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Napolitano M, Potestio L, Nocerino M, Patruno C. Considerations for managing elderly patients with atopic dermatitis. Expert Rev Clin Immunol 2024; 20:501-511. [PMID: 38193289 DOI: 10.1080/1744666x.2024.2301967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Atopic dermatitis (AD) diagnosis in elderly is challenging, due to its clinical polymorphism and the lack of diagnostic biomarkers. Moreover, the chronicity of the disease and the complex pathogenetic mechanism, make elderly AD management challenging. AREAS COVERED A narrative review of the current literature was performed using the PubMed, Medline, Embase, and Cochrane Skin databases, by researching the following terms: 'atopic dermatitis,' 'clinical phenotypes,' 'eczema,' 'elderly patients,' 'elderly type atopic dermatitis,' 'eczema clinical presentation.' The aim was to report the current knowledge on pathogenesis, clinical presentation, and treatment options of elderly AD. EXPERT OPINION Elderly type AD has recently been identified as a separate entity, with an increasing prevalence. With aging, both immunosenescence and barrier alterations can cause or modify AD presentation. Moreover, a chronic proinflammatory state (so-called 'inflammaging') is often present in elderly subjects. Older patients with AD may present with peculiar immunophenotypic profile, making AD diagnosis challenging. Similarly, the chronicity of the disease and the complex pathogenetic mechanism, make AD management a challenge. Indeed, systemic therapies for AD are often contraindicated or not tolerated and the management of elderly type AD is often burdened with numerous difficulties, leading to undertreated disease. Even if dupilumab and tralokinumab represent a valuable therapeutic weapon, more data on safety of JAK inhibitors are required.
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Affiliation(s)
- Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Ruggiero A, Nocerino M, Trischitta G, Costanzo L, Fabbrocini G, Gallo L, Megna M. Persistent candidiasis infection during anti-IL-17 treatment for plaque psoriasis requiring biologic discontinuation: a case series and literature review. Int J Dermatol 2023; 62:e135-e137. [PMID: 36183321 DOI: 10.1111/ijd.16429] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/12/2022] [Accepted: 09/19/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Angelo Ruggiero
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giovanni Trischitta
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Costanzo
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Gallo
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology-Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Greco V, Miano C, Nocerino M, Potestio L, Fabbrocini G, Nappa P, Mascolo M, Russo D, Ocampo-Garza SS. Zosteriform leiomyomas after Herpes Zoster infection: the isotopic pathway. Ital J Dermatol Venerol 2023; 158:60-61. [PMID: 36939502 DOI: 10.23736/s2784-8671.22.07249-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Affiliation(s)
- Vincenzo Greco
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Miano
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Paola Nappa
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Massimo Mascolo
- Unit of Pathology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Daniela Russo
- Unit of Pathology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Sonia S Ocampo-Garza
- Unit of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy -
- Nuevo León Autonomous University, Dr. José Eleuterio González University Hospital, Department of Dermatology, Monterrey, México
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Tranchini P, Costa C, Fabbrocini G, Mascolo M, Russo D, Scalvenzi M, DE Fata Salvatores G, DI Guida A, Miano C, Marino V, Abategiovanni L, Nocerino M, Lauro W, Perrotta A, Megna M, Camela E. Generalized violaceous maculopapular rash and multiple verrucous nodules on the testes: a case of secondary syphilis misdiagnosed as lymphoma. Ital J Dermatol Venerol 2022; 157:522-524. [PMID: 35470815 DOI: 10.23736/s2784-8671.22.07227-9] [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: 01/20/2023]
Affiliation(s)
- Paolo Tranchini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudia Costa
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Massimo Mascolo
- Unit of Pathology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Daniela Russo
- Unit of Pathology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Massimiliano Scalvenzi
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gaia DE Fata Salvatores
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Adriana DI Guida
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Chiara Miano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Vincenzo Marino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luisa Abategiovanni
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Wanda Lauro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Anna Perrotta
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy -
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Patruno C, Nocerino M, Maffei M, Menna L, Fornaro L, Fabbrocini G, Napolitano M. Two is better than one: effectiveness of dupilumab on atopic dermatitis and chronic rhinosinusitis with nasal polyps in an adolescent. Dermatol Ther 2022; 35:e15857. [DOI: 10.1111/dth.15857] [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: 05/05/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Cataldo Patruno
- Department of Health Sciences University Magna Graecia of Catanzaro Catanzaro Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Marianna Maffei
- Otolaryngology Head and Neck Surgery Unit, AORN Ospedali dei Colli Naples Italy
| | - Luca Menna
- Section of Dermatology, Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Luigi Fornaro
- Section of Dermatology, Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery University of Naples Federico II Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery University of Naples Federico II Italy
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Megna M, Fornaro L, Potestio L, Luciano MA, Nocerino M, Delfino M, Guarino M, Fabbrocini G, Camela E. Efficacy and Safety of Anti-TNF Biosimilars for Psoriasis in Pediatric and Geriatric Populations: A 72-Week Real-Life Study. Psoriasis (Auckl) 2022; 12:199-204. [PMID: 35844291 PMCID: PMC9278721 DOI: 10.2147/ptt.s365493] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/19/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose To determine the efficacy and safety of adalimumab (ADA) and etanercept (ETA) biosimilars in elderly and children with psoriasis. Methods A real-life retrospective observational study was conducted on pediatric (<18 years) and geriatric (≥65 years) psoriasis patients treated with anti-TNF biosimilar agents referring to the Psoriasis Unit of the University of Naples Federico II, Italy, from January 2018 to January 2022. At baseline, demographic characteristics (age and sex), data on psoriasis duration and severity (measured by Psoriasis Area Severity Index [PASI] and body surface area [BSA]), presence of psoriatic arthritis if applicable, comorbidities, and previous psoriasis treatments were recorded. Patients were monitored by regular follow-ups (week 12, 24, 48 and 72) through clinical and haematological assessments and adverse events (AEs) were registered. Results A total of 11 children and 23 elderly psoriasis patients were enrolled. Concerning children, 6 (54.5%) were under ADA biosimilar and 5 (45.5%) under ETA biosimilar. ETA and ADA biosimilars were equally effective and safe for up to 72 weeks (mean PASI and BSA < 3). No significant AEs were reported, and none discontinued treatment. In the elderly, 15 (65.2%) were treated with ADA biosimilar and 8 (34.8%) with ETA biosimilar. ETA and ADA biosimilars were equally effective up to 72 weeks (mean PASI < 4 and mean BSA < 5%). AEs (mainly mild) were registered in 9 subjects (39.1%). Also, 4 (17.4%) patients discontinued biologicals for secondary lack of efficacy (3, 75%) or AEs (1, 25%). Conclusion Our study found that ADA and ETA biosimilars are effective and safe for the treatment of moderate-to-severe psoriasis in children and the elderly. No statistically significant efficacy and safety differences were found between ADA and ETA biosimilars in both children and the elderly. Geriatric patients displayed a higher discontinuation rate and side effects than the pediatric counterpart even if without approaching statistical significance.
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Affiliation(s)
- Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Luigi Fornaro
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Luca Potestio
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Maria Antonietta Luciano
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Mariateresa Nocerino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Mario Delfino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Maria Guarino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
| | - Elisa Camela
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, Italy
- Correspondence: Elisa Camela, Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Naples, NA, 80131, Italy, Tel +39 - 081 – 7462457, Fax +39 - 081 – 7462442, Email
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Napolitano M, Fabbrocini G, Nocerino M, Potestio L, Patruno C. The effects of dupilumab treatment on general health-related work productivity of adult atopic patients. Ital J Dermatol Venerol 2022; 157:228-230. [PMID: 35274879 DOI: 10.23736/s2784-8671.22.07179-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Moderate-to-severe atopic dermatitis (AD) is associated with negative impact on general health-related quality of life and work productivity. The objective was to investigate the improvement of work productivity and activity impairment associated to ameliorated general health in moderate-to severe AD patients during dupilumab treatment. METHODS We enrolled adult atopic patients with clinical indication to dupilumab therapy. The patients were required to be employed at baseline. At baseline and after 16 weeks, the AD severity was evaluated using EASI, Numerical Rating Scale (NRS) for pruritus (P-NRS) and sleep (S-NRS), and Dermatology Life Quality Index (DLQI). Work impairment and activity impairment on general health were assessed using the Work Productivity and Activity Impairment: General Health (WPAI:GH) questionnaire. RESULTS Two hundred sixty-eight patients were enrolled, 243 [131 males (53.91%)] completed the study. At week 16, 64.61% of patients achieved EASI75, 29.21% EASI50, and 6.17% EASI90. Likewise, a significant improvement in P-NRS, S-NRS, and DLQI was observed. At baseline, 90 patients were part-time employed, while 153 reported a full-time employment. During the 16 weeks of dupilumab therapy, we observed a significant decrease in percentage mean of absenteeism, presenteeism, and total work productivity impairment. CONCLUSIONS Improvement of general health in moderate to severe AD patients treated with dupilumab seems to be associate with improvements in work-related outcomes.
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Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy -
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Napolitano M, Nocerino M, Vincenzo P, Martora F, Fabbrocini G, Dastoli S, Patruno C. Dupilumab for the treatment of atopic dermatitis in transplant patients: two case reports and literature review. Dermatol Ther 2022; 35:e15324. [PMID: 35048522 PMCID: PMC9285570 DOI: 10.1111/dth.15324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/06/2022] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Picone Vincenzo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Italy
| | - Stefano Dastoli
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Napolitano M, Nocerino M, Miano C, Fabbrocini G, Patruno C. A case of adult scrotal oedema probably induced by the interaction between lacidipine and clarithromycin. Ital J Dermatol Venerol 2022; 157:371-372. [PMID: 35005854 DOI: 10.23736/s2784-8671.21.07096-1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy -
| | - Chiara Miano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Maurelli MP, Pepe P, Illiano S, Nocerino M, Ciuca L, Saralli G, Cringoli G, Rinaldi L. A five-year retrospective study on ascarid infections in dogs in southern Italy. SCHWEIZ ARCH TIERH 2022; 164:79-88. [PMID: 34983742 DOI: 10.17236/sat00339] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION A 5-year retrospective analysis of ascarid infections (Toxocara canis and Toxascaris leonina) in dogs from southern Italy was performed to update the epidemiological scenario of these parasites and to identify the risk factors which may favour these infections in animals in this study area. A total of 8,149 dogs, referred to our labs for copromicroscopic analysis using the FLOTAC technique, was considered. A sub-sample of 500 faecal samples were analysed also with the Mini-FLOTAC technique. Of the overall dog samples analysed, 9,2 % (95 % CI = 8,6-9,8) resulted positive for T. canis while 0,5 % (95 % CI = 0,4-0,7) resulted positive for T. leonina. Co-infections with T. canis and T. leonina were found in 0,1 % of dogs (95 % CI = 0,0-0,1). The results obtained by the FLOTAC and Mini-FLOTAC examinations showed a nearly perfect k agreement (k = 0,99, P < 0,001) between these two techniques. Chi-square test showed positivity to T. canis and T. leonina significantly (P < 0,001) associated with dogs housed outdoor (i.e., that lived in garden or in kennel). Moreover, the positivity for T. canis was significantly associated (P < 0,001) also with age (i.e., puppies), as shown by the logistic regression. The decreasing overall prevalence both for T. canis and T. leonina during the years of monitoring, showed that, as suggested by the European Scientific Counsel Companion Animal Parasites, the regular diagnosis could contribute to an efficient control of these parasites.
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Affiliation(s)
- M P Maurelli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
| | - P Pepe
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
| | - S Illiano
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
| | - M Nocerino
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
| | - L Ciuca
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
| | - G Saralli
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana M. Aleandri, Rome, Italy
| | - G Cringoli
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
| | - L Rinaldi
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, CREMOPAR, Naples, Italy
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Napolitano M, Potestio L, De Lucia M, Nocerino M, Fabbrocini G, Patruno C. Alitretinoin for the treatment of severe chronic eczema of the hands. Expert Opin Pharmacother 2021; 23:159-167. [PMID: 34789049 DOI: 10.1080/14656566.2021.1998457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Chronic hand eczema (CHE) is a frequent skin disorder affecting up to 10% of the population and strongly reduces Quality of Life (QoL). The first-line therapeutic strategies for the management of CHE include a change of lifestyle, an education program for the skin and the application of specific emollients. Topical corticosteroids or calcineurin inhibitors are the most used anti-inflammatory drugs. However, up to 65% of patients require systemic options. Alitretinoin, a retinoid structurally related to vitamin A, is the first systemic treatment approved in the European Union (EU) for severe CHE refractory to potent topical corticosteroids. AREAS COVERED This review summarizes the available data on the pharmacokinetics, pharmacodynamics, efficacy, and safety profile of oral alitretinoin for the treatment of CHE. EXPERT OPINION Alitretinoin can be considered as a valid therapeutic option for the treatment of CHE in patients not responding to ordinary treatments. Clinical trials and real-life experiences showed that it acts effectively on both objective and subjective clinical signs, resulting in a significant improvement in QoL of patients. As for other retinoids, caution should be taken in patients with certain chronic diseases (hepatopathies, kidney failure, hyperlipidemia, thyroid dysfunction) or childbearing potential women.
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Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Luca Potestio
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico Ii, Naples, Italy
| | - Mario De Lucia
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico Ii, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico Ii, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico Ii, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Abstract
INTRODUCTION Dupilumab represents a breakthrough in the management of atopic dermatitis (AD), thanks to its powerful T-helper (Th)2-mediated immunity modulating activity. It can reduce the atopic skin molecular signature and induce a significant decrease in the clinical signs and symptoms of AD patients. AREAS COVERED Th2 activation has been confirmed or suspected in skin diseases other than AD, and several reports about the treatment with dupilumab in these conditions have been published. In order to review the new indications of dupilumab in dermatology, we performed a search on PubMed, Embase, Cochrane Skin databases, and clinicaltrials.gov. EXPERT OPINION The analysis of available literature suggests that dupilumab may have a large application in dermatology, besides AD. Clinical trials are underway on some widespread disease (i.e. chronic urticaria, bullous pemphigoid, alopecia areata, or allergic contact dermatitis). The data are still partial, but they seem to indicate that dupilumab is efficacious and safe. On the other hand, the dupilumab use in some rare skin diseases remains only hypothetical or linked to few case reports. Dupilumab could have a prominent position in the therapeutic algorithm of chronic skin diseases that significantly affect the quality of life of patients, require long-term treatment, or lacking effective therapies.
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Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Adriana Di Guida
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Napolitano M, Fabbrocini G, Ruggiero A, Marino V, Nocerino M, Patruno C. The Efficacy and Safety of Abrocitinib as a Treatment Option for Atopic Dermatitis: A Short Report of the Clinical Data. Drug Des Devel Ther 2021; 15:1135-1147. [PMID: 33731985 PMCID: PMC7956861 DOI: 10.2147/dddt.s240866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/01/2021] [Indexed: 01/19/2023]
Abstract
Atopic dermatitis (AD) is a chronic, pruritic, inflammatory skin disease that predominantly affects children. However, it can persist in adulthood and/or start at older ages. Both dysfunction of the epidermal barrier and immune dysregulation are known to play a role in the pathogenesis of AD. In the last years, numerous studies showed that Janus kinase (JAK) enzymes have a key role in AD pathogenesis. Therefore, oral and topical JAK inhibitors are new emerging treatments for AD. We report the data relating to abrocitinib, an oral JAK1 inhibitor. For this purpose, we examined articles already published concerning, in particular, concluded clinical trials. Furthermore, we also report the design of current ongoing clinical trials. The search was carried out considering the main search engines relating to medical literature and clinical trials. From all the data we collected, abrocitinib proved to be an effective drug in significantly reducing the severity of moderate-to-severe AD when compared to placebo. Furthermore, the efficacy was similar to other well-established treatment for AD, such as dupilumab. Adverse events were generally mild; indeed, the drug was definitively suspended only in few patients.
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Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Vincenzo Marino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
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Marasca C, Fabbrocini G, Abategiovanni L, Camela E, Nocerino M, Di Guida A, De Fata Salvatores G. Adalimumab in the Management of Isotretinoin-Induced Acne Fulminans: Report of a Case. Skin Appendage Disord 2021; 7:115-119. [PMID: 33796557 DOI: 10.1159/000512032] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 05/15/2020] [Accepted: 10/05/2020] [Indexed: 01/26/2023] Open
Abstract
Acne fulminans (AF) is a rare, acute, and severe form of acne vulgaris often associated with systemic symptoms. Its treatment is challenging and controversial. We report a case of isotretinoin-induced AF (IIAF) in a 12-year-old boy resistant to traditional therapies (oral steroids and isotretinoin). The patient was successfully treated with adalimumab that can be considered an effective off-label option in the treatment of resistant IIAF in children.
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Affiliation(s)
- Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luisa Abategiovanni
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Elisa Camela
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Adriana Di Guida
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gaia De Fata Salvatores
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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15
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Donnarumma M, Nocerino M, Lauro W, Annunziata MC, Marasca C, Fabbrocini G. Isotretinoin in acne treatment during the coronavirus disease 2019 (COVID-19): A retrospective analysis of adherence to therapy and side effects. Dermatol Ther 2020; 34:e14677. [PMID: 33320409 PMCID: PMC7883110 DOI: 10.1111/dth.14677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/27/2020] [Accepted: 12/11/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Marianna Donnarumma
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Wanda Lauro
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maria Carmela Annunziata
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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16
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Cinelli E, Nocerino M, Patrì A, Megna M, Fabbrocini G, Gallo L. Mycoses in the elderly population: what a 16-year experience has taught us. Int J Dermatol 2020; 60:e60-e62. [PMID: 33502781 DOI: 10.1111/ijd.15126] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/26/2020] [Accepted: 07/15/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Eleonora Cinelli
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Angela Patrì
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Lucia Gallo
- Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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Affiliation(s)
- Maddalena Napolitano
- Department of Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Angelo Ruggiero
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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18
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Napolitano M, Gallo L, Megna M, Fabbrocini G, Nocerino M, Abategiovanni L, Patruno C. Hypersensitivity reaction to certolizumab pegol in a patient affected by psoriatic arthritis. Dermatol Ther 2019; 32:e12900. [PMID: 30964566 DOI: 10.1111/dth.12900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 03/06/2019] [Accepted: 04/06/2019] [Indexed: 11/30/2022]
Abstract
The pathogenic mechanism of hypersensitivity reactions (HSRs) to monoclonal antibodies is not fully understood. HSRs can occur after the first exposure or multiple exposures and include acute infusion reactions induced by cytokine release, besides Type I, Type III, and Type IV reactions.). We reported a case of anaphylactic reaction to certolizumab pegol in a patient affected by psoriatic arthritis and a possible management of this condition.
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Affiliation(s)
- Maddalena Napolitano
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Lucia Gallo
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Mariateresa Nocerino
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Luisa Abategiovanni
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Cataldo Patruno
- Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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