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Stanganelli I, Serafini M, Cainelli T, Cristofolini M, Baldassari L, Staffa M, Bucchi L. Accuracy of Epiluminescence Microscopy among Practical Dermatologists: A Study from the Emilia-Romagna Region of Italy. Tumori 2018; 84:701-5. [PMID: 10080681 DOI: 10.1177/030089169808400618] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS AND BACKGROUND The accuracy of epiluminescence microscopy (ELM) for pigmented skin lesions (PSLs) is still unclear. The large scale utilization of the technique is generally discouraged. The present study was aimed at comparing the accuracy of ELM with that of clinical examination alone in a group of 20 practical dermatologists. METHODS AND STUDY DESIGN Thirty digital clinical images of benign and malignant PSLs and their digital ELM counterparts were used. A set of cumulative accuracy measures reported in the combined clinical/ELM diagnosis was compared with that reported in the clinical diagnosis alone. RESULTS The proportion of nonmelanocytic lesions (NMLs), melanocytic nevi, and melanomas correctly identified, the predictive value of such diagnoses, and the proportion of melanomas detected by referral for biopsy (irrespective of the diagnosis reported) increased significantly. The cases referred for biopsy despite a "benign" impression decreased significantly among NMLs. CONCLUSIONS The observed tendency towards a greater accuracy suggests that even in the routine dermatology practice ELM has the potential to improve the clinical examination of PSLs.
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Affiliation(s)
- I Stanganelli
- Skin Cancer Clinic, Center for Cancer Prevention, Department of Prevention, Ravenna Health Care District, Italy
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Affiliation(s)
- R. Valsecchi
- Dermatology Division Ospedali Riuniti of Bergamo, Italy
| | - P. Bellavita
- Immunohaematology Division Ospedali Riuniti of Bergamo, Italy
| | - A. Cavagnera
- Immunohaematology Division Ospedali Riuniti of Bergamo, Italy
| | - T. Cainelli
- Dermatology Division Ospedali Riuniti of Bergamo, Italy
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Bajetta E, Del Vecchio M, Vitali M, Martinetti A, Ferrari L, Queirolo P, Sertoli MR, Cainelli T, Cellerino R, Cascinelli N. A Feasibility Study using Polychemotherapy (Cisplatin + Vindesine + Dacarbazine) plus Interferon-Alpha or Monochemotherapy with Dacarbazine plus Interferon-Alpha in Metastatic Melanoma. Tumori 2018; 87:219-22. [PMID: 11693798 DOI: 10.1177/030089160108700402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Background This trial evaluated the feasibility and tol-erability of an immunochemotherapeutic approach that uses cisplatin, vindesine, and dacarbazine (DTIC), or only DTIC, in combination with interferon alpha-2a (IFN-a), in patients with metastatic melanoma, considering the significant toxicity of several different regimens used up to now. Methods Between May 1995 and September 1997, 51 melanoma patients (50 of whom were assessable) entered a multicentric trial and were randomized to receive cisplatin (30 mg/m2 daily for 3 days) + vindesine (2.5 mg/m2 only day 1) + DTIC (250 mg/m2 daily for 3 consecutive days) + IFN-α (3 MIU im 3x/wk continuously) (CVD arm) versus DTIC (800 mg/m2 day 1) + IFN-α (3 MIU im 3x/wk continuously) (DTIC arm). The chemotherapy was recycled every 21 days. Patient reevaluation was performed every two cycles, and the treatment was continued in case of objective response or stabilization of disease. Results We observed 3 complete responses, 2 partial responses and 5 stable diseases in the CVD arm, and 2 partial responses and 4 stabilizations of disease in the DTIC arm. Conclusions We conclude that these chemotherapeutic regimens are well tolerated regimens with modest toxicity. Future trials will be conducted associating the CVD regimen with biological response modifiers (IFN, IL-2) in order to improve the results.
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Affiliation(s)
- E Bajetta
- Unit of Medical Oncology B, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.
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Thaçi D, Reitamo S, Gonzalez Ensenat M, Moss C, Boccaletti V, Cainelli T, van der Valk P, Buckova H, Sebastian M, Schuttelaar M, Ruzicka T. Proactive disease management with 0·03% tacrolimus ointment for children with atopic dermatitis: results of a randomized, multicentre, comparative study. Br J Dermatol 2008; 159:1348-56. [DOI: 10.1111/j.1365-2133.2008.08813.x] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Di Landro A, Valsecchi R, Cainelli T. Temporary henna tattoos: an increasing risk of contact dermatitis. Am J Contact Dermat 2001; 12:186-7. [PMID: 11575261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
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Cappellini MD, Martinez di Montemuros F, Tavazzi D, Fargion S, Pizzuti A, Comino A, Cainelli T, Fiorelli G. Seven novel point mutations in the uroporphyrinogen decarboxylase (UROD) gene in patients with familial porphyria cutanea tarda (f-PCT). Hum Mutat 2001; 17:350. [PMID: 11295834 DOI: 10.1002/humu.35] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In this work, we describe seven novel molecular defects in the uroporphyrinogen decarboxylase gene responsible for familial porphyria cutanea tarda in Italian subjects with reduced erythrocyte URO-D activity. Four of these molecular abnormalities (R142Q, L161Q, S219F, P235S) are missense mutations, one (Q206X) is a nonsense mutation, one (IVS8-1 G>C) is a splicing defect causing the exon 9 deletion and one (1107 G>A) is located in the 3' untranslated region of UROD gene. All the amino acid substitutions fall in conserved regions in several organisms suggesting an important role in catalysis or in the protein structure stabilization. Three of these mutations have been detected in more than one subject. These results suggest a molecular heterogeneity at the UROD locus in Italian PCT patients although recurrent mutations have been identified.
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Affiliation(s)
- M D Cappellini
- Centro Anemie Congenite, Ospedale Maggiore Policlinico IRCCS, Dipartimento di Medicina Interna, University of Milan, Italy.
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Naldi L, Fortina AB, Lovati S, Barba A, Gotti E, Tessari G, Schena D, Diociaiuti A, Nanni G, La Parola IL, Masini C, Piaserico S, Peserico A, Cainelli T, Remuzzi G. Risk of nonmelanoma skin cancer in Italian organ transplant recipients. A registry-based study. Transplantation 2000; 70:1479-84. [PMID: 11118094 DOI: 10.1097/00007890-200011270-00015] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Organ transplant recipients are at an increased risk of nonmelanoma skin cancer. Few data concern heart transplantation and populations from southern Europe. METHODS A total of 1,329 patients who received their first kidney (1,062 subjects) or heart allograft (267 subjects) were included in a partly retrospective cohort study to evaluate the risk of skin cancer. The incidence rate per 1,000 person-years and the cumulative incidence were computed. Standardized morbidity ratio was estimated by comparison with Italian cancer registry data. To analyze the role of potential prognostic factors, Cox's regression method was used. RESULTS The overall incidence rate of nonmelanoma skin cancer was 10.0 cases per 1,000 posttransplant person-years (95% confidence interval 8.2-11.7). This estimate was far higher than expected in the general population. The overall risk of developing skin cancer increased from a cumulative incidence of 5.8% after 5 posttransplant years to an incidence of 10.8% after 10 years of graft survival. In a Cox proportional hazard risk model, the most important factors that appeared to favor the development of skin cancer were age at transplantation and sex. After adjustment for age at transplantation and sex, no definite increased risk was documented among heart as compared with kindney transplant recipients. CONCLUSIONS Our study confirms the increased risk of nonmelanoma skin cancer among organ transplant recipients in a southern European population.
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Affiliation(s)
- L Naldi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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Di Landro A, Marchesi L, Reseghetti A, Cainelli T. Warty linear streaks of the palm and sole: possible late manifestations of incontinentia pigmenti. Br J Dermatol 2000; 143:1102-3. [PMID: 11069534 DOI: 10.1046/j.1365-2133.2000.03863.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Naldi L, Lovati S, Farina C, Gotti E, Cainelli T. Paecilomyces marquandii cellulitis in a kidney transplant patient. Br J Dermatol 2000. [DOI: 10.1046/j.1365-2133.2000.03729.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Fabbrocini G, Russo N, Pagliuca MC, Delfino M, Staibano S, Molea G, Mancini A, Virgili A, Valente MG, Bratina G, Galbiati S, Marzaduri A, Orlandi K, Bottoni U, Calvieri S, Di Landro A, Cainelli T, Delfino S, De Rosa G. p53, cyclin-D1, PCNA, AgNOR expression in squamous cell cancer of the lip: a multicenter study. Photodermatol Photoimmunol Photomed 2000; 16:172-7. [PMID: 11019942 DOI: 10.1034/j.1600-0781.2000.160405.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND The development of squamous cell carcinoma of the lower lip is an interesting model of photocarcinogenesis because of the structural and topographic characteristics of the lips. The purpose of this study was to evaluate the expression of immunohistochemical markers on the lips of patients with lower lip squamous cell carcinoma (LLSCC), compared with a control population. METHODS Of the 98 subjects involved in the study, 58 were suffering from squamous cell carcinoma of the lower lip. The remaining 40 acted as a control. The case studies were taken from six university and hospital dermatology and plastic surgery departments. Questionnaires were administered to assess the risk factors for LLSCC. The cases involving squamous cell carcinoma underwent surgical excision and punch biopsy specimens were obtained from 20 control patients. Tissues were prepared in 5-microm-thick sections to carry out the following immunohistochemical study: PCNA, p53, AgNOR, cyclin-D1, bcl-2. RESULTS The lower lip was the predominant location of squamous cell carcinoma, with the following factors playing important roles: chronic sun exposure, history of smoking, alcohol use and familial risk of cutaneous tumors. The male/female ratio in our survey was 5:1. The p53 protein was positive in approximately 50% of SCC cases and in 20% of controls. This protein is mostly associated with chronically photoexposed skin areas. AgNOR positivity increased with the loss of cellular differentiation; a progressive increase in size and a poorly defined shape were evident in poorly differentiated carcinomas. CONCLUSIONS The results of this multicenter study showed that there is a noticeable difference in the expression of PCNA, p53, cyclin-D1, and AgNOR in tissues from patients with LLSCC and controls.
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Affiliation(s)
- G Fabbrocini
- Dept. Biol. and Patol. Cell. and Mol., Federico II University of Naples, Italy
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Abstract
The possible relation between use of sunscreens and the risk of cutaneous malignant melanoma (CMM) was investigated in a case-control study conducted in 27 Italian centres on 542 incident, histologically confirmed cases and 538 controls admitted for acute, other than neoplastic or dermatologic conditions. Compared with subjects reporting never sunscreen use, the multivariate odds ratios (OR), after allowance for age, sex, geographic area, education, skin, eye and hair colour, freckles, number of naevi, history of sunburns, tanning pattern and duration of sunny vacations, were 0.97 (95% confidence interval [CI] 0.69 to 1.35) for those reporting "sometimes" and 0.80 (95% CI 0.54 to 1.17) for those reporting "often " sunscreen use. With reference to type of product most frequently used, the ORs were 0.96 (95% CI 0.52 to 1.77) for minimal, 0.90 (95% CI 0.63 to 1.28) for moderate and 1.41 (95% CI 0.85 to 2. 35) for high sunburn protection factor. With reference to duration of use, the OR was 0.86 (95% CI 0.58 to 1.29) for use started since >/=20 years. None of the corresponding trends in risks were significant. The ORs for sunscreen use were similar across strata of major identified covariates and, if anything, tended to decline after multivariate analysis. The present findings confirm that sunscreen use, as currently adopted in Italy, is not appreciably related to subsequent CMM risk.
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Affiliation(s)
- L Naldi
- Department of Dermatology, Bergamo General Hospital, Bergamo, Italy
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Turin L, Riva F, Galbiati G, Cainelli T. Fast, simple and highly sensitive double-rounded polymerase chain reaction assay to detect medically relevant fungi in dermatological specimens. Eur J Clin Invest 2000; 30:511-8. [PMID: 10849020 DOI: 10.1046/j.1365-2362.2000.00659.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Early detection of fungal infection is essential for beginning of prompt and specific therapy. In this study we describe a rapid and sensitive procedure to detect, by polymerase chain reaction (PCR) assays, a wide range of medically important opportunistic and pathogenic fungi in dermal specimens from dermatomycoses-affected patients. MATERIALS AND METHODS Three primer pairs, amplifying fragments of the highly conserved gene coding for small ribosomal RNA (18S rDNA) and the adjacent internal transcribed spacer (ITS) rDNA, previously published by others, were probed on DNA from pure cultures of medically relevant human and animal fungal species. In order to evaluate the specificity of the assay, amplifications of control DNAs from other eukaryotes and prokaryotes were also carried out, and they gave negative results. RESULTS These primer sets, in single amplification or double-rounded PCR assays, allowed specific amplification when applied to a wide number of fungal DNA from human and animal tissue specimens, including dermatophytes (genera Trichophyton, Microsporum), several yeast species (Candida, Saccharomyces, Cryptococcus, Malassezia) and moulds (Aspergillus, Penicillium). The PCR assay was able to detect as little as 10 pg of fungal DNA, corresponding to approximately 25 fungal genomes per sample specimen. A small-scale DNA extraction method was also developed. This simple, time-saving and sensitive procedure was successfully applied to 40 human and veterinary specimens, and the diagnosis was confirmed with cultural techniques, being shown to work even in the presence of other lesions or contaminating organisms. CONCLUSIONS This method allows early recognition of fungal pathogen cells in clinical samples as an alternative tool to conventional detection techniques.
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Affiliation(s)
- L Turin
- Istituto di Microbiologia e Immunologia Veterinaria, Universitá di Milano, Italy.
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Naldi L, Gallus S, Imberti GL, Cainelli T, Negri E, La Vecchia C. Sunlamps and sunbeds and the risk of cutaneous melanoma. Italian Group for Epidemiological Research in Dermatology. Eur J Cancer Prev 2000; 9:133-4. [PMID: 10830582 DOI: 10.1097/00008469-200004000-00011] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
We report phakomatosis pigmentovascularis detected in a Caucasian child characterized by the presence of a nevus flammeus and nevus anemicus on the face, a telangiectatic linear nevus of the right leg, and a very extensive blue spot covering 60% of the body surface, with ocular melanosis. Multiple angiomatous lesions of the kidney are associated without alterations of the central nervous system (CNS). This association has not been reported before; it could be a further expression of the complex of developmental defects. Our case corresponds exactly to type IIb in the classification of phakomatosis pigmentovascularis proposed by Hasegawa. As this classification seems very extensive, the higher incidence of cases corresponding to the second subtype suggests that we should identify it by the term phakomatosis pigmentovascularis, while the others could be considered as only very uncommon variants.
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Affiliation(s)
- A Di Landro
- Clinica Dermatologica V, Universita' degli Studi di Milano, Bergamo General Hospital Bergamo,
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Abstract
Hypopigmented mycosis fungoides is a variant of mycosis fungoides characterized by the presence of hypopigmented patches as the sole manifestation of the disease. It has been described almost always in young black or dark-skinned patients. The only white patient described was a 64-year-old woman who not only had hypopigmented lesions, but also nodular lesions with lymphadenopathy. We describe hypopigmented lesions arising in a white boy 12 years of age, born in northern Italy, without any foreign ancestors. The microscopic alterations, with epidermotropism, the immunologic markers, the negativity of T-cell receptor gene rearrangement, and the good response to PUVA therapy correspond to the main findings in black patients with this disease. Long-term follow-up of these patients is important to obtain better knowledge of the natural history of the disorder. Hypopigmented mycosis fungoides must now be included in the differential diagnosis of hypopigmented macular lesions not only in black or dark-skinned patients but also in white patients.
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Affiliation(s)
- A Di Landro
- Department of Dermatology V, Bergamo General Hospital, Italy
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Affiliation(s)
- A Di Landro
- Clinica Dermatologica Va Università delgi Studi di Milano, Ospedali Riuniti, Bergano, Italy
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Naldi L, Adamoli L, Fraschini D, Corbetta A, Imberti L, Reseghetti A, Reciputo A, Rossi E, Cainelli T, Masera G. Number and distribution of melanocytic nevi in individuals with a history of childhood leukemia. Cancer 1996; 77:1402-8. [PMID: 8608522 DOI: 10.1002/(sici)1097-0142(19960401)77:7<1402::aid-cncr27>3.0.co;2-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND An increased number of melanocytic nevi at the termination of chemotherapy has been documented in children with hematologic malignancies. The persistence of the increased number of nevi over time and the relationship with personal (e.g. phenotype) and disease related variables remain to be explored. METHODS One hundred Italian patients diagnosed as having acute lymphatic or myeloid leukemia, after 1975, were recruited and compared with a group of 100 control individuals drawn from friend of the enrolled patients. Information regarding lifetime sun exposure, phenotypic characteristics, and number of nevi was collected by experienced dermatologists. Counts of nevi were expressed both as totals and as counts per unit of body surface area ("density"). Multiple linear regression analysis was employed to control for potentially confounding factors when comparing patients and controls. RESULTS The patients and controls were fairly comparable in terms of constitutional characteristics, but the patients had a significantly higher number and density of nevi > or = 2 mm or larger in diameter. In addition, patients had a greater number of large nevi ( > or = 6 mm in greatest dimension), and of nevi in unusual areas, such as the palms and soles. Differences in nevus density between patients and controls were notably maintained in the older age group ( > 12 years). None of the disease-related factors analyzed (e.g. treatment protocol and radiotherapy), appeared to be significantly correlated with nevus density. CONCLUSIONS Patients with a history of childhood leukemia have a sustained increase in their nevus density. A fairly convincing body of evidence indicates that a large number of melanocytic nevi is the strongest risk factor for melanoma. Therefore, the utility of periodic skin examination of these should be considered.
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Affiliation(s)
- L Naldi
- Department of Dermatology, University of Milan, Bergamo General Hospital, Italy
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Businco L, Meglio P, Amato G, Balsamo V, Cainelli T, Cantone P, Castro M, Coletta A, Corrias A, Giorgi PL, Grazioli I, Longo-Papadia L, Marcucci F, Masi M, Pavesio D, Scotta S, Seidenari S, Vierucci A. Evaluation of the efficacy of oral cromolyn sodium or an oligoantigenic diet in children with atopic dermatitis: a multicenter study of 1085 patients. J Investig Allergol Clin Immunol 1996; 6:103-9. [PMID: 8727267] [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: 02/01/2023] Open
Abstract
One thousand eighty-five children with atopic dermatitis were enrolled in a multicenter study to evaluate the efficacy of 4 weeks of oral sodium cromoglycate or 4 weeks of a restricted diet. One thousand-eleven children (93%) concluded the study. At the end of the trial there was a significant improvement in skin lesions in the two groups: 61% of the patients in the sodium cromoglycate group and 69% in the restricted diet showed a significant improvement in atopic dermatitis. We concluded that, at least in our experimental design, both sodium cromoglycate and a restricted diet are equally effective in atopic dermatitis.
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Affiliation(s)
- L Businco
- Ped. Dpt., La Sapienza University of Rome, Italy
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Parazzini F, D'Oro LC, Naldi L, Bianchi C, Chatenoud L, Ricci E, Cainelli T, Pansera B, Mezzanotte C, Tessari GP, Locatelli A. Sexually transmitted diseases and risk of HIV infection. Acta Derm Venereol 1996; 76:147-9. [PMID: 8740272 DOI: 10.2340/0001555576147149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
We have analyzed the association between sexually transmitted diseases (STD) and HIV infection, using data from a cross-sectional survey of subjects attending STD clinics in Northern Italy conducted since 1988. A total of 1,711 subjects (1,259 males, 452 females), who had referred themselves to three STD clinics in Northern Italy for suspected STD or STD treatment, were included for the study. Out of these, 145 subjects (113 males and 32 females) were HIV-positive. A total of 58 HIV-positive and 368 HIV-negative subjects reported a history of STD; the corresponding odds ratio (OR) was 2.3 (95% confidence interval (CI) 1.5-3.6) for subjects reporting a history of STD. Considering various STD in details, the estimated OR was 1.8 (95% CI 0.8-3.8) for a history of gonorrhoea and 1.5 (95% CI 0.8-2.7) of syphilis, and the OR was 1.8 (95% CI 1.0-3.2) and 2.2 (95% CI 1.3-3.8), respectively, for a positive TPHA and VDRL test. The results of the test for HbsAg were available in 50 HIV-positive and 1,028 HIV-negative subjects; the OR of HIV infection in subjects with HbSAg was 3.9 (95% CI 1.7-9.0). Presence of genital ulcers at clinical examination was not significantly associated with the risk of HIV infection (OR yes vs no genital ulcers 1.5, 95% CI 0.6-2.8).
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Affiliation(s)
- F Parazzini
- Mario Negri Institute for Pharmacological Research, University of Milan, Italy
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Garattini L, Cainelli T, Tribbia G, Scopelliti D. Economic evaluation of an educational campaign for early diagnosis of cutaneous melanoma. Pharmacoeconomics 1996; 9:146-155. [PMID: 10160093 DOI: 10.2165/00019053-199609020-00006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Public educational campaigns for the early diagnosis of cutaneous melanoma are considered an effective approach in the prevention of this disease, since they increase the number of cases detected early and consequently lengthen patients' life expectancy. We performed an economic evaluation of such a campaign in Bergamo, Italy, in order to quantify its costs and consequences. We used cost-effectiveness analysis to compare the costs and effects of the campaign with those of the 'do nothing' option. The analysis was performed from the perspective of the Italian National Health Service [the Servizio Sanitario Nazionale (SSN)]. Accordingly, only direct costs related to publicly financed healthcare services were considered. No indirect costs or benefits were considered because they are not relevant to the SSN. Incremental analysis was used to obtain results in terms of additional costs per life-year saved (LYS). Overall LYS were quantified by comparing the survival curves for 4 subgroups of patients with different lesional thicknesses at diagnosis ( < 0.76mm, 0.76 to 1.50mm, 1.51 to 3.00mm and > 3.00mm). All costs were estimated in 1993 Italian lire (L). Overall effectiveness amounted to 233.49 LYS. Using a 5% discount rate, the value of effectiveness was 171.3 LYS. The total cost of the educational campaign (i.e. the sum of the organisational and 'induced' costs minus the costs saved) was estimated at L817 million (approximate 1993 exchange rate $US1 = L1573), and L905 million after discounting at a rate of 5%. Thus, using discounted cost and effectiveness data, the cost of the educational campaign was L5.28 million per LYS.
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Affiliation(s)
- L Garattini
- Centre for Health Economics, Mario Negri Institute for Pharmacological Research, Ranica, Italy
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Naldi L, Parazzini F, Peli L, Chatenoud L, Cainelli T. Dietary factors and the risk of psoriasis. Results of an Italian case-control study. Br J Dermatol 1996; 134:101-6. [PMID: 8745893] [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: 02/01/2023]
Abstract
We have conducted a case-control study to explore the relation between the consumption of selected foods and psoriasis. The out-patient services of nine teaching hospitals and five general hospitals in northern and southern Italy took part. Cases were newly diagnosed psoriatics with a history of skin problems of no more than 2 years. As controls, we selected subjects with newly diagnosed skin conditions, other than psoriasis, who were seen in the same out-patient clinics. Inclusion of cases and controls was limited to the age group 16-65 years. A total of 316 psoriatics and 366 controls were recruited. Anthropometric measures, including height and weight, were obtained. Diet was assessed by a semiquantitative food frequency questionnaire. Psoriasis appeared to be positively associated with body mass index (chi 2(1) trend 4.3, P < 0.05). Significant inverse relations with psoriasis were also observed for the intake of carrots (chi 2(1) trend 4.8, P < 0.05), tomatoes (chi 2(1) trend 26.3, P < 0.01), fresh fruit (chi 2(1) trend 11.7, P < 0.01) and index of beta-carotene intake (chi 2(1) trend 9.1, P < 0.01). Although largely explorative, these results provide some evidence for a potential role of diet in psoriasis.
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Affiliation(s)
- L Naldi
- Department of Dermatology University of Milan, Italy
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25
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Valsecchi R, Bontempelli M, Cainelli T, Leghissa P, Landro A. Vitiligo is associated with a significant increase in HLA-DR6 and a decrease in DQw2 antigens in Northern Italian patients. J Eur Acad Dermatol Venereol 1995. [DOI: 10.1111/j.1468-3083.1995.tb00427.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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26
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Bergamo General Hospital, Italy
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27
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28
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Bergamo General Hospital, Italy
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29
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Abstract
We report five cases of combined Clark's nevi. Like all melanocytic nevi, Clark's nevus can combine with other nevi to produce lesions that are hard to interpret clinically and histologically. The morphology of combined Clark's nevus can resemble that of a melanoma associated with a nevus.
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Affiliation(s)
- L Marchesi
- Department of Dermatology, University of Milan, Italy
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30
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Abstract
The cause of psoriasis has only recently been subject to structured epidemiologic research approach. This is reflected in the scarcity of quantitative knowledge about etiologic factors for psoriasis other than genetics. A schematic model suggests that susceptibility to develop psoriatic lesions includes both genetic and extragenetic predisposing factors. Expression in terms of visible lesions is modulated by precipitating or trigger factors. Unlike many chronic diseases, psoriasis spontaneously waxes and wanes. When assessing factors that trigger the onset of the disease, one must also consider factors that lead to recurrence or exacerbation. Cohort and case-control studies are the main methodologic options for risk assessment. Combination of these techniques and the merging of an epidemiologic approach with basic biologic research are suggested routes to valuable results in this area.
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Affiliation(s)
- L Naldi
- Department of Dermatology University of Milan, Bergamo General Hospital, Italy
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31
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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32
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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33
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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34
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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35
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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36
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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37
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Brevi A, Naldi L, Cainelli T, Parazzini F. Prevalence and awareness of hepatitis B virus carrier status in Italy. Genitourin Med 1993; 69:241. [PMID: 8335320 PMCID: PMC1195070 DOI: 10.1136/sti.69.3.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
BACKGROUND There are still unanswered questions about optimal treatment strategies and long-term prognosis of pemphigus. The Italian Group for Epidemiologic Research in Dermatology (GISED) started to register pemphigus in March 1990. METHODS The registry is hospital-based, covering newly diagnosed cases referred to 33 dermatologic centers in the north and the middle-south of Italy. Serum samples were collected at the time of diagnosis, for centralized storage. RESULTS In the period between March 1990 and December 1991, 110 cases were collected, with 105 retained. Median age at diagnosis was 54, and the man to woman ratio was 0.7. The median lag of diagnosis was 4 months. Seventy-four of 79 patients with pemphigus vulgaris/vegetans and 24 of the 26 with pemphigus erythematosus/foliaceus were given corticosteroid treatment. CONCLUSIONS A hospital-based registry is feasible and provides useful information about both clinical aspects and management of pemphigus, serving as a basis for developing ad hoc research programs (e.g., formal epidemiologic studies and clinical research).
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Affiliation(s)
- L Naldi
- Clinica Dermatologica, Università degli Studi di Milano, Ospedali Riuniti di Bergamo, Italy
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39
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Abstract
We report a case of agminate blue nevus combined with a lentigo patch in a 38-year-old woman. The combination was interpreted as a unique and peculiar variant of speckled lentiginous nevus.
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Affiliation(s)
- L Marchesi
- Department of Dermatology, Bergamo General Hospital, Italy
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40
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Naldi L, Locati F, Marchesi L, Cortelazzo S, Finazzi G, Galli M, Brevi A, Cainelli T, Barbui T. Cutaneous manifestations associated with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome: a case-control study. Ann Rheum Dis 1993; 52:219-22. [PMID: 8484676 PMCID: PMC1005021 DOI: 10.1136/ard.52.3.219] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To study the association of a variety of dermatological manifestations related to vascular abnormalities with antiphospholipid antibodies in patients with suspected primary antiphospholipid syndrome. METHOD Case-control study. Consecutive patients referred to the coagulation and haemostasis service of a general hospital for the first determination of antiphospholipid antibodies (lupus anticoagulant and anticardiolipin antibodies) and newly diagnosed disorders (for example, thrombocytopenia, thrombotic disorders, and unexplained repeated abortions) were selected. Patients were examined by two dermatologists according to predefined criteria, and information about general characteristics and relevant dermatological and medical histories were collected using an ad hoc questionnaire. The study was limited to patients without evidence of systemic lupus erythematosus. A total of 35 patients was examined; 13 subjects were positive for lupus anticoagulant or anticardiolipin antibodies, or both (cases), and 22 were negative (controls). RESULTS Moderate to severe livedo reticularis and acrocyanosis were significantly associated with antiphospholipid antibodies, with relative risks of 13.1 (95% confidence interval 1.1 to 149.0) and 8.6 (95% confidence interval 1.1 to 65.1). Capillaritis was also associated with the antibodies. Histories of Raynaud's phenomenon and superficial thrombophlebitis were more common in cases than controls. CONCLUSIONS This study provides quantitative evidence of the association of antiphospholipid antibodies with several cutaneous diseases in which vascular abnormalities seem to play a major part. The study suggests that these manifestations might appear early in the development of the antiphospholipid syndrome.
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Affiliation(s)
- L Naldi
- Cattedra di Clinica Dermosifilopatica, Università degli Studi di Milano, Ospedali Riuniti, Bergamo, Italy
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Abstract
Kathon is a biocide consisting of a mixture of two isothiazolinone derivatives (5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one) in an approximate ratio of 3:1, respectively, and with MgCl2 and Mg(NO3)2 present as stabilizers. The isothiazolinones are marketed under several brand names, and the concentration of the active ingredient varies according to their intended application. At a concentration of 3-15 ppm it shows activity against a wide spectrum of fungi, gram-positive and gram-negative bacteria. Contact allergy to it has been caused by cosmetics and also by products used in the pottery and various other industries. Recently we had the opportunity to observe 6 cases of occupational allergic contact dermatitis from an isothiazolinone mixture named Grotan TK 2 in a large textile industry producing nylon. An oil emulsion containing isothiazolinones is used in the spinning phase of the work cycle to prevent bacterial contamination that would damage yarn quality; furthermore, it helps to decrease the electrostatic charge that is produced by high speed at which the yarn moves and also to decrease the breakage possibility.
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti di Bergamo, Italy
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Naldi L, Brevi A, Cavalieri d'Oro L, Ferri C, Marchesi L, Cainelli T. Painful distal erythema and thrombocytosis. Erythromelalgia secondary to thrombocytosis. Arch Dermatol 1993; 129:105-6, 109. [PMID: 8420478 DOI: 10.1001/archderm.129.1.105b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- L Naldi
- Ospedali Riuniti di Bergamo, Italy
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Parazzini F, D'oro LC, Bianchi C, Mezzanotte C, Naldi L, Imberti GL, Pansera B, Cainelli T, Carlino A, Graefemberghi S. Determinants of hepatitis B virus surface antigen positivity in adults attending sexually transmitted disease clinics in Italy. Genitourin Med 1992; 68:345-6. [PMID: 1427814 PMCID: PMC1195999 DOI: 10.1136/sti.68.5.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Abstract
This study was performed to evaluate eyelid dermatitis in a group of patients of our Allergy Unit between January 1990 and April 1991. Among the 1158 patients seen during this period, 150 had eyelid dermatitis: 135 females and 15 males, with a mean age of 35 years. Of the 150 patients with eyelid dermatitis, 54 had eczema localized to the eyelids only, 49 to the eyelids and face, 19 to the eyelids and hands, and 28 to the eyelids and other sites. 98 patients (65.3%) were diagnosed as having allergic contact dermatitis, 25 (16.6%) irritant contact dermatitis, 21 (14%) atopic dermatitis, and 6 (4%) seborrhoeic dermatitis. Patch test reactions to nickel sulphate, Kathon CG and fragrance-mix occurred more frequently in patients with eyelid dermatitis than in those without.
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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Naldi L, Bronzoni M, d'Oro LC, Locati F, Marchesi L, Cainelli T. Figurate erythema, photosensitivity, and conjunctival irritation of recent onset. Subacute cutaneous lupus erythematosus (SCLE) and keratoconjunctivitis sicca. Arch Dermatol 1992; 128:1265, 1268. [PMID: 1519943 DOI: 10.1001/archderm.1992.01680190123018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- L Naldi
- Department of Dermatology, Ospedali Riuniti di Bergamo, Italy
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Marchesi L, Naldi L, Di Landro A, Cavalieri d'Oro L, Brevi A, Cainelli T. Segmental lentiginosis with "jentigo" histologic pattern. Am J Dermatopathol 1992; 14:323-7. [PMID: 1503204] [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: 12/27/2022]
Abstract
We report a case of segmental lentiginosis (unilateral lentiginosis), that is, asymmetric distribution of lentigines on one side of the body, in a 23-year-old woman. Lesions involved the right side of the face and the cervical region, mostly within the area of division of the trigeminal nerve. Histologic examination disclosed a lentiginous pattern as well as some nests of melanocytes at the dermal-epidermal junction (so-called jentigo pattern). Similar cases have been described in the literature under the term "zosteriform lentiginous nevus," which in our opinion makes for confusion since the same term has also been used to describe cases that fit the diagnostic criteria for speckled lentiginous nevus (nevus spilus).
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Affiliation(s)
- L Marchesi
- Department of Dermatology, University of Milan, Italy
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Naldi L, Marchesi L, Locati F, Berti E, Cainelli T. Unusual manifestations of primary cutaneous amyloidosis in association with Raynaud's phenomenon and livedo reticularis. Clin Exp Dermatol 1992; 17:117-20. [PMID: 1516235 DOI: 10.1111/j.1365-2230.1992.tb00177.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A patient with unusual manifestations of primary cutaneous amyloidosis, including macules, papules, oedematous plaques and urticarial lesions is described. Raynaud's phenomenon and livedo reticularis were an associated finding. During the acute phase, single doses of systemic corticosteroids resulted in an impressive, long-lasting improvement in cutaneous manifestations.
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Affiliation(s)
- L Naldi
- Department of Dermatology, Ospedali Riuniti di Bergamo, Italy
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49
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Abstract
In a survey of clinical trials concerning the efficacy of short-contact therapy with anthralin in psoriasis vulgaris, focusing principally on methodologic issues, twenty-four papers published between January 1982 and December 1989, in English, French, and Italian, were selected. Nine of 24 papers reported on more than one trial, giving a total of 37 clinical trials to be evaluated. A great heterogeneity was evident in many aspects of the design and conduct of these trials, making pooling of results impossible. Most trials suffered from flaws in general methodologic aspects such as randomization and blinding. Limitations in general applicability of results were discussed with reference to the popular use of self-control design and selection of composite indexes (e.g., PASI) as an outcome variable. Published trials are not a reliable guide to clinical decisions concerning short-contact therapy, and some methodologic observations we made could be of general interest in designing clinical trials of psoriasis.
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Affiliation(s)
- L Naldi
- Department of Dermatology, University of Milan, Bergamo, Italy
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Affiliation(s)
- R Valsecchi
- Department of Dermatology, Ospedali Riuniti, Bergamo, Italy
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