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Psoriasis causes detriment in a person's physical, mental and social health which impairs their quality of life (QoL). However, the current psoriasis management may not adequately address all relevant health domains. Since the goal of healthcare is to restore or maintain health, health outcomes should include all areas of the patient's overall health. Life satisfaction, QoL and patient well‐being are essential to a comprehensive approach to the disease. With the inclusion of more people‐centred policies, care of patients with psoriasis should evolve towards a holistic and integrated assessment of the disease impact, including subjective measures of well‐being in order to encompass all aspects of health. The main objective of this expert review is to give the concept of well‐being a place as an entity within the holistic therapeutic approach for patients with psoriasis. Identifying and defining common goals beyond the skin with the patient and testing them throughout the course of treatment will benefit and enhance treatment success. We propose a series of recommendations for application in clinical practice, providing tangible clinical guidance for implementing well‐being in the management of psoriasis. Among the recommendations are the need to initially listen to the patient, to know their level of empowerment or what they want to achieve, their preferences in decision making, the evaluation of not only the physical but also the emotional impact of the disease (well‐being), the definition of the aspects that can generate a cumulative deterioration of the disease throughout life, and a continuous assessment of the patient's preferences with the opinion of the expert clinician and the integration of the knowledge of external clinical evidence. [ABSTRACT FROM AUTHOR]

This article examines the effectiveness of risankizumab, a medication used to treat moderate-to-severe plaque psoriasis. The study found that risankizumab was effective in improving psoriasis symptoms, with a high percentage of patients experiencing significant improvement and complete skin clearance. The study also found that patients who had not previously been treated with biologic drugs and those with a shorter disease history had better responses to the treatment. However, the study has some limitations, and further research is needed to fully understand the long-term effects of risankizumab on psoriasis. [Extracted from the article]

This article discusses the occurrence of parapsoriasis in three patients with a long history of atopic dermatitis who were undergoing treatment with the drug dupilumab. Parapsoriasis is a rare skin disease that can potentially progress into mycosis fungoides, a type of cutaneous T-cell lymphoma. The patients experienced the development of irregular, slightly itchy patches on their trunk and lower limbs during dupilumab treatment. The drug was discontinued, and the patients started a new therapy with partial remission of their skin manifestations. The article highlights the importance of correctly diagnosing atopic dermatitis before administering dupilumab and the need for continuous monitoring of patients undergoing this treatment. It also suggests that patients with a long history of severe atopic dermatitis and previous use of immunosuppressive agents may be at higher risk for lymphomatous disorders. [Extracted from the article]

Background: Tildrakizumab (TIL) is an interleukin (IL)‐23p19 inhibitor for the treatment of moderate‐to‐severe plaque psoriasis with long‐term efficacy and safety demonstrated in Phase III trials. Studies conducted in conditions closer to clinical practice are needed. Objectives: The TRIBUTE study (open‐label, Phase IV) assessed the efficacy and impact on health‐related quality of life (HRQoL) of TIL 100 mg in adult moderate‐to‐severe psoriasis patients (naïve to IL‐23/Th17 pathway inhibitors) in conditions similar to clinical practice. Methods: Key efficacy measure was Psoriasis Area Severity Index (PASI). HRQoL was evaluated using the Dermatology Life Quality Index (DLQI) and Skindex‐16. Additional patient‐reported outcomes included Pain‐, Pruritus‐ and Scaling‐Numerical Rating Scale (NRS), Medical Outcome Study (MOS)‐Sleep, Work Productivity and Activity Impairment (WPAI), Patient Benefit Index (PBI) and Treatment Satisfaction Questionnaire for Medication (TSQM). Results: One hundred and seventy‐seven patients were enrolled (six patients did not complete the study). After 24 weeks, the proportion of patients achieving PASI scores ≤ 3, PASI 75, PASI 90 and DLQI 0/1 was 88.4%, 92.5%, 74.0% and 70.4%, respectively. Skindex‐16 overall score improved (mean absolute change from baseline, MACB [95%CI]: −53.3 [−58.1, −48.5]). Significant benefits (MACB [95%CI]) were found on pruritus‐, pain‐ and scaling‐NRS scores (−5.7 [−6.1, −5.2], −3.5 [−4.1, −3.0] and −5.7 [−6.2, −5.2], respectively), MOS‐Sleep (−10.4 [−13.3, −7.4] Sleep problems Index II) and WPAI (−36.4 [−42.6, −30.2] activity impairment, −28.2 [−34.7, −21.7] productivity loss, −27.0 [−32.9, −21.1] presenteeism and −6.8 [−12.1, −1.5] absenteeism). 82.7% of patients reported PBI ≥ 3 and the mean (SD) global TSQM score was high (80.5 [18.5]). Only one serious treatment‐emergent adverse event was reported (not‐related to TIL). Conclusions: TIL 100 mg treatment after 24 weeks in conditions close to real clinical practice showed a quick and high improvement in psoriasis signs and HRQoL. Patient reported improvements in sleep outcomes and work productivity, relevant benefits and high treatment satisfaction. The safety profile was favourable and consistent with Phase III trials. [ABSTRACT FROM AUTHOR]

Dupilumab, a monoclonal antibody inhibiting interleukin (IL) 4 and IL‐13, is approved for the treatment of moderate to severe atopic dermatitis (AD) in children aged ≥6 years, adolescents, and adults. Both clinical trials and real‐life data demonstrate its efficacy and safety. However, some cutaneous adverse events (cAEs) have been observed during real‐world experiences. The authors' aim was to analyze the spectrum of cAEs in patients receiving dupilumab for the treatment of AD in a real‐world setting. A retrospective review of electronic medical records was conducted for 916 patients (475 males and 541 females; mean age, 50.23 ± 19.66 years [range, 18–91 years]) who had received dupilumab for a minimum of 1 month for the treatment of AD from December 2018 to November 2022 at the Department of Dermatology of University Federico II of Naples (Italy). The mean duration of dupilumab treatment was 27.31 ± 21.26 months. A total of 148 of 916 (16.15%) (90 males; mean age, 50.91 ± 15.34 years) patients reported other cAEs apart of AD flare; namely, facial redness (82 of 916; 8.95%), psoriasis (39 of 916; 4.25%), alopecia areata (11 of 916; 1.2%), skin peeling (11 of 916; 1.2%), parapsoriasis (three of 916; 0.32%), and vitiligo (two of 916; 0.21%). Thirty‐one of 916 (3.38%) patients discontinued dupilumab because of cAEs (18 of 916; 1.96%) for facial redness, 10 of 916 (1.09%) for psoriasis, and three of 916 (0.32%) for parapsoriasis. In our population, most of the cAEs were mild and did not require discontinuation of dupilumab. These findings would enable dermatologists understand the cutaneous side effects of dupilumab better, resulting in improved treatment plan decisions in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Guselkumab is a fully human 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. [Correction added on [28‐02‐2023], after first online publication: 'humanized monoclonal antibody' has been changed to 'fully human monoclonal antibody' in the preceding sentence.] 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 centres, 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. [ABSTRACT FROM AUTHOR]

This article discusses a case of a severe relapse of pemphigus vulgaris (PV) after receiving the SARS-CoV-2 vaccine. The patient, a 56-year-old female with a previous diagnosis of PV, experienced multiple erythematous erosions on her body, including her eyelids, after receiving the Moderna mRNA-1273 vaccine. The patient had been in remission for 18 months prior to the relapse. Treatment with intravenous corticosteroids and rituximab resulted in an improvement in the patient's condition. The article suggests that SARS-CoV-2 vaccines may trigger relapses in autoimmune skin diseases and further studies are needed to understand the association. [Extracted from the article]

Long-term efficacy and safety of Dupilumab in adolescents with moderate-to-severe atopic dermatitis: results through week 52 from a phase III open-label extension trial (LIBERTY AD PED-OLE). The mean percentage reduction of NRS itch score (mean value of 8.2 at baseline, 1.6 at week 32 and 1.3 at week 52) showed a reduction of 80.5% at week 32 and of 84.1% at week 52. Dupilumab, a fully human monoclonal antibody inhibiting signalling of both interleukin (IL)-4 and IL-13, was approved by European Medical Agency (EMA) in August 2019 for adolescents aged >=12 years with moderate-to-severe atopic dermatitis (AD) after randomized clinical trials demonstrating long-term efficacy and safety.[[1], [3]] Real-world studies, both at week 16[5] and week 32/52,[[6]] are rarely reported. [Extracted from the article]

Such hypotheses find additional feedback when patients are asked about deodorants use during a flare-up; only 25% of them used deodorants in such condition, with higher PGA score related to reduced deodorants use ( I p i = 0.037). Deodorant use is similar and frequent in patients with minimal to mild HS, while almost half of the patients scoring HS-PGA 3 stated to not use deodorants. Diode laser and intense pulsed light laser, indeed, showed better outcomes than any other method, with no patients reporting worsening after laser hair removal even if it was used only by 8% of patients. [Extracted from the article]

Background: Hydroxyisohexyl 3‐cyclohexene carboxaldehyde (HICC), contained in fragrance mix II (FM II), has been recognized as a contact sensitizer since the mid‐1990s. After several attempts to reduce its use during the last two decades, HICC was permanently banned from the European market in August 2021. Objectives: To assess the prevalence and the time trend of contact allergy to HICC and to investigate the concordance of HICC allergy compared to FM II allergy in an unselected Italian patch test population. Methods/Patients: Retrospective analysis on demographics and patch test results of HICC‐sensitized and/or FM II‐sensitized patients was performed over a 6‐year period (2016–2021) at 6 patch test Clinics in Italy. Results: Among 7266 patients (4942 females, 68.0%, mean age 45.4 ± 20.6 years), 1% (70) resulted positive to HICC and 2.1% (153) to FM II. Clinical relevance was documented in 72.9% (51/70) of HICC positive patients. Among the 169 HICC and/or FM II positive patients, 9.5% had a positive reaction to HICC only, 31.9% to both HICC and FM II, and 58.6% to FM II only. The prevalence trend line of HICC positive reactions showed a decrease from 1.15% (2016) to 0.96% (2021). Conclusions: We documented a decreasing trend of HICC allergy in Italy, in line with the data recently reported in literature. Nevertheless, HICC should be maintained in the baseline series to monitor the benefits of its ban from the European market. [ABSTRACT FROM AUTHOR]

Histological examination confirmed the diagnosis of basal cell carcinoma for both; (d) Dermatoscopy of the 3-cm basal cell carcinoma. Multiple metastatic basal cell carcinoma with concurrent metastatic pleomorphic sarcoma in chronic lymphedema area-case report. The patient presented to our observation with three lesions of the same thigh affected by lymphoedema (Figure 1). [Extracted from the article]

Background: COVID‐19 is a highly contagious respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2. COVID‐19 outbreak, which caused thousands of deaths, has been declared a pandemic by the World Health Organization in March 2020. Aim: Skin manifestations related to SARS‐CoV‐2 infection can be divided mainly into five groups: chilblainlike lesions (CBLLs), maculopapular eruptions, urticarial eruptions, vesicular eruptions, and livedo or necrosis. Other skin findings reported are erythema multiforme (EM)‐like lesions and skin findings associated with multisystem inflammatory syndrome in children (MIS‐C) and rarely with multisystem inflammatory syndrome in adults (MIS‐A). Other manifestations such as pityriasis rosea or shingles are also reported. Methods: A total of 60 articles including reviews, studies and case reports were selected for the evaluation in this review. Results: The skin manifestations associated with COVID‐19 infection are numerous and can vary widely. The major dermatological patterns of COVID‐19 can be classified as inflammatory reactions (maculopapular/morbilliform, urticarial and vesicular rashes), or lesions of vascular origin (chilblain like rashes, petechiae/purpura, and livedo acemose‐like pattern) Conclusion: We believe that the dermatologist could play an important role in the response to the SARS‐CoV‐2 pandemic through early recognition of skin lesions suggestive of COVID‐19, particularly in paucisymptomatic infections where this recognition could direct toward an early diagnosis of infection that certainly leads to a better prognosis. [ABSTRACT FROM AUTHOR]

Background: Although long‐term management of psoriasis is paramount, this approach is challenging in clinical practice. In the recent PSO‐LONG trial, a fixed‐dose combination of betamethasone dipropionate (BD) and calcipotriol (Cal) foam applied twice a week on non‐consecutive days for 52 weeks (proactive treatment) reduced the risk of relapse. However, the role of Cal/BD foam in the long‐term management of psoriasis needs further clarifications. The ProActive Management (PAM) program, a nationwide Italian project, aims at reaching a consensus on the role of proactive management of psoriasis. Methods: A steering committee generated some statements through the nominal group technique (NGT). The statements were voted by an expert panel in an adapted Delphi voting process. Results: Eighteen statements were proposed, and the majority of them (14/18) reached a consensus during the Delphi voting. The need to provide long‐term proactive topical treatment to reduce the risk of relapse for the treatment of challenging diseases sites or in patients where phototherapy or systemic therapies are contraindicated/ineffective was widely recognized. A consensus was reached about the possibility to associate the proactive treatment with systemic and biological therapies, without the need for dose intensification, thus favoring a prolonged remission. Moreover, the proactive treatment was recognized as more effective than weekend therapy in increasing time free from relapses. Approaches to improve adherence, on the other hand, need further investigation. Conclusions: The inclusion in guidelines of a proactive strategy among the effective treatment options will be a fundamental step in the evolution of a mild‐moderate psoriasis therapeutic approach. [ABSTRACT FROM AUTHOR]

At baseline, the following data were collected for each patient: (i) personal and demographic data; (ii) psoriasis duration and presence of psoriatic arthritis; (iii) comorbidities; (iv) previous treatments for psoriasis; (v) psoriasis severity through body surface area (BSA) and psoriasis activity severity index (PASI). A "last observation carried forward" method, where if a patient dropped out of the study the last available value was "carried forward" until the end of the treatment, was used. The introduction of biologic drugs has revolutionized the management of moderate-to-severe psoriasis.[1] In particular, anti-interleukin (IL)-23s have been recently approved.[2] Tildrakizumab is a fully human immunoglobulin G1 antibody selectively targeting the p19 subunit of IL-23 without binding to p40 subunit shared by IL-12 and 23.[3] Even if two randomized controlled trials (CTs) (reSURFACE 1 and reSURFACE 2) showed the superiority of tildrakizumab compared with placebo and etanercept, real-life data are limited.[[4], [6], [8]] Thus, the aim of our 28-week retrospective study was to assess the effectiveness and safety of tildrakizumab for moderate-to-severe psoriasis in a real-life setting. [Extracted from the article]

Strategies on long‐term management of patients affected by atopic dermatitis (AD) undergoing treatment with dupilumab achieving good clinical response (GCR) or experiencing dupilumab‐related adverse events (AEs) are scant. Data of patients who implemented longer than scheduled dupilumab dosing interval due to GCR (at least 52 weeks of treatment and controlled AD activity [Eczema Area Severity Index ≤7 and Dermatology Life Quality Index ≤5 for at least 6 months]) or AEs (dupilumab‐related and treatment‐resistant conjunctivitis) were retrospectively collected. Dupilumab was tapered to Q3W or Q4W based on physician‐patient shared decision. At baseline (T0) and each follow‐up (week 16 [T1] and week 32 [T2]) disease severity was assessed. A total of 59 patients implemented longer than scheduled dosing interval (44 GCR, 15 AEs). Among these, 50 (35 GCR and 15 conjunctivitis) patients switched to 300 mg Q3W, while nine GCR subjects to Q4W. In the GCR group Q3W, 34 and 31 patients maintained clinical response at T1 and T2, whereas eight and seven Q4W subjects maintained clinical response at the same timepoints, respectively. No significant differences in AD severity were observed between T1 and T2 in both groups. Contrariwise, one Q3W and one Q4W patients at T1, and three Q3W and one Q4W subjects at T2, returned to dupilumab labeled dosage due to AD worsening. In conjunctivitis group, dupilumab Q3W was maintained in eight and four patients at T1 and T2, respectively. Three patients at T1 and three at T2 subjects returned to the labeled interval due to conjunctivitis remission. Four patients at T1 and four subjects at T2 interrupted dupilumab due to the persistence of conjunctivitis. A longer dupilumab dosing interval may be a valuable option in patients with a GCR and may be a useful strategy to reduce treatment‐related conjunctivitis, also with pharmacoeconomic benefit. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic inflammatory, itching skin with a significant psychosocial impact on patients and relatives. In adults and adolescents besides flexural eczema, head and neck eczema, and hand eczema, which are the most frequent clinical phenotypes (84.9% and 84.2%, respectively), there are also other possible presentation such as, portrait‐like dermatitis (20.1%), diffuse eczema (6.5%), eczema nummulare‐like (5.8%), prurigo nodularis‐like (2.1%) and erythrodermia (0.7%). Diagnosis can be easy due to the typically distributed eczematous lesions, albeit with age‐related differences, However, it is also extremely heterogeneous in severity, course, and sometimes particular clinical features. Currently, there are no better diagnostic criteria than an experienced dermatologist for the diagnosis of AD. Misdiagnosis and delayed treatment will have an impact not only on the child's physical health, but also and especially on the child's psychological health. The aim of our review was to group the main differential diagnoses in pediatric age where the diagnosis can often hide many pitfalls. [ABSTRACT FROM AUTHOR]

Urticaria is a disease characterized by wheals and/or angioedema. Chronic spontaneous urticaria (CSU) occurs for longer than 6 weeks and appears independently of any identifiable exogenous stimulus. During the vaccination campaign for Coronavirus disease 2019 (COVID‐19) pandemic, several cutaneous adverse events have been described, among which urticaria lasting less than 6 weeks (acute urticaria, AU). AU due to vaccines can be IgE or non‐IgE mediated; the former typically develop within 4 h of drug exposure, the latter occurs later and the mechanism is unclear. In this retrospective study we analyzed the frequency and clinical characteristics of urticaria occurring after COVID‐19 vaccine (post‐vaccination urticaria relapse) in adult CSU patients treated with antihistamine and omalizumab, and in clinical remission. [ABSTRACT FROM AUTHOR]

Background: Contact allergy and atopic dermatitis (AD) are both common inflammatory T cell‐mediated diseases and many factors may influence the prevalence of contact allergy in AD patients. In children, their possible correlation was debated with conflicting results. Objectives: The present study aimed to assess the prevalence of contact sensitivity in children and to investigate the association with AD. Materials and methods: A retrospective multicentre study on children aged from 0 to 14 years patch tested between January 2017 and December 2018 was performed. Children were consecutively patch tested with the SIDAPA (Società Italiana Dermatologia Allergologica Professionale Ambientale) baseline series. Results: Among the 432 children investigated for contact allergy, 125 (28.9%) showed a positive reaction to at least one of the allergens tested, with a higher prevalence of positive patch test reactions in girls (32.3%) than in boys (25.0%). The most frequent contact allergens were nickel sulphate (10.2%), cobalt chloride (6.7%), methylisothiazolinone (3.7%), fragrance mix‐2 (3.2%), potassium dichromate (2.8%), fragrance mix‐1 (2.1%) and methylchloroisothiazolinone/methylisothiazolinone (2.1%). One‐hundred‐three children (23.8%) suffered from AD showing a higher prevalence of positive patch test (36.9%) compared to children without AD (26.4%). Conclusions: Despite the topic being still controversial, the present study suggests a consistent prevalence of contact allergy among children with higher sensitivity rate among children with AD than without AD. [ABSTRACT FROM AUTHOR]

Eleven biologic drugs are currently approved for psoriasis management. Real‐life studies are needed to guide clinicians in choosing a tailored‐tail therapy. The aim of our retrospective study is to indirectly compare the efficacy and safety of ixekizumab and brodalumab in psoriasis patients. A single‐centre real‐life retrospective study was performed enrolling moderate‐to‐severe psoriatic patients under biologic treatment with ixekizumab or brodalumab. For each patient, clinical and demographic data were collected and the effectiveness and safety of brodalumab and ixekizumab treatment were evaluated at weeks 4, 12, and 24. Psoriasis Area Severity Index (PASI) and Body Surface Area (BSA) were used for psoriasis severity. A total of 139 patients were included in the study: 98(70.5%) and 41(29.5%) patients received ixekizumab and brodalumab, respectively. Mean PASI and BSA significantly reduced at each follow up for both ixekizumab and brodalumab groups. Even if ixekizumab reached higher rates of PASI90 and PASI100 than brodalumab (PASI90: 43.8% vs. 39.0% PASI100: 20.4% vs. 17.1% at week4 and PASI90: 83.6% vs. 75.6% PASI100: 71.5% vs. 60.9% at week24), these results were not statistically significant. Adverse events, mainly mild, were registered in 25.5% of ixekizumab and 26.8% of brodalumab group, respectively. Discontinuation rate was higher for brodalumab (17.1% vs. 9.1%), without statistical significance. Our study showed comparable efficacy and safety for ixekizumab and brodalumab. [ABSTRACT FROM AUTHOR]

Background: Rosacea is a chronic inflammatory disease of the facial skin that affects all skin types and occurs mostly in adults. The main clinical sign of rosacea is a characteristic and persistent form of centro‐facial erythema that is prone to exacerbation and can impair quality of life (QoL). The current therapeutic approach for rosacea is to combine various treatments, use appropriate skincare products and avoid flare‐up triggers. Objective: To evaluate the use of a facial skincare product containing protein‐free sap extruded from Rhealba® oat plantlets and mandarin extract in subjects with rosacea. Methods: Three clinical studies were conducted in adult subjects with various rosacea phenotypes (erythematotelangiectatic or papulopustular) and treatment histories to assess the dermatological and ophthalmological tolerance of the study product, as well as its clinical effectiveness, after a twice‐daily application on the whole face and neck for up to 4 weeks. Results: Tolerance of the product was rated as good to very good by dermatologists across the three studies, which involved a total of 105 evaluable subjects. Subjects with untreated erythematotelangiectatic rosacea reported fewer functional signs and symptoms of the disease and an improved QoL. The evaluation of skin biometric parameters revealed a reduction in transepidermal water loss, indicating that the study product helped to restore skin barrier integrity after 4 weeks, and a higher skin pH, indicating that the cutaneous microbiote was respected. Most subjects (93%) who had either undergone a superficial dermatological procedure for erythematotelangiectatic rosacea or were taking oral/topical treatments for papulopustular rosacea, rated the study product as very good (8/10) and felt it further relieved their symptoms. Conclusion: Overall, the study product was very well tolerated and may be beneficial for subjects with rosacea as an adjunct to superficial dermatological procedures or oral/topical therapies, in line with the current recommendations for rosacea management. [ABSTRACT FROM AUTHOR]

Background: Moderate‐to‐severe atopic dermatitis (AD) in the adolescence is a high burden disease, and its treatment can be very challenging due to paucity of approved systemic drugs for this age and their side‐effects. Dupilumab was recently approved for treatment of adolescent AD. Objectives: A multicentre, prospective, real‐world study on the effectiveness and safety of dupilumab in adolescents (aged from ≥12 to <18 years) with moderate‐to‐severe AD was conducted. The main AD clinical phenotypes were also examined. Methods: Data of adolescents with moderate‐to‐severe AD treated with dupilumab at label dosage for 16 weeks were collected. Treatment outcome was assessed by EASI, NRS itch, NRS sleep loss and CDLQI scores at baseline and after 16 weeks of treatment. The clinical scores were also evaluated according to clinical phenotypes. Results: One hundred and thirty‐nine adolescents were enrolled in the study. Flexural eczema and head and neck eczema were the most frequent clinical phenotypes, followed by hand eczema and portrait‐like dermatitis. Coexistence of more than 1 phenotype was documented in 126/139 (88.5%) adolescents. Three patients (2.1%) contracted asymptomatic SARS‐CoV‐2 infection and 1 of the discontinued dupilumab treatment before the target treatment period. A significant improvement in EASI, NRS itch, NRS sleep loss and CDLQI was observed after 16 weeks of treatment with dupilumab. This outcome was better than that observed in clinical trials. Dupilumab resulted effective in all AD phenotypes, especially in diffuse eczema. Twenty‐eight (20.1%) patients reported adverse events, conjunctivitis and flushing being the most frequent. None of patients discontinued dupilumab due to adverse event. Conclusions: Dupilumab in adolescent AD showed excellent effectiveness at week 16 with consistent improvement of all clinical scores. Moreover, dupilumab showed a good safety profile also in this COVID‐19 pandemic era. [ABSTRACT FROM AUTHOR]

Dupilumab is a monoclonal antibody approved for the treatment of moderate‐to‐severe atopic dermatitis (AD) in patients aged ≥12 years. Large, double‐blind, randomized, placebo‐controlled trials showed its efficacy and safety in adolescents. However, real‐life data are few. The aim of this monocentric retrospective observational study (December 2020–November 2021) was to assess the effectiveness and safety of dupilumab in AD adolescents treated for at least 24 weeks. For each patient demographic features, clinical data and adverse events (AEs) were collected. Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS) for pruritus (P‐NRS) and for sleep disturbances (S‐NRS), and Children Dermatology Life Quality Index (cDLQI) were assessed at baseline, week (W)4, W16, and W24. Twenty‐seven patients (18 males; 15.23 ± 3.54 years) were enrolled. Dupilumab was administered subcutaneously at dosage of 600 mg induction dose, followed by 300 mg every 2 weeks in 14 (51.85%) patients with a weight ≥60 kg, while 13 (48.15%) patients with a weight <60 kg were treated with dupilumab 200 mg every 2 weeks after a loading dose of 400 mg. The mean EASI score at baseline was 26.96 ± 4.93 and significantly reduced to 3.74 ± 3.47 at W16 (<0.001), and to 3.4 ± 5.04 at W24 (p < 0.001). P‐NRS (9.14 ± 0.94 at baseline vs. 2.33 ± 4.93 at W16 [p < 0.001], and 1.45 ± 2.35 at W24 [p < 0.001]), S‐NRS (7.88 ± 1.64 at baseline vs. 0.92 ± 1.35 at W16 [p < 0.001], and 1.66 ± 2.84 at W24 [p < 0.0001]) and cDLQI (26.62 ± 4.45 vs. 2.18 ± 3.51 at baseline vs. 2.18 ± 3.51 at W16 [p < 0.001], and 3.4 ± 5.02 at W24 [p < 0.001]) showed a statistically significative improvement as well. Injection‐site reaction (5/27; 18.52%), conjunctivitis (2/27; 7.41%), and asthenia (2/27; 7.41%) were the main AEs collected. This study seems to confirm the efficacy and safety of dupilumab in adolescents with moderate‐to‐severe AD also in real‐life setting. [ABSTRACT FROM AUTHOR]

Herein, we report a case series on four adolescent patients (three male, 75.0%; mean age: 16.25 ± 0.96 years, range 14-17 years), affected by moderate-to-severe AD undergoing treatment with upadacitinib for at least 16 weeks (W). JAAD Int. 2021; 6: 27 - 36. 7 Napolitano M, Fabbrocini G, Genco L, Martora F, Potestio L, Patruno C. Rapid improvement in pruritus in atopic dermatitis patients treated with upadacitinib: a real-life experience. The effectiveness of upadacitinib was assessed evaluating the following scores at baseline, W4 and W16: Eczema Area Severity Index (EASI), children's Dermatology Life Quality Index (cDLQI), Pruritus Numerical Rating Scale (P-NRS) and Sleep Numerical Rating Scale (S-NRS). [Extracted from the article]

PAR2 is correlated with itch NRS in patients with COVID-19 acral lesions; histamine is not correlated with itch NRS in patients with COVID-19 acral lesions. COVID-19-associated chilblain pruritus is non-histaminergic mediated and correlated to epidermal interleukin 31 We sought to investigate the pathophysiological mechanisms of these itchy toes, focusing on itch mediators and the itchy cytokine interleukin (IL) 31 through an immunofluorescence study and correlating them with itch intensity in COVID-19 patients with COVID toes. [Extracted from the article]

These patch test results are consistent with the diagnosis of airborne allergic contact dermatitis (ACD) "by proxy" caused by aerosoled budesonide followed by systemic contact dermatitis due to prednisone. Our case demonstrates that budesonide induced an airborne allergic contact dermatitis, whereas prednisone provoked a systemic allergic contact dermatitis. Keywords: budesonide; case report; contact dermatitis; corticosteroids EN budesonide case report contact dermatitis corticosteroids 483 485 3 05/09/23 20230601 NES 230601 Budesonide is patch tested in several baseline series, since it is a recognized contact sensitizer and considered as a detector of sensitization to topical corticosteroids.[[1]] CASE REPORT A 37-year-old female developed an edematous dermatitis of the face about 6 h after she had held her daughter in her arms while the child was aerosoled for asthma with a medication (Aircort solution, Italchimici, Italy) containing budesonide 1 mg, sodium citrate, sodium chloride, disodium edetate, anhydrous citric acid, polysorbate 80, and water for injections. [Extracted from the article]

Kaposi's sarcoma (KS) is a multifocal systemic disease, originating from endothelial cells mainly affecting elderly men. Intralesional chemotherapy with vinblastine or vincristine is an effective and well‐tolerated treatment in patients presenting single nodules on the skin. Despite reflectance confocal microscopy represents a useful diagnostic method for many dermatological diseases, to date, there are few data regarding the use of RCM in mucocutaneous KS. Objective of this study was to evaluate the use of RCM for therapeutic follow‐up in KS patients treated with intralesional vincristine. An observational retrospective study involving patients with a histological diagnosis of classic KS was conducted. All patients were treated with intralesional vincristine; reflectance confocal microscopy images were taken for each patient at baseline (T0) and 1 month after vincristine injection. Four male patients with a median age of 76.8 years were included in the study and four nodules (one for each patient) were evaluated with RCM examination before and after vincristine injections. At 1 month from intralesional vincristine treatment, therapeutic response was confirmed at RCM examination; a reduction of inflammatory cell at the stratum spinosum level in all evaluated lesions was observed; at papillary dermis levels, black luminal structures were decreased in diameter and superficial linear canalicular structures were not represented. Aggregates of inflammatory cells and of hemosiderin deposition, at the dermal level, were reduced in number. Reflectance confocal microscopy showed to be a promising method to evaluate vincristine therapeutic response in patients with KS; further studies evaluating RCM use in KS patients in order to monitor treatment efficacy are still required. [ABSTRACT FROM AUTHOR]

Recent knowledge on the key role of interleukin (IL) 23/17 axis in psoriasis pathogenesis, led to development of new biologic drugs. Risankizumab is a humanized immunoglobulin G1 monoclonal antibody specifically targeting IL23. Its efficacy and safety were showed by both clinical trials and real‐life experiences. However, real‐life data on effectiveness and safety of risankizumab in patients who previously failed anti‐IL17 are scant. To assess the efficacy and safety of risankizumab in patients who previously failed anti‐IL17. A 52‐week real‐life retrospective study was performed to assess the long‐term efficacy and safety of risankizumab in patients who previously failed anti‐IL17. A total of 39 patients (26 male, 66.7%; mean age 50.5 ± 13.7 years) were enrolled. A statistically significant reduction of psoriasis area severity index (PASI) and body surface area (BSA) was assessed at each follow‐up (PASI at baseline vs. week 52: 13.7 ± 5.8 vs. 0.9 ± 0.8, p < 0.0001; BSA 21.9 ± 14.6 vs. 1.9 ± 1.7, p < 0.0001). Nail psoriasis severity index improved as well, being statistically significative only at week 16 and thereafter [9.3 ± 4.7 at baseline, 4.1 ± 2.4 (p < 0.01) at week 16, 1.4 ± 0.8 (p < 0.0001) at week 52]. Treatment was discontinued for primary and secondary inefficacy in 1(2.6%) and 3(7.7%) patients, respectively. No cases of serious adverse events were assessed. Our real‐life study confirmed the efficacy and safety of risankizumab, suggesting it as a valuable therapeutic weapon among the armamentarium of biologics, also in psoriasis patients who previously failed anti‐IL17 treatments. [ABSTRACT FROM AUTHOR]

Risankizumab has been recently approved for moderate‐to‐severe plaque psoriasis; however, real‐life studies are scarce. Analysis of possible predictor factors of treatment response are limited to body mass index (BMI) and previous biologic experience. Our objectives were to evaluate the effectiveness and safety of Risankizumab and to investigate on possible predictor factors response. We retrospectively analyzed 166 patients from two centers in Italy who undergone Risankizumab for psoriasis. The proportion of patients achieving a 100%, 90%, 75% of improvement in Psoriasis Area Severity Index (PASI) and PASI <3 were collected at weeks 16, 28, 40, and 52. Study population was analyzed in subgroups to investigate possible predictors of response to Risankizumab since week 40. At the time of analysis 165, 103, 30, and 11 patients had completed 16, 28, 40, and 52 weeks of treatment, respectively. The mean PASI score decreased from 12.5 ± 5.1 at baseline to 1.9 ± 2.4 at week 16. Similar reductions were observed when considering PASI <3, PASI 75, PASI 90, and PASI 100. Previous biologics failure, different smoking habits, obesity, and joint involvement resulted in a lower response to risankizumab. In particular, significant differences in mean PASI at any time‐points was observed between psoriatic arthritis (PSA) and non‐PSA patients: 2.7 versus 1.7 (p = 0.036), 1.9 versus 0.4 (p = 0.006), and 4.1 versus 0.5 (p = 0.016) at 16, 28, and 40 weeks, respectively. No difference in response to risankizumab occurred in the case of involvement of difficult‐to‐treat areas. In this population, Risankizumab was effective and safe. Smoking habits, joint involvement, obese status, and previous biologic experience may negatively affect treatment response, while difficult body sites involvement have minor impact. [ABSTRACT FROM AUTHOR]

Moreover, CRDD generally presents with multiple skin lesions.[2] Our case reports an atypical presentation of CRDD characterized by the presence of a single lesion and branching vessels at dermoscopy which might open up the scenario of differential diagnoses of CRDD to other pathologies. Keywords: basal cell carcinoma; lymphoma; Rosai Dorfmann EN basal cell carcinoma lymphoma Rosai Dorfmann 1124 1126 3 02/27/23 20230301 NES 230301 A 33-year-old Caucasian man presented to our outpatient clinic with an asymptomatic papule localized on his face that slowly progressed for 6 months. Clinically, CRDD tends to affect middle-aged Asian women.[2] The lesions show no predilection for specific body areas and are generally found in clusters.[2] Although there is no classic clinical presentation of CRDD, three main forms can be distinguished: papularnodular, plaque, and tumor.[3] It can also present with vesicles and pustules.[3] In the present case, the cutaneous lesion could fall into the category of the papulonodular type. [Extracted from the article]

Persistent candidiasis infection during anti-IL-17 treatment for plaque psoriasis requiring biologic discontinuation: a case series and literature review According to the therapeutic algorithm proposed by Saunte et al.,[5] mucocutaneous candidiasis occurring on therapy with anti-IL-17 drugs is mostly easily manageable with topical and, sometimes, systemic antifungal therapy.[5] Discontinuing the biological treatment is not mandatory, but it may be suggested in case of frequent and close relapses or therapeutic difficulties. The role of interleukin (IL)-17 in the pathogenesis of both psoriasis and psoriatic arthritis (PsA) is widely recognized.[[1]] IL-17A is also a key cytokine involved in the immune response against I Candida i mucocutaneous infections.[2] Indeed, a genetic deficiency of IL-17A has been linked to persistent or recurrent I Candida i infection.[3] Therefore, patients treated with anti-IL-17A may have an increased risk of I Candida i mucocutaneous infection.[3] Herein, we report two cases of patients with psoriasis and PsA treated with secukinumab and ixekizumab, respectively, who developed oral candidiasis requiring treatment discontinuation. [Extracted from the article]

(d) Dermoscopic images of the tongue showed papillomatous structures with a purplish background. gl Since the patient was reluctant to undergo an incisional biopsy on the lesions of tongue and glans, we decided to perform dermoscopy and in vivo RCM. Kaposi's sarcoma (KS) is a cancer of the endothelial cells of blood and lymphatic vessels associated with human herpes virus-8 (HHV-8) infection. At RCM examination, the mucosa of glans showed irregular honeycombing pattern of the stratum spinosum with clusters of roundish mild refractive structures in the intercellular spaces corresponding to inflammatory cells. [Extracted from the article]

Psychometric validation of the psoriasis symptoms and impacts measure (P-SIM): a novel patient-reported outcome instrument for patients with plaque psoriasis, using reported data from the BE RADIANT phase 3b trial. Erythrodermic psoriasis (EP) is a rare variant of psoriasis characterized by a severe, in some cases life-threatening, clinical course.[1] EP affects about 1%-2% of psoriasis patients with generalized erythema and scaling covering the entire body surface.[2] In recent years, numerous therapeutic alternatives are available for EP treatment; however, there are still no standardized international guidelines, and most biologics are used on the basis of clinical practice, case reports, or small case series.[1] Bimekizumab is a novel humanized monoclonal antibody that neutralizes both interleukin (IL)-17A and IL-17F.[3] IL-17A and IL-17F have been shown to be functionally dysregulated in different immune-mediated inflammatory diseases such as psoriasis and psoriatic arthritis.[3] Given the overlapping biology of these two cytokines, Bimekizumab was developed in order to provide a greater depth of clinical response rather than IL-17A inhibition alone.[3] It has been recently approved for the treatment of moderate-to-severe plaque psoriasis in adults who are candidates for systemic therapy.[3] Bimekizumab use in EP, as the case of the other biological drugs, is still off label. Following the onset of COVID-19 pandemic, the patient suspended outpatient follow-ups and adalimumab treatment, experiencing a progressive worsening of the disease. [Extracted from the article]

To the Editor, Linear psoriasis is a rare form of psoriasis first described in 1951, being characterized by the distribution of skin lesions along Blaschko's lines. Linear psoriasis is extremely rare in children and only five pediatric cases has been reported so far (Table 1). 1 TABLE Main features of patients with linear psoriasis. This condition is intensely pruritic and usually resistant to antipsoriatic therapies.[[1], [3]] The differential diagnosis of linear psoriasis may be wide. [Extracted from the article]

The mean latency between initiation of TNF-alpha antagonist therapy and the appearance of alopecia was 6 months. Antitumor necrosis factor-alpha (TNF-alpha) biologic agents represent efficacious treatments for moderate-to-severe psoriasis and psoriatic arthritis.[1] Given the increase in their use, new possible adverse events, including paradoxical ones, are being reported. Psoriatic alopecia/alopecia areata-like reactions secondary to anti-tumor necrosis factor- therapy: a novel cause of noncicatricial alopecia. [Extracted from the article]

Recent epidemiological studies highlighted a possible link between PsO and demyelinating disorders such as MS.[2] Herein, we reported the case of a 40-year-old female who suffered from PsO and MS successfully treated with a combination therapy of secukinumab and fingolimod. Keywords: fingolimod; multiple sclerosis; psoriasis; real-life experience; secukinumab EN fingolimod multiple sclerosis psoriasis real-life experience secukinumab e100 e102 3 02/17/23 20230201 NES 230201 Dear Editor, Psoriasis (PsO) is a chronic inflammatory disease characterized by erythemato-desquamative plaques with systemic involvement (psoriatic arthritis, metabolic syndrome, cardiovascular disorders, Crohn's disease, and depression).[1] Multiple sclerosis (MS) is an auto-immune neurological disease characterized by inflammation, demyelination, gliosis, and neuronal loss. [Extracted from the article]

COVID-19, hidradenitis suppurativa, lichen planus, psoriasis, vaccine Cutaneous adverse reaction following COVID-19 vaccination: Report from a southern Italian referral centre. Comment on "cutaneous adverse reactions following the Pfizer/BioNTech COVID-19 vaccine" by Luo et al. [Extracted from the article]

Background: Melasma is a common skin disorder characterized by alterations in normal skin pigmentation. The objective was to evaluate the efficacy and safety of a skin whitening serum containing niacinamide, hydroxyphenoxy propionic acid, dipotassium glycyrrhizate, glycolic acid, and 4‐n‐butylresorcinol applied twice daily combined with a spot‐preventing SPF50+ sunscreen for treatment of melasma. Methods: Twelve healthy Caucasian women with melasma (Fitzpatrick skin types II−IV) were enrolled in this pilot clinical study. Efficacy evaluations were performed at baseline and weeks 4, 8, and 12 of treatment and included clinical and instrumental assessments. Results: All endpoints for melasma hyperpigmentation showed a statistically significant improvement from baseline to the end of the study. There was only one dropout. No signs of irritation or discomfort were observed at baseline, w4, w8, or w12. An overall improvement in melasma was observed both clinically and on reflectance confocal microscopy (RCM). Conclusion: This topical skin whitening serum had favorable outcomes for the treatment of melasma hyperpigmentation in adult women, as demonstrated on investigator and instrumental assessments. The results of this pilot study need to be confirmed in randomized, controlled studies with a larger sample size. [ABSTRACT FROM AUTHOR]

The introduction of immune checkpoint inhibitors (ICIs) opened a new era in oncologic therapy. The favourable profile of ICIs in terms of efficacy and safety can be overshadowed by the development of immune‐related adverse events (irAEs). Dermatologic irAEs (dirAEs) appear in about 40% of patients undergoing immunotherapy and mainly include maculopapular, psoriasiform, lichenoid and eczematous rashes, auto‐immune bullous disorders, pigmentary disorders, pruritus, oral mucosal lesions, hair and nail changes, as well as a few rare and potentially life‐threatening toxicities. The EADV task force Dermatology for Cancer Patients merged the clinical experience of the so‐far published data, incorporated the quantitative and qualitative characteristics of each specific dirAEs, and released dermatology‐derived, phenotype‐specific treatment recommendations for cutaneous toxicities (including levels of evidence and grades of recommendation). The basic principle of management is that the interventions should be tailored to serve the equilibrium between patients' relief from the symptoms and signs of skin toxicity and the preservation of an unimpeded oncologic treatment. [ABSTRACT FROM AUTHOR]

Keywords: alopecia areata; COVID-19; herpes zoster; vaccine EN alopecia areata COVID-19 herpes zoster vaccine 36 38 3 01/23/23 20230101 NES 230101 The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic spread over the world in 2019. Herpes zoster and alopecia areata following mRNA BNT162b2 COVID-19 vaccine: Controversial immune effects 2022; 35 (5): e15411. doi: 10.1111/dth.15411 7 May Lee M, Bertolani M, Pierobon E, Lotti T, Feliciani C, Satolli F. Alopecia areata following COVID-19 vaccination: vaccine-induced autoimmunity?. [Extracted from the article]

Concurrent atopic dermatitis and psoriasis successfully treated with Brodalumab. Biological drugs have completely revolutionized the management of chronic inflammatory skin diseases, such as psoriasis. However, the pathogenesis of biologic induced EE is yet to be clarified as demonstrated by their possible occurrence also during anti-IL-23.9 We decided to prescribe guselkumab as it has been recently shown to be the most widely used drug in patients with concomitant psoriasis and atopic eczema, sometimes in combination with dupilumab.10 The pathogenesis of EE during biological therapy is still unknown. [Extracted from the article]

IL‐23‐inhibitors, such as guselkumab and risankizumab, represent the newest class of biologics approved for psoriasis. Phase III trials have shown their efficacy and safety. However, real life data are still scant. to indirectly compare the effectiveness, safety and tolerability of guselkumab and risankizumab in real world practice. An Italian single‐center retrospective cohort study enrolling moderate‐to‐severe psoriasis patients from September 1, 2018 and December 31, 2020 was performed to indirectly compare guselkumab and risankizumab efficacy and safety. Sixty eight patients were included (36 received guselkumab and 32 risankizumab). The groups were comparable for all analyzed characteristics, except for mean psoriasis duration (p < 0.01) which was higher for guselkumab. In guselkumab group, mean PASI reduced from 16.1 ± 6.4 (baseline) 2.1 ± 0.9 (week‐28) (p < 0.001) up to 0.9 ± 0.8 (week‐44) (p < 0.001). In risankizumab group mean PASI decreased from 13.5 ± 4.9 (baseline) 1.9 ± 0.8 (p < 0.001), (week‐28) (p < 0.001) up to 0.9 ± 0.4 (week‐40) (p < 0.001). No significant difference in mean PASI and BSA were observed between the treatments. No cases of serious AEs, injection site reaction, candida, malignancy, cardiovascular events were reported in both groups. Guselkumab and risankizumab showed favorable efficacy and safety profile, being comparable in terms of PASI90 and PASI100 responses as well as in AEs frequency and discontinuation rates. [ABSTRACT FROM AUTHOR]

EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: An obserVAtional (CANOVA) study was aimed at providing real‐world evidence of the effectiveness of biologics in Italian patients with moderate–severe psoriasis. It was an observational, retro‐prospective cohort study conducted in 17 Italian dermatology clinics. Adult patients with moderate–severe plaque psoriasis, who started a biologic treatment between 24 weeks and 24 months before enrolment, were included. With a follow‐up visit at 6 months after enrolment, each patient had at least 12 months of observation. The primary objective was to describe the clinical response rates (PASI 75) after 16/24/52 weeks from biologic treatment start. Secondary outcomes were sustained response, quality of life, and treatment satisfaction. Of the 669 eligible patients (64% males), 52% were naïve to biologics, though a mean duration of psoriasis since first diagnosis of 18.6 years (SD 13.2). The most frequently prescribed biologics were secukinumab (41%), ustekinumab (25%), TNF‐inhibitors (22%) and ixekizumab (12%). PASI 75 was achieved by 86% of patients (95% CI: 82%–89%) at 16 weeks, 90% (87%–93%) at 24 weeks, and 91% (89%–94%) at 52 weeks. Patients achieving PASI 90 and PASI 100 at 52 weeks were 75% (71%–79%) and 53% (49%–57%), respectively. Sustained PASI 75 response after 1 year from treatment start was achieved by 78% (74%–82%) of patients. Mean DLQI total score was 2.3 (SD 3.9) at enrollment and decreased at the final visit to 1.8 (3.6). A high level of treatment satisfaction was expressed by patients over the study period. This large real‐world study confirms in the clinical practice the good effectiveness and acceptability of biologics in psoriasis patients. [ABSTRACT FROM AUTHOR]

Dupilumab is a fully human monoclonal antibody targeting interleukin (IL) 4 and IL13 pathways. We performed a retrospective observational study to evaluate the efficacy of dupilumab for the treatment of adult patients referred to our department, from January 2019 to May 2021, with a diagnosis of moderate to severe atopic dermatitis (AD) and concomitant chronic rhinosinusitis with nasal polyps (CRSwNP), with a clinical indication for dupilumab treatment. Skin disease activity was assessed using EASI, Numerical Rating Scale (NRS) for pruritus (P‐NRS) and sleep (S‐NRS), and Dermatology Life Quality Index (DLQI). The CRSwNP activity was evaluated using 22‐item Sino‐Nasal Outcome Test (SNOT‐22), endoscopic nasal polyp score (ENPS), nasal congestion or obstruction score (scale 0–3), loss‐of‐smell score (scale 0–3), and rhinosinusitis disease severity (visual analog scale 0–10 cm). A significant improvement of all the score values was recorded assessing patients at baseline, week (W)16, and W24. In particular, concerning the CRSwNP, a reduction of ENPS score (baseline: 4.9 ± 1.85; W16: 2.49 ± 1.42, p < 0.01; W24: 1.68 ± 1.25, p < 0.01) and SNOT‐22 (baseline: 35.9 ± 19.11; W16: 12.85 ± 6.31, p < 0.01; W24: 10.71 ± 7.29, p < 0.01) was observed. Furthermore, dupilumab is a labeled drug for the treatment of both AD and CRSwNP. The use of a single drug to obtain the improvement up to the near remission of AD and CRSwNP increases not only patient's compliance with the treatment, but also the benefits in terms of health cost related to these chronic diseases. [ABSTRACT FROM AUTHOR]

Dupilumab showed significant improvement of adolescent atopic dermatitis (AD) signs and symptoms in clinical trials, with a good safety profile. Herein we report the real‐word effectiveness and safety of dupilumab in adolescents with moderate to severe AD from January to October 2020, during the COVID‐19 pandemic in Italy. All patients had a diagnosis of AD for a mean [SD] 12.8 [3.1] years. Baseline demographics, AD characteristics (EASI, cDLQI, NRS itch score, NRS sleep loss score) at baseline and week 16, and safety data were collected. Nineteen patients (52.6% men; mean [SD] age, 15.6 [1.4] years [range, 13–17 years]) were included in the analysis. All patients reached EASI‐50 and 78.9% EASI‐75, especially in those with EASI≥30 and BMI < 25 at baseline, with marked reduction for cDLQI (77.4%), NRS itch score (5.9 point), and NRS sleep loss score (87.5%). One patient contracted asymptomatic SARS‐CoV‐2 infection and 1 developed mild conjuntivitis, without stopping dupilumab. In this real‐word experience the effectiveness of dupilumab was excellent and resulted higher than that observed in clinical trials, with a good safety profile during COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Dear Editor, Id reaction, or dermatophytid, is a hyperergic reaction that develops from a remote immunologic insult.1 It occurs from several stimuli which include inflammatory skin conditions and infectious entities. It provides a cellular level resolution comparable with conventional histopathology.4 RCM has been proven useful for different inflammatory, melanocytic, and neoplastic disorders including the evaluation of dermatophyte infection.2,5 We present the first report of RCM of dermatophytid associated with tinea cruris and pedis. The id tends to resolve after the primary lesion has been treated, as was the case of our patient.2 The RCM offers a prompt, easy, and noninvasive technique for the diagnosis of dermatophytic infections and id reactions, reducing the number of skin scrapings or biopsies. [Extracted from the article]

Indeed, in literature there are studies that have not shown superiority of secukinumab and ixekizumab compared with adalimumab on PsA according to ACR20.6 Hence, treating algorithm selection in PsA patients maybe not always easy. Psoriasis has a prevalence of 2%-4% in western adults, and 20%-30% of psoriasis patients may develop psoriatic arthritis (PsA).1 PsA is an inflammatory musculoskeletal disease, affecting both men and women and usually following psoriasis development; hence PsA screening questionnaires are frequently used for a prompt diagnosis.2 It is a complex disease that affects multiple organ systems including peripheral and axial joints, entheses, skin, and nails. [Extracted from the article]