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This retrospective study investigates the histopathological outcomes, upgrade rates, and disease-free survival (DFS) of high-risk breast lesions, including atypical ductal hyperplasia (ADH or DIN1b) and lobular in situ neoplasms (LIN), following Vacuum-Assisted Breast Biopsy (VABB) and surgical excision. The study addresses the challenge posed by these lesions due to their association with synchronous or adjacent Breast Cancer (BC) and increased future BC risk. The research, comprising 320 patients who underwent stereotactic VABB, focuses on 246 individuals with a diagnosis of ADH (120) or LIN (126) observed at follow-up. Pathological assessments, categorized by the UK B-coding system, were conducted, and biopsy samples were compared with corresponding excision specimens to determine upgrade rates for in situ or invasive carcinoma. Surgical excision was consistently performed for diagnosed ADH or LIN. Finally, patient follow-ups were assessed and compared between LIN and ADH groups to identify recurrence signs, defined as histologically confirmed breast lesions on either the same or opposite side. The results reveal that 176 (71.5%) patients showed no upgrade post-surgery, with ADH exhibiting a higher upgrade rate to in situ pathology than LIN1 (Atypical Lobular Hyperplasia, ALH)/LIN2 (Low-Grade Lobular in situ Carcinoma, LCIS) (38% vs. 20%, respectively, p-value = 0.002). Considering only patients without upgrade, DFS at 10 years was 77%, 64%, and 72% for ADH, LIN1, and LIN2 patients, respectively (p-value = 0.92). The study underscores the importance of a multidisciplinary approach, recognizing the evolving role of VABB. It emphasizes the need for careful follow-up, particularly for lobular lesions, offering valuable insights for clinicians navigating the complex landscape of high-risk breast lesions. The findings advocate for heightened awareness and vigilance in managing these lesions, contributing to the ongoing refinement of clinical strategies in BC care.

The primary aim of our study was to assess the main mammographic and ultrasonographic features of invasive male breast malignancies. The secondary aim was to evaluate whether a specific radiological presentation would be associated with a worse receptor profile. Radiological images (mammography and/or ultrasound) of all patients who underwent surgery for male invasive breast cancer in our institution between 2008 and 2023 were retrospectively analyzed by two breast radiologists in consensus. All significant features of radiological presentation known in the literature were re-evaluated. Fifty-six patients were selected. The mean age at surgery of patients was 69 years (range: 35–81); in 82% of cases (46 patients), the histologic outcome was invasive ductal carcinoma. A total of 28 out of 56 (50%) patients had preoperative mammography; in 9/28 cases (32%), we found a mass with microcalcifications on mammography. The mass presented high density in 25 out of 28 patients (89%); the mass showed irregular margins in 15/28 (54%) cases. A total of 46 out of 56 patients had preoperative ultrasounds. The lesion showed a solid mass in 41/46 (89%) cases. In 5/46 patients (11%), the lesion was a mass with a mixed (partly liquid–partly solid) structure. We did not find any statistically significant correlation between major types of radiological presentation and tumor receptor arrangement. Knowledge of the main radiologic presentation patterns of malignant male breast neoplasm can help better manage this type of disease, which is rare but whose incidence is increasing.

Allergic contact dermatitis (ACD) is a common inflammatory skin disease caused by delayed hypersensitivity to chemical and biotic contact allergens. ACD significantly affects the patients' quality of life negatively impacting both occupational and non-occupational settings. Patch testing is the gold standard diagnostic in vivo test to precise the ACD etiology and to correctly perform prevention. According to the Italian Medicines Agency (AIFA) legislative decree no. 178 of 29th May 1991, allergens are defined as medicines and therefore they are subject to strict regulation. In 2017, AIFA (decree no. 2130/2017) started a procedure to regulate contact allergens on the Italian market and actually the contact allergens temporarily authorized are reported in AIFA decree no. 98/2022, valid until November 2023. The availability on the market of contact allergens to diagnose ACD and continuous updating on the basis of new epidemiological trends are mandatory, jointly with the continuous update of the baseline and integrative series for patch testing. For this reason, the scientific community represented in Italy by the Skin Allergies Study Group of SIDeMaST (Italian Society of Dermatology and Venereology) and SIDAPA (Italian Society of Allergological, Occupational and Environmental Dermatology) are constantly working, in close relationship with the European scientific communities with large expertise in this important sector of the modern Dermatology. Herein, we report the setting up of regulatory legislation by AIFA and the new Italian Adult Baseline Series for patch testing.

Pumped hydro storage (PHS) is the most mature and widely used technology for large-scale energy storage. Hydropower plants are in fact also employed for this aim. However, most hydraulic sites suitable for this purpose have been already exploited. Therefore, the use of abandoned mines represents an alternative solution to take advantage of the availability of underground volumes as hydro storages. This paper investigates the potential of PHS plants integrated within a power generation system that comprises both programmable (e.g., hydropower and nuclear power plants) and non-programmable (e.g., wind and solar power plants) energy systems. All systems are connected with the power grid. To this purpose, this paper develops a methodology aimed at identifying the optimal sizing of the PHS plant as well as the optimal operation of the whole power generation system at Country level, with the goal of minimizing the imported energy. The methodology is validated by using Sweden as the case study, to assess the energy and economic feasibility of PHS plants in 2050. Different future scenarios of electricity production, demand, and cost are analyzed. The analyses carried out in this paper demonstrate that PHS plants are highly recommended if the cost of imported energy is expected to increase. In such a scenario, PHS is mainly employed to meet domestic electricity demand.

Purpose of the article: The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged ≥ 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices. Materials and methods: A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged ≥ 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation. Results: The mean PASI score was 16.6 ± 9.4 at baseline and significantly decreased to 4.3 ± 5.2 after 4 weeks (p < 0.001), and 1.1 ± 1.7 after 16 week (p < 0.001). This level of improvement was maintained after 36 weeks (p < 0.001). PASI ≤2 was recorded in 36 (36.7%) at week 4, 68% and 69.4% at week 16 and 36, respectively. By week 16, 86/98 (87.8%) patients reached PASI75, 71/98 (72.4%) obtained PASI90, and 52/98 (53.1%) PASI100. Binary logistic regression tests showed a significant association of PASI100 by week 4 with lower PASI at baseline. PASI 100 at 16 or 36 weeks was not

Introduction: Genital involvement is observed in approximately 60% of patients with psoriasis, presenting clinicians with formidable challenges in treatment. While new biologic drugs have emerged as safe and effective options for managing psoriasis, their efficacy in challenging-to-treat areas remains inadequately explored. Intriguingly, studies have shown that interleukin (IL)-17 inhibitors exhibit effectiveness in addressing genital psoriasis. Objectives: We aimed to determine the effectiveness profile of bimekizumab in patients affected by moderate-to-severe plaque psoriasis with involvement of genitalia. Methods: Bimekizumab, a dual inhibitor of both IL-17A and IL-17F, was the focus of our 16-week study, demonstrating highly favorable outcomes for patients with genital psoriasis. The effectiveness of bimekizumab was evaluated in terms of improvement in Static Physician's Global Assessment of Genitalia (sPGA-G) and Psoriasis Area and Severity Index. Results: Sixty-five adult patients were enrolled. Remarkably, 98.4% of our participants achieved a clear sPGA-G score (s-PGA-g=0) within 16 weeks. Moreover, consistent improvements were observed in PASI scores, accompanied by a significant reduction in the mean Dermatology Life Quality Index (DLQI), signifying enhanced quality of life. Notably, none of the patients reported a severe impairment in their quality of life after 16 weeks of treatment. In our cohort of 65 patients, subgroup analyses unveiled that the effectiveness of bimekizumab remained unaffected by prior exposure to other biologics or by obesity. Conclusions: Our initial findings suggest that bimekizumab may serve as a valuable treatment option for genital psoriasis. Nevertheless, further research with larger sample sizes and longer-term follow-up is imperative to conclusively validate these results.

Purpose: Tildrakizumab is a selective inhibitor of IL-23 approved for the treatment of moderate-to-severe plaque psoriasis in two dosages. We conducted a 16-week multicenter retrospective study to compare the effectiveness and safety of tildrakizumab 200 mg versus tildrakizumab 100 mg in patients with a high disease burden or high body weight. Materials and methods: Our retrospective study included 134 patients treated with tildrakizumab 200 mg and 364 patients treated with tildrakizumab 100 mg from 28 Italian Dermatology Units affected by moderate-to-severe plaque psoriasis. The patients had a body weight above 90 kg or a high disease burden (Psoriasis Area and Severity Index [PASI] ≥ 16 or the involvement of difficult-to-treat areas). We evaluated the effectiveness of tildrakizumab at the week-16 visit in terms of PASI90, PASI100 and absolute PASI ≤ 2. Results: After 16 weeks of treatment with tildrakizumab 200 mg, PASI90 was reached by 57.5% of patients and PASI100 by 39.6% of patients. At the same time point, 34.3% and 24.2% of patients treated with tildrakizumab 100 mg achieved PASI90 and PASI100, respectively. Conclusions: Our data suggest that tildrakizumab 200 mg has better effectiveness than tildrakizumab 100 mg in patients with a body weight ≥ 90 kg and a high disease burden.

Bimekizumab è un anticorpo monoclonale umanizzato, recentemente approvato per il trattamento della psoriasi a placche moderato-grave, inibitore selettivo delle isoforme dell’interleuchina-17A e F. Le esperienze real-life riguardanti l’utilizzo del farmaco sono limitate ed il profilo del paziente con riposta più elevata PASI100 cioè super responder SR non è stato analizzato. Presentiamo questo studio multicentrico, retrospettivo volto a disegnare il profilo del paziente che beneficia maggiormente del trattamento con bimekizumab, considerando come SR coloro che raggiungono PASI 100 alla settimana-4 e 16. Sono stati studiati pazienti adulti affetti da psoriasi moderato-grave, trattati con bimekizumab per almeno 16 settimane presso 21 centri dermatologici italiani, secondo regole di appropriatezza AIFA e in accordo con la scheda tecnica del farmaco. Endpoints di efficacia erano PASI75, PASI90 e PASI100 alla settimana 4 e 16, ed in particolare la percentuale di SR ai due tempi. I pazienti che non raggiungevano tale target venivano definiti come non-super responders NSRs. Sono stati studiati 137 pazienti con età media 52,47±15,56 anni, BMI medio 27,43±5,91 e PASI medio al basale di 16,00±9,29. Alla settimana 4 il 72% dei pazienti raggiungeva PASI75, il 50% PASI90, mentre il 43% otteneva PASI100, definendo la popolazione SR alla settimana 4. Alla settimana 16, il 93% dei pazienti raggiungeva PASI75, il 77% PASI90, il 70% dei pazienti risultava essere SR mentre solo il 7% non raggiungeva PASI 75. Sono emerse alcune differenze caratterizzanti pazienti con un più rapido raggiungimento dello stato di SRs alla settimana 4 rispetto alla settimana 16: età ≥46<65, coesistenza di <2 comorbidità e stato naïve a precedenti trattamenti biologici. Considerando alcune caratteristiche clinico-demografiche è stata condotta un’analisi univariata per valutare le differenze tra SR e NSRs. Lo stato di NSR è risultato associato significativamente alla settimana 4 con: BMI≥25 &

We examine the effect of higher-harmonic passive cavities (HHCs) on the beam response to rf noise. Upon invoking certain assumptions to make the problem tractable, we employ Vlasov methods to show that when the dipole approximation applies the HHCs have a generally limited impact. Beam loading in the main cavity is included in the analysis. We illustrate our results and the limitations of our model in application to the Lawrence Berkeley National Laboratory ALS (Advanced Light Source) and the future ALS Upgrade (ALS-U) offering validation against macroparticle simulations.

Background: Embolisation of the parenchymal tract is a key step after any other transhepatic or transplenic percutaneous portal vein catheterization since eventual venous bleeding is difficult to control and may require surgical management. Different techniques have been proposed to perform tract embolisation. The aim of this study is to compare the safety and efficacy of different techniques of haemostasis of the parenchymal tract. Materials and methods: All the interventional procedures with percutaneous transhepatic or transplenic access to the portal vein (excluding ipsilateral portal vein embolisation) from January 2010 to July 2020, in two tertiary hospitals, were retrospectively analyzed. The following data were evaluated: access site, the technique of embolisation, technical success in terms of immediate thrombosis of the tract, safety and clinical efficacy in terms of the absence of hemorrhagic and thrombotic complications. Results: One-hundred-sixty-one patients underwent 220 percutaneous transhepatic or transplenic portal vein catheterization procedures. The main indications were pancreatic islet transplantation, portal anastomotic stenosis after liver transplantation, and portal vein thrombosis recanalization. As embolic materials gelfoam was used in 105 cases, metallic micro-coils in 54 cases, and cyanoacrylic glue in 44 cases; in 17 cases the parenchymal tract was not embolized. Technical success was 98% without significant difference among groups (p-value = 0.22). Eighteen post-procedural abdominal bleedings occurred, all grade 3 and were managed conservatively; difference among groups was not significant (p-value = 0.25). We detected 12 intrahepatic portal branch thromboses not related to the embolisation technique; only one case of non-target embolisation was documented after liver tract embolisation with glue, without clinical consequences. Conclusion: Embolisation of the parenchymal tract after percutaneous portal vein catheterization is technical

Embolization in pediatric patients encompasses a large spectrum of indications, ranging from the elective treatment of congenital diseases of the cardiovascular system to the urgent management of acute hemorrhagic conditions. In particular, the endovascular treatment of central and peripheral vascular malformations and hypervascular tumors represents a wide chapter for both congenital and acquired situations. Thanks to the progressive availability of low-profile endovascular devices and new embolic materials, the mini-invasive approach has gradually overtaken surgery. In this review, the main embolization procedures will be illustrated and discussed, with a focus on clinical indications and expected outcomes. The most recent mini-invasive techniques will be described, with hints on the cutting-edge devices and embolic materials.

Il filosofo Aristotele, nella Politica, afferma: «la parola è fatta per esprimere ciò che è giovevole e ciò che è nocivo e, di conseguenza, il giusto e l’ingiusto». Di fronte alle nefandezze del «secolo breve», così come Hobsbawm definisce il Novecento, il potere della parola acquista un valore fondamentale per poter giudicare quanto è accaduto. In modo particolare la lezione di Primo Levi, deportato ad Auschwitz sotto il nazifacismo e quella di Eugenio Corti, sottotenente del 35° corpo d’armata che partecipò alla ritirata di Russia, in modo simile e al contempo diverso, mostrano, con le loro opere letterarie, quanto la parola sia la risposta al potere totalitario: un contropotere all’ideologia nazista e comunista. Si vogliono quindi confrontare queste due esperienze mettendo in luce quanto la letteratura riesca a far crollare poteri egemonici basati sulla distruzione della persona e sul convincimento di un mondo svincolato dalle libertà di pensiero.

Fourth-generation storage rings enabled by multi-bend achromat lattices are being inaugurated worldwide and many more are planned for the next decade. These sources deliver stable ultra-high brightness radiation with unmatched levels of transverse coherence by virtue of their highly advanced magnetic lattices. Optimization of these challenging and strongly nonlinear lattices with many degrees of freedom bounded by extensive sets of constraints and multiple often conflicting optimization goals is highly demanding and requires application of the most advanced numerical tools available to the community. While multi-objective genetic algorithms have been very successful in supporting these optimization efforts, the algorithms suffer from a fundamental limitation of their stochastic nature: an exceedingly vast number of candidate lattices, most of which eventually are rejected, has to be fully evaluated. This comes at immense computational cost and thus drives excessive runtime despite use of large supercomputing clusters. We therefore propose to employ deep learning techniques and iterative retraining of neural networks to massively accelerate such lattice evaluation, thereby allowing lattice optimization to rely on far fewer a priori assumptions, open up to larger search ranges, and include right from the start and in parallel multiple error distributions to find truly global optima, all while completing a full optimization campaign in weeks rather than months. In this paper we present the neural network designs, the deep learning approach, iterative retraining procedures, and demonstrate how these machine learning techniques can be incorporated into existing state-of-the-art optimization workflows with only minimal changes applied to the optimization pipeline itself and none at all to the employed tracking codes.

Contains fulltext : 297080.pdf (Publisher’s version ) (Open Access), A key principle of clinical studies and case reports is that they should reflect the demographics and epidemiology of the patient population concerned. Here, we have compiled a diverse group of clinical cases of generalized pustular psoriasis (GPP) to showcase the differences in GPP presentation in patients worldwide. We attempt to capture the broad spectrum of clinical presentations of GPP and showcase the diversity of the patient population. The patients included in this series are diverse in age, genetic background, skin phototype and medical history. Moreover, they present with a variety of clinical courses of GPP and different degrees of systemic involvement, and experience flares triggered by different inciting factors. The key learnings from this case series may support physicians in identifying and managing patients with this rare and multifaceted disease that can affect patients both physically and psychologically.

Introduction: Bimekizumab is a monoclonal antibody that targets Interleukin-17 A and F, approved for the treatment of moderate-to-severe plaque psoriasis. While bimekizumab has been evaluated in several phase-III clinical trials, real-world evidence is still very limited. Method: This multicenter retrospective study included patients affected by plaque psoriasis treated with bimekizumab from May 1, 2022 to April 30, 2023, at 19 Italian referral hospitals. Patients affected by moderate-to-severe plaque psoriasis eligible for systemic treatments were included. The effectiveness of bimekizumab was evaluated in terms of reduction in psoriasis area and severity index (PASI) compared with baseline at weeks 4 and 16. The main outcomes were the percentages of patients achieving an improvement of at least 75% (PASI75), 90% (PASI90) and 100% (PASI100) in PASI score. Results: The study included 237 patients who received at least one injection of bimekizumab. One hundred and seventy-one patients and 114 reached four and 16 weeks of follow-up, respectively. Complete skin clearance was achieved by 43.3% and 75.4% of patients at weeks 4 and 16, respectively. At week 16, 86.8% of patients reported no impact on their quality of life. At week 16, there were no significant differences between bio-naïve and bio-experienced patients in terms of PASI75, PASI90 and PASI100. The most commonly reported adverse events (AEs) were oral candidiasis (10.1%). No severe AEs or AEs leading to discontinuation were observed throughout the study. Conclusion: Our experience supports the effectiveness and tolerability of bimekizumab in a real-world setting with similar results compared with phase-III clinical trials.

Brodalumab is a recombinant, fully human immunoglobulin IgG2 monoclonal antibody specifically targeted against interleukin-17RA that has been approved for the treatment of moderate-to-severe psoriasis in Europe. We developed a Delphi consensus document focused on brodalumab for the treatment of moderate-to-severe psoriasis. Based on published literature and their clinical experience a steering committee drafted 17 statements covering 7 domains specific to the treatment of moderate-to-severe psoriasis with brodalumab. A panel of 32 Italian dermatologists indicated their level of agreement using a 5-point Likert scale (from 1 = “strongly disagree” to 5 = “strongly agree”) using an online modified Delphi method. After the first round of voting (32 participants), positive consensus was reached for 15/17 (88.2%) of the proposed statements. Following a face-to-face virtual meeting, the steering committee decided that 5 statements would form “main principles” and 10 statements formed the final list. After a second round of voting, consensus was reached in 4/5 (80%) of the main principles and 8/10 (80%) for consensus statements. The final list of 5 main principles and 10 consensus statements identify key indications specific to the use of brodalumab in the treatment of moderate-to-severe psoriasis in Italy. These statements aid dermatologists in the management of patients with moderate-to-severe psoriasis.

Introduction: While several European studies have reported real-world apremilast use, patient-perceived benefits, and treatment satisfaction, local reimbursement criteria for apremilast vary and data from Italy are limited. Methods: The cross-sectional DARWIN study enrolled consecutive patients who had initiated apremilast for plaque psoriasis 6 (± 1) months prior to enrolment at a single visit across 24 Italian dermatological sites. Disease severity was assessed using body surface area (BSA) and Physician Global Assessment (PGA). Patient-reported outcomes assessed 6 (± 1) months after apremilast initiation were Dermatology Life Quality Index (DLQI), Patient Benefit Index (PBI), and 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9). Results: Of 184 patients enrolled between July 2019 and January 2021, 180 were included in the analysis. At apremilast initiation, median (25th–75th percentile) time since psoriasis diagnosis was 8.6 (3.2–22.2) years; median BSA, 10.0% (5.0–16.0); mean (standard seviation, SD) DLQI total score, 13.5 (8.0). Over half (54.9%) of patients with available data reported psoriasis had a very or extremely large effect on their quality of life (QoL); half reported itching (50.6%) and/or special areas involvement (50.0%). Most (73.9%) had comorbidities and were biologic-naïve (81.5%). The most common reasons for initiating apremilast were lack of efficacy of previous treatment (56.7%) and contraindications to other treatments (44.4%). At 6 (± 1) months, most patients were continuing apremilast and/or reported a Global PBI score ≥ 1 (minimum clinical benefit) (86.1% and 90.0%, respectively); approximately half achieved BSA ≤ 3% and/or DLQI total score ≤ 5 (47.1% and 48.5%); 18.8% achieved PGA = 0; mean (SD) TSQM-9 global treatment satisfaction score was 59.0 (24.8). Apremilast was well tolerated; no new safety signals were identified. Conclusions: Patients treated with apremilast for 6 months in Italian clinical practice rep

Background: Generalized pustular psoriasis (GPP) is a rare, severe inflammatory skin disease characterized by recurrent episodes of flares. Characteristics of patients experiencing a flare are hardly described in a real-life setting. The aim of the study is to investigate the clinical characteristics of patients experiencing a flare of GPP. Methods: Multicenter retrospective observational study on consecutive patients experiencing a flare of GPP between 2018 and 2022. Disease severity and quality of life were assessed by Generalized Pustular Psoriasis Area, Body Surface Area (BSA), and Severity Index (GPPASI), and Dermatology life quality index (DLQI) questionnaire, respectively. Visual analogue scale (VAS) of itch and pain, triggers, complications, comorbidities, pharmacological therapies, and outcome were collected. Results: A total of 66 patients, 45 (68.2%) females, mean age 58.1 ± 14.9 years, were included. The GPPASI, BSA, and DLQI were 22.9 ± 13.5 (mean ± standard deviation), 47.9 ± 29.1, and 21.0 ± 5.0, respectively. The VAS of itch and pain were 6.2 ± 3.3 and 6.2 ± 3.0, respectively. Fever (>38 °C) and leukocytosis (WBC > 12 × 109/L) were found in 26 (39.4%) and 39 (59.1%) patients, respectively. Precipitating triggers were identified in 24 (36.3%) and included infections (15.9%), drugs (10.6%), stressful life events (7.6%), and corticosteroids withdrawal (3.0%). Fourteen (21.2%) patients were hospitalized because of complications including infections in 9 (13.6%) leading to death in one case and hepatitis in 3 (4.5%). Conclusions: GPP flares can be severe and cause severe pain and itch with significant impact on the quality of life. In about one-third of patients the flare may have a persistent course and, with complications, lead to hospitalization.

Purpose: SUPREME, a phase IIIb study conducted in Italy, demonstrated safety and high efficacy of secukinumab for up to 72 weeks in patients with moderate-to-severe plaque-type psoriasis. SUPREME 2.0 study aimed to provide real-world data on the long-term drug survival and effectiveness of secukinumab beyond 72 weeks. Patients and Methods: SUPREME 2.0 is a retrospective observational chart review study conducted in patients previously enrolled in SUPREME study. After the end of the SUPREME study, eligible patients continued treatment as per clinical practice, and their effectiveness and drug survival data were retrieved from medical charts. Results: Of the 415 patients enrolled in the SUPREME study, 297 were included in SUPREME 2.0; of which, 210 (70.7%) continued secukinumab treatment throughout the 42-month observation period. Patients in the biologic-naïve cohort had higher drug survival than those in the biologic-experienced cohort (74.9% vs 61.7%), while HLA-Cw6–positive and HLA-Cw6–negative patients showed similar drug survival (69.3% and 71.9%). After 42 months, Psoriasis Area and Severity Index (PASI) 90 was achieved by 79.6% of patients overall; with a similar proportion of biologic-naïve and biologic-experienced patients achieving PASI90 (79.8% and 79.1%). The mean absolute PASI score reduced from 21.94 to 1.38 in the overall population, 21.90 to 1.24 in biologic-naïve and 22.03 to 1.77 in biologic-experienced patients after 42 months. The decrease in the absolute PASI score was comparable between HLA-Cw6–positive and HLA–Cw6-negative patients. The baseline Dermatology Life Quality Index scores also decreased in the overall patients (10.5 to 2.32) and across all study sub-groups after 42 months. Safety was consistent with the known profile of secukinumab, with no new findings. Conclusion: In this real-world cohort study, secukinumab showed consistently high long-term drug survival and effectiveness with a favourable safety profile.

Esponente della scapigliatura democratica, ammiratore di Zola e attivista politico, Paolo Valera è lo scrittore che si è fatto carico di rappresentare e denunciare ingiustizie e ipocrisie della capitale morale d’Italia. La sua esperienza di giornalista attento ai mali sociali lo ha spinto a calarsi nei bassifondi cittadini, per ritrarre il degrado in cui vivevano il quarto e il quinto stato. La sua denuncia sociale dunque passa attraverso lo studio delle condizioni di vita del sottoproletariato, mostrando una particolare attenzione alla questione alimentare. Dalla denuncia della “malattia della fame” di Milano sconosciuta (1879), passando per le sofferenze del romanzo semiautobiografico Alla conquista del pane (1882) fino al suo capolavoro, il romanzo La folla (1901), il cibo si costituisce come un sistema con cui Valera ha portato avanti la sua lotta contro la società borghese, fino a rendere la parola "nausea" (in linea con la poetica del disgusto naturalista) come un termine chiave per il suo stile.

Introduction: Bimekizumab is a monoclonal antibody that targets Interleukin-17 A and F, approved for the treatment of moderate-to-severe plaque psoriasis. While bimekizumab has been evaluated in several phase-III clinical trials, real-world evidence is still very limited. Method: This multicenter retrospective study included patients affected by plaque psoriasis treated with bimekizumab from May 1, 2022 to April 30, 2023, at 19 Italian referral hospitals. Patients affected by moderate-to-severe plaque psoriasis eligible for systemic treatments were included. The effectiveness of bimekizumab was evaluated in terms of reduction in psoriasis area and severity index (PASI) compared with baseline at weeks 4 and 16. The main outcomes were the percentages of patients achieving an improvement of at least 75% (PASI75), 90% (PASI90) and 100% (PASI100) in PASI score. Results: The study included 237 patients who received at least one injection of bimekizumab. One hundred and seventy-one patients and 114 reached four and 16 weeks of follow-up, respectively. Complete skin clearance was achieved by 43.3% and 75.4% of patients at weeks 4 and 16, respectively. At week 16, 86.8% of patients reported no impact on their quality of life. At week 16, there were no significant differences between bio-naïve and bio-experienced patients in terms of PASI75, PASI90 and PASI100. The most commonly reported adverse events (AEs) were oral candidiasis (10.1%). No severe AEs or AEs leading to discontinuation were observed throughout the study. Conclusion: Our experience supports the effectiveness and tolerability of bimekizumab in a real-world setting with similar results compared with phase-III clinical trials.

Arterioportal fistulas (APFs) are uncommon vascular abnormalities with a heterogeneous etiology. In pediatric orthotopic liver transplantation (OLT), APFs are frequently iatrogenic, following percutaneous liver interventions. The aim of this study was to report the 10-year experience of a tertiary referral center for pediatric OLT in the interventional radiological (IR) and conservative management of acquired APFs. A retrospective search was performed to retrieve pediatric patients (<18 years old) with a diagnosis of APF at color Doppler ultrasound (CDUS) or computed tomography angiography (CTA) from 2010 to 2020. Criteria for IR treatment were the presence of hemodynamic alterations at CDUS (resistive index <0.5; portal flow reversal) or clinical manifestations (bleeding; portal hypertension). Conservatively managed patients served as a control population. Clinical and imaging follow-up was analyzed. Twenty-three pediatric patients (median age, 4 years; interquartile range = 11 years; 15 males) with 24 APFs were retrieved. Twenty patients were OLT recipients with acquired APFs (16 iatrogenic). Twelve out of twenty-three patients were managed conservatively. The remaining 11 underwent angiography with confirmation of a shunt in 10, who underwent a total of 16 embolization procedures (14 endovascular; 2 transhepatic). Technical success was reached in 12/16 (75%) procedures. Clinical success was achieved in 8/11 (73%) patients; three clinical failures resulted in one death and two OLTs. After a median follow-up time of 42 months (range 1–107), successfully treated patients showed an improvement in hemodynamic parameters at CDUS. Conservatively managed patients showed a stable persistence of the shunts in six cases, spontaneous resolution in four, reduction in one and mild shunt increase in one. In pediatric patients undergoing liver interventions, APFs should be investigated. Although asymptomatic in most cases, IR treatment of APFs should be considered whenever

The Advanced Light Source Upgrade (ALS-U) is a 4th generation diffraction-limited soft x-ray radiation source, consisting of a new accumulator ring (AR) and a new storage ring (SR). In both rings coupling-impedance driven instabilities need careful evaluation to ensure meeting the machine's high-performance goals. This paper presents the workflow followed in building the impedance models and the beam-stability analysis based on those models. We follow the commonly accepted approach of separating the resistive-wall and the geometric parts of the impedance; the former is obtained by analytical formulas, the latter by numerical electro-magnetic codes (primarily CST Studio software) with perfectly-conducting boundary conditions. Impedance budgets are established and pseudo-Green functions calculated to be used in beam dynamics studies. We also present various ways to cross-check simulation results for reliable impedance modeling. Finally, the crucial single-bunch instability current thresholds for various operation modes are determined and discussed.

The Advanced Light Source Upgrade (ALS-U) is a 4th generation diffraction-limited soft x-ray radiation source, consisting of a new accumulator ring (AR) and a new storage ring (SR). In both rings coupling-impedance driven instabilities need careful evaluation to ensure meeting the machine's high-performance goals. This paper presents the workflow followed in building the impedance models and the beam-stability analysis based on those models. We follow the commonly accepted approach of separating the resistive-wall and the geometric parts of the impedance; the former is obtained by analytical formulas, the latter by numerical electro-magnetic codes (primarily CST Studio software) with perfectly-conducting boundary conditions. Impedance budgets are established and pseudo-Green functions calculated to be used in beam dynamics studies. We also present various ways to cross-check simulation results for reliable impedance modeling. Finally, the crucial single-bunch instability current thresholds for various operation modes are determined and discussed.

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Introduction: Psoriasis affects children with a considerable burden in early life. Treating pediatric psoriasis is challenging also because of the lack of updated specific guidelines. With the recent approval of several biologics for pediatric psoriasis and the ongoing COVID-19 pandemic, the management of young psoriatic patients is facing major changes. A revision of treatment recommendations is therefore needed. Methods: In September 2021, a board of six Italian dermatologists convened to update treatment recommendations. The board issued evidence- and consensus-based statements covering relevant areas of pediatric psoriasis, namely: assessment of psoriasis severity, management of children with psoriasis, and treatment of pediatric psoriasis. To reach consensus, the statements were submitted to a panel of 24 experts in a Delphi process performed entirely via videoconference. A treatment algorithm was produced. Results: There was full consensus that psoriasis severity is determined by the extension/severity of skin lesions, site of lesions, and impact on patient quality of life. Agreement was reached on the need for a multidisciplinary approach to pediatric psoriasis and the importance of patient/parents education. The relevance of vaccinations, including COVID-19 vaccination, for psoriatic children was acknowledged by all participants. Management issues that initially failed to reach consensus included the screening for psoriasis comorbidities and early treatment with biologics to prevent them and the use of telemedicine to facilitate patient follow-up. There was full consensus that topical corticosteroids are the first choice for the treatment of mild pediatric psoriasis, while phototherapy and systemic therapy are used in children with moderate-severe psoriasis. According to the proposed treatment algorithm, biologics are the first line of systemic therapy. Conclusions: Targeted systemic therapies are changing the treatment of moderate-severe pediatric psoriasis

BACKGROUND: Hidradenitis suppurativa (HS) is characterized by periodic worsening of symptoms. However, clinical parameters associated with flare are still to be established. The aim of this study was to investigate factors associated with flare outbreak in HS patients in treatment with adalimumab. METHODS: Moderate-severe HS patients were included in this retrospective analysis. In total, 115 HS patients treated with adalimumab from 5 Italian centers were reviewed. Gender, ages at onset/baseline, therapeutic delay, family history, Body Mass Index, smoking, comorbidities, phenotypes, body areas involved, Hurley stage, International Hidradenitis Suppurativa Severity Score System (IHS4), Dermatology Life Quality Index (DLQI) and Visual Analogue Scale for pain (pain-VAS) were collected at baseline. Flares were modelled with baseline features using univariate and multivariate Cox regression. The factors significantly correlated with flares in the univariate model were analyzed using a recurrent event survival analysis (Andersen-Gill model) to assess the relation between them and flares recurrence. RESULTS: During the observation period 80.9% of patients developed flares, detecting 252 flares, overall. A univariate model identified five risk factors associated with the outbreak of flares: age, therapeutic delay, groin involvement, Hurley III, higher IHS4, whereas, from multivariate model, only IHS4 resulted to be significantly correlated. Additionally, flares were positively associated with higher DLQI and pain-VAS. Finally, the Andersen-Gill model showed four factors correlated with flares recurrence: age, therapeutic delay, Hurley III and higher IHS4. CONCLUSIONS: An early treatment of HS may prevent both the disease progression and reduce the recurrence of flares.

SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by moderate to severe plaque psoriasis. The content of the guideline includes general information on the scope and purpose, health questions covered, target users and strength/limitations of the guideline, suggestions for disease severity grading and treatment goals. It presents the general treatment recommendations as well as detailed management and monitoring recommendations for the individual drugs including acitretin, cyclosporine, fumarates, methotrexate, adalimumab, apremilast, brodalumab, certolizumab pegol, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab and ustekinumab. Moreover, the guideline provides guidance for specific clinical situations such as patient with concomitant psoriatic arthritis, inflammatory bowel disease, a history of malignancies, a history of depression, diabetes, viral hepatitis, disease affecting the heart or the kidneys as well as concomitant neurological disease. Advice on how to screen for tuberculosis and recommendations on how to manage patients with a positive tuberculosis test result are given. It further covers treatment for pregnant women or those with childbearing potential. Information on vaccination, immunogenicity and systemic treatment during the COVID-19 pandemic is also provided.

Patch testing is the standard procedure used to diagnose allergic contact dermatitis. It is an in-vivo test, which reproduces the reaction to a contact allergen. This in-vivo test aims to reproduce the elicitation phase of allergic contact dermatitis and is performed applying allergens under occlusion on the skin under standardized conditions. These guidelines for the best practice in performing patch test have been developed by an Italian group of experts taking in account the Italian legislation and local pharmacological governance. Guidelines are adapted from the original article under the guidance of the European Society of Contact Dermatitis (ESCD) and on the basis of the SIDAPA guidelines.

The ALS-U light source will implement on-axis single-train swap-out injection employing an accumulator between the booster and storage rings. The accumulator ring design is a twelve period triple-bend achromat that will be installed along the inner circumference of the storage-ring tunnel. A non-conventional injection scheme will be utilized for top-off off-axis injection from the booster into the accumulator ring meant to accommodate a large $\sim 300$~nm emittance beam into a vacuum-chamber with a limiting horizontal aperture radius as small as $8$ mm. The scheme incorporates three dipole kickers distributed over three sectors, with two kickers perturbing the stored beam and the third affecting both the stored and the injected beam trajectories. This paper describes this ``3DK'' injection scheme and how it fits the accumulator ring's particular requirements. We describe the design and optimization process, and how we evaluated its fitness as a solution for booster-to-accumulator ring injection.

The Advanced Light Source Upgrade will implement on axis single-train swap-out injection employing an accumulator between the booster and storage rings. The accumulator ring (AR) design is a twelve period triple-bend achromat that will be installed along the inner circumference of the storage-ring tunnel. A nonconventional injection scheme will be utilized for top-off off axis injection from the booster into the AR meant to accommodate a large ∼300 nm emittance beam into a vacuum-chamber with a limiting horizontal aperture radius as small as 8 mm. The scheme incorporates three dipole kickers distributed over three sectors, with two kickers perturbing the stored beam and the third affecting both the stored and the injected beam trajectories. This paper describes this "3DK"injection scheme and how it fits the AR's particular requirements. We describe the design and optimization process, and how we evaluated its fitness as a solution for booster-to-accumulator ring injection.

The ALS-U light source will implement on-axis single-train swap-out injection employing an accumulator between the booster and storage rings. The accumulator ring design is a twelve period triple-bend achromat that will be installed along the inner circumference of the storage-ring tunnel. A non-conventional injection scheme will be utilized for top-off off-axis injection from the booster into the accumulator ring meant to accommodate a large $\sim 300$~nm emittance beam into a vacuum-chamber with a limiting horizontal aperture radius as small as $8$ mm. The scheme incorporates three dipole kickers distributed over three sectors, with two kickers perturbing the stored beam and the third affecting both the stored and the injected beam trajectories. This paper describes this ``3DK'' injection scheme and how it fits the accumulator ring's particular requirements. We describe the design and optimization process, and how we evaluated its fitness as a solution for booster-to-accumulator ring injection.

The Advanced Light Source Upgrade will implement on axis single-train swap-out injection employing an accumulator between the booster and storage rings. The accumulator ring (AR) design is a twelve period triple-bend achromat that will be installed along the inner circumference of the storage-ring tunnel. A nonconventional injection scheme will be utilized for top-off off axis injection from the booster into the AR meant to accommodate a large ∼300 nm emittance beam into a vacuum-chamber with a limiting horizontal aperture radius as small as 8 mm. The scheme incorporates three dipole kickers distributed over three sectors, with two kickers perturbing the stored beam and the third affecting both the stored and the injected beam trajectories. This paper describes this "3DK"injection scheme and how it fits the AR's particular requirements. We describe the design and optimization process, and how we evaluated its fitness as a solution for booster-to-accumulator ring injection.

Secukinumab, a fully human monoclonal antibody, neutralizes interleukin-17A, a cornerstone cytokine driving the multiple manifestations of psoriasis. This post-hoc analysis of the SUPREME study was performed to determine the sustainability of response to secukinumab in terms of Psoriasis Area and Severity Index (PASI) 90 in patients with moderate-to-severe plaque psoriasis. Based on PASI 90 response at week 16, patients were stratified as PASI 90 responders (PASI90R, n = 337) or non-responders (PASI90NR, n = 72). At week 20, 94.2% (n = 295/313) achieved PASI 90/100 response in PASI90R, with response maintained through week 48 (89.6%, n = 189/211). An increased proportion of patients achieved PASI 90/100 response in PASI90NR (week 20: 29.9%, n = 20/67; week 48: 57.1%, n = 20/35). Overall, 64.4% patients achieved absolute PASI score = 0 at week 24 with response sustained to week 48 (66.9%). Secukinumab showed sustained and stable efficacy in maintaining PASI 90 response in patients with moderate-to-severe plaque psoriasis up to week 48.

We introduce a perturbation-theory, mode-analysis method for longitudinal multibunch instabilities driven by the higher harmonic cavity (HHC) fundamental mode. The method, based on the exact solution of the unperturbed particle motion in the rf bucket and suitable for modeling the effect of cavities with general settings, is applied to study the feasibility of reutilizing the existing Advanced Light Source (ALS) HHCs in the ALS Upgrade (ALS-U). We find that with ALS cavities the ALS-U would be susceptible to a fast =1 mode instability. Interestingly, the instability is driven by the imaginary rather than the real part of the cavity fundamental-mode impedance.

The effect of rf harmonic cavities on the transverse mode-coupling instability (TMCI) is still not very well understood. We offer a fresh perspective on the problem by proposing a new numerical method for mode analysis and investigating a regime of potential interest to the new generation of light sources where resistive wall is the dominant source of transverse impedance. When the harmonic cavities are tuned for maximum flattening of the bunch profile we demonstrate that at vanishing chromaticities the transverse single-bunch motion is unstable at any current, with growth rate that in the relevant range scales as the 6th power of the current. With these assumptions and radiation damping included, we find that for machine parameters typical of 4th-generation light sources the presence of harmonic cavities could reduce the instability current threshold by more than a factor two.

The effect of rf harmonic cavities on the transverse mode-coupling instability (TMCI) is still not very well understood. We offer a fresh perspective on the problem by proposing a new numerical method for mode analysis and investigating a regime of potential interest to the new generation of light sources where resistive wall is the dominant source of transverse impedance. When the harmonic cavities are tuned for maximum flattening of the bunch profile we demonstrate that at vanishing chromaticities the transverse single-bunch motion is unstable at any current, with growth rate that in the relevant range scales as the 6th power of the current. With these assumptions and radiation damping included, we find that for machine parameters typical of 4th-generation light sources the presence of harmonic cavities could reduce the instability current threshold by more than a factor two.

We introduce a perturbation-theory, mode-analysis method for longitudinal multibunch instabilities driven by the higher harmonic cavity (HHC) fundamental mode. The method, based on the exact solution of the unperturbed particle motion in the rf bucket and suitable for modeling the effect of cavities with general settings, is applied to study the feasibility of reutilizing the existing Advanced Light Source (ALS) HHCs in the ALS Upgrade (ALS-U). We find that with ALS cavities the ALS-U would be susceptible to a fast =1 mode instability. Interestingly, the instability is driven by the imaginary rather than the real part of the cavity fundamental-mode impedance.

We study the effect of a passive harmonic cavity, introduced to cause bunch lengthening, in an electron storage ring. We derive a formula for the induced voltage from such a cavity with high Q, excited by a sequence of bunches, allowing for arbitrary gaps in the sequence and arbitrary currents. Except for a minor term that can be determined iteratively, the voltage is given in terms of a single mode of the Fourier transforms of the bunch forms, namely, the mode at the resonant frequency of the cavity. Supposing that the only wakefield is from the harmonic cavity, we derive a system of coupled Haïssinski equations which determine the bunch positions and profiles in the equilibrium state. The number of unknowns in the system is only twice the number of bunches, and it can be solved quickly by a Newton iteration, starting with a guess determined by path following from a solution at a weak current. We explore the effect of the fill pattern on the bunch lengthening and also the dependence on the shunt impedance and detuning of the cavity away from the third harmonic of the main accelerating cavity. We consider two measures to reduce the effects of gaps: (i) distribution of the gaps around the ring to the greatest extent allowed and (ii) "guard bunches"with higher charges adjacent to the gaps, compensating for the charge missing in gaps. Results for parameters of the forthcoming Advanced Light Source upgrade are presented.

The concept of using a single nonlinear kicker (NLK) to inject electron beams into a storage ring has been proposed and tested in several synchrotron radiation light source facilities. Different from pulsed dipole kicker magnets used in a conventional local-bump injection, the single nonlinear kicker provides a nonlinear distribution of magnetic fields which has a maximum value off axis where the injected beam arrives and a zero or near-zero value at the center where the stored beam passes by. Therefore, the injected beam will receive a kick from the NLK and lose its transverse momentum, and will be eventually captured by the storage ring. In the meantime the stored beam at the center will receive no kick or less kick, which significantly reduces the injection perturbations on the stored beam. In addition, the NLK injection requires less space for the kicker and removes the complications of synchronizing four pulsed kicker magnets. Because of these advantages, several light source facilities are either proposing or already using this NLK injection as a replacement of the conventional local-bump injection scheme. In this paper, we will discuss the working principal of this NLK injection, and use both Advanced Light Source and Advanced Light source Upgrade as examples to optimize the NLK injections. By optimizing the NLK design and injection conditions, we could achieve maximum injection efficiencies for both facilities with a large injected beam from the existing ALS booster.

We study the effect of a passive harmonic cavity, introduced to cause bunch lengthening, in an electron storage ring. We derive a formula for the induced voltage from such a cavity with high Q, excited by a sequence of bunches, allowing for arbitrary gaps in the sequence and arbitrary currents. Except for a minor term that can be determined iteratively, the voltage is given in terms of a single mode of the Fourier transforms of the bunch forms, namely, the mode at the resonant frequency of the cavity. Supposing that the only wakefield is from the harmonic cavity, we derive a system of coupled Haïssinski equations which determine the bunch positions and profiles in the equilibrium state. The number of unknowns in the system is only twice the number of bunches, and it can be solved quickly by a Newton iteration, starting with a guess determined by path following from a solution at a weak current. We explore the effect of the fill pattern on the bunch lengthening and also the dependence on the shunt impedance and detuning of the cavity away from the third harmonic of the main accelerating cavity. We consider two measures to reduce the effects of gaps: (i) distribution of the gaps around the ring to the greatest extent allowed and (ii) "guard bunches"with higher charges adjacent to the gaps, compensating for the charge missing in gaps. Results for parameters of the forthcoming Advanced Light Source upgrade are presented.

The concept of using a single nonlinear kicker (NLK) to inject electron beams into a storage ring has been proposed and tested in several synchrotron radiation light source facilities. Different from pulsed dipole kicker magnets used in a conventional local-bump injection, the single nonlinear kicker provides a nonlinear distribution of magnetic fields which has a maximum value off axis where the injected beam arrives and a zero or near-zero value at the center where the stored beam passes by. Therefore, the injected beam will receive a kick from the NLK and lose its transverse momentum, and will be eventually captured by the storage ring. In the meantime the stored beam at the center will receive no kick or less kick, which significantly reduces the injection perturbations on the stored beam. In addition, the NLK injection requires less space for the kicker and removes the complications of synchronizing four pulsed kicker magnets. Because of these advantages, several light source facilities are either proposing or already using this NLK injection as a replacement of the conventional local-bump injection scheme. In this paper, we will discuss the working principal of this NLK injection, and use both Advanced Light Source and Advanced Light source Upgrade as examples to optimize the NLK injections. By optimizing the NLK design and injection conditions, we could achieve maximum injection efficiencies for both facilities with a large injected beam from the existing ALS booster.

OBJECTIVE The COVID-19 pandemic has forced many countries into lockdown and has led to the postponement of nonurgent neurosurgical procedures. Although stress has been investigated during this pandemic, there are no reports on anxiety in neurosurgical patients undergoing nonurgent surgical procedures. METHODS Neurosurgical patients admitted to hospitals in eastern Lombardy for nonurgent surgery after the lockdown prospectively completed a pre- and postoperative structured questionnaire. Recorded data included demographics, pathology, time on surgical waiting list, anxiety related to COVID-19, primary pathology and surgery, safety perception during hospital admission before and after surgery, and surgical outcomes. Anxiety was measured with the State-Trait Anxiety Inventory. Descriptive statistics were computed on the different variables and data were stratified according to pathology (oncological vs nononcological). Three different models were used to investigate which variables had the greatest impact on anxiety, oncological patients, and safety perception, respectively. Because the variables (Xs) were of a different nature (qualitative and quantitative), mostly asymmetrical, and related to outcome (Y) by nonlinear relationships, a machine learning approach composed of three steps (1, random forest growing; 2, relative variable importance measure; and 3, partial dependence plots) was chosen. RESULTS One hundred twenty-three patients from 10 different hospitals were included in the study. None of the patients developed COVID-19 after surgery. State and trait anxiety were reported by 30.3% and 18.9% of patients, respectively. Higher values of state anxiety were documented in oncological compared to nononcological patients (46.7% vs 25%; p = 0.055). Anxiety was strongly associated with worry about primary pathology, surgery, disease worsening, and with stress during waiting time, as expected. Worry about positivity to SARS-CoV-2, however, was the strongest factor asso

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Psoriasis is a common, chronic inflammatory disease with a multifactorial pathogenesis. Mean age at presentation of psoriasis is 28 years in women, which is almost the height of fertility age. Since women of childbearing potential represent a significant proportion of psoriatic patients, the impact of psoriasis and its treatment on fertility, pregnancy, and breastfeeding should be highlighted for a proper management. Therefore, when approaching to a psoriatic woman of childbearing age, Healthcare Providers should be adequately informed and ready to provide the patients with answers to the most frequently asked questions. The Italian Society of Dermatology and Venereology (SID eMaST) has fostered a Task Force named "Psoriasis in Women of Childbearing Age" which is composed by a group of Italian female dermatologists with a high expertise in psoriasis treatment. The aims of the Task Force are to increase awareness of the disease and its treatment in patients of childbearing age among both dermatologists and women affected by psoriasis and to encourage counselling on family planning. With the aim of providing a real support for the proper management of the delicate journey to motherhood, the Italian Task Force has published two different informative booklets addressed to patients and dermatologists which focus on the main issues regarding psoriasis in women of childbearing age.

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