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Grieco T, Chello C, Faina V, Gomes VV, Alei L, Sernicola A, Panasiti V, Calvieri S. Omalizumab therapy in a patient with cronic spontaneous urticaria, ulcerative colitis, hypereosinophilia and prurigo Besnier: a case report. J DERMATOL TREAT 2019; 29:10-13. [DOI: 10.1080/09546634.2018.1527990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- T. Grieco
- Dermatologic Clinic Sapienza University of Rome, Rome, Italy
| | - C. Chello
- Dermatologic Clinic Sapienza University of Rome, Rome, Italy
| | - V. Faina
- Dermatologic Clinic Sapienza University of Rome, Rome, Italy
| | - V. V. Gomes
- UOC Anatomical Pathology, Belcolle Hospital, Viterbo, Italy
| | - L. Alei
- Dermatologic Clinic Sapienza University of Rome, Rome, Italy
| | - A. Sernicola
- Dermatologic Clinic Sapienza University of Rome, Rome, Italy
| | - V. Panasiti
- Campus Bio Medico, Dermatologic Clinic, Rome, Italy
| | - S. Calvieri
- Dermatologic Clinic Sapienza University of Rome, Rome, Italy
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Neri L, Peris K, Longo C, Calvieri S, Frascione P, Parodi A, Eibenschuz L, Bottoni U, Pellacani G. Physician-patient communication and patient-reported outcomes in the actinic keratosis treatment adherence initiative (AK-TRAIN): a multicenter, prospective, real-life study of treatment satisfaction, quality of life and adherence to topical field-directed therapy for the treatment of actinic keratosis in Italy. J Eur Acad Dermatol Venereol 2018; 33:93-107. [PMID: 29920789 DOI: 10.1111/jdv.15142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 05/22/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Patients with multiple actinic keratoses (AKs) should be treated with field-directed therapy. Such treatments challenge patients' adherence due to out-of-pocket costs, length of treatment and severity of local skin reactions (LSRs). Effective physician-patient communication (PPC) may buffer therapy-related distress, thus improving quality of life, treatment satisfaction and adherence. OBJECTIVES We evaluated the interplay between PPC, LSR intensity (safety) and lesion clearance rates (effectiveness) on treatment satisfaction, quality of life and treatment adherence among patients with multiple AKs receiving topical field-directed therapies. METHODS In this observational, multicentre, longitudinal, cohort study, we included 1136 adult patients with discrete, clinically detectable, visible, multiple (three or more lesions in a 25 cm2 area), Grade I/II AKs, for whom the attending dermatologist has prescribed treatment with a topical field-directed therapy. We matched self-reported data and medical information recorded by dermatologists in standard clinical forms. Patients were followed up at two time points (T1: 8 days; T2: 25-30 days) RESULTS: Most patients were elderly, married, men with poor socio-economic status and multiple lesions of the scalp or face. The majority (n = 961) had a prescription of ingenol mebutate (IMB) and 175 received either diclofenac 3% in hyaluronic acid (DHA) or imiquimod 5% (IMQ). Clearance rate at 1 month was 84%. Most patients felt very supported (n = 819, 73%) and rated dermatologist's explanations very clear (n = 608, 54%). Treatment satisfaction (effectiveness and convenience scales) increased along the follow-up, especially for those on IMB (Δpre-post = -4.00; other: Δpre-post = -0.25; interaction P < 0.001). Communication clarity was associated with higher treatment satisfaction scores (β = 0.4-0.6, P < 0.01) and lower risk of non-adherence among IMB patients (risk difference: 16%, P < 0.01). CONCLUSION Communication clarity was associated with patient-reported outcomes and adherence beyond AK-related clinical parameters. Our study questions the current episodic approach to AK management and provides the rationale to develop chronic care models fostering patients' engagement and treatment alliance.
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Affiliation(s)
- L Neri
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - K Peris
- Department of Dermatology, Catholic University, Rome, Italy
| | - C Longo
- Skin Cancer Unit, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - S Calvieri
- Department of Internal Medicine and Clinical Sciences, University of Rome 'La Sapienza', Rome, Italy
| | - P Frascione
- Department of Dermatologic Oncology, Regina Elena National Institute for Cancer Treatment and Research, Rome, Italy
| | - A Parodi
- Division of Dermatology, Università di Genova, DISEM, Genova, Italy
| | - L Eibenschuz
- Department of Dermatologic Oncology, Santa Maria and San Gallicano Dermatologic Institute, Istituto Fisioterapici Ospidalieri (IFO) of Rome, Rome, Italy
| | - U Bottoni
- Department of Health Science, University Magna Graecia, Catanzaro, Italy
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
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Paolino G, Cota C, Giona F, Donati P, Lora V, Moliterni E, Santopietro M, Calvieri S, Carbone A, Zalaudek I. The different dermoscopic features of the yellow background in Langerhans and non-Langerhans cells histiocytosis. Clin Exp Dermatol 2017; 42:679-682. [PMID: 28543371 DOI: 10.1111/ced.13137] [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] [Accepted: 10/25/2016] [Indexed: 11/28/2022]
Affiliation(s)
- G Paolino
- Dermatological Clinic, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - C Cota
- Dermatopathological Laboratory, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - F Giona
- Department of Cellular Biotechologies and Haematology, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - P Donati
- Dermatopathological Laboratory, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - V Lora
- Clinical Department, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - E Moliterni
- Dermatological Clinic, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - M Santopietro
- Department of Cellular Biotechologies and Haematology, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - S Calvieri
- Dermatological Clinic, La Sapienza University of Rome, Viale del Policlinico 15, 00186, Rome, Italy
| | - A Carbone
- Department of Oncologic Dermatology, San Gallicano Dermatologic Institute, IRCCS, Rome, Italy
| | - I Zalaudek
- Dermatology Department, Medical University of Graz, Auenbruggerplatz, Graz, Austria
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Grieco T, Faina V, Porzia A, Paolino G, Morrone S, Bottoni U, Calvieri S, Mainiero F. Atopic dermatitis IL17A- and IFN-γ-producing lymphocytes: investigation in blood, chronic lesions and APT. J Eur Acad Dermatol Venereol 2017; 31:e438-e439. [DOI: 10.1111/jdv.14258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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)
- T. Grieco
- Dermatologic Clinic; Sapienza University of Rome; Viale del Policlinico 15 Rome 00161 Italy
| | - V. Faina
- Dermatologic Clinic; Sapienza University of Rome; Viale del Policlinico 15 Rome 00161 Italy
| | - A. Porzia
- Department of Molecular Medicine; Sapienza University of Rome; Viale Regina Elena 291 Rome 01161 Italy
| | - G. Paolino
- Dermatologic Clinic; Sapienza University of Rome; Viale del Policlinico 15 Rome 00161 Italy
| | - S. Morrone
- Department of Experimental Medicine; Sapienza University of Rome; Viale Regina Elena 324 Rome Italy
| | - U. Bottoni
- Dermatologic Clinic; Sapienza University of Rome; Viale del Policlinico 15 Rome 00161 Italy
| | - S. Calvieri
- Dermatologic Clinic; Sapienza University of Rome; Viale del Policlinico 15 Rome 00161 Italy
| | - F. Mainiero
- Department of Experimental Medicine; Sapienza University of Rome; Viale Regina Elena 324 Rome Italy
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5
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D'Epiro S, Macaluso L, Salvi M, Luci C, Mattozzi C, Marzocca F, Salvo V, Scarnò M, Calvieri S, Richetta AG. Safety and prolonged efficacy of Botulin Toxin A in primary hyperhidrosis. Clin Ter 2017; 165:e395-400. [PMID: 25524193 DOI: 10.7417/ct.2014.1780] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hyperhidrosis is a condition characterized by generalized or localized hyperfunction of the eccrine sweat glands with a deep negative impact on patient's quality of life. OBJECTIVES To evaluate the efficacy and the safety of Botulin Toxin A (BTX-A) intradermal injection in the treatment of primary axillary and palmar hyperhidrosis, investigating symptoms-free period, and the subjective improving of quality life. MATERIALS AND METHODS 50 consecutive patients with primary hyperhidrosis were evaluated detecting age, gender, hyperhidrosis onset period, disease duration and years of treatment with BTX-A, Minor's iodine test, Hyperhidrosis Disease Severity Scale (HDSS), Dermatology Life Quality Index (DLQI). RESULTS The treatment is significantly effective both for axillae and palms: the majority of the patients improved their HDSS and Minor's scores from a value of 4 in the two tests, to values of 1 (HDSS) and 0 (Minor test). Patients reported a duration of symptoms relief from 4 to 12 months, with a mean of 5.68 months; specifically, we have observed that the axillary group experienced a longer symptoms-free period (mean RFS 7.2 months) than the palmar group (mean: RFS 4.27 months). CONCLUSIONS Authors suggest that BTX-A is a safe, easy, and fast procedure for the treatment of primary axillary and palmar hyperhidrosis.
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Affiliation(s)
- S D'Epiro
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - L Macaluso
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - M Salvi
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - C Luci
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - C Mattozzi
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - F Marzocca
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - V Salvo
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - M Scarnò
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - S Calvieri
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
| | - A G Richetta
- Dermatology Clinic, 'Sapienza' University of Rome, Italy
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Rossi A, Miraglia E, Fortuna M, Calvieri S, Giustini S. Topical cetirizine and oral vitamin D: a valid treatment for hypotrichosis caused by ectodermal dysplasia. J Eur Acad Dermatol Venereol 2017; 31:367-370. [DOI: 10.1111/jdv.13864] [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: 02/03/2016] [Accepted: 06/21/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A. Rossi
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - E. Miraglia
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - M.C. Fortuna
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - S. Calvieri
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
| | - S. Giustini
- Department of Dermatology and Venereology; “Sapienza” University of Rome; Rome Italy
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D'Epiro S, Salvi M, Luzi A, Mattozzi C, Luci C, Macaluso L, Marzocca F, Salvo V, Cantisani C, Paolino G, Calvieri S, Richetta AG. Drug cutaneous side effect: focus on skin ulceration. Clin Ter 2016; 165:e323-9. [PMID: 25203350 DOI: 10.7417/ct.2014.1750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Skin ulcers are defined as tissue loss interesting the deeper layers of the dermis and hypodermis, with low tendency to spontaneous healing. They cause disability related to pain, risk of infection and amputation, chronic management, requiring working absence with notably economic burden. The major cause is often related to underlying vascular disease, infections, tumors, autoimmunity, trauma, even if literature occasionally reported several cases of drug inducing skin ulceration. Most of drugs involved are chemotherapy agents and more recently molecular target therapies. Evidences supporting these drugs as the major cause of skin ulcers include delay of onset after therapy initiation, improvement after withdrawal of the drug, recurrence after its reintroduction and, sometimes, simultaneous occurrence of other skin lesions that have previously been reported to be associated with these agents. Attention should be reserved to patients undergoing antineoplastic agents, especially if previously affected by predisposing comorbidities, considering such side effect as possible differential diagnosis for skin ulceration in neoplastic patients.
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Affiliation(s)
- S D'Epiro
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - M Salvi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - A Luzi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Mattozzi
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Luci
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - L Macaluso
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - F Marzocca
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - V Salvo
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - C Cantisani
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - G Paolino
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - S Calvieri
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
| | - A G Richetta
- Department of Dermatology and Venereology, Policlinico "Umberto I", "Sapienza" University of Rome, Italy
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Miraglia E, Fabbrini G, Di Biasi C, Iacovino C, Ferrazzano G, Gualdi G, Calvieri S, Giustini S. Chiari type 1 malformation in Neurofibromatosis type 1: experience of a center and review of the literature. Clin Ter 2016; 167:e6-10. [PMID: 26980639 DOI: 10.7417/t.2016.1912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the possible correlation and the true incidence between Neurofibromatosis type 1 and Arnold-Chiari malformation type I. MATERIALS AND METHODS We reviewed all clinical charts, neurological consultations and MRI scans of 428 NF1 patients followed by 1994 to 2014 in our Department. NF1 patients in our clinic are seen usually every year by both the dermatologist and the neurologist. All patients also undergo a brain and spinal cord with the same 1.5 Tesla MRI scan. RESULTS We found a diagnosis of Arnold Chiari malformation type I in 9 of the 428 NF1 cases (2%). CONCLUSION This frequency is higher than that expected on the basis of a chance association. Therefore we underline the importance of serial MRI studies in patients with NF1 to assess the presence of cranio-cervical anomalies. Future studies should try to better understand what are the pathogenetic mechanisms underlying this close association.
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Affiliation(s)
- E Miraglia
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
| | - G Fabbrini
- Department of Neurology and Psychiatry, Sapienza - University of Rome, Rome - IRCCS Neuromed Institute, Pozzilli (IS), Italy
| | - C Di Biasi
- Department of Radiology DEA, Sapienza - University of Rome, Rome
| | - C Iacovino
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
| | - G Ferrazzano
- Department of Neurology and Psychiatry, Sapienza - University of Rome, Rome
| | - G Gualdi
- Department of Radiology DEA, Sapienza - University of Rome, Rome
| | - S Calvieri
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
| | - S Giustini
- Department of Dermatology and Venereology, Sapienza - University of Rome, Rome
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Mattozzi C, Paolino G, Salvi M, Macaluso L, Luci C, Morrone S, Calvieri S, Richetta AG. Peripheral blood regulatory T cell measurements correlate with serum vitamin D level in patients with psoriasis. Eur Rev Med Pharmacol Sci 2016; 20:1675-1679. [PMID: 27212156] [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: 06/05/2023]
Abstract
OBJECTIVE Vitamin D is the precursor of a hormone (1,25-dihydroxyvitamin D3), which has many biological effects in the skin. The immune modulator properties of vitamin D are mediated in part through effects on regulatory T cells (T-reg). Currently, in psoriasis, the relationship between vitamin D and T-reg has not well elucidated. We assess whether vitamin D status is correlated with circulating T-reg in patients affected by psoriasis and if there is a correlation with the severity of the disease evaluated with Psoriasis Area Severity Index (PASI) score. PATIENTS AND METHODS For each patient we have analyzed, PASI-score, serum levels vitamin D and regulatory T cell percentages. Spearmen's coefficient was used between serum vitamin D levels and the predictors. Subsequently, the independent predictive factors were assessed by Multiple Regression. RESULTS A total of 26 patients were included in our analysis. Using no parametric Spearman's Coefficient test between serum levels of vitamin D and the single variables, we found an association with T-reg population (p < 0.001) and with PASI-score (p = 0.04). CONCLUSIONS While vitamin D treatment induces a cytokine profile known to favor the differentiation of T cells with suppressive activity, at the same time, several studies showed how vitamin D can prime for tolerogenic dendritic cells able to favor the differentiation of Treg from T naïve cells. Low levels of vitamin-D may decrease the number of circulatory T-reg, disrupting the immunological homeostasis in psoriatic patients and encouraging the inflammatory activity.
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Affiliation(s)
- C Mattozzi
- Department of Dermatology and Venereology, "Sapienza" University of Rome, Rome, Italy.
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Paolino G, Bekkenk MW, Didona D, Eibenschutz L, Richetta AG, Cantisani C, Viti G, Carbone A, Buccini P, De Simone P, Ferrari A, Scali E, Calvieri S, Silipo V, Cigna E, Viti GP, Bottoni U. Is the prognosis and course of acral melanoma related to site-specific clinicopathological features? Eur Rev Med Pharmacol Sci 2016; 20:842-848. [PMID: 27010139] [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: 06/05/2023]
Abstract
OBJECTIVE Acral melanoma is an uncommon type of melanoma in Caucasian patients. However, acral melanoma is the most common type of melanoma in African and Asian patients. Comparison analyses between hand-acral melanoma and foot-acral melanoma have been rarely reported in the literature. Acral melanoma is an uncommon melanocytic tumor characterized by an intrinsic aggressiveness, with specific histological and clinicopathological features. Acral melanoma involves the palms, soles and sub-ungueal sites. PATIENTS AND METHODS A total of 244 patients with acral melanoma were included in our analysis. The current study was performed in three different medical centers: Sapienza University of Rome, San Gallicano Institute of Rome and University of Magna Graecia (Italy). The Kaplan-Meier product was used to estimate survival curves for disease-free survival and overall survival. The log-rank test was used to evaluate differences between the survival curves. Assuming that the effects of the predictor variables are constant over time, the independent predictive factors were assessed by Spearman's test and subsequently data were analyzed performing Cox proportional-hazard regression. RESULTS In both univariate and multivariate analyses Breslow thickness (p < 0.0001) and ulceration (p = 0.003) remained the main predictors. General BRAF mutation was detected in 13.8% of cases. We found that median Breslow value and the percentage of recurrences were similar in hand-acral melanoma and foot-acral melanoma, as well as there were no differences in both short and long-term. CONCLUSIONS The absence of differences in survival between hand-acral melanoma and foot-acral melanoma shows that the aggressiveness of the disease is related to distinct mutational rate, as well as to anatomical site-specific features, rather than to the visibility of the primary lesion.
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Affiliation(s)
- G Paolino
- Dermatologic Clinic, "La Sapienza" University of Rome, Rome, Italy.
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Cantisani C, Paolino G, Bottoni U, Calvieri S. Daylight-Photodynamic Therapy for the Treatment of Actinic Keratosis in Different Seasons. J Drugs Dermatol 2015; 14:1349-1353. [PMID: 26580886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND non-melanoma skin cancer (NMSC) is the most common malignancy, whose public health significance is often unrecognized. Its incidence continues to grow at an alarming rate, becoming an occupational disease. Available treatments alternative to surgery include: photodynamic therapy, electrochemiotherapy, cryotherapy, ablative lasers, 5-fluorouracil, imiquimod, ingenol mebutate, and diclofenac. Each of these options has its advantages and disadvantages. Photodynamic therapy (PDT), using topically applied photosensitizer precursors such as methylaminolaevulinate (MAL), is a useful nonsurgical treatment, well accepted by patients, but the main limitation is pain. Recently, in order to overcome this limit, visible light irradiation photherapy was considered. AIM we report our experience comparing conventional PDT (406 patients) with daylight-mediated PDT (D-PDT) 240 patients with multiple actinic keratoses (AK), afferent to our photodynamic outpatients clinic from September 2013 to June 2014. MATERIALS AND METHODS to establish predictors for the clinical response to conventional PDT and daylight PDT (DPDT), a retrospective study on 646 patients was performed. The following parameters have been evaluated: sex, age, anatomic site of the primary tumor and local skin reactions. We used the Spearmen's coefficient between the clinical response and the predictors analyzed; while Odds Ratio (OR) was performed to evaluate general clinical response and local skin reaction between PDT and D-PDT patients. Subsequently, we performed a sub-analysis, focusing to the anatomical sites, and we subdivided anatomical sites in face and scalp, nose, trunk, and extremities. RESULTS a total of 406 patients treated with PDT and 240 patients treated with D-PDT, were enrolled in the current report. The median age was 71 years in PDT and 73 years in D-PDT. The mean clinical response in PDT was of 74.4% and 95% in D-PDT. Performing OR between PDT and D-PDT, according to the clinical response, we found a better behavior in patients treated with D-PDT (P < 0.03); the same significance was maintained according to the presence or absence of local skin reaction (P < 0.0002). Using no parametric Spearman's Coefficient test among predictive factors and the therapeutical response we found that D-PDT showed a better clinical response in patients with AK size ≥ 0.6 mm (P < 0.03), while this evidence was not present in PDT. The nose remained in both PDT and DPDT the main anatomical site with a better clinical response to the treatment. CONCLUSION Since efficacy of D-PDT is comparable or superior to conventional type, but is simpler and better appreciated by patients, in our opinion it may be used routinely to treat sun exposed multiple AKs especially in sun damaged skin also for aesthetic purposes.
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Bottoni U, Paolino G, Ambrifi M, Didona D, Albanesi M, Clerico R, Lido P, Brachini A, Corsetti P, Richetta AG, Cantisani C, Calvieri S. Association between autoimmune disease and cutaneous melanoma with regard to melanoma prognosis. Clin Exp Dermatol 2015; 40:254-9. [PMID: 25475359 DOI: 10.1111/ced.12531] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2014] [Indexed: 12/29/2022]
Abstract
BACKGROUND An association between autoimmune disease and malignant melanoma (MM) has often been reported in the literature as a positive prognostic factor for MM. Consequently, we evaluated the influence of different autoimmune diseases on the prognosis of MM. AIM To evaluate the prognosis of patients with MM who also had an autoimmune disorder, whether tumour-associated, paraneoplastic or drug-induced. METHODS Autoimmune diseases were classified and analysed as tumour-associated, paraneoplastic or drug-induced. Patients were enrolled according to their clinicopathological features and matched with control groups. Kaplan-Meier analysis was used to estimate disease-free survival (DFS) and overall survival (OS), and log-rank test was used to evaluate differences between the survival curves. RESULTS In total, 49 patients with MM and tumour-associated autoimmune disease were included in our analysis. No case of paraneoplastic autoimmune disease was detected. The survival analyses showed a range of results, from a worsening of DFS and OS to a lack of any difference. In a second analysis, we separately analysed patients who developed autoimmune disorders after starting adjuvant therapy with interferon-α; we did not find significant differences between these patients and the untreated patients. CONCLUSIONS Autoimmune disease, whether tumour-associated or drug-induced, was not associated with better prognosis in patients with MM. The results suggest that the reported relationship between autoimmunity and MM may be a result of individual variation in sensitivity to the autoimmune disease, the tumour or the treatments.
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Affiliation(s)
- U Bottoni
- Department of Dermtology, University Magna Graecia, Catanzaro, Italy
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13
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Rossi A, Iorio A, Di Nunno D, Priolo L, Fortuna MC, Garelli V, Carlesimo M, Calvieri S, Mari E. Conditions simulating androgenetic alopecia. J Eur Acad Dermatol Venereol 2015; 29:1258-64. [PMID: 25571781 DOI: 10.1111/jdv.12915] [Citation(s) in RCA: 5] [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] [Received: 04/09/2014] [Accepted: 11/07/2014] [Indexed: 11/26/2022]
Abstract
Androgenetic alopecia is a common form of hair loss, characterized by a progressive hair follicular miniaturization, caused by androgen hormones on a genetically susceptible hair follicle, in androgenic-dependent areas. Characteristic phenotype of androgenetic alopecia is also observed in many other hair disorders. These disorders are androgenetic-like diseases that cause many differential diagnosis or therapeutic error problems. The objective of this review was to systematically analyse the greatest number of conditions that mimic the AGA pattern and explain their disease pathogenesis.
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Affiliation(s)
- A Rossi
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - A Iorio
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - D Di Nunno
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - L Priolo
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - M C Fortuna
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - V Garelli
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - M Carlesimo
- Dermatology University of Rome 'Sapienza', II School Italy
| | - S Calvieri
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
| | - E Mari
- Dipartimento di Medicina Interna e Specialità mediche Clinica Dermatologica, University of Rome 'Sapienza', I School Italy
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Cantisani C, Paolino G, Corsetti P, Bottoni U, Didona D, Calvieri S. Evaluation of Ingenol mebutate efficacy for the treatment of actinic keratosis with Antera 3D camera. Eur Rev Med Pharmacol Sci 2015; 19:92-97. [PMID: 25635981] [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: 06/04/2023]
Abstract
OBJECTIVE Cumulative exposure of the skin to ultraviolet radiation promotes mutation in keratinocytes and their abnormal growth led to the formation of scaly lesions, called actinic keratoses (AKs). Its incidence is growing at an emerging rate, becoming a worldwide problem especially for occupational ultraviolet (UV) rays exposure. Detectable lesions are often associated with field changes, where the surrounding skin is altered and subclinical lesions may be present. Thus, a field-directed therapy, such as topical treatment, should be preferred for the prevention of invasive cancer development. A retrospective analysis was made, evaluating the efficacy of ingenol-mebutate gel, using a novel device the 3D in vivo optical skin Imaging (Antera 3D, Miravex, Ireland). PATIENTS AND METHODS We included all patients with multiple non-hypertrophic Aks, to whom it was prescribed ingenol-mebutate gel, applied at the dosages of 0.015 for lesions in the scalp/face (for 3 consecutive days) and at the dosage of 0.05% for lesions in the trunk and/or extremities (for 2 consecutive days). RESULTS A reduction of the lesions and of median hemoglobin levels, after a follow-up of 60 days, was observed in 100% of patients. CONCLUSIONS Ingenol mebutate gel, the last topical molecule appeared in the Italian market showed its efficacy using Antera 3D also in terms of hemoglobin reduction. Therefore, this camera could be considered an useful tool for the identification of the area to be treated and for therapeutic follow-up.
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Affiliation(s)
- C Cantisani
- Department of Oncoematology-Dermatology, Azienda Policlinico Umberto I, "Sapienza" University, Rome, Italy.
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15
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Bottoni U, Paolino G, Didona D, Corsetti P, Clerico R, Cantisani C, Richetta AG, Arcidiacono V, Scali E, Pranteda G, Calvieri S. Improvement of survival in patients with melanoma and non-melanoma skin cancers compared to patients without double cutaneous malignancies. Eur Rev Med Pharmacol Sci 2015; 19:1640-4. [PMID: 26004604] [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: 06/04/2023]
Abstract
OBJECTIVE The worldwide incidence of cutaneous malignant melanoma (MM) has been rising steadily over the past 30 years. At the same time non-melanoma skin cancers (NMSC) are the most prevalent type of cancer in United States and Europe. Up to date, no paper has explored the influence on the general survival in patients with MM and NMSC. We decided to perform a study with the aim to evaluate the different survival in patients with MM-NMSC compared to control patients (MM-CTRL). PATIENTS AND METHODS To evaluate prognosis in both groups, we analyzed disease-free survival (DFS) and overall survival (OS).Kaplan-Meier product was performed for the survival analysis. Median DFS was 73 months in group and 72 months in MM-CTRL patients (p = 0.4); while, median OS was 74.2 months in MM-NMSC patients and 63.1 in MM-CTRL (p < 0.001). Also at Odds-Ratio (OR), the statistical significance was maintained (p < 0.007) with a better prognostic value for MM-NMSC. RESULTS Among group patients, the ones with a basal cell carcinoma showed a batter behavior, than the ones with squamous cell carcinoma (p = 0.01). CONCLUSIONS Patients with MM-NMSC showed a better survival than MM-CTRL patients (p < 0.001). The causes of this improved survival are still unknown; probably the endogenous immune response can play a pivotal role in this class of patients. However, further studies are necessary to better understand this phenomenon, not yet explored in literature.
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Affiliation(s)
- U Bottoni
- Unit of Dermatology, "Sapienza" University of Rome, Rome, Italy.
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Cantisani C, Miraglia E, Giustini S, Calvieri S. Multiple painful papulo-nodular lesions: clinical pitfall. Clin Ter 2014; 165:e423-5. [PMID: 25524199 DOI: 10.7417/ct.2014.1786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 43-year-old male presented with multiple (>10) painful, papulo-nodular lesions, associated with paresthesia, over the face, neck and trunk, appeared 15 years prior and increased with time. The patient's brother has cutaneous leiomyomas and testicle cancer, his mother underwent hysterectomy for symptomatic leiomyomas while his maternal grandfather died from aggressive renal cell carcinoma at age 57 years. The patient reported that he had removed a kidney cancer 5 years prior. Dermoscopy, histologic evaluation and genetical analysis were done and Hereditary leiomyomatosis and renal cell carcinoma was diagnosed.
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Affiliation(s)
- C Cantisani
- Department of Dermatology. "Sapienza" University, Rome, Italy
| | - E Miraglia
- Department of Dermatology. "Sapienza" University, Rome, Italy
| | - S Giustini
- Department of Dermatology. "Sapienza" University, Rome, Italy
| | - S Calvieri
- Department of Dermatology. "Sapienza" University, Rome, Italy
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17
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Visconti B, Paolino G, Carotti S, Pendolino AL, Morini S, Richetta AG, Calvieri S. Immunohistochemical expression of VDR is associated with reduced integrity of tight junction complex in psoriatic skin. J Eur Acad Dermatol Venereol 2014; 29:2038-42. [PMID: 25220655 DOI: 10.1111/jdv.12736] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 08/04/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND Cell junctions are crucial for the formation and maintenance of the paracellular barrier and for cell polarity in simple epithelia and endothelia. Altered localization and formation of tissue junction proteins in the epidermis have been described in plaque-type psoriasis. Vitamin D receptor (VDR) is a nuclear hormone involved in anti-proliferative and pro-differentiation pathways in keratinocytes. However, still to date, vitamin D/VDR signalling involved in tissue barrier related to psoriasis remains largely unknown. OBJECTIVE To study the expression of VDR and tight junctions (TJ) proteins (claudin 1, ZO-1 and occludin) in psoriatic skin, and to correlate the expression of VDR with that of the junctional proteins claudin- 1, occludin and ZO- 1. METHODS A total of 20 psoriatic tissue samples were included in the analysis. Immunohistochemical studies for VDR, claudin-1, occludin and ZO-1 were performed. RESULTS We observed a reduction of VDR, claudin-1 and ZO-1 expression in psoriatic skin if compared to normal skin, and the statistical analysis showed a significant correlation between a downgrading of VDR expression and that of claudin-1 (P < 0.005) and ZO-1(P < 0.005). CONCLUSIONS Our results suggest a new role of VDR in the maintenance of the homeostasis skin barrier. Although the exiguity of our cohort, VDR status appears to be associated with the expression level and functions of TJ proteins, suggesting multiple and different cellular functions of the VDR.
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Affiliation(s)
- B Visconti
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, 'Sapienza' University of Rome, Rome, Italy
| | - G Paolino
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, 'Sapienza' University of Rome, Rome, Italy
| | - S Carotti
- Laboratory of Microscopic and Ultrastructural Anatomy, CIR, University Campus Bio-Medico of Rome, Rome, Italy
| | - A L Pendolino
- Laboratory of Microscopic and Ultrastructural Anatomy, CIR, University Campus Bio-Medico of Rome, Rome, Italy
| | - S Morini
- Laboratory of Microscopic and Ultrastructural Anatomy, CIR, University Campus Bio-Medico of Rome, Rome, Italy
| | - A G Richetta
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, 'Sapienza' University of Rome, Rome, Italy
| | - S Calvieri
- Unit of Dermatology, Department of Internal Medicine and Medical Specialties, 'Sapienza' University of Rome, Rome, Italy
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Longo C, Neri L, Argenziano G, Calvieri S, Calzavara-Pinton P, Cantisani C, Catricalà C, Peris K, Peserico A, Pimpinelli N, Pellacani G. Management of local skin reactions after the application of ingenol mebutate gel for the treatment of actinic keratosis: four illustrative cases. J Eur Acad Dermatol Venereol 2014; 30:320-1. [DOI: 10.1111/jdv.12714] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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)
- C. Longo
- Dermatology and Skin Cancer Unit; Arcispedale S. Maria Nuova; IRCCS; Reggio Emilia Italy
| | - L. Neri
- Dipartimento di Scienze Cliniche e di Comunità; Università di Milano; Milano Italy
| | - G. Argenziano
- Dermatology and Skin Cancer Unit; Arcispedale S. Maria Nuova; IRCCS; Reggio Emilia Italy
| | - S. Calvieri
- Clinica Dermatologica; Policlinico Umberto I; “Sapienza” Università di Roma; Rome Italy
- Ematologia-oncologia Anatomia Patologica e Medicina Rigenerativa; Policlinico Umberto I; “Sapienza” Università di Roma; Rome Italy
| | - P.G. Calzavara-Pinton
- Clinica Dermatologica; Spedali Civili di Brescia; Università di Brescia; Brescia Italy
| | - C. Cantisani
- Clinica Dermatologica; Policlinico Umberto I; “Sapienza” Università di Roma; Rome Italy
| | - C. Catricalà
- IFO-Istituto Dermatologico; IRCCS Santa Maria e San Gallicano; Rome Italy
| | - K. Peris
- Dermatology Institute; Policlinico Gemelli; Catholic University of Rome; Rome Italy
| | - A. Peserico
- Clinica Dermatologica; Dipartimento di Medicina-DIMED; Università di Padova; Padova Italy
| | - N. Pimpinelli
- Department of Surgery and Translational Medicine - Division Dermatology; University of Florence Medical School; Florence Italy
| | - G. Pellacani
- Department of Dermatology; University of Modena and Reggio Emilia; Modena Italy
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Miraglia E, Cantisani C, Giustini S, Ambrifi M, Soda G, Calvieri S. Basal cell carcinomas in a young woman with Steinert's disease. Dermatol Online J 2014; 20:13030/qt15k425wz. [PMID: 25148278] [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] [Received: 08/15/2014] [Accepted: 08/15/2014] [Indexed: 06/03/2023] Open
Abstract
Steinert's disease or Myotonic dystrophy type I (DM1) is an autosomal dominant disease characterized by myotonia, muscular dystrophy, cataracts, hypogonadism, frontal balding, and electrocardiographic alterations.Several tumors have been associated with DM1 such as pilomatricoma, thymomas and insulinomas. Herein, we describe the unusual onset of multiple basal cell carcinomas in a young woman with DM1.
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Miraglia E, Pecorella I, Persechino F, Visconti B, Calvieri S, Giustini S. A rare association between neurofibromatosis type 1 and vulvar sarcoma. GIORN ITAL DERMAT V 2014; 149:374-376. [PMID: 24819769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- E Miraglia
- Department of Dermatology, La Sapienza University of Rome, Policlinico Umberto I, Rome, Italy -
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21
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Rossi A, Iorio A, Scarnò M, Fortuna M, Priolo L, Di Nunno D, Carlesimo M, Calvieri S, Mari E. Use of Topical Minoxidil, 17α-Estradiol and Hydrocortisone Butyrate in Frontal Fibrosing Alopecia. EUR J INFLAMM 2014. [DOI: 10.1177/1721727x1401200219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A valid approach to treating frontal fibrosing alopecia (FFA), a scarring alopecia, does not yet exist. The aim of this study is to evaluate the efficacy of a topical application composed of minoxidil, hydrocortisone butyrate, 17α-estradiol, ciclosilicone pentamer, and alcohol in women affected by FFA. Forty women affected by FFA were treated with 2 ml of a topical lotion composed of 2% minoxidil base, 0.08% hydrocortisone butyrate, 0.05% 17α-estradiol, 16% ciclosilicone pentamer, 96° alcohol, applied once a day on the scalp. A score index, based on the comparison of the photos, taken at the beginning (T0) and after 36 months (T36), was used. The topical lotion led to an improvement in 20 patients, stabilization in 15 patients and worsening of the clinical condition in 5 women. This topical lotion induces a considerable improvement or stabilization of frontal fibrosing alopecia.
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Affiliation(s)
- A. Rossi
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
| | - A. Iorio
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
| | - M. Scarnò
- CASPUR (Inter-University Consortium for Supercomputing), Rome, Italy
| | - M.C. Fortuna
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
| | - L. Priolo
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
| | - D. Di Nunno
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
| | - M. Carlesimo
- Dermatology Sant'Andrea Hospital, University of Rome “Sapienzd”, II School, Italy
| | - S. Calvieri
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
| | - E. Mari
- Department of Internal Medicine and Medical Specialities, University of Rome “Sapienza”, Italy
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22
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Bottoni U, Clerico R, Paolino G, Corsetti P, Ambrifi M, Brachini A, Richetta A, Nisticò S, Pranteda G, Calvieri S. Melanoma and IFN alpha: potential adjuvant therapy. J BIOL REG HOMEOS AG 2014; 28:271-279. [PMID: 25001659] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Interferon alpha (IFNalpha) is the most used adjuvant treatment in clinical practice for melanoma (MEL) high-medium risk patients; however, the use of IFNalpha has yielded conflicting data on Overall Survival (OS) and disease free survival (DFS) rates. Starting from these considerations, we carried out an analysis on our MEL patients who received adjuvant IFNalpha therapy, in order to identify possible predictors for their outcome. A total of 140 patients were included in our analysis. Patients with Breslow thickness ≤2.00 mm presented a significantly longer mean DFS than patients with Breslow ≥2.01 mm (p = 0.01). Using non- parametric Spearmans Coefficient test we found association between DFS and Breslow thickness (p < 0.001) and between DFS and ulceration (p = 0.03). Performing Multiple Regression test, Breslow thickness (p < 0.001) remained the only statistically significant predictor. From the OS analysis we found that patients with lower Breslow values ≤ 2.00 mm (p < 0.0001), and absence of ulceration (p <0.004) showed a significantly better long-term survival. From the current analysis we found that the use of low dose IFNalpha is justified only for cutaneous melanoma ≤ 4.01 mm that was not ulcerated; patients with Breslow ≥ 4.01 mm, in our opinion, should not carry out adjuvant treatment with low dose IFNalpha, because its side effects could be higher than the its benefits.
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Affiliation(s)
- U Bottoni
- Department of Health Sciences, University Magna Graecia, Viale Europa, Germaneto, Catanzaro, Italy
| | - R Clerico
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
| | - G Paolino
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
| | - P Corsetti
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
| | - M Ambrifi
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
| | - A Brachini
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
| | - A Richetta
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
| | - S Nisticò
- Department of Health Sciences, University Magna Graecia, Viale Europa, Germaneto, Catanzaro, Italy
| | - G Pranteda
- Dermatology Unit, NESMOS Department, II School of Medicine, Sapienza University Rome, S. Andrea Hospital, Via Grottarossa, Rome, Italy
| | - S Calvieri
- Unit of Dermatology, Umberto I Polyclinic, La Sapienza University, Via del Policlinico, Rome, Italy
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Calvieri S, Rossi A. Alopecia in genetic diseases. GIORN ITAL DERMAT V 2014; 149:1-13. [PMID: 24566562] [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
Congenital abnormalities of the hair shaft are conditions in most cases linked to chemical, biochemical, and morphological alterations, genetically determined. These alterations may be associated with a larger array of symptoms, as mentioned above, or may occur isolated. The number of genes involved and their penetration are responsible for the mode of transmission, severity, and phenotypic expression of the disease. Furthermore, in some cases, these abnormalities can be considered true pathognomonic markers of disease. Within this disorder, two groups are classically identified: with increased fragility of the hair shaft and without increased fragility. Congenital abnormalities of the hair shaft that present an increased fragility of hair include: Trichorrhexis nodosa congenita, Trichoschisis, Trichorrhexis invaginata, Trichothiodystrophy, Trichoclasia, Pili torti, Monilethrix and Loose anagen syndrome; while the alterations that are not associated with a greater fragility of the hair are: Pili annulati, Longitudinal grooves, Uncombable hair syndrome (Pili trianguli et canaliculi), Woolly hair, Woolly hair with dominant inheritance, Familial recessive woolly hair and Woolly hair nevus.
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Affiliation(s)
- S Calvieri
- Department of Internal Medicine and Medical Specialties, Unit of Dermatology Sapienza University, Rome, Italy -
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Rossi A, Calvieri S. Treatment for alopecia. GIORN ITAL DERMAT V 2014; 149:103-106. [PMID: 24566570] [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
Satisfactory, evidence-based medicine regimen for treating alopecia are available in literature only regarding alopecia areata and androgenetic alopecia. About all the other kinds of alopecia, recommendations for therapy are still based upon the literature review, expert opinion, personal experience, expected adverse effects, and some pragmatic considerations such as the cost and the patient's compliance. Cicatricial alopecia is one of the most difficult challenges for dermatologists, because it is uncommon, its etiopathogenesis is not completely understood and there is no best therapy approach. Moreover, in Italy, most of the drugs mentioned below are not always available. Finally, therapies for hair disorders are long treatment and not always lead to a good improvement.
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Affiliation(s)
- A Rossi
- Department of Internal Medicine and Medical Specialties, Unit of Dermatology Sapienza University, Rome, Italy -
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25
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Miraglia E, Cantisani C, Giustini S, Ambrifi M, Soda G, Calvieri S. Basal cell carcinomas in a young woman with Steinert’s disease. Dermatol Online J 2014. [DOI: 10.5070/d3208023530] [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: 11/08/2022] Open
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Cantisani C, Ricci S, Grieco T, Paolino G, Faina V, Silvestri E, Calvieri S. Topical promethazine side effects: our experience and review of the literature. Biomed Res Int 2013; 2013:151509. [PMID: 24350243 PMCID: PMC3852816 DOI: 10.1155/2013/151509] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 08/19/2013] [Accepted: 09/24/2013] [Indexed: 12/13/2022]
Abstract
Promethazine hydrochloride is a first-generation H1 receptor antagonist, antihistamine, and antiemetic medication that can also have strong sedative effects. The apparent ability of topical H1r/2r antagonists to target epidermal H1/2r was translated into increased efficacy in the treatment of inflammatory dermatoses, likely due to decreased inflammation and enhanced barrier function.
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Affiliation(s)
- C. Cantisani
- Department of Dermatology and Plastic Surgery, University “Sapienza” of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - S. Ricci
- Section of Legal Medicine, Department of Anatomical, Histological, Medical Legal and Locomotive System Sciences, University of Rome “Sapienza”, Viale Regina Elena 336, 00161 Rome, Italy
| | - T. Grieco
- Department of Dermatology and Plastic Surgery, University “Sapienza” of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - G. Paolino
- Department of Dermatology and Plastic Surgery, University “Sapienza” of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - V. Faina
- Department of Dermatology and Plastic Surgery, University “Sapienza” of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - E. Silvestri
- Department of Dermatology and Plastic Surgery, University “Sapienza” of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - S. Calvieri
- Department of Dermatology and Plastic Surgery, University “Sapienza” of Rome, Viale del Policlinico 155, 00161 Rome, Italy
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Panasiti V, Curzio M, Roberti V, Lieto P, Devirgiliis V, Gobbi S, Naspi A, Coppola R, Lopez T, di Meo N, Gatti A, Trevisan G, Londei P, Calvieri S. Metastatic volume: an old oncologic concept and a new prognostic factor for stage IV melanoma patients. Dermatology 2013; 227:55-61. [PMID: 24008289 DOI: 10.1159/000351713] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 04/26/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The last melanoma staging system of the 2009 American Joint Committee on Cancer takes into account, for stage IV disease, the serum levels of lactate dehydrogenase (LDH) and the site of distant metastases. OBJECTIVE Our aim was to compare the significance of metastatic volume, as evaluated at the time of stage IV melanoma diagnosis, with other clinical predictors of prognosis. METHODS We conducted a retrospective multicentric study. To establish which variables were statistically correlated both with death and survival time, contingency tables were evaluated. The overall survival curves were compared using the Kaplan-Meier method. RESULTS Metastatic volume and number of affected organs were statistically related to death. In detail, patients with a metastatic volume >15 cm(3) had a worse prognosis than those with a volume lower than this value (survival probability at 60 months: 6.8 vs. 40.9%, respectively). The Kaplan-Meier method confirmed that survival time was significantly related to the site(s) of metastases, to elevated LDH serum levels and to melanoma stage according to the latest system. CONCLUSION Our results suggest that metastatic volume may be considered as a useful prognostic factor for survival among melanoma patients.
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Affiliation(s)
- V Panasiti
- Plastic Surgery Unit, Campus Bio-Medico, University of Rome, Rome, Italy
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Roberti V, Devirgiliis V, Curzio M, Gobbi S, Coppola R, Calvieri S, Panasiti V. The blue globular pattern in dermoscopy. Dermatology 2013; 226:260-6. [PMID: 23796824 DOI: 10.1159/000350257] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 02/24/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Seborrheic keratosis (SK) is a frequent benign epithelial skin tumor. Generally its diagnosis is clinical, however SK can sometimes clinically simulate a melanocytic lesion; therefore we need dermoscopy to reach a correct diagnosis. Milia-like cysts and comedo-like openings are the common dermoscopic features of SK, but it is not a rare finding that SK can display one or more dermoscopic patterns suggestive of a melanocytic origin. OBJECTIVES We describe a case series of SKs with a blue globular pattern simulating a melanocytic lesion. METHODS We retrospectively evaluated 224 SKs seen during 2011 at the Dermatoscopy Unit of the Department of Dermatology, University of Rome 'Sapienza'. RESULTS Five SKs showed a blue globular pattern, without the SK main features generally seen in dermoscopy; globules were multiple, round or oval, well-demarcated, small and medium-sized, blue-colored and equally distributed within the lesion. Histopathologic examination was consistent with acanthotic SK. CONCLUSIONS Identification of the blue globular pattern can be helpful for the dermoscopic diagnosis of SK, especially when its common dermoscopic features are absent.
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Affiliation(s)
- V Roberti
- Department of Dermatology, University of Rome Sapienza, Rome, Italy
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Curatolo P, Rotunno R, Miraglia E, Mancini M, Calvieri S, Giustini S. Complete remission of Merkel cell carcinoma treated with electrochemotherapy and etoposide. GIORN ITAL DERMAT V 2013; 148:310-311. [PMID: 23670070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Bottoni U, Nisticò S, Amoruso G, Sacco A, Arcidiacono V, Calvieri S. Erythema Multiforme Major after Whole Brain Radiotherapy: A Case of Emar Syndrome? EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100224] [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: 11/15/2022] Open
Affiliation(s)
- U. Bottoni
- Department of Health Sciences, Dermatology Unit, University of Catanzaro “Magna Grcecia”, Italy
| | - S. Nisticò
- Department of Health Sciences, Dermatology Unit, University of Catanzaro “Magna Grcecia”, Italy
| | - G.F. Amoruso
- Department of Health Sciences, Dermatology Unit, University of Catanzaro “Magna Grcecia”, Italy
| | - A. Sacco
- Department of Health Sciences, Dermatology Unit, University of Catanzaro “Magna Grcecia”, Italy
| | - V. Arcidiacono
- Department of Health Sciences, Dermatology Unit, University of Catanzaro “Magna Grcecia”, Italy
| | - S. Calvieri
- Department of Dermatology, University of Roma “Sapienza”, Rome, Italy
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Grieco T, Faina V, Dies L, Milana M, Alei L, Silvestri E, Calvieri S. A case of sensitization to alitretinoin. Clin Ter 2013; 164:e207-e209. [PMID: 23868640 DOI: 10.7417/ct.2013.1570] [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: 06/02/2023]
Abstract
Alitretinoin is a unique retinoid authorised for the treatment of adults with severe chronic hand eczema (CHE) refractory to potent topical steroids. The most common adverse events (AEs) were typical class effects of oral retinoids including headache, flushing and skin disorders. To our knowledge, there are no cases of sensitization to alitretinoin reported in literature. We present a case of sensitization to alitretinoin.
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Affiliation(s)
- T Grieco
- Department of Dermatology, Sapienza University of Rome, Italy.
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Cantisani C, Lazic T, Salvi M, Richetta AG, Frascani F, De Gado F, Mattozzi C, Fazia G, Calvieri S. Male tuberculous mastitis: a rare entity. Clin Ter 2013; 164:e293-e295. [PMID: 24045526 DOI: 10.7417/ct.2013.1591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A 28-year old male presented to our clinic complaining of a recent onset of a painful right breast lump with redness and nipple discharge. Fine-needle aspiration biopsy revealed caseating granulomas, with a culture positive for Mycobacterium tuberculosis. He was found to have a positive PPD, but no other site of pulmonary or extra-pulmonary tuberculosis was identified. Treatment with anti-tuberculous drugs lead to complete clinical resolution of the breast lesion. The breast is a rare site of extra-pulmonary tuberculosis (TB), comprising only 0.1% of all cases. TB is re-emerging in the Western world with the increasing prevalence of immunosuppressive disorders. Increasing immigration rates and widespread travel are further contributing to TB globalization. With the re-emergence of TB, atypical forms are appearing, with an increase in the proportion of extra-pulmonary disease and a widening of the age range at presentation. Tuberculous mastitis(TM) is found mostly in young, multiparous women. Male TM is extremely rare, and accounts for only 4% of all cases. This strikingly lower incidence in males points towards a significant role of parity, pregnancy and lactation as likely predisposing factors. Although a rare disease, TM is an important differential diagnosis for breast cancer. A high index of suspicion is the cornerstone for diagnosis. Awareness of this condition is important not only for dermatologists, but for surgeons, radiologists and pathologists, as well. Clinicians are encouraged to provide a careful assessment of the breasts, an important organ also in men.
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Affiliation(s)
- C Cantisani
- Department of Dermatology, Sapienza" University, Rome, Italy
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Rossi A, Iorio A, Scali E, Gerardi M, Priolo L, Misciali C, Carlesimo M, Calvieri S, Mari E. Frontal Fibrosing Alopecia and Lichen Planopilaris: Clinical, Dermoscopic and Histological Comparison. EUR J INFLAMM 2013. [DOI: 10.1177/1721727x1301100134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) are classified as scarring alopecia. Most authors consider FFA as a clinical variant of LPP on the basis of their similar histological findings; other authors think these pathologies are two different entities. We studied 48 cases of FFA and 86 cases of LPP. Clinical diagnosis was histologically confirmed and all patients underwent videodermoscopy. Moreover, histological study, identifying the main targets of these diseases, results helpful to confirm the diagnosis. FFA selectively affects vellus-like hair in the frontoparietal region and is characterized by a mild skin atrophy and a total loss of follicular openings. In LPP an involvement of total preterminal, terminal and vellus-like follicles, partial or total loss of follicular openings, diffuse hair thinning and twisting, perifollicular erythematous or violaceous papules and mild/severe spinous follicular hyperkeratosis with scalp sclerosis are the features observed. Videodermoscopy improves diagnostic capability, appearing to be helpful to underline FFA and LPP features, confirmed by histologic studies which identify and show different intensity of inflammatory process. Therefore, the two diseases could be considered two different entities on the basis of the different clinical features and the different targets, that can be related to a different pathogenetic mechanism.
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Affiliation(s)
- A. Rossi
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
| | - A. Iorio
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
| | - E. Scali
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
| | - M. Gerardi
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
| | - L. Priolo
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
| | - C. Misciali
- University of Bologna Dipartimento Neurosensomotorio, Bologna, Italy
| | - M. Carlesimo
- Sant'Andrea Hospital, Dermatology, University of Rome “Sapienza”, II School, Rome, Italy
| | - S. Calvieri
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
| | - E. Mari
- Dipartimento di Malattie Interne e Specialità Mediche, Clinica Dermatologica University of Rome “Sapienza”, Rome, Italy
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Grieco T, Faina V, Milana M, Dies L, Bianchini D, Calvieri S. Allergic diseases and climate changes: our experience and an update. Clin Ter 2013; 164:e17-e21. [PMID: 23455746 DOI: 10.7417/ct.2013.1515] [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: 06/01/2023]
Abstract
AIMS Recent research has shown that there are many effects of climate change on aeroallergens and thus allergic diseases in humans. It is not easy to evaluate the impact of climate change and air pollution on the prevalence of allergic diseases. The present study is devoted to decipher the possible relationships between climatic changes and allergic diseases, and in particular with atopic dermatitis (AD). MATERIALS AND METHODS To evaluate the aeroallergens effects on AD, we submitted to an allergological study protocol 59 children patients with AD to study the interaction between aeroallergens-atopy patch test (APT) and skin prick test (SPT). The same tests were performed on to the same patients after 24 months to assess the time trend. RESULTS We found a high prevalence of house dust mites and grasses pollen APT positivity in AD's and in respiratory patients and we also found an increase in positive results in the same patients after 24 months. However, we observed a variation in the control group, in which in earlier tests all patients had negative results but after 24 months we found some positivity. CONCLUSION We found a correlation between APT and SPT in AD and we observed a concordance between APT results and the atopy score index, underlying the triggering role of these aereoallergens in the atopic patient's skin reactivity.
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Affiliation(s)
- T Grieco
- Department of Dermatology, University Sapienza, Rome, Italy.
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Cantisani C, Paradisi A, Richetta AG, Mattozzi C, Calvieri S. Acute generalized exanthematous pustulosis during antituberculosis therapy. Clin Ter 2013; 164:e137-e138. [PMID: 23698216 DOI: 10.7417/ct.2013.1546] [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: 06/02/2023]
Abstract
Acute generalized exanthematous pustulosis (AGEP) is a significant adverse cutaneous reaction most often induced by drugs and by acute infections. Its clinical hallmark is the sudden onset of multiple, disseminated, non-follicular, sterile pustules on an erythematous background usually arising in intertriginous folds, associated with fever, massive neutrophilia and sometimes eosinophilia. Antitubercular therapy is described as an uncommon cause of AGEP. We report the onset of disseminated non-follicular sterile pustules on an erythematous background in a 68-year-old man receiving a combination of isoniazid, pyrazinamide and rifampicin that may have been the etiologic agents. A thorough history, including a medication history, with clinicopathologic correlation is crucial in patients presenting with acute diffuse pustular lesions.
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Affiliation(s)
- C Cantisani
- Department of Dermatology, University of Rome Sapienza, Rome, Italy.
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Rossi A, Cantisani C, Carlesimo M, Scarnò M, Scali E, Mari E, Garelli V, Maxia C, Calvieri S. Serum Concentrations and IL-2, IL-6, IL-12 and TNF-α in Patients with Alopecia Areata. Int J Immunopathol Pharmacol 2012; 25:781-8. [DOI: 10.1177/039463201202500327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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
Alopecia areata (AA) has been represented as a restricted T cell-mediated autoimmune disease. Several studies have shown that cytokines may play an important role in its pathogenesis although many pathways exist. We investigated cytokine (IL-2, IL-6, IL-12 and TNFα) levels in peripheral blood mononuclear cell (PBMC) of 105 patients with different grade and duration of alopecia areata, to confirm that T-cell responses in AA is regulated via mechanisms of peripheral T-cell tolerance. We observed that IL-12 levels are higher for patients with bigger extensions and tend to increase according to the duration of the AA; TNFα, instead, is more related to the gender of the patients and to the duration. Therefore abnormalities in cytokines production, showed by our results, may suggest that T-cell responses in AA scalp are closely regulated via mechanisms of peripheral T-cell tolerance and therefore confirm that this disease has an immuno-pathogenesis. Our aim is to shed light upon the complexity of AA underlying mechanisms and indicate pathways that may suggest future treatments.
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Affiliation(s)
- A. Rossi
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
| | - C. Cantisani
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
| | - M. Carlesimo
- NESMO-Dermatology, Sant'Andrea Hospital, II School University of Rome “Sapienza”, Rome, Italy
| | - M. Scarnò
- CASPUR: Inter-university consortium for supercomputing, Rome, Italy
| | - E. Scali
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
| | - E. Mari
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
| | - V. Garelli
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
| | - C. Maxia
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
| | - S. Calvieri
- U.O.C. Clinica Dermatologica Dipartimento di Medicina Interna e Specialità Mediche University of Rome “Sapienza”, Rome, Italy
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Cavallaro G, Pedullà G, Crocetti D, D'Ermo G, Giustini S, Calvieri S, De Toma G. Vacuum-assisted closure treatment of leg skin necrosis after angiographic embolization of a giant plexiform neurofibroma. G Chir 2012; 33:239-242. [PMID: 22958807] [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: 06/01/2023]
Abstract
Type 1 neurofibromatosis is a relatively common inherited disease of the nervous system, with a frequency of almost 1 in 3000. It is associated with neurofibromas of various sites. Our case report is about the surgical management of a giant neurofibroma of the right gluteal fold in a 46-year-old male with NF1. The patient presented with increasing edema and accelerated growth of the mass; he underwent percutaneous embolization of lesion vessels that induced necrosis of the neurofibroma. The patient was taken to the operating room, where surgical resection of the bulk of the lesion was undertaken. The postoperative course was complicated by delayed wound closure managed with antibiotics and vacuum-assisted wound closure. Giant neurofibromas similar to this tumor require complex preoperative, intraoperative and postoperative management strategies. Surgical debulk is best managed with preoperative percutaneous embolization that help to avoid surgical bleeding. Postoperative delayed wound closure was managed with the application of negative pressure in a closed environment that triggers granulation and tissue formation.
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Affiliation(s)
- G Cavallaro
- Department of Medico-Surgical Sciences and Biotechnologie, Sapienza University of Rome, Italy
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Richetta AG, Mattozzi C, Giancristoforo S, D'Epiro S, Cantisani C, Macaluso L, Salvi M, Calvieri S. Safety and efficacy of Adalimumab in the treatment of moderate to severe palmo-plantar psoriasis: an open label study. Clin Ter 2012; 163:e61-e66. [PMID: 22555836] [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: 05/31/2023]
Abstract
INTRODUCTION Psoriasis of the hands and feet is highly debilitating and difficult to treat. Lesions are very painfull, disabilitating and impair quality of life of patients. Most treatment options have limited efficacy, short duration of response and several adverse events. OBJECTIVE To investigate the safety and efficacy of Adalimumab in the management of palmo-plantar psoriasis. PATIENTS AND METHODS Adults patients with moderate to severe palmoplantar psoriasis were enrollend in this trial. They received a 6 courses of Adalimumab 40 mg 1 vial every 2 weeks. The study consisted of treatment period of 12 weeks (Weeks 1-12). Safety and efficacy were assessed at weeks 0.6 and 12. PGA (Physician's Global Assesment) and DLQI were used to measure the efficacy. Primary end point of the study was to evaluate patients who achieved a reduction in PGA at week 12. The secondary end point was to evaluate patients who achieved a 50% reduction in PGA at week 12. The tertiary end point evaluated patients who achieved a PGA rating of clear or almost clear. RESULTS Of 11 patients enrolled 6 showed overall improvement of at least one point of PGA at week 12; 4 of them obtained a PGA of 0 while 5 patient of 11 a ≥ 50% improvement from the beginning of the study. 8 patients showed an increase in quality of life score while receiving the drug at week 12. No serious adverse events were reported during the study. CONCLUSION Continuous treatment with Adalimumab for 12 weeks was safe and efficacious in this open-label clinical trial of patients with palmoplantar psoriasis.
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Affiliation(s)
- A G Richetta
- Department of Dermatology and Venereology, Policlinico Umberto I, Rome, Italy.
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Grieco T, Faina V, Alei L, Dies L, Milana M, Calvieri S. Systemic contact dermatitis (SCD) due to dietary nickel. Clin Ter 2012; 163:e127-e128. [PMID: 22964704] [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: 06/01/2023]
Abstract
Systemic contact dermatitis (SCD) can be caused by nickel in sensitized subjects. Nickel allergy is commonly characterized by localized reactions ensuring cutaneous exposure to this element. Systemic reactions can occur after dietary nickel ingestion. We report a case of a woman with Systemic Contact Dermatitis due to nickel.
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Affiliation(s)
- T Grieco
- Department of Dermatology, University Sapienza, Rome, Italy.
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Devirgiliis V, Panasiti V, Fioriti D, Anzivino E, Bellizzi A, Cimillo M, Curzio M, Melis L, Roberti V, Gobbi S, Liteo P, Richetta AG, Calvieri S, Chiarini F, Nicosia R, Pietropaolo V. Antibacterial activity of methyl aminolevulinate photodynamic therapy in the treatment of a cutaneous ulcer. Int J Immunopathol Pharmacol 2011; 24:793-5. [PMID: 21978711 DOI: 10.1177/039463201102400326] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
We describe a 79-year-old female with a chronic venous ulceration infected by Staphylococcus aureus and Enterococcus faecalis and not responsive to conventional treatments. The patient was treated with Methyl-Aminolaevulinate Photodynamic Therapy (MAL-PDT). After four weeks the cutaneous swabs become negative and we observed a significant clinical improvement. Therefore we suppose that MALPDT could represent a valid therapeutic option in the treatment of infected chronic ulcers.
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Richetta AG, Curatolo P, D'Epiro S, Mancini M, Mattozzi C, Giancristoforo S, Rotunno R, Calvieri S. Efficacy of electrochemotherapy in ulcerated basal cell carcinoma. Clin Ter 2011; 162:443-445. [PMID: 22041802] [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: 05/31/2023]
Abstract
Basal cell carcinoma is the most common cutaneous malignant tumor, accounting for up to 80% of non melanoma skin cancers. Surgery, radiotherapy and chemotherapy have been for long time the main options for its treatment. Electrochemotherapy (ECT) is a novel local treatment successfully used in primary skin tumors. We report a case of a man affected by ulcerated basal cell carcinoma treated with ECT. In our case ECT was successful in the management of extensive basal cell carcinoma in clinical conditions whereas other approaches, would have been dangerous and inappropriate. To our knowledge, ECT must be considered as an alternative of traditional techniques when they are contraindicated in relation to the appearance of the lesions or the patient medical history.
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Affiliation(s)
- A G Richetta
- Department of Dermatology, Umberto I Hospital, University Sapienza, Rome, Italy.
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Richetta AG, Lichtener M, Mattozzi C, Miccoli A, Giancristoforo S, D'Epiro S, Vullo V, Calvieri S. Fusariosis and skin T cell lymphoma: concomitant more than a differential diagnosis. Clin Ter 2010; 161:265-267. [PMID: 20589360] [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: 05/29/2023]
Abstract
Cytotoxic T cell lymphomas of the skin include a spectrum of a peripheral T cell and natural killer (NK) cell lymphomas with primary and secondary skin manifestation and bad prognosis. Fusarium species have recently emerged as the second most common pathogenic fungi in immunocompromised patients, and they are moderately resistant to most antifungal agents. We report a woman with concomitant cytotoxin T cell lymphomas of the skin and Fusarium spp infection. Patient was treated at the same time with antiblastic and antifungal therapy. First line antifungal therapy was amphotericin B-lipid complex (3 mg/Kg iv/die) and then for clinical failure voriconazole (6 mg/Kg bid, loading dose and 4 mg /Kg bid). Lymphoma was treated with a CHOEP 21 regiment without remission and after with gemcitabine and vinerolbine. Patient presented a partial remission of cutaneous and pulmonary lesions. Our case is intrinsically interesting because Fusarium infection was concomitant to cutaneous lymphoma and did non occur during neutropenic phases of chemotherapy. In a case with multiple ulcerated nodules of the skin is very important to discriminate from disseminated cutaneous Fusarium infection and neoplastic conditions such as cutaneous lymphoma. Early treatment of Fusarium infection in a patient with neoplastic disease could avoid a dissemination during immunosuppressive condition caused by antiblastic therapy.
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Affiliation(s)
- A G Richetta
- Department of Dermatology, Umberto I Hospital, University Sapienza, Rome, Italy.
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Grieco T, Cantisani C, Faina P, Cantoresi F, lacobellis F, Silvestri E, Faina V, Calvieri S. Tacrolimus 0.1% and granuloma annulare: description of three cases. J Eur Acad Dermatol Venereol 2009; 23:1445-6. [DOI: 10.1111/j.1468-3083.2009.03217.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mancini M, Panasiti V, Devirgiliis V, Pietropaolo V, Fioriti D, Nicosia R, Curzio M, Roberti V, Gobbi S, Bottoni U, Chiarini F, Calvieri S. Bromhidrosis Induced by Sphingomonas Paucimobilis: A Case Report. Int J Immunopathol Pharmacol 2009; 22:845-8. [DOI: 10.1177/039463200902200332] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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
Bromhidrosis is a clinical disorder characterized by excessive or abnormal foul axillary odour due to the interaction of apocrine glands with micro-organisms which causes a serious personal and social handicap for affected people. We present the case of a 50-year-old caucasian female with bromhidrosis. The patient referred that this symptom had begun two months previously. Her past treatments included antibacterial soap, topical antibacterial agents and perfumes, but none of these relieved the patient of the odour. A cultural examination of axillary smear was carried out and it revealed the presence of ciprofloxacin sensible Sphingomonas paucimobilis. Therefore the patient was treated with ciprofloxacin and after 1 week the infection resolved completely.
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Affiliation(s)
| | | | | | | | - D Fioriti
- Department of Urology, Sapienza University, Rome
| | | | | | | | | | - U. Bottoni
- Department of Dermatology and Oncology, “Magna Graecia” University of Catanzaro, Italy
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Cantoresi F, Sorgi P, Arcese A, Bidoli A, Bruni F, Carnevale C, Calvieri S. Improvement of psoriatic onychodystrophy by a water-soluble nail lacquer. J Eur Acad Dermatol Venereol 2009; 23:832-4. [DOI: 10.1111/j.1468-3083.2009.03209.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Panasiti V, Devirgiliis V, Curzio M, Rossi M, Roberti V, Bottoni U, Calvieri S. Erythema annulare centrifugum as the presenting sign of breast carcinoma. J Eur Acad Dermatol Venereol 2009; 23:318-20. [DOI: 10.1111/j.1468-3083.2008.02848.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cantisani C, De Gado F, Grieco T, Faina P, Calvieri S, Scuderi N. Patch test reactions and breast implants. J Plast Reconstr Aesthet Surg 2008; 61:1540-1. [DOI: 10.1016/j.bjps.2008.04.041] [Citation(s) in RCA: 7] [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] [Received: 10/05/2007] [Revised: 04/07/2008] [Accepted: 04/08/2008] [Indexed: 11/26/2022]
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48
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Richetta A, Mattozzi C, Carlomagno V, Maiani E, Carboni V, Giancristoforo S, D'Epiro S, Bruni F, Calvieri S. A case of infliximab-induced psoriasis. Dermatol Online J 2008; 14:9. [PMID: 19094847] [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: 05/27/2023] Open
Abstract
Anti-tumor necrosis factor (anti-TNF-alpha) are a group of new drugs able to inhibit the action of this cytokine. Although systemic side effects have been well described, cutaneous adverse reactions have not yet been clearly elucidated. The authors report a case of a 29-year-old man affected by Crohn disease and ankylosing spondylitis who developed psoriatic lesions after IV infusion of infliximab 5 mg/Kg. The patient underwent cyclosporine treatment after interruption of biological therapy, and had complete resolution of cutaneous lesions. The reason for this phenomenon is not clear, Obviously more studies are necessary to define more clearly this paradoxical reaction. In addition, dermatologists must be informed about this potential cutaneous adverse event.
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Affiliation(s)
- A Richetta
- Department of Cutaneous and Venereal Diseases and Plastic Surgery, Policlinico Umberto I, University of Rome La Sapienza, Rome, Italy.
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Richetta AG, Mattozzi C, Carlomagno V, Maiani E, Carboni V, Giancristoforo S, D'Epiro S, Bruni F, Calvieri S. A case of infliximab-induced psoriasis. Dermatol Online J 2008. [DOI: 10.5070/d31zh0d26q] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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50
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Devirgiliis V, Panasiti V, Borroni RG, Rossi M, Curzio M, Riggio R, Fioriti D, Nicosia R, Pietropaolo V, Tecca M, Chiarini F, Innocenzi D, Calvieri S. Cutaneous cryptococcosis in a patient affected by chronic lymphocytic leukaemia: a case report. Int J Immunopathol Pharmacol 2008; 21:463-6. [PMID: 18547493 DOI: 10.1177/039463200802100227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Cryptococcosis is an opportunistic infection, the incidence of which is increased in the immunocompromised patients. Cryptococcus neoformans is an encapsulated fungus that mainly infects the lungs and the central nervous system, possibly involving different organs. Cutaneous cryptococcosis is classified into localized infection, usually occurring after traumatic inoculation (primary cutaneous cryptococcosis) and cutaneous manifestation due to hematogenous dissemination (secondary cutaneous cryptococcosis), mostly in patients with underlying immunosuppression. We report a case of cutaneous cryptococcosis in a patient affected by chronic lymphocytic leukaemia.
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