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Artosi F, Costanza G, Di Prete M, Garofalo V, Lozzi F, Dika E, Cosio T, Diluvio L, Shumak RG, Lambiase S, Di Raimondo C, Campa S, Piscitelli P, Miani A, Bianchi L, Campione E. Epidemiological and clinical analysis of exposure-related factors in non-melanoma skin cancer: A retrospective cohort study. Environ Res 2024; 247:118117. [PMID: 38218521 DOI: 10.1016/j.envres.2024.118117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
BACKGROUND The incidence of non-melanoma skin cancers (NMSCs) increased over last decades, probably due to environmental concerns or to the increase of frail patients with age related comorbidities. Currently, the relationship of increasing global skin cancer rates with increased ultraviolet radiations (UVRs) resulting from stratospheric ozone depletion, global warming, and air pollution from fossil-fuel combustion. AIMS We conducted a retrospective epidemiological study including 546 NMSC patients managed at the Dermatology Unit of the Tor Vergata Hospital to highlight different trends of sun exposure or different comorbidities. METHODS Descriptive and inferential statistical analyses were performed to evidence differences between continous variable and Spearman rank test for dicotomical variables. Charlson Comorbidity Index was calculated to obtain the 10-years survival rate in order to identify the mean comorbidity burden of our patients. RESULTS Considering patients with comorbidities (73.81%), actinic keratoses (AKs) was the most frequent lesion. In patients with a history of previous melanoma, basal cell carcinoma (BCC) was predominant (ANOVA test, p < 0.05) with a statistically significant correlation (rho = 0.453; p < 0.01). Squamous cell carcinoma (SCC) showed a higher rate in arterial hypertension patients, followed by the chronic heart failure and hematologic neoplasms (60%, 29.7% and 32.1%, respectively) groups. Men were more affected than women, representing 61.54% of patients. Chronic sun exposure is directly correlated with SCC rho = 0.561; p < 0.01), whereas BCC correlated with a history of sunburns (rho = 0.312; p < 0.05). CONCLUSIONS History of photo-exposition had an important role on NMSC development especially for work or recreational reasons. Sex, age, and presence of comorbidities influenced different NMSC types. BCC was more frequent in younger patients, associated with melanoma and sunburns. The presence of SCC is associated with older patients and the hypertension group. AKs were diagnosed predominantly in oldest men, with a chronic sun-exposure history, and hematologic neoplasms group.
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Affiliation(s)
- Fabio Artosi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Gaetana Costanza
- Unit of Virology, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Monia Di Prete
- Dermatopathology Laboratory, Istituti Fisioterapici Ospitalieri, Istituto San Gallicano, via Fermo Ognibene 23, 00144, Rome, Italy.
| | - Virginia Garofalo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Emi Dika
- Dermatology, IRCCS Policlinico Sant'Orsola, via Massarenti 9, 40138, Bologna, Italy.
| | - Terenzio Cosio
- PhD Course Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), Microbiology Section, Department of Experimental Medicine, University of Rome Tor Vergata, via Montpellier 1, 00133, Rome, Italy.
| | - Laura Diluvio
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Ruslana Gaeta Shumak
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Sara Lambiase
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Cosimo Di Raimondo
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Serena Campa
- Italian Society of Environmental Medicine, SIMA, Italy.
| | - Prisco Piscitelli
- Italian Society of Environmental Medicine, SIMA, Italy; University of Salento, Lecce, Italy.
| | - Alessandro Miani
- Italian Society of Environmental Medicine, SIMA, Italy; Department of Environmental Sciences and Policies, University of Milan, Milan, Italy.
| | - Luca Bianchi
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
| | - Elena Campione
- Dermatology Unit, Policlinico Tor Vergata, System Medicine Department, University of Tor Vergata, Rome, Italy, via Montpellier 1, 00133, Rome, Italy.
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Paganini C, Maffei V, Vellucci L, Talamonti M, Petruzzellis A, Le Pera L, Di Raimondo C, Bianchi L, Galluzzo M. Efficacy and Safety of Dupilumab in the Treatment of Hand Eczema: A Retrospective Study. J Clin Med 2024; 13:1876. [PMID: 38610641 PMCID: PMC11012359 DOI: 10.3390/jcm13071876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Hand eczema (HE) is a prevalent chronic condition that exerts a substantial and enduring adverse effect on quality of life (QoL) and imposes an economic burden on society. Managing HE poses challenges due to the limited effectiveness and potential adverse effects associated with many currently available topical and systemic treatments. Methods: This article examines twenty-one patients affected by HE treated with dupilumab, a fully human monoclonal antibody targeting interleukin IL-4 and IL-13 signaling. This involves a retrospective descriptive statistical analysis. Results: At week 6, HECSI-75 was achieved by 12 patients (57.9%). The proportion of patients meeting the HECSI-75 criteria steadily increased over the observation weeks, reaching 90% at week 16 and 100% at week 104. Furthermore, HECSI-90 and HECSI-100 were achieved by 75% and 60% of patients at week 16 and by 100% and 85% of patients at week 68, respectively. All patients who reached week 104 maintained complete disease remission according to HECSI 100. Conclusions: In all patients, dupilumab was shown to be an effective drug in achieving disease clearance, as indicated by all the parameters considered at each evaluation point (Week 6, Week 16, Week 32, Week 52, Week 68, Week 84, and Week 104), in comparison to the initial baseline.
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Affiliation(s)
- Claudia Paganini
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
| | - Virginia Maffei
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
| | - Laura Vellucci
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
| | - Marina Talamonti
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
| | - Alessandra Petruzzellis
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
| | - Lorenzo Le Pera
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
| | - Cosimo Di Raimondo
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
| | - Marco Galluzzo
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.V.); (A.P.); (L.L.P.); (L.B.)
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
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Paganini C, Talamonti M, Maffei V, Di Raimondo C, Bianchi L, Galluzzo M. Dupilumab for Treatment of Prurigo Nodularis: Real-Life Effectiveness for up to 84 Weeks. J Clin Med 2024; 13:878. [PMID: 38337572 PMCID: PMC10856572 DOI: 10.3390/jcm13030878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 01/25/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: Prurigo nodularis (PN) is a persistent and inflammatory dermatological condition characterized by chronic itching and the formation of hardened nodules, significantly impacting the affected individuals' quality of life and psychological well-being. The management of PN poses challenges due to the limited efficacy and undesirable side effects associated with current interventions. (2) Methods: This article examines sixteen patients affected by PN treated with dupilumab, a fully human monoclonal antibody targeting interleukin IL-4 and IL-13 signaling. This involves a retrospective descriptive statistical analysis. (3) Results and (4) Conclusions: In all patients, dupilumab proves to be an effective drug in achieving disease clearance, as indicated by all the parameters considered as assessed by both physicians and patients at each evaluation point (Week 6, Week 16, Week 32, Week 52, Week 68, and Week 84), in comparison to the initial baseline.
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Affiliation(s)
- Claudia Paganini
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.B.)
| | - Marina Talamonti
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
| | - Virginia Maffei
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.B.)
| | - Cosimo Di Raimondo
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
| | - Luca Bianchi
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.B.)
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
| | - Marco Galluzzo
- Department of Systems Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (C.P.); (V.M.); (L.B.)
- Dermatology Unit, Fondazione Policlinico Tor Vergata, 00133 Rome, Italy; (M.T.); (C.D.R.)
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Di Raimondo C, Lozzi F, Di Domenico PP, Campione E, Bianchi L. The Diagnosis and Management of Cutaneous Metastases from Melanoma. Int J Mol Sci 2023; 24:14535. [PMID: 37833981 PMCID: PMC10572973 DOI: 10.3390/ijms241914535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Melanoma is one of the deadliest skin tumors, accounting for almost 90% of skin cancer mortality. Although immune therapy and targeted therapy have dramatically changed the prognosis of metastatic melanoma, many patients experience disease progression despite the currently available new treatments. Skin metastases from melanoma represent a relatively common event as first sign of advanced disease or a sign of recurrence. Skin metastases are usually asymptomatic, although in advanced stages, they can present with ulceration, bleeding, and superinfection; furthermore, they can cause symptoms related to compression on nearby tissues. Treatments vary from simple surgery resections to topical or intralesional local injections, or a combination of these techniques with the most recent systemic immune or target therapies. New research and studies should focus on the pathogenesis and molecular mechanisms of the cutaneous metastases of melanoma in order to shed light on the mechanisms underlying the different behavior and prognoses of different patients.
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Affiliation(s)
- Cosimo Di Raimondo
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy; (F.L.); (P.P.D.D.); (E.C.); (L.B.)
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Rapanotti MC, Cugini E, Campione E, Di Raimondo C, Costanza G, Rossi P, Ferlosio A, Bernardini S, Orlandi A, De Luca A, Bianchi L. Epithelial-to-Mesenchymal Transition Gene Signature in Circulating Melanoma Cells: Biological and Clinical Relevance. Int J Mol Sci 2023; 24:11792. [PMID: 37511550 PMCID: PMC10380315 DOI: 10.3390/ijms241411792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/14/2023] [Accepted: 07/20/2023] [Indexed: 07/30/2023] Open
Abstract
The most promising method for monitoring patients with minimal morbidity is the detection of circulating melanoma cells (CMCs). We have shown that CD45-CD146+ABCB5+ CMCs identify a rare primitive stem/mesenchymal CMCs population associated with disease progression. The epithelial-to-mesenchymal transition (EMT) confers cancer cells a hybrid epithelial/mesenchymal phenotype promoting metastatization. Thus, we investigated the potential clinical value of the EMT gene signature of these primitive CMCs. A reliable quantitative real-time polymerase chain reaction (qRT-PCR) protocol was settled up using tumor cell lines RNA dilutions. Afterwards, immune-magnetically isolated CMCs from advanced melanoma patients, at onset and at the first checkpoint (following immune or targeted therapy), were tested for the level of EMT hallmarks and EMT transcription factor genes. Despite the small cohort of patients, we obtained promising results. Indeed, we observed a deep gene rewiring of the EMT investigated genes: in particular we found that the EMT gene signature of isolated CMCs correlated with patients' clinical outcomes. In conclusion, We established a reliable qRT-PCR protocol with high sensitivity and specificity to characterize the gene expression of isolated CMCs. To our knowledge, this is the first evidence demonstrating the impact of immune or targeted therapies on EMT hallmark gene expressions in CMCs from advanced melanoma patients.
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Affiliation(s)
- Maria Cristina Rapanotti
- Department of Anatomic Pathology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Elisa Cugini
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Gaetana Costanza
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Piero Rossi
- Surgery Division, Department of Surgery Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Amedeo Ferlosio
- Department of Anatomic Pathology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Sergio Bernardini
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Augusto Orlandi
- Department of Anatomic Pathology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
| | - Anastasia De Luca
- Department of Biology, University of Rome Tor Vergata, Via della Ricerca Scientifica 1, 00133 Rome, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
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Di Raimondo C, Lombardo P, Tesei C, Esposito F, Meconi F, Secchi R, Lozzi F, Monopoli A, Narducci MG, Scala E, Angeloni C, De Stefano A, Rahimi S, Bianchi L, Cantonetti M. Role of Neutrophil-to-Lymphocyte Ratio (NLR) in Patients with Mycosis Fungoides. Diagnostics (Basel) 2023; 13:diagnostics13111979. [PMID: 37296831 DOI: 10.3390/diagnostics13111979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) at baseline has been demonstrated to correlate with higher stages of disease and to be a prognostic factor in numerous cancers. However, its function as a prognostic factor for mycosis fungoides (MF) has not been yet clarified. OBJECTIVE Our work aimed to assess the association of the NLR with different stages of MF and to outline whether higher values of this marker are related to a more aggressive MF. METHODS We retrospectively calculated the NLRs in 302 MF patients at the moment of diagnosis. The NLR was obtained using the complete blood count values. RESULTS The median NLR among patients with early stage disease (low-grade IA-IB-IIA) was 1.88, while the median NLR for patients with high-grade MF (IIB-IIIA-IIIB) was 2.64. Statistical analysis showed positive associations of advanced MF stages with NLRs higher than 2.3. CONCLUSIONS Our analysis demonstrates that the NLR represents a cheap and easily available parameter functioning as a marker for advanced MF. This might guide physicians in recognizing patients with advanced stages of disease requiring a strict follow-up or an early treatment.
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Affiliation(s)
- Cosimo Di Raimondo
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Paolo Lombardo
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Cristiano Tesei
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Fabiana Esposito
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Federico Meconi
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Roberto Secchi
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Flavia Lozzi
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy
| | | | | | - Enrico Scala
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Cecilia Angeloni
- Department of Diagnostic Imaging and Interventional Radiology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Alberto De Stefano
- Volunteers Association of Fondazione Policlinico "Tor Vergata", 00133 Rome, Italy
| | - Siavash Rahimi
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Maria Cantonetti
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
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Mannino M, Piccerillo A, Dika E, Vaccari S, Quaglino P, Rubatto M, Longo C, Borsari S, Pellacani G, Fargnoli MC, Caponio C, Argenziano G, Briatico G, Bianchi L, Di Raimondo C, Calzavara Pinton PG, Zalaudek I, Di Stefani A, Peris K. Advanced Cutaneous Squamous Cell Carcinoma: Italian Multicentric Retrospective Analysis of Patient Profiles and Therapeutic Approaches. Dermatology 2023; 239:422-428. [PMID: 36921583 DOI: 10.1159/000528555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/11/2022] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND Advanced cutaneous squamous cell carcinoma (aCSCC) represents an area of unmet clinical need, with no standardized treatments until the recent approval of immune checkpoint inhibitors (ICIs). OBJECTIVES The aim of the study was to describe clinical characteristics and therapeutic strategies of a real-life Italian cohort of aCSCC patients managed at the beginning of cemiplimab approval as compassionate use in Italy. METHODS A multicenter retrospective study was performed by 10 Italian centers in the period January 1, 2018-May 31, 2020. Patients aged ≥18 years and diagnosed with aCSCC (locally aCSCC and metastatic CSCC) were eligible for the study. Analysis of patients' characteristics and treatment strategies was performed. RESULTS 239 patients were initially recruited in the study: 19 patients were excluded due to incomplete data collection, yielding a final cohort of 220 patients, of which 191 and 220 were included for patients' clinical characteristics and therapeutic intervention analysis, respectively. Median age at the time of diagnosis was 81 years (range: 72-86); nodal metastases were detected in 64/220 (29%) patients, and distant metastatic spread was reported in 33/220 (15%) patients. Most of our patients referred chronic occupational and/or recreational sun exposure, experienced ≥1 sunburn during their lifetime, never wore hats or used photoprotective filters, and presented with signs of cumulative sun damage (solar lentigines and/or actinic keratosis). Majority of our cohort received at least one intervention directed to the primary tumor (n = 212, 96.3%); surgery and radiotherapy were the most common therapeutic choices. Immunotherapy was administered to a small number of patients as compassionate use, especially in the metastatic setting. CONCLUSIONS Our study outlines the complex and heterogeneous clinical and therapeutic landscape of aCSCC patients at the beginning of ICI era, highlighting the need of a standardized care for this fragile and high-need patient population.
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Affiliation(s)
- Maria Mannino
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy,
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy,
| | - Alfredo Piccerillo
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - Emi Dika
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Sabina Vaccari
- Dermatology Unit, IRCCS Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Marco Rubatto
- Department of Medical Sciences, Dermatologic Clinic, University of Turin, Turin, Italy
| | - Caterina Longo
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefania Borsari
- Azienda Unità Sanitaria Locale, IRCCS di Reggio Emilia, Centro Oncologico ad Alta Tecnologia Diagnostica-Dermatologia, Reggio Emilia, Italy
| | - Giovanni Pellacani
- Department of Dermatology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Chiara Caponio
- Unit of Dermatology, Ospedale San Salvatore, L'Aquila, Italy
| | | | | | - Luca Bianchi
- UOSD di Dermatologia, Policlinico Tor Vergata, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cosimo Di Raimondo
- UOSD di Dermatologia, Policlinico Tor Vergata, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Iris Zalaudek
- Department of Dermatology and Venerology, University of Trieste, Trieste, Italy
| | - Alessandro Di Stefani
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ketty Peris
- UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
- Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
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Campione E, Di Prete M, Di Raimondo C, Costanza G, Palumbo V, Garofalo V, Mazzilli S, Franceschini C, Dika E, Bianchi L, Orlandi A. Topical Treatment of Actinic Keratosis and Metalloproteinase Expression: A Clinico-Pathological Retrospective Study. Int J Mol Sci 2022; 23:ijms231911351. [PMID: 36232651 PMCID: PMC9569516 DOI: 10.3390/ijms231911351] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/21/2022] Open
Abstract
Actinic keratosis is an intraepithelial proliferation of atypical keratinocytes that could progress into invasive squamous cell carcinoma. Most evidence suggests an important role of the dermal matrix metalloproteinases in the progression of atypical skin epithelial lesions. We evaluated the clinical efficacy of three different therapeutic modalities (a medical device containing 0.8% piroxicam cream and 50+ sunscreen, photodynamic therapy, and ingenol mebutate gel) to treat suspicious actinic keratoses, which were biopsied for histopathological examination and then analyzed for the expression of matrix metalloproteinases by immunohistochemistry. Clinical, dermoscopic, and reflectance confocal microscopy evaluations revealed a gradual decrease in all standard scores validated for actinic keratosis assessment at the end of the treatments. From a histopathological point of view, we documented the substantial restoration of normal skin architecture, while the immunohistochemical evaluation of matrix metalloproteinases showed a reduction in expression in the treated skin lesions compared to the baseline. As actinic keratoses are considered the precursors of squamous cell carcinoma, their treatment is crucial to prevent the development of a more aggressive disease. Our study monitored the evolution of actinic keratoses subjected to three different topical therapies, with the value of correlating clinical and histopathological findings. Moreover, as the matrix metalloproteinases are largely recognized factors involved in the pathogenesis and evolution of actinic keratosis to squamous cell carcinoma, the demonstration by immunohistochemistry of a reduction in their expression after the treatments adds new valuable concern to the field.
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Affiliation(s)
- Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence:
| | - Monia Di Prete
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Gaetana Costanza
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Vincenzo Palumbo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Virginia Garofalo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sara Mazzilli
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Chiara Franceschini
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Emi Dika
- Division of Dermatology, Azienda Ospedaliero-Universitaria di Bologna, 40126 Bologna, Italy
- Division of Dermatology, Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Augusto Orlandi
- Anatomic Pathology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
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9
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Garofalo V, Geraci F, Di Prete M, Lanna C, Lozzi F, Cosio T, Lambiase S, Gaeta Schumak R, Di Raimondo C, Diluvio L, Bianchi L, Campione E. Early clinical response to 5-fluorouracil 0.5% and salicylic acid 10% topical solution in the treatment of actinic keratoses of the head: an observational study. J DERMATOL TREAT 2022; 33:2664-2669. [PMID: 35435128 DOI: 10.1080/09546634.2022.2067817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Actinic keratosis is one of the most common dermatological disorders. A new topical solution, constituted by 0.5% 5-fluorouracil and 10% salicylic acid (Actikerall, Almirall) has been introduced in the treatment pipeline of non-hyperkeratotic actinic keratoses of the head and neck. PATIENTS AND METHODS We analyzed in an observational prospective clinical study the short-term treatment effectiveness of 5-fluorouracil and salicylic acid on face and scalp actinic keratoses of grade 1 and 2 of forty patients. Efficacy assessment was performed by clinical dermatological examination, collecting color photographs, calculating AKASI score, and by means of dermoscopy for each target lesion at every visit. RESULTS AKASI score decreased from an initial score of 3.3 to a final score of 0.9. At week 4, we were able to record a complete clearance of 50% of the treated lesions and a partial clearance of 28%. At the end of 12 weeks, 84% of the total lesions showed complete clearance, while 8% had partial clearance. CONCLUSIONS 5-fluorouracil and salicylic acid topical solution is effective in the treatment of mild to moderate actinic keratoses. In the future, further studies are needed to evaluate the chance of adjusting drug dosage according to patients' and actinic keratoses features.
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Affiliation(s)
- Virginia Garofalo
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Francesco Geraci
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Monia Di Prete
- Anatomic Pathology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy.,Anatomic Pathology, Santa Maria di Ca' Foncello Hospital, 31100 Treviso, Italy
| | - Caterina Lanna
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Flavia Lozzi
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Terenzio Cosio
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Sara Lambiase
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Ruslana Gaeta Schumak
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Laura Diluvio
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Luca Bianchi
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
| | - Elena Campione
- Dermatology Unit, University of Rome Tor Vergata, Via Montpellier, 1 00133 Rome, Italy
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10
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Di Raimondo C, Vaccarini S, Nunzi A, Rapisarda V, Zizzari A, Meconi F, Monopoli A, Narducci MG, Scala E, Bianchi L, Tesei C, Cantonetti M. Continuous low-dose gemcitabine in primary cutaneous T cell lymphoma: a retrospective study. Dermatol Ther 2022; 35:e15482. [PMID: 35373414 DOI: 10.1111/dth.15482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 03/24/2022] [Accepted: 03/30/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE the aim of our retrospective study was to evaluate the efficacy of a continuous therapy with a lower dosage of gemcitabine compared to those usually administered in patients with CTCL. MATERIAL AND METHODS twenty-two patients received different dosages of gemcitabine. Dosage and schedule of the drug were chosen on the basis of clinical features. Gemcitabine was given at 1000 mg every 15 days in 13 patients (4 MF, 9 SS); at 1000 mg at days +1, +8, +15 in 6 cases (3 MF, 3 SS). RESULTS All patients had been previously treated: four patients had received both skin directed and systemic treatments. Eighteen patients had received photopheresis, IFN, chemotherapy and immunotherapy. The Objective Response Rate (CR+PR) among all patients was 54.5% (12 of 22 patients) with a CR of 4.5% (1 of 22 patients) and a PR of 50% (11 of 22 patients). Patients with SS had an ORR of 61.5% (8 of 13 patients) with 1 CR (7%) and 7 PR (53.8%); patients with MF showed an ORR of 55.6% (5 of 9 patients) but no patients experienced CR (0%). The schedule with the highest efficacy and the lowest toxicity profile was 1000 mg every 15 days. Median PFS and OS in all patients were 17 and 45 months respectively. Gemcitabine was generally well tolerated. This article is protected by copyright. All rights reserved. CONCLUSIONS we have demonstrated that a much lower dose of gemcitabine (1000 mg once every 15 days) in patients with advanced-stage and refractory CTCL can lead to a durable response, with tolerable and manageable adverse effects. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Cosimo Di Raimondo
- Department of Dermatology, University of Roma Tor Vergata, Rome, IT.,Istituto dermopatico dell'Immacolata, IDI-IRCCS, Rome, IT
| | - Sara Vaccarini
- Department of Hematology, University of Roma Tor Vergata, Rome, IT
| | - Andrea Nunzi
- Department of Hematology, University of Roma Tor Vergata, Rome, IT
| | - Vito Rapisarda
- Department of Hematology, University of Roma Tor Vergata, Rome, IT
| | | | - Federico Meconi
- Department of Hematology, University of Roma Tor Vergata, Rome, IT
| | | | | | - Enrico Scala
- Istituto dermopatico dell'Immacolata, IDI-IRCCS, Rome, IT
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, Rome, IT
| | - Cristiano Tesei
- Department of Hematology, University of Roma Tor Vergata, Rome, IT
| | - Maria Cantonetti
- Department of Hematology, University of Roma Tor Vergata, Rome, IT
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11
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Di Raimondo C, Rao L, Lozzi F, Lombardo P, Silvaggio D, Vellucci L, Tofani L, Campione E, Bianchi L. Cemiplimab and ruxolitinib in concomitant cutaneous squamous cell carcinoma and myelofibrosis. Dermatol Ther 2022; 35:e15421. [DOI: 10.1111/dth.15421] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 03/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Ludovico Rao
- Department of Dermatology University of Roma Tor Vergata Rome Italy
| | - Flavia Lozzi
- Department of Dermatology University of Roma Tor Vergata Rome Italy
| | - Paolo Lombardo
- Department of Dermatology University of Roma Tor Vergata Rome Italy
| | | | - Laura Vellucci
- Department of Dermatology University of Roma Tor Vergata Rome Italy
| | - Lorenzo Tofani
- Department of Dermatology University of Roma Tor Vergata Rome Italy
| | - Elena Campione
- Department of Dermatology University of Roma Tor Vergata Rome Italy
| | - Luca Bianchi
- Department of Dermatology University of Roma Tor Vergata Rome Italy
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12
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Di Raimondo C, Rubio-Gonzalez B, Palmer J, Weisenburger DD, Zain J, Wu X, Han Z, Rosen ST, Song JY, Querfeld C. Expression of Immune Checkpoint Molecules PD1, PD-L1 and ICOS in Mycosis Fungoides and Sézary Syndrome: Association with Disease Stage and Clinical Outcome. Br J Dermatol 2022; 187:234-243. [PMID: 35194801 PMCID: PMC9357001 DOI: 10.1111/bjd.21063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 01/11/2022] [Accepted: 02/18/2022] [Indexed: 12/01/2022]
Abstract
Background The relationship between immune checkpoint status and disease outcome is a major focus of research in cutaneous T‐cell lymphoma (CTCL), a disfiguring neoplastic dermatological disorder. Mycosis fungoides (MF) and Sézary syndrome (SS) are the two most common types of CTCL. Objectives The aim was to evaluate the immune checkpoint markers programmed death protein 1 (PD1), inducible T‐cell co‐stimulator (ICOS) and programmed death‐ligand 1 (PD‐L1) in skin biopsies from patients with CTCL relative to disease stage and overall survival. Methods This consecutive case series enrolled 47 patients: 57% had stage IA–IIA disease and 43% had stage IIB–IVA2 disease (including seven with SS). Results PD1, PD‐L1 and ICOS expression was seen in all biopsies. Notably, PD‐L1 was predominantly expressed on histiocytes/macrophages, but focal expression on CTCL cells was seen. High expression of either ICOS or PD‐L1 was associated with advanced‐stage disease (P = 0·007 for both) and with the appearance of large‐cell transformation (LCT), a histopathological feature associated with a poor prognosis (ICOS: P = 0·02; PD‐L1: P = 0·002). PD1 expression was not significantly associated with disease stage (P = 0·12) or LCT (P = 0·49), but expression was high in SS biopsies. A high combined checkpoint marker score (PD1, PD‐L1 and ICOS) was associated with advanced‐stage disease (P = 0·001), LCT (P = 0·021) and lower overall survival (P = 0·014). Conclusions These findings demonstrate the existence of a complex immunoregulatory microenvironment in CTCL and support the development of immunotherapies targeting ICOS and PD‐L1 in advanced disease.
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Affiliation(s)
| | | | - Joycelynne Palmer
- Department of Computational and Quantitative Medicine, Division of Biostatistics
| | | | - Jasmine Zain
- Department of Hematology/Hematopoietic Cell Transplantation
| | - Xiwei Wu
- Integrative and Genomics Core.,Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Zhen Han
- Division of Dermatology.,Beckman Research Institute, City of Hope, Duarte, CA, USA
| | - Steve T Rosen
- Department of Hematology/Hematopoietic Cell Transplantation.,Beckman Research Institute, City of Hope, Duarte, CA, USA
| | | | - Christiane Querfeld
- Division of Dermatology.,Department of Pathology.,Department of Hematology/Hematopoietic Cell Transplantation.,Beckman Research Institute, City of Hope, Duarte, CA, USA
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13
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Di Raimondo C, Han Z, Su C, Wu X, Qin H, Sanchez JF, Yuan YC, Martinez X, Abdulla F, Zain J, Chen CW, Rosen ST, Querfeld C. Identification of a Distinct miRNA Regulatory Network in the Tumor Microenvironment of Transformed Mycosis Fungoides. Cancers (Basel) 2021; 13:cancers13225854. [PMID: 34831008 PMCID: PMC8616450 DOI: 10.3390/cancers13225854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 01/10/2023] Open
Abstract
Simple Summary Transformed mycosis fungoides (LCT-MF) is a histopathological marker of poor prognosis and associated with worse survival. We compared miRNA and mRNA expression profiles of LCT-MF with classic MF and found a distinct miRNA regulatory network modulated immunosuppressive tumor microenvironment in LCT-MF. Our findings provide novel insights and therapeutic targets for LCT-MF. Abstract Large cell transformation of mycosis fungoides (LCT-MF) occurs in 20–50% of advanced MF and is generally associated with poor response and dismal prognosis. Although different mechanisms have been proposed to explain the pathogenesis, little is known about the role of microRNAs (miRs) in transcriptional regulation of LCT-MF. Here, we investigated the miR and mRNA expression profile in lesional skin samples of patients with LCT-MF and non-LCT MF using RNA-seq analysis. We found miR-146a and miR-21 to be significantly upregulated, and miR-708 the most significantly downregulated miR in LCT-MF. Integration of miR and mRNA expression profiles revealed the miR-regulated networks in LCT-MF. Ingenuity pathway analysis (IPA) demonstrated the involvement of genes for ICOS-ICOSL, PD1-PDL1, NF-κB, E2F transcription, and molecular mechanisms of cancer signaling pathways. Quantitative real time (qRT)-PCR results of target genes were consistent with the RNA-seq data. We further identified the immunosuppressive tumor microenvironment (TME) in LCT-MF. Moreover, our data indicated that miR-146a, -21 and -708 are associated with the immunosuppressive TME in LCT-MF. Collectively, our results suggest that the key LCT-MF associated miRs and their regulated networks may provide insights into its pathogenesis and identify promising targets for novel therapeutic strategies.
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Affiliation(s)
- Cosimo Di Raimondo
- Division of Dermatology, City of Hope, Duarte, CA 91010, USA; (C.D.R.); (Z.H.); (C.S.); (X.M.); (F.A.)
- Department of Dermatology, University of Roma Tor Vergata, Rome 00133, Italy
| | - Zhen Han
- Division of Dermatology, City of Hope, Duarte, CA 91010, USA; (C.D.R.); (Z.H.); (C.S.); (X.M.); (F.A.)
- Beckman Research Institute, City of Hope, Duarte, CA 91010, USA; (J.F.S.); (C.-W.C.); (S.T.R.)
| | - Chingyu Su
- Division of Dermatology, City of Hope, Duarte, CA 91010, USA; (C.D.R.); (Z.H.); (C.S.); (X.M.); (F.A.)
- Beckman Research Institute, City of Hope, Duarte, CA 91010, USA; (J.F.S.); (C.-W.C.); (S.T.R.)
| | - Xiwei Wu
- Department of Molecular and Cellular Biology, City of Hope, Duarte, CA 91010, USA; (X.W.); (H.Q.)
- Integrative Genomics Core, City of Hope, Duarte, CA 91010, USA
| | - Hanjun Qin
- Department of Molecular and Cellular Biology, City of Hope, Duarte, CA 91010, USA; (X.W.); (H.Q.)
- Integrative Genomics Core, City of Hope, Duarte, CA 91010, USA
| | - James F. Sanchez
- Beckman Research Institute, City of Hope, Duarte, CA 91010, USA; (J.F.S.); (C.-W.C.); (S.T.R.)
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA 91010, USA;
| | - Yate-Ching Yuan
- Department of Computational Quantitative Medicine, City of Hope, Duarte, CA 91010, USA;
- Translational Bioinformatics, Center for Informatics, City of Hope, Duarte, CA 91010, USA
| | - Xochiquetzal Martinez
- Division of Dermatology, City of Hope, Duarte, CA 91010, USA; (C.D.R.); (Z.H.); (C.S.); (X.M.); (F.A.)
| | - Farah Abdulla
- Division of Dermatology, City of Hope, Duarte, CA 91010, USA; (C.D.R.); (Z.H.); (C.S.); (X.M.); (F.A.)
| | - Jasmine Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA 91010, USA;
| | - Chun-Wei Chen
- Beckman Research Institute, City of Hope, Duarte, CA 91010, USA; (J.F.S.); (C.-W.C.); (S.T.R.)
- Department of Systems Biology, City of Hope, Duarte, CA 91010, USA
| | - Steven T. Rosen
- Beckman Research Institute, City of Hope, Duarte, CA 91010, USA; (J.F.S.); (C.-W.C.); (S.T.R.)
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA 91010, USA;
| | - Christiane Querfeld
- Division of Dermatology, City of Hope, Duarte, CA 91010, USA; (C.D.R.); (Z.H.); (C.S.); (X.M.); (F.A.)
- Beckman Research Institute, City of Hope, Duarte, CA 91010, USA; (J.F.S.); (C.-W.C.); (S.T.R.)
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA 91010, USA;
- Department of Pathology, City of Hope, Duarte, CA 91010, USA
- Correspondence: ; Tel.: +1-626-634-4436; Fax: +1-626-218-6190
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14
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Rapanotti MC, Cugini E, Nuccetelli M, Terrinoni A, Di Raimondo C, Lombardo P, Costanza G, Cosio T, Rossi P, Orlandi A, Campione E, Bernardini S, Blot-Chabaud M, Bianchi L. MCAM/MUC18/CD146 as a Multifaceted Warning Marker of Melanoma Progression in Liquid Biopsy. Int J Mol Sci 2021; 22:12416. [PMID: 34830300 PMCID: PMC8623757 DOI: 10.3390/ijms222212416] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/26/2022] Open
Abstract
Human malignant melanoma shows a high rate of mortality after metastasization, and its incidence is continuously rising worldwide. Several studies have suggested that MCAM/MUC18/CD146 plays an important role in the progression of this malignant disease. MCAM/MUC18/CD146 is a typical single-spanning transmembrane glycoprotein, existing as two membrane isoforms, long and short, and an additional soluble form, sCD146. We previously documented that molecular MCAM/MUC18/CD146 expression is strongly associated with disease progression. Recently, we showed that MCAM/MUC18/CD146 and ABCB5 can serve as melanoma-specific-targets in the selection of highly primitive circulating melanoma cells, and constitute putative proteins associated with disease spreading progression. Here, we analyzed CD146 molecular expression at onset or at disease recurrence in an enlarged melanoma case series. For some patients, we also performed the time courses of molecular monitoring. Moreover, we explored the role of soluble CD146 in different cohorts of melanoma patients at onset or disease progression, rather than in clinical remission, undergoing immune therapy or free from any clinical treatment. We showed that MCAM/MUC18/CD146 can be considered as: (1) a membrane antigen suitable for identification and enrichment in melanoma liquid biopsy; (2) a highly effective molecular "warning" marker for minimal residual disease monitoring; and (3) a soluble protein index of inflammation and putative response to therapeutic treatments.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- CD146 Antigen/blood
- CD146 Antigen/chemistry
- CD146 Antigen/genetics
- Disease Progression
- Female
- Follow-Up Studies
- Gene Expression
- Gene Expression Regulation, Neoplastic
- Humans
- Liquid Biopsy
- Longitudinal Studies
- Male
- Melanoma/blood
- Melanoma/genetics
- Melanoma/pathology
- Middle Aged
- Neoplasm Recurrence, Local/blood
- Neoplasm Recurrence, Local/genetics
- Neoplasm, Residual/blood
- Neoplasm, Residual/genetics
- Neoplastic Cells, Circulating/metabolism
- Skin Neoplasms/blood
- Skin Neoplasms/genetics
- Skin Neoplasms/pathology
- Solubility
- Young Adult
- Melanoma, Cutaneous Malignant
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Affiliation(s)
- Maria Cristina Rapanotti
- Department of Onco-Haematology, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (E.C.); (M.N.); (A.T.); (G.C.); (S.B.)
| | - Elisa Cugini
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (E.C.); (M.N.); (A.T.); (G.C.); (S.B.)
| | - Marzia Nuccetelli
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (E.C.); (M.N.); (A.T.); (G.C.); (S.B.)
| | - Alessandro Terrinoni
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (E.C.); (M.N.); (A.T.); (G.C.); (S.B.)
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (C.D.R.); (P.L.); (T.C.); (E.C.); (L.B.)
| | - Paolo Lombardo
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (C.D.R.); (P.L.); (T.C.); (E.C.); (L.B.)
| | - Gaetana Costanza
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (E.C.); (M.N.); (A.T.); (G.C.); (S.B.)
| | - Terenzio Cosio
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (C.D.R.); (P.L.); (T.C.); (E.C.); (L.B.)
| | - Piero Rossi
- Department of Surgery Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy;
| | - Augusto Orlandi
- Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy;
| | - Elena Campione
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (C.D.R.); (P.L.); (T.C.); (E.C.); (L.B.)
| | - Sergio Bernardini
- Department of Laboratory Medicine, University of Rome Tor Vergata, Viale Oxford 81, 00133 Rome, Italy; (E.C.); (M.N.); (A.T.); (G.C.); (S.B.)
| | - Marcel Blot-Chabaud
- Institut National de la Sante et de la Recherche Medicale (INSERM), UMR-S 1076, Aix-Marseille University, UFR Pharmacy, 13005 Marseille, France;
| | - Luca Bianchi
- Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (C.D.R.); (P.L.); (T.C.); (E.C.); (L.B.)
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15
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Di Raimondo C, Caposiena Caro RD, Spallone D, Silvaggio D, Lombardo P, Del Duca E, Campione E, Spallone G, Bianchi L. Baseline neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) correlate with advanced stages in cutaneous squamous cell carcinoma. Int J Dermatol 2021; 61:175-179. [PMID: 34212366 DOI: 10.1111/ijd.15755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 05/25/2021] [Accepted: 06/10/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) and red blood cell distribution width (RDW) at diagnosis have been shown to correlate with advanced disease and to be prognostic factors in many tumors. However, their role as a prognostic factor for cutaneous squamous cell carcinoma (cSCC) has not yet been studied. OBJECTIVE Therefore, the aim of our study was to evaluate the correlation of NLR and RDW with stages of disease in patients with cSCC in order to define whether or not higher values of these two markers correlate with a more aggressive disease. METHODS We retrospectively analyzed the NLR and RDW in a total of 51 newly diagnosed cSCC patients. NLR and RDW were calculated using data obtained from the complete blood count (CBC). RESULTS Median NLR among patients with the non-advanced disease (in situ and stage I) was 2.2, whereas median NLR for patients with advanced disease was 4.87. Median RDW among patients with early stage disease was 13.7%, while median RDW in patients with advanced disease was 15.81%. Statistical analysis showed positive associations of advanced cSCC stages with NLR or RDW higher than 3.07 or 14.5%, respectively. CONCLUSIONS Therefore, our analysis demonstrated how both NLR and RDW represent cheap and easily available factors that could be used as markers for advanced cSCC. They could help to identify patients with advanced stages disease that requires a strict follow-up.
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Affiliation(s)
| | | | - Diana Spallone
- Department of Plastic Surgery, San Giovanni Hospital, Rome, Italy
| | | | - Paolo Lombardo
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Ester Del Duca
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Elena Campione
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Spallone
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
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16
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Jothishankar B, Espinosa ML, Zain J, Parekh V, Di Raimondo C, Abdulla F. Complete response to romidepsin as monotherapy in treatment-resistant subcutaneous panniculitis-like T-cell lymphoma. JAAD Case Rep 2020; 6:1245-1247. [PMID: 33294555 PMCID: PMC7701033 DOI: 10.1016/j.jdcr.2020.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Maria L. Espinosa
- University of Chicago Pritzker School of Medicine, Chicago, Illinois
- Correspondence to: Maria L. Espinosa, BS, 924 E 57th St Suite 104, Chicago, IL 60637.
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Lozzi F, Di Raimondo C, Lanna C, Diluvio L, Mazzilli S, Garofalo V, Dika E, Dellambra E, Coniglione F, Bianchi L, Campione E. Latest Evidence Regarding the Effects of Photosensitive Drugs on the Skin: Pathogenetic Mechanisms and Clinical Manifestations. Pharmaceutics 2020; 12:E1104. [PMID: 33213076 PMCID: PMC7698592 DOI: 10.3390/pharmaceutics12111104] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 12/27/2022] Open
Abstract
Photosensitivity induced by drugs is a widely experienced problem, concerning both molecule design and clinical practice. Indeed, photo-induced cutaneous eruptions represent one of the most common drug adverse events and are frequently an important issue to consider in the therapeutic management of patients. Phototoxicity and photoallergy are the two different pathogenic mechanisms involved in photosensitization. Related cutaneous manifestations are heterogeneous, depending on the culprit drug and subject susceptibility. Here we report an updated review of the literature with respect to pathogenic mechanisms of photosensitivity, clinical manifestations, patient management, and prediction and evaluation of drug-induced photosensitivity. We present and discuss principal groups of photosensitizing drugs (antimicrobials, nonsteroidal anti-inflammatory drugs, anti-hypertensives, anti-arrhythmics, cholesterol, and glycemia-lowering agents, psychotropic drugs, chemotherapeutics, etc.) and their main damage mechanisms according to recent evidence. The link between the drug and the cutaneous manifestation is not always clear; more investigations would be helpful to better predict drug photosensitizing potential, prevent and manage cutaneous adverse events and find the most appropriate alternative therapeutic strategy.
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Affiliation(s)
- Flavia Lozzi
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Caterina Lanna
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Laura Diluvio
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Sara Mazzilli
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Virginia Garofalo
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Emi Dika
- Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Via Massarenti, 1-40138 Bologna, Italy;
| | - Elena Dellambra
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell’Immacolata–Istituto di Ricovero e Cura a Carattere Scientifico (IDI-IRCCS), via dei Monti di Creta 104, 00167 Rome, Italy;
| | - Filadelfo Coniglione
- Department of Clinical Science and Translational Medicine, Tor Vergata University, 00133 Rome, Italy;
| | - Luca Bianchi
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
| | - Elena Campione
- Dermatology Unit, Department of Internal Medicine, Tor Vergata University, 00133 Rome, Italy; (F.L.); (C.D.R.); (C.L.); (L.D.); (S.M.); (V.G.)
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Del Duca E, Morelli P, Bennardo L, Di Raimondo C, Nisticò SP. Cytokine Pathways and Investigational Target Therapies in Hidradenitis Suppurativa. Int J Mol Sci 2020; 21:ijms21228436. [PMID: 33182701 PMCID: PMC7696820 DOI: 10.3390/ijms21228436] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting areas with a high density of apocrine glands and characterized by subcutaneous nodules that may evolve into fistulas with pus secretion. Methods: The aim of this review is to investigate all current knowledge on cytokine regulation in the pathogenesis of HS. A systematic literature research using the words “cytokine”, “interleukin”, “pathway”, and “hidradenitis suppurativa” was performed in PubMed/Medline and Scopus/Embase databases. A search of the clinicaltrials.gov website for interventional recruiting and completed trials including the term “hidradenitis suppurativa” was also performed up to August 2020. We will discuss the pathogenetic role of various cytokines in HS and potential therapeutic targets for this debilitating disease. Results: The pathophysiology underlying this complex condition has not been clearly defined. An upregulation of various cytokines, such as tumor necrosis factor alpha (TNF-α), interleukin (IL)-1, IL-17, IL-23, and other molecules seems to be related to this inflammatory condition. Various cells, such as lymphocytes T Helper 1 and 17 and keratinocytes seem to be involved in the genesis of this condition. Conclusions: Several future studies and clinical trials are necessary in order to have new knowledge about HS and to properly treat this complex condition.
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Affiliation(s)
- Ester Del Duca
- Department of Health Science, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (P.M.); (L.B.); (S.P.N.)
- Correspondence: ; Tel.: +39-917-9694-386; Fax: +39-0961-369-6150
| | - Paola Morelli
- Department of Health Science, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (P.M.); (L.B.); (S.P.N.)
| | - Luigi Bennardo
- Department of Health Science, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (P.M.); (L.B.); (S.P.N.)
| | - Cosimo Di Raimondo
- Department of Dermatology, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Steven Paul Nisticò
- Department of Health Science, University of Catanzaro Magna Graecia, 88100 Catanzaro, Italy; (P.M.); (L.B.); (S.P.N.)
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Di Raimondo C, Del Duca E, Silvaggio D, Di Prete M, Lombardo P, Mazzeo M, Spallone G, Campione E, Botti E, Bianchi L. Cutaneous mastocytosis: A dermatological perspective. Australas J Dermatol 2020; 62:e1-e7. [PMID: 33040350 DOI: 10.1111/ajd.13443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 12/01/2022]
Abstract
Mastocytosis is a rare disease characterised by expansion and collection of clonal mast cells in various organs including the skin, bone marrow, spleen, lymph nodes and gastrointestinal tract. The prevalence of mastocytosis has been estimated to be one in 10 000, while the estimated incidence is one per 100 000 people per year. Cutaneous mastocytosis is classified into (i) maculopapular cutaneous mastocytosis, also known as urticaria pigmentosa; (ii) diffuse cutaneous mastocytosis; and (iii) mastocytoma of the skin. In adults, cutaneous lesions are usually associated with indolent systemic mastocytosis and have a chronic evolution. Paediatric patients, on the contrary, have often cutaneous manifestations without systemic involvement and usually experience a spontaneous regression. Diagnosis of cutaneous mastocytosis may be challenging due to the rarity of the disease and the overlap of cutaneous manifestations. This short review describes pathogenesis and clinical aspects of cutaneous mastocytosis with a focus on diagnosis and currently available therapies.
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Affiliation(s)
| | - Ester Del Duca
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | | | - Monia Di Prete
- Department of Anatomic Pathology, University of Rome Tor Vergata, Rome, Italy
| | - Paolo Lombardo
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Mauro Mazzeo
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Spallone
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Elena Campione
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Elisabetta Botti
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
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20
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Schipani G, Del Duca E, Todaro G, Scali E, Dastoli S, Bennardo L, Bonacci S, Di Raimondo C, Pavel AB, Colica C, Xu X, Procopio A, Patruno C, Nisticó SP. Arsenic and chromium levels in hair correlate with actinic keratosis/non melanoma skin cancer: results of an observational controlled study. G Ital Dermatol Venereol 2020. [PMID: 32938163 DOI: 10.23736/s0392-0488.20.06600-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The role of heavy metals in carcinogenetic process has been widely established however, information on the most common environmental metals that serve as major risk factors for actinic keratosis (AK)/non-melanoma skin cancer (NMSC) are still lacking. We aim to evaluate levels of the most common environmental heavy metals in hair of patients with AK/NMSC as compared to healthy controls. METHODS 31 patients diagnosed with AK/NMSC and 34 healthy controls were enrolled. Patients were interviewed for heavy metals exposure and underwent hair analysis for detection of arsenic (As), cadmium (Cd), chromium (Cr), nickel (Ni) and lead (Pb). Continuous variables were analyzed using Wilcoxon non-parametric rank test and proportions were compared by Fisher exact test. Statistical significance was determined by p<0.05. RESULTS In our cohort we observed 48.4% patients had AKs, 16.1% basal cell carcinoma (BCC), 9.7% squamous cell carcinoma (SCC) and 25.9% of patients presented with a combination of these lesions. There were significantly elevated levels of As and Cr in AKNMSC group as compared to controls. CONCLUSIONS We identified a strong positive correlation between As and Cr concentration and AK/NMSC adding new clues to the scenery of NMSC risk factors that should be taken under consideration in exposed populations.
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Affiliation(s)
- Giusy Schipani
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Ester Del Duca
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy.,Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Giuseppe Todaro
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Elisabetta Scali
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Stefano Dastoli
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Luigi Bennardo
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy -
| | - Sonia Bonacci
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Ana B Pavel
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carmela Colica
- CNR, IBFM UOS of Germaneto, University "Magna Græcia", Catanzaro, Italy
| | - Xu Xu
- Alibaba Group, Hangzhou, China
| | - Antonio Procopio
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Cataldo Patruno
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Steven P Nisticó
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
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Di Raimondo C, Mazzeo M, Di Prete M, Lombardo P, Silvaggio D, Del Duca E, Bianchi L, Spallone G. Efficacy of Vismodegib in pigmented basal cell carcinoma: Appearances are deceiving. Dermatol Ther 2020; 33:e14057. [PMID: 32713089 DOI: 10.1111/dth.14057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/20/2020] [Indexed: 11/29/2022]
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer in humans. Pigmented basal cell carcinoma (pBCC) is a rare variant of BCC. Vismodegib, was the first drug to be approved for the treatment of locally advanced (laBCCs) or metastatic basal cell carcinoma. The aim of this study was to evaluate the efficacy of Vismodegib in patients with pBCCs. We retrospectively analyzed patients receiving Vismodegib as treatment for laBCCs presenting also various pBCCs. After 6 months of treatment, we performed excisional biopsies of pBCCs, that apparently at clinical and dermoscopic assessment did not respond to therapy. A total of nine patients were assessed. After 6 months of treatment, locally advanced target BCCs showed complete remission in four out of nine patients (44.4%), four patients (44.4%) were considered in partial remission and one patient (11%) showed no response to treatment. On the contrary, all the pBCCs showed both clinically and dermoscopically resistance to treatment. Therefore, clinically persistent pBCCs were surgically removed in three patients. Histology showed a complete elimination of the neoplastic cells together with features of previous regression. Our findings indicate that the efficacy of Vismodegib is higher than that documented by clinical or even dermatoscopic observation alone.
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Affiliation(s)
| | - Mauro Mazzeo
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Monia Di Prete
- Department of Anatomic Pathology, University of Roma Tor Vergata, Rome, Italy
| | - Paolo Lombardo
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | | | - Ester Del Duca
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Spallone
- Department of Dermatology, University of Roma Tor Vergata, Rome, Italy
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Del Duca E, Zingoni T, Bennardo L, Di Raimondo C, Garofalo V, Sannino M, Petrini N, Cannarozzo G, Bianchi L, Nisticò SP. Long-Term Follow-Up for Q-Switched Nd:YAG Treatment of Nevus of Ota: Are High Number of Treatments Really Required? A Case Report. Photobiomodul Photomed Laser Surg 2020; 39:137-140. [PMID: 32758019 DOI: 10.1089/photob.2020.4812] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: Q-switched laser is considered a gold standard treatment for Nevus of Ota (NO). We report how few laser sessions in long intervals of time may achieve satisfying outcomes reducing the rate of possible procedure-linked side effects such as burning, cornea injuries, or hyperpigmentation. Background: NO represents a congenital dermal melanocytosis in the trigeminal distribution majorly occurring in Asian individuals. Multiple reports have shown efficacy and safety of Q-switched laser for the treatment of this condition, but they were based on an empiric regimen, often leading to unnecessary overtreatments. At the best of our knowledge, no long-term follow-up observations of single laser sessions have been conducted to assess the proper intervals and number of treatments. Materials and methods: A 36-year-old Asian woman, Fitzpatrick skin type IV with clinical diagnosis of NO, was treated with 1064 nm 6 ns Q-switched laser one session per year for a total of two sessions. Clinical result was valued by two physicians independently using standardized and polarized light. No use of general anesthesia or sedation was needed in our experience. Corneal shields have been used. Results: After only two sessions of the Q-switched laser performed 1 year apart, the result was excellent with a 95% of clinical response. No side effect was observed. Conclusions: In our experience, Q-switched Nd:YAG laser is an effective treatment for NO with no necessity of high number of treatments. A larger population is needed to confirm this preliminary result.
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Affiliation(s)
- Ester Del Duca
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.,Department of Dermatology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Tizianno Zingoni
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Luigi Bennardo
- Department of Dermatology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Cosimo Di Raimondo
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Virginia Garofalo
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Mario Sannino
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Nerella Petrini
- Department of Dermatology, University of Florence, Florence, Italy
| | - Giovanni Cannarozzo
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Steven Paul Nisticò
- Laser Unit, Department of Dermatology, University of Rome Tor Vergata, Rome, Italy.,Department of Dermatology, University Magna Graecia of Catanzaro, Catanzaro, Italy
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23
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Jothishankar B, Di Raimondo C, Mueller L, Zain J, Parekh V, Abdulla F. Primary cutaneous marginal zone lymphoma treated with doxycycline in a pediatric patient. Pediatr Dermatol 2020; 37:759-761. [PMID: 32323885 DOI: 10.1111/pde.14165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We present the third reported case of a primary cutaneous marginal zone lymphoma (PCMZL) treated with doxycycline in a pediatric patient with negative serology for Borrelia burgdorferi. A 14-year-old boy presented with multiple asymptomatic erythematous papules and nodules on his extremities and trunk which biopsy confirmed to be PCMZL. He was started on doxycycline and experienced a near-complete response. Given the favorable side effect profile of doxycycline and the indolent nature of PCMZL, we believe doxycycline is a possible therapy for PCMZL pediatric patients who have widely disseminated cutaneous disease.
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Affiliation(s)
| | | | - Lisa Mueller
- Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Jasmine Zain
- City of Hope National Medical Center, Duarte, CA, USA
| | | | - Farah Abdulla
- Children's Hospital of Los Angeles, Los Angeles, CA, USA
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Di Raimondo C, Parekh V, Song JY, Rosen ST, Querfeld C, Zain J, Martinez XU, Abdulla FR. Primary Cutaneous CD30+ Lymphoproliferative Disorders: a Comprehensive Review. Curr Hematol Malig Rep 2020; 15:333-342. [DOI: 10.1007/s11899-020-00583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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25
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Dattola A, Mazzeo M, Di Stefano F, Manfreda V, Vollono L, Di Raimondo C, Di Matteo E, Bianchi L. Clinical efficacy and safety of certolizumab pegol in cutaneous symptoms on psoriasis in patients with psoriatic arthritis: A retrospective analysis in real life. Dermatol Ther 2020; 33:e13409. [DOI: 10.1111/dth.13409] [Citation(s) in RCA: 1] [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] [Received: 10/30/2019] [Revised: 11/29/2019] [Accepted: 04/10/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Mauro Mazzeo
- Department of Dermatology University of Rome “Tor Vergata” Rome Italy
| | - Flavia Di Stefano
- Department of Dermatology University of Rome “Tor Vergata” Rome Italy
| | - Valeria Manfreda
- Department of Dermatology University of Rome “Tor Vergata” Rome Italy
| | - Laura Vollono
- Department of Dermatology University of Rome “Tor Vergata” Rome Italy
| | | | | | - Luca Bianchi
- Department of Dermatology University of Rome “Tor Vergata” Rome Italy
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26
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Mazzilli S, Vollono L, Cosio T, Donati M, Piccolo A, Di Raimondo C, Campione E, Bianchi L. Reflectance Confocal Microscopy Applied to Linear (en Coup de Sabre) Morphea. Skin Appendage Disord 2020; 6:171-174. [PMID: 32656238 DOI: 10.1159/000506748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/22/2020] [Indexed: 11/19/2022] Open
Abstract
En coup de sabre morphea is a clinical variant of morphea, presenting as a linear depressed, atrophic area in the paramedian forehead or the frontoparietal scalp, resembling a stroke from a sword. It affects the skin and subcutaneous connective tissues, with possible extension to the underlying musculature, cartilage, and bone and variable association with neurologic symptoms. A 50-year-old woman presented to our clinic for evaluation of an atrophic lesion on her forehead and scalp appearing 1 year before, progressively extending over time. An alopecic atrophic area involving the skin and subcutaneous tissues of her right forehead and scalp arranged in a linear fashion with an "en coup de sabre" appearance was observed in relation with hair loss in the affected area. Reflectance confocal microscopy showed marked hyperreflective areas with severe eccrine gland atrophy. All sebaceous glands had disappeared, with sporadic follicular persistence reduction. Histopathological examination of a punch biopsy specimen taken from a central parietal alopecic area was consistent with a diagnosis of morphea. To our knowledge, this is the first report regarding the use of reflectance confocal microscopy as an ancillary diagnostic technique in linear localized morphea of the scalp and face. This noninvasive technique may represent a useful tool in distinguishing between early stages of the disease, with prevalence of inflammatory lymphocytic infiltrate, and late stages characterized by more prominent sclerosis with mild or absent signs of inflammation.
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Affiliation(s)
- Sara Mazzilli
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Laura Vollono
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Terenzio Cosio
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Michele Donati
- Department of Surgical Pathology, Campus Biomedico, Rome, Italy
| | - Arianna Piccolo
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Elena Campione
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
| | - Luca Bianchi
- Dermatology Unit, Department of "Medicina dei Sistemi," Tor Vergata University, Rome, Italy
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27
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Virgen CA, Nguyen TA, Di Raimondo C, Amini A, Margolin KA, Parekh V, Abdulla FR, Modi B. Bullous pemphigoid associated with cemiplimab therapy in a patient with locally advanced cutaneous squamous cell carcinoma. JAAD Case Rep 2020; 6:195-197. [PMID: 32149176 PMCID: PMC7033293 DOI: 10.1016/j.jdcr.2020.01.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Cesar A. Virgen
- Department of Dermatology, University of California–Irvine, Irvine, Los Angeles
| | - Tuyet A. Nguyen
- Department of Dermatology, Kaiser Permanente–Los Angeles Medical Center, Duarte, California
| | - Cosimo Di Raimondo
- Division of Dermatology, City of Hope National Medical Center, Duarte, California
- Policlinico Tor Vergata, Rome, Italy
| | - Arya Amini
- Department of Radiation Oncology, City of Hope National Medical Center, Duarte, California
| | - Kim A. Margolin
- Department of Medical Oncology and Therapeutic Research, City of Hope National Medical Center, Duarte, California
| | - Vishwas Parekh
- Department of Pathology, City of Hope National Medical Center, Duarte, California
| | - Farah R. Abdulla
- Division of Dermatology, City of Hope National Medical Center, Duarte, California
| | - Badri Modi
- Division of Dermatology, City of Hope National Medical Center, Duarte, California
- Correspondence to: Badri Modi, MD, Division of Dermatology, City of Hope National Cancer Center, 1500 East Duarte Rd, Duarte, CA 91010.
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28
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Di Raimondo C, Abdulla FR, Zain J, Querfeld C, Rosen ST. Rituximab, lenalidomide and pembrolizumab in refractory primary cutaneous diffuse large B-cell lymphoma, leg type. Br J Haematol 2019; 187:e79-e82. [PMID: 31566707 DOI: 10.1111/bjh.16211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Cosimo Di Raimondo
- Division of Dermatology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.,Department of Dermatology, Policlinico "Tor Vergata", Rome, Italy
| | - Farah R Abdulla
- Division of Dermatology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Jasmine Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Christiane Querfeld
- Division of Dermatology, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.,Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.,Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Steven T Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.,Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
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Martinez XU, Di Raimondo C, Abdulla FR, Zain J, Rosen ST, Querfeld C. Leukaemic variants of cutaneous T-cell lymphoma: Erythrodermic mycosis fungoides and Sézary syndrome. Best Pract Res Clin Haematol 2019; 32:239-252. [PMID: 31585624 PMCID: PMC9056079 DOI: 10.1016/j.beha.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/05/2019] [Indexed: 01/22/2023]
Abstract
Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common types of cutaneous lymphoma, accounting for approximately 60% of cutaneous T-cell lymphomas. Diagnosis requires correlation of clinical, histologic, and molecular features. A multitude of factors have been linked to the aetiopathogenesis, however, none have been definitively proven. Erythrodermic MF (E-MF) and SS share overlapping clinical features, such as erythroderma, but are differentiated on the degree of malignant blood involvement. While related, they are considered to be two distinct entities originating from different memory T cell subsets. Differential expression of PD-1 and KIR3DL2 may represent a tool for distinguishing MF and SS, as well as a means of monitoring treatment response. Treatment of E-MF/SS is guided by disease burden, patients' ages and comorbidities, and effect on quality of life. Current treatment options include biologic, targeted, immunologic, and investigational therapies that can provide long term response with minimal side effects. Currently, allogeneic stem cell transplantation is the only potential curative treatment.
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Affiliation(s)
| | - Cosimo Di Raimondo
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA; Policlinico Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
| | - Farah R Abdulla
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA.
| | - Jasmine Zain
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA.
| | - Steven T Rosen
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA; Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, United States.
| | - Christiane Querfeld
- City of Hope National Medical Center, 1500 E. Duarte Road, Duarte, CA 91010, USA; Beckman Research Institute, 1500 E. Duarte Road, Duarte, CA, 91010, United States.
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Caposiena Caro RD, Cannizzaro MV, Mazzeo M, Di Matteo E, Di Raimondo C, Rossi P, Bianchi L. Letter to the Editor regarding "Lymphedema in patients with hidradenitis suppurativa: a systematic review of published literature". Int J Dermatol 2018; 58:E92-E93. [PMID: 30578546 DOI: 10.1111/ijd.14342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Maria V Cannizzaro
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Mauro Mazzeo
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Eleonora Di Matteo
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Cosimo Di Raimondo
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Piero Rossi
- Department of General Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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Mazzeo M, Di Raimondo C, Gurnari C, Rapanotti MC, Giunta A, Franceschini L, Rizzo M, Minieri M, Provenzano I, Bernardini S, Cantonetti M, Bianchi L. Early detection of IgH monoclonal rearrangement in follicular spicules of the nose preceding multiple myeloma diagnosis. GIORN ITAL DERMAT V 2018; 155:364-366. [PMID: 30249084 DOI: 10.23736/s0392-0488.18.06016-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Mauro Mazzeo
- Department of Dermatology, Tor Vergata University, Rome, Italy -
| | | | - Carmelo Gurnari
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | | | | | - Luca Franceschini
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Manuela Rizzo
- Department of Hematology, Tor Vergata University, Rome, Italy
| | - Marilena Minieri
- Department of Clinical Biochemistry and Molecular Biology, Tor Vergata University, Rome, Italy
| | - Ida Provenzano
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, Tor Vergata University, Rome, Italy
| | - Maria Cantonetti
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, Tor Vergata University, Rome, Italy
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Giallongo C, Tibullo D, Parrinello NL, La Cava P, Di Rosa M, Bramanti V, Di Raimondo C, Conticello C, Chiarenza A, Palumbo GA, Avola R, Romano A, Di Raimondo F. Granulocyte-like myeloid derived suppressor cells (G-MDSC) are increased in multiple myeloma and are driven by dysfunctional mesenchymal stem cells (MSC). Oncotarget 2018; 7:85764-85775. [PMID: 26967390 PMCID: PMC5349872 DOI: 10.18632/oncotarget.7969] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 02/05/2016] [Indexed: 01/06/2023] Open
Abstract
Granulocytic-Myeloid-derived suppressor cells (G-MDSC) are increased in Multiple Myeloma (MM) patients but the mechanisms of G-MDSC generation are still unknown. There are many evidences of the role of mesenchymal stem cells (MSC) in promoting MM cell growth, survival and drug-resistance. We here used a specific experimental model in vitro to evaluate the ability of MSC to induce G-MDSC. We found that although MSC derived from healthy donors (HD), MGUS and MM were able to generate the same amount of MDSC, only MM-MSC-educated G-MDSC exhibited suppressive ability. In addition, in comparison with MSC derived from HD, MM-MSC produce higher amount of immune-modulatory factors that could be involved in MDSC induction. Compared to G-MDSC obtained from co-culture models with MSC from healthy subjects, both MGUS and MM-MSC-educated G-MDSC showed increase of immune-modulatory factors. However, only MM-MSC educated G-MDSC 1) up-regulated immune-suppressive factors as ARG1 and TNFα, 2) expressed higher levels of PROK2, important in angiogenesis and inflammatory process, and 3) showed ability to digest bone matrix.Our data demonstrate that MM-MSC are functionally different from healthy subjects and MGUS-MSC, supporting an evolving concept regarding the contribution of MM-MSC to tumor development and progression.
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Affiliation(s)
- Cesarina Giallongo
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Daniele Tibullo
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy.,Department of Biological, Geological and Environmental Sciences, University of Catania, Catania, Italy
| | | | - Piera La Cava
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
| | - Michelino Di Rosa
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Vincenzo Bramanti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Cosimo Di Raimondo
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
| | - Concetta Conticello
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
| | - Annalisa Chiarenza
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
| | - Giuseppe A Palumbo
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
| | - Roberto Avola
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Alessandra Romano
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
| | - Francesco Di Raimondo
- Division of Hematology, A.O.U. Policlinico-OVE, Catania, University of Catania, Italy
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Mazzeo M, Di Raimondo C, Vaccarini S, Ferlosio A, Orlandi A, Cantonetti M, Bianchi L. Psoriasiform sarcoidosis: an unusual variety. GIORN ITAL DERMAT V 2018; 154:492-493. [PMID: 29368850 DOI: 10.23736/s0392-0488.18.05756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Mauro Mazzeo
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
| | - Cosimo Di Raimondo
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy -
| | - Sara Vaccarini
- Department of Hematology, University of Rome Tor Vergata, Rome, Italy
| | - Amedeo Ferlosio
- Department of Anatomic Pathology, University of Rome Tor Vergata, Rome, Italy
| | - Augusto Orlandi
- Department of Anatomic Pathology, University of Rome Tor Vergata, Rome, Italy
| | - Maria Cantonetti
- Department of Hematology, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Rome, Italy
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Vetro C, Romano A, Amico I, Conticello C, Motta G, Figuera A, Chiarenza A, Raimondo CD, Giulietti G, Bonanno G, Palumbo GA, Raimondo FD. Endoscopic features of gastro-intestinal lymphomas: From diagnosis to follow-up. World J Gastroenterol 2014; 20:12993-13005. [PMID: 25278693 PMCID: PMC4177478 DOI: 10.3748/wjg.v20.i36.12993] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Revised: 02/28/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
Many progresses have been done in the management of gastrointestinal (GI) lymphomas during last decades, especially after the discovery of Helicobacter pylori-dependent lymphoma development. The stepwise implementation of new endoscopic techniques, by means of echoendoscopy or double-balloon enteroscopy, enabled us to more precisely describe the endoscopic features of GI lymphomas with substantial contribution in patient management and in tailoring the treatment strategy with organ preserving approaches. In this review, we describe the recent progresses in GI lymphoma management from disease diagnosis to follow-up with a specific focus on the endoscopic presentation according to the involved site and the lymphoma subtype. Additionally, new or emerging endoscopic technologies that have an impact on the management of gastrointestinal lymphomas are reported. We here discuss the two most common subtypes of GI lymphomas: the mucosa-associated lymphoid tissue and the diffuse large B cell lymphoma. A general outline on the state-of-the-art of the disease and on the role of endoscopy in both diagnosis and follow-up will be performed.
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MESH Headings
- Animals
- Endoscopy, Gastrointestinal
- Endosonography
- Helicobacter Infections/complications
- Helicobacter Infections/microbiology
- Helicobacter pylori/pathogenicity
- Humans
- Intestinal Neoplasms/diagnostic imaging
- Intestinal Neoplasms/microbiology
- Intestinal Neoplasms/pathology
- Intestinal Neoplasms/therapy
- Lymphoma, B-Cell, Marginal Zone/diagnostic imaging
- Lymphoma, B-Cell, Marginal Zone/microbiology
- Lymphoma, B-Cell, Marginal Zone/pathology
- Lymphoma, B-Cell, Marginal Zone/therapy
- Lymphoma, Large B-Cell, Diffuse/diagnostic imaging
- Lymphoma, Large B-Cell, Diffuse/microbiology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/therapy
- Neoplasm Grading
- Predictive Value of Tests
- Stomach Neoplasms/diagnostic imaging
- Stomach Neoplasms/microbiology
- Stomach Neoplasms/pathology
- Stomach Neoplasms/therapy
- Treatment Outcome
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Romano A, Chiarenza A, Conticello C, Cavalli M, Vetro C, Di Raimondo C, Cunsolo R, Palumbo GA, Di Raimondo F. Salvage therapy with pegylated liposomal doxorubicin, bortezomib, cyclophosphamide, and dexamethasone in relapsed/refractory myeloma patients. Eur J Haematol 2014; 93:207-13. [PMID: 24673398 DOI: 10.1111/ejh.12325] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES In vitro studies have shown synergistic anti-myeloma effects of bortezomib combined with alkylating agents or anthracycline. We tested safety and efficacy of the combination of bortezomib, doxorubicin cyclophosphamide, and dexamethasone (ABCD) in the treatment of relapsed/refractory myeloma. METHODS ABCD consisted of bortezomib given intravenous (IV) at dosage 1.3 mg/m(2) , dexamethasone 40 mg IV on days 1, 4, 8, and 15, pegylated liposomal doxorubicin (PLD) 20 mg IV on days 1 and 15, plus cyclophosphamide 100 mg/d per os for 15 d. Between January 2008 and February 2009, 24 patients received a median of four 28-d ABCD cycles (range 1-6). All patients had been already treated with a median of two previous lines of treatment (range 1-6): 38% were resistant to previous therapies and 62% were relapsed. RESULTS Clinical response was observed in 12 patients (50%), including 29% of very good partial remissions or better. Side effects included hematological toxicity (31% any grade), grades 3-4 thrombocytopenia (9%), grades 3-4 anemia (17%). Non-hematological toxicity affected 32% of administered cycles and included gastrointestinal disturbances (54%), peripheral neuropathy (8%), and infections (8%). After a median follow-up of 21.5 months (range 2-44 months), median of progression-free survival (PFS) was 8.7 months and median overall survival was 22.5 months. Achieving at least partial response within the second cycle was associated with a better PFS (19.5 months vs. 3.5 months), P = 0.03, HR 0.35 (CI 95% 0.13-0.90). CONCLUSION ABCD is safe and effective for relapsed/refractory MM subjects previously treated with novel agents.
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Affiliation(s)
- Alessandra Romano
- Department of Clinical and Molecular Biomedicine, Section of Haematology, University of Catania, Catania, Italy; Division of Hematology, Azienda Policlinico-OVE, Catania, Italy; Fondazione Umberto Veronesi, Rome, Italy
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Vetro C, Chiarenza A, Romano A, Amico I, Calafiore V, Di Raimondo C, Coppolino F, Di Raimondo F. Prognostic assessment and treatment of primary gastric lymphomas: how endoscopic ultrasonography can help in tailoring patient management. Clin Lymphoma Myeloma Leuk 2013; 14:179-85. [PMID: 24369919 DOI: 10.1016/j.clml.2013.10.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 10/03/2013] [Accepted: 10/21/2013] [Indexed: 12/18/2022]
Abstract
Endoscopic ultrasonography (EUS) has recently gained a pivotal role in the management of gastric lymphomas, especially in the diagnostic workup. Its accuracy and reliability have overcome those of other imaging techniques, such that it represents an invaluable tool for the management of gastric lymphomas. Although this technique is operator dependent, its application in large series has proved its reliability. Thus, it has generally been considered a useful tool for providing information crucial in deciding the treatment program, especially for mucosa-associated lymphoid tissue (MALT) lymphomas, for which EUS can provide an accurate evaluation of disease extension and treatment response probability. Limited-stage disease, confined to the submucosa, has a greater probability to respond to sole Helicobacter pylori eradication. In contrast, the value of EUS in response assessment and follow-up monitoring is still debated, with discordant opinions about its reliability and clinical advantages, because normalization of the EUS findings occurs with a considerable delay compared to the histologic evaluation. In the follow-up setting, preliminary data have indicated that persistently positive EUS findings in low-grade gastric lymphoma could represent a warning for a possible relapse. However, in high-grade gastric lymphoma, such findings do not have any clinical implications.
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Affiliation(s)
- Calogero Vetro
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Annalisa Chiarenza
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Alessandra Romano
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Irene Amico
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
| | - Valeria Calafiore
- Division of Hematology, AOU Policlinico-OVE, University of Catania, Catania, Italy
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