglio S, Della Valle CM, Wu X, Valenzano KJ, Benjamin R, Donati MA, Guerrini R, Genuardi M, Morrone A. Fabry disease: polymorphic haplotypes and a novel missense mutation in the GLA gene. Clin Genet 2011; 81:224-33. [PMID: 21517827 DOI: 10.1111/j.1399-0004.2011.01689.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fabry disease: polymorphic haplotypes and a novel missense mutation in the GLA gene. Fabry disease (FD) is an X-linked lysosomal storage disorder with a heterogeneous spectrum of clinical manifestations that are caused by the deficiency of α-galactosidase A (α-Gal-A) activity. Although useful for diagnosis in males, enzyme activity is not a reliable biochemical marker in heterozygous females due to random X-chromosome inactivation, thus rendering DNA sequencing of the α-Gal-A gene, alpha-galactosidase gene (GLA), the most reliable test for the confirmation of diagnosis in females. The spectrum of GLA mutations is highly heterogeneous. Many polymorphic GLA variants have been described, but it is unclear if haplotypes formed by combinations of such variants correlate with FD, thus complicating molecular diagnosis in females with normal α-Gal-A activity. We tested 67 female probands with clinical manifestations that may be associated with FD and 110 control males with normal α-Gal-A activity. Five different combinations of GLA polymorphic variants were identified in 14 of the 67 females, whereas clearcut pathogenetic alterations, p.Met51Ile and p.Met290Leu, were identified in two cases. The latter has not been reported so far, and both mutant forms were found to be responsive to the pharmacological chaperone deoxygalactonojirimycin (DGJ; migalastat hydrochloride). Analysis of the male control population, as well as male relatives of a suspected FD female proband, permitted the identification of seven different GLA gene haplotypes in strong linkage disequilibrium. The identification of haplotypes in control males provides evidence against their involvement in the development of FD phenotypic manifestations.
Collapse
Affiliation(s)
- L Ferri
- Department of Sciences for Woman and Child's Health, University of Florence, Florence, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Rigante D, Zampetti A, Bersani G, Candelli M, Piras A, Rendeli C, Antuzzi D, Feliciani C, Stabile A. Serum Interleukin-18 in Children with Henoch-Schönlein Purpura: A Promising Marker of Disease Activity? EUR J INFLAMM 2011. [DOI: 10.1177/1721727x1100900209] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Henoch-Schönlein purpura (HSp) is the most common systemic vasculitis of childhood with typical skin involvement and concurrent signs involving joints, gastrointestinal tract, and kidney. HSp pathogenesis is still far from being completely understood, though a knotty cytokine complex is believed to contribute to its intimate processes. The aim of our evaluation is to establish the relationship between serum levels of interleukin (IL)-18 and disease outcome and establish its feasibility to provide a marker of disease activity or even a prognostic tool in clinical practice. We examined clinical/laboratory variables and serum IL-18 in 17 children hospitalized during a year for HSp, diagnosed by EULAR/PRINTO/PRES criteria; the same patients were re-evaluated after 6 months. All results were compared with 25 age-matched healthy controls. IL-12 and IL-6 were also evaluated in a cohort of the same patients and compared with controls. General and clinical variables (sex, edema of the extremities, gastrointestinal or renal complications, relapses and renal involvement at 6 months) had no relationship with cytokine levels. Serum IL-18 and IL-6 levels were found significantly increased at diagnosis in HSp patients when compared with healthy controls. After 6 months, serum IL-18 and IL-12 levels were significantly decreased in patients, while IL-12 and IL-6 levels were significantly increased compared to healthy controls. Though preliminary and expecting further confirmation on a larger sample, our data support the conclusion that serum IL-18 levels reflect HSp activity.
Collapse
Affiliation(s)
- D. Rigante
- Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy
| | - A. Zampetti
- Department of Dermatology, Università Cattolica Sacro Cuore, Rome, Italy
| | - G. Bersani
- Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy
| | - M. Candelli
- Department of Internal Medicine, Università Cattolica Sacro Cuore, Rome, Italy
| | - A. Piras
- Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy
| | - C. Rendeli
- Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy
| | - D. Antuzzi
- Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy
| | - C. Feliciani
- Department of Dermatology, Università Cattolica Sacro Cuore, Rome, Italy
| | - A. Stabile
- Department of Pediatric Sciences, Università Cattolica Sacro Cuore, Rome, Italy
| |
Collapse
|
39
|
Abstract
Fabry disease is an X-linked inherited condition due to the absence or reduction of alpha-galactosidase activity in lysosomes, that results in accumulation of globotriaosylceramide (Gb3) and related neutral glycosphingolipids. Manifestations of Fabry disease include serious and progressive impairment of renal and cardiac function. In addition, patients experience pain, gastrointestinal disturbance, transient ischaemic attacks and strokes. Additional effects on the skin, eyes, ears, lungs and bones are often seen. The first symptoms of classic Fabry disease usually appear in childhood. Despite being X-linked, females can suffer the same severity of symptoms as males, and life expectancy is reduced in both females and males. Enzyme replacement therapy (ERT) can stabilize the progression of the disease. The rarity of the classic form of Fabry disease, however, means that there is a need to improve the knowledge and understanding that the majority of physicians have concerning Fabry disease, in order to avoid misdiagnosis and/or delayed diagnosis. This review aims to raise awareness of the signs and symptoms of Fabry disease; to provide a general diagnostic algorithm and to give an overview of the effects of ERT and concomitant treatments. We highlight a need to develop comprehensive international guidelines to optimize ERT and adjunctive therapy in patients with Fabry disease, including females and children.
Collapse
Affiliation(s)
- A Mehta
- Lysosomal Storage Disorders Unit, Department of Academic Haematology, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
40
|
Zampetti A, Mastrofrancesco A, Flori E, Maresca V, Picardo M, Amerio P, Feliciani C. Proinflammatory cytokine production in HaCaT cells treated by eosin: implications for the topical treatment of psoriasis. Int J Immunopathol Pharmacol 2010; 22:1067-75. [PMID: 20074471 DOI: 10.1177/039463200902200423] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Psoriasis is a multifactorial skin dermatosis characterized in its classical form by erythematous and hyperkeratotic plaques on extensor surfaces of the body, that in most cases can be managed therapeutically by topical agents. Hyperproliferation and a marked inflammation in both epidermis and dermis are thought to be driven by interaction of activated type-1 T lymphocytes and antigen-presenting cells and keratinocytes that release several proinflammatory and immunomodulating molecules. The aim of this study is to investigate whether tetrabromofluorecin, commonly know as eosin, a classical compound traditionally topically used in psoriasis for its presumed anti-inflammatory activities, is able to modulate the production of TNF-alpha, IL-6 and IL-8 that are recognized as the most active and characterized cytokines in the pathogenesis of this skin disorder. HaCaT cell line was used to verify the effects on epidermal inflammation by eosin at scalar doses after testing the viability of cells. Two different population of cells, one stimulated by IFNgamma and one non-stimulated, were cultivated in presence of tolerable concentrations. The expression and release of IL-6, IL-8, IL-10, and TNF-alpha were analysed by RT-PCR and ELISA, respectively. Our results show that tolerable concentrations of eosin were 0.05%, 0.02%, and 0.01%. The expression and production of TNFalpha, IL-8 and IL-6 were dramatically reduced in presence of eosin 0.05% and 0.02% and the action of eosin was more pronounced on TNF-alpha. In agreement with clinical data, our results show that in presence of tolerable concentrations, eosin seems to influence remarkably the production of three important cytokines involved in the hyperproliferation and inflammatory process, giving a specific explanation of its efficacy and supporting its topical use in the clinical setting.
Collapse
Affiliation(s)
- A Zampetti
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
| | | | | | | | | | | | | |
Collapse
|
41
|
|
42
|
Caldarola G, De Simone C, Carbone A, Tulli A, Amerio P, Feliciani C. TNFα and its Receptors in Psoriatic Skin, before and after Treatment with Etanercept. Int J Immunopathol Pharmacol 2009; 22:961-6. [DOI: 10.1177/039463200902200411] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Psoriasis is a chronic inflammatory skin condition characterized by inflammatory dermal infiltrate and hyperproliferative keratinocytes. The pathogenesis of this disease is mediated by a dysregulation of the innate immunity and cytokine production. Tumor Necrosis Factor alpha (TNFα) is considered the most important cytokine involved in the pathological mechanism of psoriasis. Recently, several therapies have been introduced for the treatment of psoriasis that try to block TNF alpha activity. Among these treatments Etanercept is a fusion protein that specifically targets TNF alpha. We performed a study on twelve psoriatic patients aimed at evaluating the effect of Etanercept treatment on the production and expression of TNFα and its receptors, in lesional and uninvolved psoriatic skin. We demonstrated that after three month of Etanercept treatment at 50 mg/wk, TNF, TNF-RI and TNF-RII immunostaining in lesional and non-lesional skin samples of patients was greatly reduced, suggesting that this treatment not only acts on stable lesional plaques, but also at a very early stage of the disease.
Collapse
Affiliation(s)
| | | | | | - A. Tulli
- Dermatology Department, University of Chieti-Pescara, Chieti, Italy
| | - P. Amerio
- Dermatology Department, University of Chieti-Pescara, Chieti, Italy
| | | |
Collapse
|
43
|
Feliciani C, Caldarola G, Kneisel A, Podstawa E, Pfütze M, Pfützner W, Hertl M. IgG autoantibody reactivity against bullous pemphigoid (BP) 180 and BP230 in elderly patients with pruritic dermatoses. Br J Dermatol 2009; 161:306-12. [PMID: 19485996 DOI: 10.1111/j.1365-2133.2009.09266.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pruritic dermatoses of the elderly often pose a diagnostic and therapeutic challenge. Specifically, a prodromal phase of bullous pemphigoid (BP) has to be considered in patients with pruritic lesions of polymorphic appearance. These conditions frequently do not fulfil all the clinical, histological and immunopathological criteria for establishing the diagnosis of BP. OBJECTIVES To investigate IgG reactivity against the autoantigens of BP, BP180 and BP230, by enzyme-linked immunosorbent assay, in elderly patients affected with various pruritic disorders who had never experienced clinically apparent blisters. METHODS The sera of 15 elderly patients with pruritic disorders (group I) were tested for IgG reactivity against BP180 and BP230. Also included were 30 patients with full-blown BP (group II) and 25 age-matched patients with immediate-type allergic reactions (group III). RESULTS Thirty-three per cent of the patients with pruritic disorders (group I) showed IgG against BP230 and/or BP180: four of 15 patients had IgG against BP230 while two of the 15 group I patients were BP180 reactive. All the BP sera (group II) showed IgG reactivity against BP180 and/or BP230. Notably, two of 25 control sera (group III) showed IgG reactivity against either BP180 or BP230. CONCLUSIONS The present findings suggest that IgG reactivity against BP230 (i.e. the COOH terminus), and to a lesser extent against BP180, is a common finding in pruritic disorders of the elderly with a wide clinical spectrum. IgG-mediated autoimmunity against the intracellular BP230 may facilitate a chronic, inflammatory response eventually leading to full-blown BP which is presumably associated with IgG against BP180.
Collapse
Affiliation(s)
- C Feliciani
- Department of Dermatology and Allergology, Philipps University Marburg, 35039 Marburg, Germany
| | | | | | | | | | | | | |
Collapse
|
44
|
Feliciani C, De Simone C, Amerio P. Dermatological signs during inflammatory bowel diseases. Eur Rev Med Pharmacol Sci 2009; 13 Suppl 1:15-21. [PMID: 19530507] [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] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Crohn disease (CD) and UI-cerative Colitis (UC) are characterized by ulcerative lesions of the bowel. Some patients show similar lesions of the skin or oral and/or perianal mucosa. Sometimes these lesions, or some other skin lesions are the first sign of bowel disease. Dermatologists could suspect an inflammatory bowel disease (IBD) during skin lesions such as pyoderma gangrenosum (PG) or erythema nodosum (EN). These entities are very well known by dermatologists and its role is to diagnose internal chronic disease associated to EN or PG. Depending on the associated disease the treatment may vary from steroids to anti TNF biologics.
Collapse
Affiliation(s)
- C Feliciani
- Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
| | | | | |
Collapse
|
45
|
De Simone C, Caldarola G, D’agostino M, Zampetti A, Amerio P, Feliciani C. Exacerbation of pemphigus after influenza vaccination. Clin Exp Dermatol 2008; 33:718-20. [DOI: 10.1111/j.1365-2230.2008.02835.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
46
|
Cavalieri S, Feliciani C, Massi G, Addolorato G, Gasbarrini G, Amerio P, Rotoli M. Lymphoepithelioma-like carcinoma of the skin. Int J Immunopathol Pharmacol 2008; 20:851-4. [PMID: 18179760 DOI: 10.1177/039463200702000424] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The term lymphoepithelioma-like carcinoma identifies a group of nasopharingeal epithelial tumors characterized by aggregates of malignant undifferentiated cells surrounded by a dense reactive lymphoplasmacellular infiltrate. Primary cutaneous localization is rare, with approximately 30 cases reported in literature. We describe a case of primary lymphoepithelioma-like carcinoma of the skin in a 92-year-old woman. Immunohistochemical examination was positive for cytokeratine (KL1 and EMA) as regards epithelial cells, while the lymphocitic infiltrate was positive for LCA and CD3. In situ hybridization for Epstein Barr virus in tumor cells was negative. Electron microscopy showed rounded and occasionally spindle-shaped poorly-differentiated squamous epithelial cells, and a lymphoid stroma consisting mostly of normal-appearing small lymphocytes. Examination of the nasopharynx did not show any tumoral mass and after a 7 years follow-up the patient is free of local and distant recurrences. This tumor affects people aged over 50 years and is localized to the face, but scalp, shoulder and forearm may be involved. Research of Epstein-Barr virus is always negative in this tumor, unlike nasopharingeal epithelial carcinoma. The differential diagnosis of lymphoepithelioma-like carcinoma of the skin may present some difficulties and includes squamous cell carcinoma. Lymphoepithelioma-like carcinoma of the skin is a malignant neoplasm which tends to relapse locally and has a moderate tendency to metastatize.
Collapse
Affiliation(s)
- S Cavalieri
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | | | | | | | | | | | | |
Collapse
|
47
|
Affiliation(s)
- G Caldarola
- Department of Dermatology, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | | | | | | | | | | |
Collapse
|
48
|
Amerio P, Tracanna M, De Remigis P, Betterle C, Vianale L, Marra ME, Di Rollo D, Capizzi R, Feliciani C, Tulli A. Vitiligo associated with other autoimmune diseases: polyglandular autoimmune syndrome types 3B+C and 4. Clin Exp Dermatol 2007; 31:746-9. [PMID: 16803462 DOI: 10.1111/j.1365-2230.2006.02171.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Vitiligo is a common skin disease characterized by depigmented maculae resulting from a reduction of the number and function of melanocytes. Many studies suggest that vitiligo might be an autoimmune disease. Vitiligo has been frequently described in association with other autoimmune diseases. Among the diseases described in association with vitiligo are the so-called autoimmune polyglandular syndromes (APS). Vitiligo can be present in all types of APS but the most frequent association appears to be in APS-3. APS-3 was defined as the association between autoimmune thyroiditis and another autoimmune disease. Here we report one patient with thyroiditis, vitiligo and autoimmune gastritis (APS-3B+C), one patient with chronic autoimmune thyroiditis, vitiligo and alopecia (APS-3C), and one case of a young patient with type 1 diabetes mellitus and vitiligo (APS-4), according to the newest classification. We stress the importance of a thorough assessment for autoimmune diseases in selected patients with vitiligo.
Collapse
Affiliation(s)
- P Amerio
- Department of Dermatology, University of Chieti-Pescara, Italy.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
|
50
|
|