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Ilaria Proietti,1 Nevena Skroza,1 Alessandra Mambrin,1 Federica Marraffa,2 Ersilia Tolino,1 Nicoletta Bernardini,1 Anna Marchesiello,1 Giovanni Rossi,1 Salvatore Volpe,1 Concetta Potenza1 1Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, Italy; 2Department of Clinical Internal, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, ItalyCorrespondence: Ilaria ProiettiDermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, 04019, ItalyEmail ilaria.proietti@uniroma1.itAbstract: Cancer patients are experiencing an increase in overall survival as a consequence of earlier diagnosis and newer effective anticancer therapies. However, cancer survivors often face long-term consequences from their original cancer diagnosis and long-term sequelae of anticancer treatment. Maintaining patients’ quality of life is of paramount importance and this can be accomplished by a multidisciplinary treatment approach, including aesthetic treatments to improve patients’ body image and positively impact their quality of life. In this perspective, we will discuss the importance of aesthetic treatments in cancer patients. In addition, we will summarise the data available regarding the use of several aesthetic treatments such as fillers, botulinum toxin and laser use in cancer patients, their safety, their efficacy, and the specific precautions that need to be implemented in this particular subset of cancer patients.Keywords: aesthetic treatment, cancer patient, fillers, botulinum toxin, laser therapy

Background The susceptibility of patients with chronic plaque psoriasis and the risks or benefits related to the use of biological therapies for COVID-19 are unknown. Few data about prevalence, clinical course and outcomes of COVID-19 among psoriatic patients were reported. The aims of this study were 1) to assess the prevalence and severity of COVID-19 in psoriatic patients treated with biologic agents during the first phase of the emergency (22 February to 22 April 2020) in Italy, and 2) to report the clinical outcomes of patients who have been exposed to individuals with confirmed SARS-CoV-2 infection. Methods Patients with moderate-to-severe chronic plaque psoriasis, aged ≥18 years and undergoing treatment with biologic agents as of 22 February 2020, were eligible to be included in PSO-BIO-COVID study. Demographic and clinical characteristics of patients using any biologic for psoriasis treatment between 22 February and 22 April 2020 were registered. For all confirmed or suspected cases of COVID-19, data about concomitant disease, ongoing therapies, and comorbidities were also reported. Results A total of 12,807 psoriatic patients were included in the PSO-BIO-COVID study. In this cohort twenty-six patients (0.2%) had a swab confirmation of SARS-CoV-2 infection. Eleven patients required hospitalization and two died. 125 of 12807 patients (1.0%) with exposure to a patient with COVID-19 under quarantine or active health surveillance, were reported. Conclusion The incidence of COVID-19 observed in our cohort of psoriatic patients (0.2%) is similar to that seen in the general population (0.31%) in Italy. However, the course of the disease was mild in most patients. Biological therapies may likely lessen "cytokine storm" of COVID-19, which sometimes lead to multiple organ failure, ARDS, and death.

Topical treatment is the mainstay for mild or moderate psoriasis, but patients are generally little satisfied. Calcipotriol/betamethasone dipropionate (Cal/BD) cutaneous foam has shown to improve signs and symptoms in plaque psoriasis patients. This study assessed patient's satisfaction with Cal/BD foam in a real-life Italian dermatological clinical practice. A multicenter, 4-week observational prospective cohort study enrolled, in 17 Italian dermatology clinics, adult patients with plaque psoriasis on the body and/or scalp. Treatment satisfaction was assessed by 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9), preference over previous treatments by Patient Preference Questionnaire (PPQ), and change in disease state by Psoriasis Area Severity Index (PASI). Overall 256 patients were eligible, with a mean (SD) age of 55.6 (15.4) years, 59.4% were males. Psoriasis severity was mild in 52.0% of patients, moderate in 43.3%, and severe in 4.7%. Scalp involvement was present in 36.7% of patients. Previous antipsoriatic treatments had been received by 80.5% of patients. TSQM-9 median (25th-75th percentile) scores were 83.3 (66.7-88.9) for effectiveness, 77.8 (66.7-88.9) for convenience, and 78.6 (64.3-92.9) for global satisfaction. Mean (SD) PASI value decreased from 7.3 (4.8) to 2.1 (2.7) after 4 weeks. More than 90% of patients previously treated for psoriasis evaluated the Cal/BD foam more effective, easier to use and better tolerated compared to previous topical treatments at PPQ. This observational study provides real-life evidence of a high level of satisfaction with effectiveness and convenience of the Cal/BD foam in a cohort of plaque psoriasis patients, with an objective improvement in PASI.

Psoriasis is a multifactorial chronic inflammatory skin disease characterized by erythemato-squamous lesions with a chronic relapsing course. The desease clinical activity (PASI) and the patient's quality of life (DLQI) are the main elements to assess for setting up a correct therapeutic management.The aim of the study was to evaluate the management of the patient with moderate-severe psoriasis in therapy with biological drugs and to establish the difference in the achievement of PASI 90 and DLQI 0-1 between a group of patients treated with only biological drugs and a group of patients receiving biologic therapy in combination with a topical ointment.We conducted a prospective, observational real-life study enrolling 60 patients with moderate to severe psoriasis and divided in two groups: Group A patients treated with biological drugs, Group B patiens treated with biological drugs in association with an ointment composed of betamethasone, salicylic acid and ammonium sulpho-ichtyolate, applied 2 times a day. PASI and DLQI were evaluated at study beginning (T0) for both study groups, after 12 weeks (T3) for sample in therapy with biological drugs and after 24 weeks (T6) for sample in co-medication therapy.The two-way ANOVA method was used to evaluate the standard deviations (SD): at T3 and T6 Group B obtained a significant PASI reduction and improvement of DLQI (* p value0.05) compared to Group A.Our study shown that the patients treated with biologics in co-medication with topical therapy reached a significantly higher PASI and DQLI compared with those treated with only biologics. Furthermore we observed that the association with topical oinment showed more efficacy in the treatment of areas such as palm-plantar region, that is often difficult-to-treat region, even for biologic drugs.

Nevena Skroza, Nicoletta Bernardini, Ilaria Proietti, Concetta Potenza Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy Abstract: Actinic keratoses (AKs) are epidermal cutaneous neoplasia observed predominantly in middle-aged and older subjects with mainly photo type I and photo type II on sun-exposed surfaces as a result of DNA damage. AKs have historically been characterized as being “precancerous”; however, now it is considered by many authors a carcinoma in situ that can persist or progress to invasive squamous cell carcinoma (SCC) with metastatic potential. Despite the advances in the recognition of typical clinic, dermoscopic and histologic patterns, currently it is not yet possible to predict which AKs will progress to SCC. For this reason, early diagnosis and effective therapy are recommended based on cost/risk/benefit analysis. Current treatment consists of lesion-directed or field-directed therapies or a combination of both. Among the topical field therapies, ingenol mebutate stands out for its therapeutic efficacy, both as directed lesion therapy and as field directed therapy. The aim of this review is to demonstrate the utility of ingenol mebutate in the management of AK in daily clinical practice and to highlight data from real world in order to confirm evidence from pivotal studies. In order to explore clinical data from real world, PubMed searches were performed with the search terms “clinical data ingenol mebutate” and “real world ingenol mebutate”. The hits were examined for relevant articles using defaults criteria. The timeframe for the sample search started from the first publication on this topic in 2008 up to now. A total of 23 articles were found using the keywords specified above. The overview points out a low number of real-life studies on the effectiveness and tolerability of this novel treatment due to short period of clinical experience for its recent approval. Further real-life studies are required in order to better identify the efficacy, safety and adherence of the drug on a larger population. Keywords: ingenol mebutate, actinic keratosis, field cancerization, real world, photodamage, novel treatment

Basal cell carcinoma (BCC) is the most frequent skin cancer and is characterized by slow growth, even if it can be locally invasive and rarely metastasizes. Many different phenotypic presentations and histopathologic subtypes have been described, and the current guidelines subdivide BCCs into low-risk (nodular and superficial) and high-risk subtypes (micronodular, infiltrating, and morphoeic BCC and those with squamous differentiation). Dermoscopy allows the identification of the features associated with these different subtypes. Compared with the low-risk forms of BCC, more aggressive ones tend to undergo more frequently incomplete surgical excision and perineural invasion, so the identification of these lesions before surgery is extremely important. The gold standard of treatment is surgery, particularly for the H region of the face and infiltrative lesions, but other options are available and selected according to many variables, including body area, age, comorbidities, and clinical, dermoscopic, and histopathological features of the lesion. Moreover, the possible complications of surgical approaches, namely healing defects, failure of skin grafts, and wound infection, should be considered. In this review we discuss the management of BCC localized on the face and scalp, according to the currently available treatment options.

Objective-Arginase can reduce NO availability. In this study, we explored arginase as a determinant of endothelial dysfunction in small arteries from obese patients and its relationship with aging and microvascular remodeling. Approach and Results-Small arteries were dissected after subcutaneous fat biopsies and evaluated on a pressurized micromyograph. Endothelium-dependent vasodilation was assessed by acetylcholine, repeated under L-NAME (NG-nitro-L-arginine-methyl ester), N(ω)-hydroxy-nor-l-arginine (arginase inhibitor) and gp91ds-tat (NADPH [nicotinamide adenine dinucleotide phosphate oxidase] oxidase inhibitor) in vessels from young (age 30 years) control and obese subjects. Media-lumen ratio and amount of vascular wall fibrosis were used as markers of vascular remodeling. Amount of vascular superoxide anions and NO production were determined with immunofluorescence, whereas arginase expression was quantified using Western blot and quantitative polymerase chain reaction. Obese and older age groups had lower vascular NO, as well as higher media-lumen ratio, wall fibrosis, intravascular superoxide, and blunted inhibitory effect of L-NAME on acetylcholine versus controls and younger age groups. N(ω)-hydroxy-nor-l-arginine restored the acetylcholine-induced vasodilation in young and, to a lesser extent, in old obese subjects. This effect was abolished by addition of L-NAME. Gp91ds-tat increased the vasodilatory response to N(ω)-hydroxy-nor-l-arginine in old obese. Superoxide anions and arginase I/II levels were higher in the vascular wall of obese versus controls. Conclusions-Arginase contributes to microvascular endothelial dysfunction in obesity. Its impact is reduced by aging because of higher levels of vascular oxidative stress. Obesity is accompanied by accelerated microvascular remodeling, the extent of which is related to the amount of arginase in the vascular wall. © 2018 American Heart Association, Inc.

Questo nuovo testo di istologia, destinato alle lauree triennali è stato redatto tenero conto dell'evoluzione della disciplina e delle necessità formative delle lauree triennali sanitarie, ognuna delle quali richiede uno specifico insegnamento.

Aims. Cyclooxygenase isoforms (COX-1, COX-2) have been implicated in the development of fibrosis at gastrointestinal sites. Under bowel inflammation, transforming growth factor beta (TGF-beta) has been identified as the main regulator of fibrotic remodelling. The present study investigated the effects of cyclooxygenase inhibitors on pro-fibrotic signalling mediated by the TGF-beta/SMAD pathway in experimental colitis. Methods. Colitis was induced in rats by intrarectal 2,4-dinitrobenzenesulfonic acid (DNBS, 30 mg/rat in 0.25 ml ethanol 50%). After 6 days, systemic [body and spleen weight] and tissue inflammatory parameters [macroscopic and microscopic damage] were assessed. Three days before colitis assessment, the animals were treated daily with indomethacin (IND, non-selective COX-1/COX-2 inhibitor, 2 mg/kg), SC-560 (SC, selective COX-1 inhibitor, 2.5 mg/kg), or celecoxib (CEL, selective COX-2 inhibitor, 1 mg/kg) by intragastric gavage. At the time of sacrifice, functional and molecular tests were carried out. Peristaltic activity of control and inflamed colonic segments was studied in vitro by a modified Trendelenburg set-up. Collagen fibers (Van Gieson) and elastic fibers (orcein) were examined by histochemistry. The expression of molecular factors involved in TGF-beta signalling (TGF-beta, RhoA and SMAD6, as well as phosphorylated SMAD2, p38, ERKs and JNK), and cellular proliferation and apoptotis (PCNA, Akt and caspase-3) was analyzed by western blot. Results. Animals with colitis displayed an impairment of colonic peristalsis, as shown by a significant decrease in compliance and maximal ejection pressure, as well as an increase in the threshold pressure and luminal volume required to trigger peristalsis. Moreover, histochemistry showed an increased deposition of collagen fibers in parallel with a dramatic decrease in elastic fibers. IND, SC and CEL inhibited collagen deposition, and reverted the loss of elastic fibers. In the inflamed/fibrotic colon, western blot analysis revealed an increased expression of TGF-beta, PCNA, caspase-3, pAkt, p-p38, RhoA and pSMAD2. By contrast, the expression of SMAD6, pERKs and pJNK was reduced. In this setting, IND, SC and CEL counteracted the increased expression of TGF-beta, RhoA, pSMAD2 and p-p38, and partly reverted the reduced expression of SMAD6. Conclusions. In the DNBS model of colitis, bowel fibrosis is associated with impaired colonic peristalsis and alterations in the expression of factors driven by activation of TGF-beta signalling. The pharmacological blockade of COX-1 and COX-2 is able to counteract the fibrotic remodelling of inflamed colon, and this action appears to depend on the modulation of TGF-beta-dependent SMAD signalling, particularly through an induction of the inhibitory protein SMAD6 and a reduction of the phosphorylated status of SMAD2.

Parkinson’s disease (PD) is characterized by degeneration and loss of dopaminergic nigrostriatal neurons, responsible for neurologic symptoms. Besides motor signs, most PD patients experience gastrointestinal (GI) disturbances, including dyspepsia and constipation, which impair severely their quality of life. The pathophysiology of digestive disturbances in PD is largely unknown, but recently a link between PD and colonic inflammation has been observed in human biopsies [1]. Our study aims at evaluating some inflammatory patterns in colonic whole wall in a rat model of PD. PD was induced in rats by unilateral injection of 6-idroxydopamine (6-OHDA) into two sites of the right medial forebrain bundle. Studies were carried out 28 and 56 days after treatment on full-thickness samples from distal colon. The following parameters were examined: tissue malondialdehyde (MDA), an index of membrane lipid peroxidation; tumor necrosis factor (TNF), an index of inflammatory cytokine release; inflammatory cells (eosinophils, mast cells); glial fibrillar acid protein (GFAP) and substance P (SP) expression in myenteric ganglia by immunohistochemical staining. At both time points 6-OHDA-induced nigrostriatal denervation was associated with significant increase in: a) tissue levels of MDA (membrane oxidative stress) and TNF (tissue inflammation); b) density of eosinophil and mast cell in tunica mucosa and submucosa (inflammatory infiltration); b) GFAP expression in myenteric ganglia of tunica muscularis (enteric glia activation); c) SP expression in myenteric neurons, which is compatible with an enhanced tachykinenergic motor control as shown by preliminary functional studies on colonic muscle strips from PD rats. Our findings suggest that experimental PD, elicited by nigrostriatal dopaminergic degeneration, is associated with an inflammation of the colonic wall involving all layers. These results support the view that peripheral enteric neuroinflammation may account for GI motor dysfunctions in PD., Italian Journal of Anatomy and Embryology, Vol 119, No 1 (Supplement) 2014

Psoriasis is a systemic inflammatory immune-mediated skin disease. Recently a relationship with metabolic syndrome in terms of psoriasis severity and response to therapy was observed.We performed an open-label randomized controlled study to evaluate the role of a nutraceutical containing Q10 coenzyme, Krill-oil, lipoic acid, resveratrol, Vitis vinifera seed oil, vitamin E and selenium in addition to etanercept therapy for patients affected by psoriasis and metabolic syndrome. Forty patients were enrolled and divided into two arms, one receiving only etanercept, one other receiving also the neutraceutical. After a period of 3 months (T1) a second evaluation of the considered parameters was performed.At T1 statistically significant differences were detected in HDL cholesterol and triglycerides values both comparing the two arms and in the nutraceutical arm.Our results show that the dietary addiction of the nutraceutical to the etanercept therapy in patients affected by both psoriasis and metabolic syndrome could help to restore the normal lipid profile.

Intestinal fibrosis in inflammatory bowel disease is a dynamic, multifactorial process, which involve multiple cell types and interconnected events [1]. Angiogenesis is a hallmark of active gut disease and closely related to fibrogenetic processes. Endothelial cells and pericytes of neovessels have been found to be able to differentiate into fibroblasts and can be considered good candidates for fibrogenesis also in the intestinal tract [2]. This study was aimed to study whether the fibrotic processes occurring within the tunica muscularis of UC patients are associated with vascular remodeling. Full-thickness left colonic samples were obtained from patients with established, severe and pharmacologically unresponsive UC, who underwent bowel resection. Routine histology, histochemistry and immunohistochemistry were conducted in paraffin cross-sections. Collagen and elastic fiber distribution was evaluated within the tunica muscularis by both histochemical and immunohistochemical assays. The vascular network pattern was analyzed by revealing the expression of CD31, CD105 and nestin by immunofluorescence applied to laser confocal microscopy. A significant increase in collagen fibers and a decrease in elastin content were detected in the tonaca muscularis of UC inflamed colon, as compared with controls. In particular, enhanced collagen deposition were found at level of the longitudinal muscle and circular muscle layer, and in perivascular spaces. By contrast, elastic fiber pattern was significantly decreased throughout the whole muscle compartment. Increased blood vessel density was observed in the colonic tunica muscularis of UC samples compared with samples from healthy control individuals. In particular, the neovessels of inflamed colon showed the activation of both endothelial cells and pericytes, which overexpressed CD105 and nestin, respectively. A significant vascular remodelling (i.e., angiogenesis, endothelial proliferation and pericyte activation) has been observed in the fibrotic tunica muscularis of colon from UC patients. On the basis of the present findings, it is possible to argue that cells of newly formed vessels within the tunica muscularis may contribute to the UC-associated fibrosis by cell transition to mesenchymal phenotype., Italian Journal of Anatomy and Embryology, Vol 118, No 2 (Supplement) 2013

Parkinson’s disease (PD) is a degenerative neurological disorder, which is often associated with gastrointestinal symptoms. Among these disturbances, constipation has received considerable attention owing to its potential value as early marker of disease onset [1, 2]. Our study aims at evaluating motor dysfunctions and neurochemical coding of colonic neuromuscular compartment in a rat model of PD. Experimental PD was induced in rats by unilateral injection of 6-idroxydopamine (6-OHDA) into two sites of the right medial forebrain bundle. Functional and morphological studies were carried out 28 and 56 days after treatment. Colonic circular muscle contractions were revorded in organ baths after electrical stimulation or in the presence of exogenous substance P (SP). Colonic samples were examined by immunohistochemistry for the following parameters: density of myenteric HuC/D+ neurons and GFAP+ glial cells; distribution pattern and quantitative expression of SP, tyrosine hidroxylase (TH) and choline acethyltransferase (ChAT). Contractions elicited by electrically evoked tachykinin release as well as by exogenous SP were enhanced at both day 28 and 56, as compared to controls. Myenteric ganglia of PD animals displayed a significant increase in HuC/D+ neuron density, but no alteration in GFAP+ expression. SP+ myenteric neurons progressively increased over time, while the expression of TH and ChAT were significantly reduced at both time points. Experimental PD, elicited by nigrostriatal dopaminergic degeneration, is associated with functional and histopathological/neurochemical changes of the colonic neuromuscular compartment. The enhanced tachykinenergic motor control, associated with an upregulation of neuronal SP expression, together with reduced expression of TH and ChAT, may account for the colonic motor dysfunctions often associated to PD., Italian Journal of Anatomy and Embryology, Vol 118, No 2 (Supplement) 2013

There is currently a scarcity of animal models of intestinal fibrosis and new methods to induce fibrosis as well as reliable parameters to evaluate fibrotic remodelling in the gut wall are highly expected [1]. The aim of this study has been to assess tissue remodelling of colonic wall in a rat model of colitis, with a particular focus on the neuromuscular compartment. Colitis was induced in rats by intrarectal administration of 2,4-dinitrobenzenesulfonic acid (DNBS). After 6 and 21 days, the following parameters were assessed on paraffin sections from colonic samples: morphologic damage and tissue inflammatory infiltration by histology; collagen and elastic fibers by histochemistry; HuC/D, glial fibrillar acid protein (GFAP), nestin, substance P, connexin 43 and c-Kit by immunohistochemistry. On day 6, inflammatory and ulcerative alterations were observed in all DNBS-treated rats, and they progressed towards fibrotic lesions on day 21. Colitis was associated both with a significant increase in collagen fibers and a decrease in elastic fibers throughout the whole wall thickness. Moreover, the colonic neuromuscular compartment of inflamed animals displayed a significant decrease in myenteric neuron density, a reduced density of intramuscular and myenteric interstitial cells of Cajal, a neovessel formation and an increased immunoreactivity for GFAP, nestin and Cx43. The DNBS model of experimental colitis is characterized by a significant fibrosis of whole wall thickness, together with evident remodelling of the neuromuscular compartment. These histopathological patterns can be suitable for investigating the pathophysiology of colonic fibrosis and, therefore, to evaluate the impact of new therapeutic strategies on gut inflammation., Italian Journal of Anatomy and Embryology, Vol 118, No 2 (Supplement) 2013

Dermatitis artefacta is a disease characterized by self-inflicted skin lesions in fully aware patients. Mechanical and chemical devices are most commonly used to produce such injuries. Several psychological disorders like depression, obsessive compulsive disorders, hysteria, etc. are associated with this kind of disease. Most of the patients are young females aged between 15 and 30, but the diagnosis of dermatitis artefacta may even be made in pediatric patients or elderly people. Because of its rarity and the polymorphism of lesions, dermatitis artefacta is often a challenge for the clinicians. More difficulties might be due to the lack of cooperation in these patients, who usually refuse the dialogue with doctors and deny their primary role in damaging their skin. We present a case of an elderly woman who showed a peculiar pattern of deep excoriating lesions disseminated on the upper part of her body, with an evident state of depression. Diagnostic and therapeutic procedure, that is often long lasting and difficult in such cases, was made by teamwork of dermatologists, psychiatrists and psychologists, leading to steady control of impulses and full remission of cutaneous symptoms.

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Spontaneous and potassium-induced acetylcholine release from embryonic (E12 and E18) chick dorsal root ganglia explants at 3 and 7 days in culture was investigated using a chemiluminescent procedure. A basal release ranging from 2.4 to 13.8 pm/ganglion/5 min was detected. Potassium application always induced a significant increase over the basal release. The acetylcholine levels measured in E12 explants were 6.3 and 38.4 pm/ganglion/5 min at 3 and 7 days in culture, respectively, while in E18 explant cultures they were 10.7 and 15.5 pm/ganglion/5 min. In experiments performed in the absence of extracellular Ca2+ ions, acetylcholine release, both basal and potassium-induced, was abolished and it was reduced by cholinergic antagonists. A morphometric analysis of explant fibre length suggested that acetylcholine release was directly correlated to neurite extension. Moreover, treatment of E12 dorsal root ganglion-dissociated cell cultures with carbachol as cholinergic receptor agonist was shown to induce a higher neurite outgrowth compared with untreated cultures. The concomitant treatment with carbachol and the antagonists at muscarinic receptors atropine and at nicotinic receptors mecamylamine counteracted the increase in fibre outgrowth. Although the present data have not established whether acetylcholine is released by neurones or glial cells, these observations provide the first evidence of a regulated release of acetylcholine in dorsal root ganglia.

Different mitogens are involved in the pathogenesis of kidney damage after subtotal nephrectomy. One of them, TGF-beta, controls mesangial cell proliferation and interstitial fibrosclerosis. The transduction of the TGF-beta signal is controlled by intracellular signalling molecules such as Ras G monomeric proteins. Renal damage after subtotal nephrectomy (5/6 Nx) can be prevented by heparins, but so far no immunohistochemical correlation between TGF-beta, TGF-beta induced matrix molecules and Rho proteins has been investigated. Since the Ras transduction pathway has recently been associated with progression of renal damage, we evaluated the effect of heparan sulphate (HS) on the expression of TGF-beta, laminin, fibronectin and a Ras protein, RhoA, in the rat remnant kidney model.The immunoperoxidase technique was employed to reveal the antigens on 18 remnant kidneys from 5/6 nephrectomized rats, nine untreated and nine treated with oral HS, and on seven normal kidneys from sham-operated rats. Data were semiquantitatively analyzed by an image analyzer (Quantimet, Leica).The expression of the antigens was significantly higher in the remnant kidneys than in normals. The high TGF-beta, laminin, fibronectin and RhoA expression observed in subtotally nephrectomized rats suggests a role for these molecules in the pathogenesis of progressive renal damage. However, apart from RhoA, HS-treated rats had significantly lower levels of the antigens than the untreated rats.HS treatment is associated with significantly lower renal expression of TGF-beta, laminin and fibronectin, but not of RhoA. This suggests that the renal-protective effect of HS may be obtained by modulating the TGF-beta pathway, independently of RhoA-mediated transduction.

Background: Acne is predominantly known as a skin disorder of the adolescent population. However, current research indicates that the prevalence of adult patients with acne, especially among women, is increasing. Objective: The objective of this study was to evaluate differences between adults and teenagers with regard to acne prevalence, patient sex, acne severity, and quality of life. In adult patients, we considered differences in family history of acne, onset, and smoking habits. Design: We performed a retrospective study of a total of 1,167 patients with acne who attended our outpatient clinic from January 2008 to March 2015. Participants: The study population was divided into two groups: adolescent acne and adult acne. Among the adult subjects, 385 were female and 69 were male; among the adolescent subjects, 378 were female and 335 were male. Measurements: The severity of acne was recorded using the Global Acne Grading System. The impact of acne on quality of life was investigated using the Assessment of Quality of Life questionnaire. Results: Study results show that acne in female patients was more prevalent than in male patients. The evaluation of acne severity showed that “mild acne” is the most frequent form. With regard to smoking habits, time of onset, and family history of acne, we did not find any statistically significant differences between the sexes. Conclusion: In both sexes, there are some differences in adult acne versus the adolescent form. Treating adult acne demands a different approach to diagnosis and a tailored management plan that considers all of the variables involved.

BACKGROUND: Acne is a chronic multifactorial skin disease with a high prevalence among adolescents. The therapeutic approach for mild to moderate papulopustular acne includes the use of systemic tetracycline. Increased risk of antibiotic resistance necessitates research into alternative therapeutic approaches, such as zinc sulphate. Efficacy of zinc sulphate in acne treatment is widely reported in the literature, but drug comparison studies are lacking. OBJECTIVE: We sought to compare the efficacy and safety of zinc sulphate to lymecycline for the treatment of mild to moderate papulopustular acne. METHODS: One hundred patients were equally randomized to receive either zinc sulphate or lymecycline. Acne severity was evaluated using the subjective Global Acne Grading System (GAGS) and the Acne-specific Quality of Life (AQoL) questionnaire at baseline and after four and 12 weeks. RESULTS: Both zinc sulphate and lymecycline induced a statistically significant reduction in GAGS scores at four and 12 weeks of treatment. The improvements in AQoL scores in patients treated with zinc sulphate were significantly higher than those in the lymecycline group. CONCLUSIONS: Our study suggests that zinc sulphate is a valid alternative therapeutic approach in the treatment of mild to moderate papulopustular acne relative to lymecycline in terms of clinical efficacy, tolerability, and the occurrence of side effects.

Hyperhidrosis is an idiopathic condition of exaggerated sweat production resulting in dramatic impairments of daily activities, social interactions and occupational activities. The aim of the present study was to evaluate correlation between a subjective (Dermatology Life Quality Index) and an objective (Minor test) criterion and to assess difference in their levels over time in patients affected by axillary hyperhidrosis treated with botulinum toxin type A. Nineteen patients received injections of 50 U of botulinum toxin type A per axilla. Patients were observed for 9 months after treatment. All patients showed great improvement of hyperhidrosis by Minor test and Dermatology Life Quality Index following treatment with botulinum toxin type A, with the effect persisting for 6-9 months. All patients demonstrated direct relationship between objective improvement documented by Minor test and quality of live improvement documented by Dermatology Life Quality Index after treatment with botulinum toxin type A.

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is creating an unprecedented global public health emergency with the continuous growth of infected individuals worldwide. Italy was one of the first European country to face the first wave of infection outside mainland China. The first case of COVID-19 was confirmed in Lombardy on February 20th , 2020, and subsequently, a rapid increase in the number of detected cases was observed, spreading through Italy and the rest of Europe.3 As of April 22nd , confirmed COVID-19 cases in Italy were 183,957.

Background: Guselkumab is a humanized monoclonal antibody that binds selectively to the p19 subunit of interleukin-23, which has shown efficacy in patients with previous incomplete response to ustekinumab in the NAVIGATE clinical trial. Objectives: We conducted a 104-week multicenter retrospective study to assess the effectiveness and safety of guselkumab in patients affected by plaque psoriasis with an inadequate response to ustekinumab in a real-life setting. Methods: Our retrospective study included 233 adults affected by moderate-to-severe plaque psoriasis, enrolled in 14 different Italian centers, and treated with guselkumab after failing therapy with ustekinumab. Patient characteristics and PASI (Psoriasis Area and Severity Index) score at each visit (baseline, weeks 16, 52 and 104) were recorded. The percentages of patients achieving 75%, 90% and 100% (PASI 75, PASI 90 and PASI 100) improvement in PASI, compared with baseline, were registered. Results: At week 52, PASI 75 was reached by 89.88% of patients, PASI 90 by 71.43%, PASI 100 by 58.83% and absolute PASI ≤ 2 by 90.48%. At week 104, similar effectiveness results were observed. Compared to the NAVIGATE trial, we observed higher rates of PASI 75/90/100. Patients with the involvement of difficult-to-treat areas were significantly less likely to achieve PASI90 and PASI100 at week 16. Obese patients had significantly lower rates of PASI75 and PASI≤2 at week 52. At week 104, comparable responses were observed among all patients' subgroups, regardless of BMI status, involvement of difficult-to-treat areas, presence of cardiometabolic comorbidities and concomitant psoriatic arthritis. No significant safety findings were reported throughout the study. Conclusion: Our data suggest that the efficacy of guselkumab in patients with inadequate response to ustekinumab for plaque psoriasis in "real-life" clinical practice is comparable with NAVIGATE study with higher percentages of patients achieving PASI90 and PASI100 at weeks 16, 52 and 104.

Freshwater plants loss is one of the preeminent issues concerning biodiversity conservation, due to the alteration of inland waters by water regulation and agricultural intensification. At the same time, data suggest a relevant contribution of artificial, lowland aquatic ecosystems in supporting plant diversity. However, the underlying ecological mechanisms remain to be fully understood. To add knowledge to this subject, a wide canal network in the Bologna area (~ 1400km2, northern Italy) was investigated to analyse the riparian flora in relation to canal morphology. A systematic sampling procedure was adopted by randomly selecting 96 transects(1m × 10m) along 79 different canals, classified as small, medium, and large in terms of water depth. Flora was characterised based on the Ellenberg’s humidity and nitrophily indices, life forms, chorotypes, and alien species. The distribution of the number of species and floristic categories between transects and the role of canal depth were explored using linear mixed models and nMDS. 251 plant species were recorded; they were characterised by a broad ecology in terms of soil moisture (71% of the list) and nutrient availability (59%). Wetland and alien species—including invasive ones—were a marginal presence (< 5%, < 6%, respectively)—and canal depth showed a significant effect on compositional dissimilarity between canals, with larger canals characterised by lower diversity rates. This work reinforces the pivotal contribution of heavily modified water bodies in supporting plant richness in oversimplified landscapes, confirming the role of canal depth in driving local flora.