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1. Efficacy and Safety of Secukinumab in Elderly Patients with Moderate to Severe Plaque-Type Psoriasis: Post-Hoc Analysis of the SUPREME Study

Author

Talamonti M, Russo F, Malara G, Hansel K, Papini M, Cattaneo A, Parodi A, Chiricozzi A, Malagoli P, Bardazzi F, Brazzelli V, Dapavo P, Gisondi P, Zane C, Potenza C, Cantoresi F, Fargnoli MC, Trevisini S, Brianti P, Pescitelli L, Gigante G, Bartezaghi M, Caputo L, Aloisi E, and Costanzo A

Subjects
psoriasis, biologics, interleukin-17a, secukinumab, elderly, Dermatology, RL1-803
Abstract

Marina Talamonti,1 Filomena Russo,2 Giovanna Malara,3,4 Katharina Hansel,5 Manuela Papini,6 Angelo Cattaneo,7 Aurora Parodi,8 Andrea Chiricozzi,9,10 Piergiorgio Malagoli,11 Federico Bardazzi,12 Valeria Brazzelli,13 Paolo Dapavo,14 Paolo Gisondi,15 Cristina Zane,16 Concetta Potenza,17 Franca Cantoresi,18 Maria Concetta Fargnoli,19 Sara Trevisini,20 Pina Brianti,21 Leonardo Pescitelli,22 Giovanni Gigante,23 Marta Bartezaghi,23 Luisa Caputo,23 Elisabetta Aloisi,23 Antonio Costanzo24,25 On behalf of the SUPREME Study Group1Dermatology, University of Rome Tor Vergata, Rome, Italy; 2Department of Medical, Surgical and Neurological Science, Dermatology Section, University of Siena, S. Maria alle Scotte Hospital, Siena, Italy; 3Dermatology Unit, Hospital “Bianchi Melacrino Morelli”, Reggio, Calabria, Italy; 4Department of Dermatology, Papardo Hospital, Messina, Italy; 5Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 6Dermatologic Clinic of Terni, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 7U.O. Dermatologia, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milano, Italy; 8Di.S.Sal. Section of Dermatology, Ospedale Policlinico San Martino, University of Genova, Genova GE, 16132, Italy; 9UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli - IRCCS, Rome, Italy; 10Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy; 11Psocare Unit, I.R.C.C.S Policlinico San Donato, Milano, Italy; 12Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; 13Dermatology, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy; 14Department of Biomedical Science and Human Oncology, Second Dermatologic Clinic, University of Torino, Torino, Italy; 15Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy; 16Dermatology Department, ASST Spedali Civili di Brescia, University of Brescia, Brescia, Italy; 17Dermatology Unit “Daniele Innocenzi”, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome – Polo Pontino, Latina, Italy; 18Dermatology Unit, Department of Medicine, University of Roma, Roma, Italy; 19Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy; 20Department of Dermatology, University of Trieste, Trieste, Italy; 21Dermatology and Cosmetology Unit - San Raffaele Hospital, Milan, Italy; 22Department of Health Sciences, Dermatology Clinic, University of Firenze, Firenze, Italy; 23Novartis Farma SpA, Origgio, Italy; 24Unit of Dermatology, IRCCS Humanitas Research Hospital, Milano, Italy; 25Department of Biomedical Sciences, Humanitas University, Milano, ItalyCorrespondence: Marina Talamonti, Dermatology-Department of Systems Medicine, University of Rome Tor Vergata, PTV – Policlinico Tor Vergata, V.le Oxford 81, Rome, 00133, Italy, Tel +39 0620902743, Fax +39 0620902742, Email talamonti.marina@gmail.comPurpose: Secukinumab is a fully human monoclonal antibody that inhibits interleukin (IL)-17A approved for the treatment of moderate to severe plaque psoriasis in adults and children. We compared the efficacy and safety of secukinumab in patients aged < 65 years (adult patients) versus patients aged ≥ 65 years (elderly patients) in a post-hoc analysis of the SUPREME study.Patients and Methods: Patients with moderate to severe plaque psoriasis received subcutaneous secukinumab 300 mg per week for the first 5 weeks, then 300 mg per month. We compared the following outcomes in patients aged ≥ 65 years vs < 65 years: baseline characteristics; PASI50/75/90/100 response rates (improvements ≥ 50%/75%/90%/100% in Psoriasis Area and Severity Index (PASI) from baseline); changes in Dermatology Life Quality Index (DLQI); Hospital Anxiety and Depression Scale (HAD-A, HAD-D) score changes; treatment-emergent adverse events (TEAEs).Results: Secukinumab was slightly less effective in elderly patients than in adult patients (response rates at week 16: PASI90, 69.4% vs 80.9%, p = 0.4528; PASI100, 44.4% vs 56.7%, p = 0.8973). Elderly and adult patients showed a similar time course of changes in absolute PASI scores. Patients aged ≥ 65 years had a statistically significantly lower improvement in quality of life (mean DLQI reduction) than patients aged < 65 years at week 16 [− 5.4 (± 4.3) vs − 8.8 (± 6.9), p = 0.0065] and at week 24 [− 5.3 (± 4.4) vs − 9.2 (± 7.1), p = 0.0038]. Secukinumab treatment resulted in comparable mean reductions in anxiety and depression scores in both cohorts at 24 weeks [HAD-A, − 1.3 (± 3.3) vs − 2.1 (± 3.8), p = 0.9004; HAD-D, − 1.0 (± 3.3) vs − 1.5 (± 3.1), p = 0.4598]. The frequency of TEAEs in the two cohorts was similar (16.7% vs 14.6%, p = 0.7391).Conclusion: Secukinumab is a valid option for the management of moderate to severe psoriasis in elderly patients.Keywords: psoriasis, biologics, interleukin-17A, secukinumab, elderly

Published
2023

2. Efficacy of Secukinumab in Psoriasis: Post Hoc Gender-Wise Analysis of the SUPREME Study

Author

Stingeni L, Malara G, Conti A, Di Costanzo L, Carrera CG, Burlando M, Malagoli P, Musumeci ML, Bardazzi F, Brazzelli V, Amerio P, De Simone C, Trevisini S, Balato A, Megna M, Loconsole F, De Felice C, Bartezaghi M, Rausa A, Aloisi E, Orsenigo R, and Costanzo A

Subjects
plaque psoriasis, pasi, patient-reported outcomes, dermatology quality of life index, hospital anxiety and depression scale, Dermatology, RL1-803
Abstract

Luca Stingeni,1 Giovanna Malara,2,3 Andrea Conti,4 Luisa Di Costanzo,5 Carlo Giovanni Carrera,6 Martina Burlando,7 Piergiorgio Malagoli,8 Maria Letizia Musumeci,9 Federico Bardazzi,10 Valeria Brazzelli,11 Paolo Amerio,12 Clara De Simone,13,14 Sara Trevisini,15 Anna Balato,16 Matteo Megna,17 Francesco Loconsole,18 Catia De Felice,19 Marta Bartezaghi,20 Alice Rausa,20 Elisabetta Aloisi,20 Roberto Orsenigo,20 Antonio Costanzo21,22 On behalf of the SUPREME Study Group1Dermatology Section, Medical and Surgical Department, University of Perugia, Perugia, Italy; 2Dermatology Unit, Hospital “Bianchi Melacrino Morelli”, Reggio Calabria, Italy; 3Department of Dermatology, Papardo Hospital, Messina, Italy; 4Dermatologic Unit, Department of Surgery, Infermi Hospital, AUSL Romagna, Rimini, Italy; 5Department of Dermatology, “Gaetano Rummo” Hospital, Benevento UOC Dermatologia, AO G. Rummo, Benevento, Italy; 6U.O. Dermatologia, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milano, Italy; 7IRCCS San Martino Polyclinic Hospital, Di.S.Sal. Section of Dermatology, Genoa, Italy; 8Dermatology Unit IRCCS Policlinico San Donato, Milan, Italy; 9Dermatology Clinic, University of Catania, Catania, Italy; 10Division of Dermatology, University Hospital Policlinico “S. Orsola-Malpighi”, Bologna, Italy; 11Institute of Dermatology, Foundation IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy; 12Dermatologic Clinic, G. D’Annunzio University, Chieti, Italy; 13Istituto di Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy; 14Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy; 15Dermatology Department, University of Trieste, Trieste, Italy; 16Dermatology Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy; 17Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; 18Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy; 19Department of Clinical Dermatology, Centre for the Study and Treatment of Psoriasis, San Gallicano Dermatological Institute, IRCCS, Rome, Italy; 20Novartis Farma SpA, Origgio, Italy; 21Unit of Dermatology, IRCCS Humanitas Research Hospital, Milan, Italy; 22Department of Biomedical Sciences, Humanitas University, Milan, ItalyCorrespondence: Luca Stingeni, Dermatology Section, Medical and Surgical Department, University of Perugia, Perugia, Italy, Tel +39075-5783881, Email luca.stingeni@unipg.itPurpose: Psoriasis, a common systemic inflammatory disorder, presents with gender-related differences in the quality of life (QoL) and treatment outcomes. This post hoc analysis from the Phase 3b SUPREME study explored gender-related differences in patient characteristics and efficacy of secukinumab 300 mg on Psoriasis Area and Severity Index (PASI) 75/90/100 and impact on QoL using the Dermatology Life Quality Index (DLQI) in patients with moderate to severe psoriasis through week 24.Patients and Methods: The proportion of patients achieving PASI 75/90/100 was computed using a nonresponder imputation approach. Differences between cohorts were analyzed using a logistic regression model. The mean change from baseline in DLQI was computed using the Wilcoxon test.Results: Among the 433 patients (males: 71.6%), females had a higher DLQI than males at baseline (13.1 vs 9.5; P< 0.0001). Males had a slightly higher response for PASI 90 than females at week 16 (80.7% vs 78.1%; P=0.0779) and 24 (83.2% vs 79.7%; P=0.0319). No differences were observed between genders in PASI 100/75 responses at week 24. Both genders showed an improvement in DLQI with secukinumab at week 24 (− 10.9 vs − 8.1, respectively, in females vs males; P=0.0004).Conclusion: In summary, secukinumab was effective in the treatment of psoriasis, irrespective of gender.Keywords: plaque psoriasis, PASI, patient-reported outcomes, Dermatology Quality of Life Index, Hospital Anxiety and Depression Scale

Published
2023

3. COVID 19-associated chilblain-like acral lesions among children and adolescents: an Italian retrospective, multicenter study

Author

Romita, P., Maronese, C. A., de Marco, A., Balestri, R., Belloni Fortina, A., Brazzelli, V., Colonn, C., Di Lernia, V., El Hachem, May, Fabbrocini, G., Foti, C., Frasin, L. A., Guarneri, C., Guerriero, Cristina, Guida, S., Locatelli, A., Neri, Ilaria, Occella, C., Offidani, A., Oranges, T., Pellacani, G., Stinco, G., Stingeni, L., Barbagallo, T., Campanati, A., Cannavo, S. P., Caroppo, F., Cavalli, R., Costantini, Alessio, Cucchia, R., Diociaiuti, Andrea, Filippeschi, C., Francomano, M., Giancristoforo, S., Giuffrida, R., Martina, E., Monzani, N. A., Nappa, P., Pastorino, C., Patrizi, A., Peccerillo, F., Peris, Ketty, Recalcati, S., Rizzoli, L., Simonetti, O., Vastarella, M., Virdi, A., Marzano, A. V., Bonamonte, D., El Hachem M., Guerriero C., Neri I., Costantini A., Diociaiuti A., Peris K. (ORCID:0000-0002-5237-0463), Romita, P., Maronese, C. A., de Marco, A., Balestri, R., Belloni Fortina, A., Brazzelli, V., Colonn, C., Di Lernia, V., El Hachem, May, Fabbrocini, G., Foti, C., Frasin, L. A., Guarneri, C., Guerriero, Cristina, Guida, S., Locatelli, A., Neri, Ilaria, Occella, C., Offidani, A., Oranges, T., Pellacani, G., Stinco, G., Stingeni, L., Barbagallo, T., Campanati, A., Cannavo, S. P., Caroppo, F., Cavalli, R., Costantini, Alessio, Cucchia, R., Diociaiuti, Andrea, Filippeschi, C., Francomano, M., Giancristoforo, S., Giuffrida, R., Martina, E., Monzani, N. A., Nappa, P., Pastorino, C., Patrizi, A., Peccerillo, F., Peris, Ketty, Recalcati, S., Rizzoli, L., Simonetti, O., Vastarella, M., Virdi, A., Marzano, A. V., Bonamonte, D., El Hachem M., Guerriero C., Neri I., Costantini A., Diociaiuti A., and Peris K. (ORCID:0000-0002-5237-0463)

Abstract

BACKGROUND: Since the COVID-19 pandemic started, great interest has been given to this disease, especially to its possible clinical presentations. Besides classical respiratory symptoms, dermatological manifestations occur quite often among infected and non-infected patients, particularly in children. A prominent IFN-I response, that is generally higher in children compared to adults, may not only cause chilblain lesions, but it could also prevent infection and viral replication, thus justifying the negative swab results, as well as the absence of relevant systemic symptoms in positive cases. Indeed, reports have emerged describing chilblain-like acral lesions in children and adolescents with either proven or suspected infection. METHODS: Patients aged from 1 to 18 years old were enrolled in this study from 23 Italian dermatological units and were observed for an overall period of 6 months. Clinical pictures were collected along with data on the location and duration of skin lesions, their association with concomitant local and systemic symptoms, presence of nail and/or mucosal involvement, as well as histological, laboratory and imaging findings. RESULTS: One hundred thirty-seven patients were included, of whom 56.9% were females. Mean age was 11.97±3.66 years. The most commonly affected sites were the feet (77 patients, 56.2%). Lesions (48.5%) featured cyanosis, chilblains, blisters, ecchymosis, bullae, erythema, edema, and papules. Concomitant skin manifestations included maculo-papular rashes (30%), unspecified rashes (25%), vesicular rashes (20%), erythema multiforme (10%), urticaria (10%) and erythema with desquamation (5%). Forty-one patients (29.9%) reported pruritus as the main symptom associated with chilblains, and 56 out of 137 patients also reported systemic symptoms such as respiratory symptoms (33.9%), fever (28%), intestinal (27%), headache (5.5%), asthenia (3.5%), and joint pain (2%). Associated comorbid conditions were observed in 9 patients presen

Published
2023

4. Pruritus characteristics in a large Italian cohort of psoriatic patients

Author

Damiani, G., Cazzaniga, S., Conic, R. R. Z., Naldi, L., Griseta, V., Miracapillo, A., Azzini, M., Mocci, L., Michelini, M., Offidani, A., Bernardini, L., Campanati, A., Ricotti, G., Giacchetti, A., Norat, M., Gualco, F., Castelli, A., Cuccia, A., Diana, A., Roncarolo, G., Belli, M. A., Baldassarre, M. A., Santoro, G., Vena, G. A., Lo Console, F., Filotico, R., Mastrandrea, V., Brunetti, B., Musumeci, F., Carrabba, E., Dal Mas, P., Annicchiarico, F., Benvegnu, B., Spaziani, G., Cusano, F., Saletta Iannazzone, S., Galluccio, A., Pezza, M., Marchesi, L., Imberti, G., Reseghetti, A., Barbera, C., Reggiani, M., Lanzoni, A., Patrizi, A., Bardazzi, F., Antonucci, A., De Tommaso, S., Wallnofer, W., Ingannamorte, F., Calzavara-Pinton, P., Iannazzi, S., Zane, C., Capezzera, R., Bassisi, S., Rossi, M. T., Altamura, V., Vigl, W., Nobile, C., Aste, N., Murgia, S., Mugheddu, C., Scuderi, G., Baglieri, F., Di Dio, C., Cilioni Grilli, E., Mastronardi, C., Agnusdei, C. P., Antrilli, A., Aulisa, L., Raimondo, U., Scotto di Luzio, G., Battarra, V. C., Farro, P., Plaitano, R., Micali, G., Musumeci, M. L., Massimino, D., Li Calzi, M., La Greca, S., Pettinato, M., Sapienza, G., Valenti, G., De Giacomo, P. F., Amico, Arcangeli, F., Brunelli, D., Ghetti, E., Tulli, A., Assi, G., Amerio, P., Laria, G., Prestinari, F., Spadafora, S., Coppola, M., Caresana, G., Pezzarossa, E., Felisi, C., Donato, L., Bertero, M., Musso, L., Pa lazzini, S., Bruscino, P., Agozzino, U. C., Ottaviani, M., Simoncini, C., Virgili, A., Osti, F., Fabbri, P., Volpi, W., Caproni, M., Lotti, T., Prignano, F., Buggiani, G., Troiano, M., Fenizi, G., Altobella, A., Amoruso, A., Condello, M., Goffredo, A., Righini, M. G., Alessandrini, F., Satolli, F., Zampetti, M., Bertani, E., Fossati, S., Parodi, A., Burlando, M., Fiorucci, C., Nigro, A., Ghigliotti, G., Massone, L., Moise, G. M., Serrai, M., Cannata, G., Campagnoli, A. M., Daly, M., Leporati, C., Peila, R., Filosa, G., Bugatti, L., Nicolini, M., Nazzari, G., Cestari, R., Anastasio, F., Larussa, F. M., Pollice, N., De Francesco, F., Mazzocchetti, G., Peris, K., Fargnoli, M. C., Di Cesare, A., De Angelis, L., Flati, G., Biamonte, A. S., Quarta, G., Congedo, M., Carcaterra, A., Strippoli, D., Fideli, D., Marsili, F., Celli, M., Ceccarini, M., Bachini, L., D'Oria, M., Schirripa, V., De Filippi, C., Martini, P., Lapucci, E., Mazzatenta, C., Ghilardi, A., Simonacci, M., Bettacchi, A., Gasco, R., Zanca, A., Battistini, S., Dattola, S., Vernaci, R., Postorino, F., Zampieri, P. F., Padovan, C., Gonzalez Intchaurraga, M. A., Ladurner, J., Guarneri, B., Cannavo, S., Manfre, C., Borgia, F., Puglisi Guerra, A., Cattaneo, A., Carrera, C., Fracchiolla, C., Mozzanica, N., Prezzemolo, L., Menni, S., Lodi, A., Martino, P., Monti, M., Mancini, L., Sacrini, F., Altomare, G. F., Taglioni, M., Lovati, C., Mercuri, S. R., Schiesari, G., Giannetti, A., Conti, A., Lasagni, C., Greco, M., Ronsini, G., Schianchi, S., Fiorentini, C., Niglietta, S., Maglietta, R., Padalino, C., Crippa, D., Pini, M., Rossi, E., Tosi, D., Armas, M., Ruocco, V., Ayala, F., Balato, N., Gaudiello, F., Cimmino, G. F., Monfrecola, G., Gallo, L., Argenziano, G., Fulgione, E., Berruti, G., Ceparano, S., De Michele, I., Giorgiano, D., Leigheb, G., Deledda, S., Peserico, A., Alaibac, M., Piaserico, S., Schiesari, L., Dan, G., Mattei, I., Oro, E., Arico, M., Bongiorno, M. R., Angileri, R., Amato, S., Todaro, F., Milioto, M., Bellastro, R., Di Nuzzo, S., De Panfilis, G., Zanni, M., Borroni, G., Cananzi, R., Brazzelli, V., Lisi, P., Stingeni, L., Hansel, K., Pierfelice, V., Donelli, S., Rastelli, D., Gasperini, M., Barachini, P., Cecchi, R., Bartoli, L., Pavesi, M., De Paola, S., Corradin, M. T., Ricciuti, F., Piccirillo, A., Viola, L., Tataranni, M., Mautone, M. G., Lo Scocco, G., Niccoli, M. C., Brunasso Vernetti, A. M. G., Gaddoni, G., Resta, F., Casadio, M. C., Arcidiaco, M. C., Luvara, M. C., Albertini, G., Di Lernia, V., Guareschi, E., Catrani, S., Morri, M., De Simone, C., D'Agostino, M., Agostino, I., Calvieri, S., Cantoresi, F., Richetta, A., Sorgi, P., Carnevale, C., Nicolucci, F., Berardesca, E., Ardigo, M., De Felice, C., Gubinelli, E., Talamonti, M., Camplone, G., Cruciani, G., Riccardi, F., Barbati, R., Zumiani, G., Pagani, W., Malagoli, P. G., Pellicano, R., Donadio, D., Di Vito, C., Cottoni, F., Montesu, M. A., Pirodda, C., Addis, G., Marongiu, P., Farris, A., Cacciapuoti, M., Verrini, A., Desirello, G., Gnone, M., Fimiani, M., Pellegrino, M., Castelli, G., Zappala, L., Sesana, G., Ingordo, V., Vozza, E., Di Giuseppe, D., Fasciocco, D., Nespoli, P., Papini, M., Cicoletti, M., Bernengo, M. G., Ortoncelli, M., Bonvicino, A., Capella, G., Doveil, G. C., Forte, M., Peroni, A., Salomone, B., Savoia, P., Pippione, M., Zichichi, L., Frazzitta, M., De Luca, G., Tasin, L., Simonetto, D., Ros, S., Trevisan, G., Patamia, M., Miertusova, S., Patrone, P., Frattasio, A., Piccirillo, F., La Spina, S., Di Gaetano, L., Marzocchi, V., Motolese, A., Venturi, C., Gai, F., Pasquinucci, S., Bellazzi, R. M., Silvestri, T., Girolomoni, G., Gisondi, P., Veller Fornasa, C., Trevisan, G. P., Damiani G., Cazzaniga S., Conic R.R.Z., Naldi L., Griseta V., Miracapillo A., Azzini M., Mocci L., Michelini M., Offidani A., Bernardini L., Campanati A., Ricotti G., Giacchetti A., Norat M., Gualco F., Castelli A., Cuccia A., Diana A., Roncarolo G., Belli M.A., Baldassarre M.A., Santoro G., Vena G.A., Lo Console F., Filotico R., Mastrandrea V., Brunetti B., Musumeci F., Carrabba E., Dal Mas P., Annicchiarico F., Benvegnu B., Spaziani G., Cusano F., Saletta Iannazzone S., Galluccio A., Pezza M., Marchesi L., Imberti G., Reseghetti A., Barbera C., Reggiani M., Lanzoni A., Patrizi A., Bardazzi F., Antonucci A., De Tommaso S., Wallnofer W., Ingannamorte F., Calzavara-Pinton P., Iannazzi S., Zane C., Capezzera R., Bassisi S., Rossi M.T., Altamura V., Vigl W., Nobile C., Aste N., Murgia S., Mugheddu C., Scuderi G., Baglieri F., Di Dio C., Cilioni Grilli E., Mastronardi C., Agnusdei C.P., Antrilli A., Aulisa L., Raimondo U., Scotto di Luzio G., Battarra V.C., Farro P., Plaitano R., Micali G., Musumeci M.L., Massimino D., Li Calzi M., La Greca S., Pettinato M., Sapienza G., Valenti G., De Giacomo P.F., Amico, Arcangeli F., Brunelli D., Ghetti E., Tulli A., Assi G., Amerio P., Laria G., Prestinari F., Spadafora S., Coppola M., Caresana G., Pezzarossa E., Felisi C., Donato L., Bertero M., Musso L., Pa lazzini S., Bruscino P., Agozzino U.C., Ottaviani M., Simoncini C., Virgili A., Osti F., Fabbri P., Volpi W., Caproni M., Lotti T., Prignano F., Buggiani G., Troiano M., Fenizi G., Altobella A., Amoruso A., Condello M., Goffredo A., Righini M.G., Alessandrini F., Satolli F., Zampetti M., Bertani E., Fossati S., Parodi A., Burlando M., Fiorucci C., Nigro A., Ghigliotti G., Massone L., Moise G.M., Serrai M., Cannata G., Campagnoli A.M., Daly M., Leporati C., Peila R., Filosa G., Bugatti L., Nicolini M., Nazzari G., Cestari R., Anastasio F., Larussa F.M., Pollice N., De Francesco F., Mazzocchetti G., Peris K., Fargnoli M.C., Di Cesare A., De Angelis L., Flati G., Biamonte A.S., Quarta G., Congedo M., Carcaterra A., Strippoli D., Fideli D., Marsili F., Celli M., Ceccarini M., Bachini L., D'Oria M., Schirripa V., De Filippi C., Martini P., Lapucci E., Mazzatenta C., Ghilardi A., Simonacci M., Bettacchi A., Gasco R., Zanca A., Battistini S., Dattola S., Vernaci R., Postorino F., Zampieri P.F., Padovan C., Gonzalez Intchaurraga M.A., Ladurner J., Guarneri B., Cannavo S., Manfre C., Borgia F., Puglisi Guerra A., Cattaneo A., Carrera C., Fracchiolla C., Mozzanica N., Prezzemolo L., Menni S., Lodi A., Martino P., Monti M., Mancini L., Sacrini F., Altomare G.F., Taglioni M., Lovati C., Mercuri S.R., Schiesari G., Giannetti A., Conti A., Lasagni C., Greco M., Ronsini G., Schianchi S., Fiorentini C., Niglietta S., Maglietta R., Padalino C., Crippa D., Pini M., Rossi E., Tosi D., Armas M., Ruocco V., Ayala F., Balato N., Gaudiello F., Cimmino G.F., Monfrecola G., Gallo L., Argenziano G., Fulgione E., Berruti G., Ceparano S., De Michele I., Giorgiano D., Leigheb G., Deledda S., Peserico A., Alaibac M., Piaserico S., Schiesari L., Dan G., Mattei I., Oro E., Arico M., Bongiorno M.R., Angileri R., Amato S., Todaro F., Milioto M., Bellastro R., Di Nuzzo S., De Panfilis G., Zanni M., Borroni G., Cananzi R., Brazzelli V., Lisi P., Stingeni L., Hansel K., Pierfelice V., Donelli S., Rastelli D., Gasperini M., Barachini P., Cecchi R., Bartoli L., Pavesi M., De Paola S., Corradin M.T., Ricciuti F., Piccirillo A., Viola L., Tataranni M., Mautone M.G., Lo Scocco G., Niccoli M.C., Brunasso Vernetti A.M.G., Gaddoni G., Resta F., Casadio M.C., Arcidiaco M.C., Luvara M.C., Albertini G., Di Lernia V., Guareschi E., Catrani S., Morri M., De Simone C., D'Agostino M., Agostino I., Calvieri S., Cantoresi F., Richetta A., Sorgi P., Carnevale C., Nicolucci F., Berardesca E., Ardigo M., De Felice C., Gubinelli E., Talamonti M., Camplone G., Cruciani G., Riccardi F., Barbati R., Zumiani G., Pagani W., Malagoli P.G., Pellicano R., Donadio D., Di Vito C., Cottoni F., Montesu M.A., Pirodda C., Addis G., Marongiu P., Farris A., Cacciapuoti M., Verrini A., Desirello G., Gnone M., Fimiani M., Pellegrino M., Castelli G., Zappala L., Sesana G., Ingordo V., Vozza E., Di Giuseppe D., Fasciocco D., Nespoli P., Papini M., Cicoletti M., Bernengo M.G., Ortoncelli M., Bonvicino A., Capella G., Doveil G.C., Forte M., Peroni A., Salomone B., Savoia P., Pippione M., Zichichi L., Frazzitta M., De Luca G., Tasin L., Simonetto D., Ros S., Trevisan G., Patamia M., Miertusova S., Patrone P., Frattasio A., Piccirillo F., La Spina S., Di Gaetano L., Marzocchi V., Motolese A., Venturi C., Gai F., Pasquinucci S., Bellazzi R.M., Silvestri T., Girolomoni G., Gisondi P., Veller Fornasa C., and Trevisan G.P.

Subjects
Male, Cross-sectional study, Severity of Illness Index, Cohort Studies, 030207 dermatology & venereal diseases, 0302 clinical medicine, Risk Factors, education, itch, pruritus, psoriasis, pustular psoriasis, treatment, Adolescent, Adult, Cross-Sectional Studies, Educational Status, Facial Dermatoses, Female, Foot Dermatoses, Genitalia, Hand Dermatoses, Humans, Italy, Middle Aged, Pruritus, Psoriasis, Registries, Sex Factors, Young Adult, Epidemiology, Young adult, skin and connective tissue diseases, Settore MED/33 - MALATTIE APPARATO LOCOMOTORE, Infectious Diseases, 030220 oncology & carcinogenesis, Cohort, PRURITIS EPIDEMIOLOGY, Settore MED/35 - MALATTIE CUTANEE E VENEREE, Cohort study, medicine.medical_specialty, PSORIAS, Dermatology, Article, 03 medical and health sciences, Pharmacotherapy, Settore MED/35, Severity of illness, medicine, business.industry, medicine.disease, Pruritus,Itch sensation, business
Abstract

Background: Psoriasis (Ps) is a chronic systemic autoimmune disease associated with pruritus in 64–98% of patients. However, few modestly sized studies assess factors associated with psoriatic pruritus. Objective: To investigate factors associated with Ps pruritus intensity. Methods: Psoriasis patients 18years or older seen in one of 155 centres in Italy between September 2005 and 2009 were identified from the Italian PsoCare registry. Patients without cutaneous psoriasis and those with missed information on pruritus were excluded. Results: We identified 10802 patients, with a mean age 48.8±14.3years. Mild itch was present in 33.2% of patients, moderate in 34.4%, severe in 18.7% and very severe in 13.7%. Higher itch intensity was associated with female gender, lower educational attainment compared to university degree, pustular psoriasis, psoriasis on the head, face, palmoplantar areas, folds and genitalia, more severe disease, disease duration

Published
2019

7. Secukinumab shows high efficacy irrespective of HLA-Cw6 status in patients with moderate-to-severe plaque-type psoriasis: results from extension phase of the SUPREME study

Author

Papini, M., Cusano, F., Romanelli, Margherita, Burlando, M., Stinco, G., Girolomoni, G., Peris, Ketty, Potenza, C., Offidani, A., Bartezaghi, M., Aloisi, E., Costanzo, Rosa Maria Alba, Bianchi, L., Bottoni, U., Buligan, C., Brazzelli, V., Campanati, A., Cantoresi, F., Capo, A., Cattaneo, A., Dapavo, P., Giglio, M., Lernia, V., Nuzzo, S., Simone, Carmen, Dusi, D., Fargnoli, Maria Concetta, Flori, L., Franchi, C., Galluzzo, M., Ghilardi, A., Hansel, K., Loconsole, F., Lora, V., Malagoli, P., Malara, G., Mastrandrea, V., Megna, M., Mercuri, R., Musumeci, L., Naldi, L., Narcisi, A., Orsini, Diego, Pagnanelli, G., Patrizi, A., Pau, M., Pellacani, G., Persechino, S., Piaserico, S., Pietroleonardo, L., Prignano, F., Reseghetti, A., Russo, F., Sirna, R., Skroza, N., Stingeni, L., Trevisini, S., Zane, C., Zichichi, L., Zini, A., Romanelli M., Peris K. (ORCID:0000-0002-5237-0463), Costanzo A., Simone C., Fargnoli C., Orsini D., Papini, M., Cusano, F., Romanelli, Margherita, Burlando, M., Stinco, G., Girolomoni, G., Peris, Ketty, Potenza, C., Offidani, A., Bartezaghi, M., Aloisi, E., Costanzo, Rosa Maria Alba, Bianchi, L., Bottoni, U., Buligan, C., Brazzelli, V., Campanati, A., Cantoresi, F., Capo, A., Cattaneo, A., Dapavo, P., Giglio, M., Lernia, V., Nuzzo, S., Simone, Carmen, Dusi, D., Fargnoli, Maria Concetta, Flori, L., Franchi, C., Galluzzo, M., Ghilardi, A., Hansel, K., Loconsole, F., Lora, V., Malagoli, P., Malara, G., Mastrandrea, V., Megna, M., Mercuri, R., Musumeci, L., Naldi, L., Narcisi, A., Orsini, Diego, Pagnanelli, G., Patrizi, A., Pau, M., Pellacani, G., Persechino, S., Piaserico, S., Pietroleonardo, L., Prignano, F., Reseghetti, A., Russo, F., Sirna, R., Skroza, N., Stingeni, L., Trevisini, S., Zane, C., Zichichi, L., Zini, A., Romanelli M., Peris K. (ORCID:0000-0002-5237-0463), Costanzo A., Simone C., Fargnoli C., and Orsini D.

Abstract

na

Published
2019

8. Mycosis fungoides: Association of KIR ligands and HLA-DQB1∗05 with bad prognosis of the disease

Author

Brazzelli, V, Rivetti, N, Badulli, C, Carugno, A, Cananzi, R, De Silvestri, A, Martinetti, M, Borroni, G, Brazzelli V., Rivetti N., Badulli C., Carugno A., Cananzi R., De Silvestri A., Martinetti M., Borroni G., Brazzelli, V, Rivetti, N, Badulli, C, Carugno, A, Cananzi, R, De Silvestri, A, Martinetti, M, Borroni, G, Brazzelli V., Rivetti N., Badulli C., Carugno A., Cananzi R., De Silvestri A., Martinetti M., and Borroni G.

Abstract

Background Mycosis fungoides (MF) is the most common cutaneous T-cell lymphoma. We previously reported that the prognosis of MF patients is not only related on clinical variables but it is also associated with peculiar HLA alleles. Until today, the association of HLA ligands for KIR with the prognosis of the disease has not yet been analysed. Objective We investigated the frequency of HLA ligands for killer cell Immunoglobulin-like receptors (KIRs) in MF patients, evaluating if the presence of particular HLA alleles that are ligands for KIR may have prognostic value. Methods The study includes 46 Caucasian MF patients that, between 1993 and 1997, underwent HLA genomic typing. All patients were diagnosed and followed up from 1977 to 2012 (mean follow-up of 11 years). Results MF patients have been divided into two groups (long survivors and dead patients). We noticed that the HLA-Bw6/Bw6 specificity increased among the group of seven dead patients compared to the group of 39 long survivors (71.4% vs. 41.0%, P = ns, OR = 3.59), while in the long survivors group the HLA- Bw4/Bw4 specificity increased when compared to dead patients (23.0% vs. 0%, P = ns). Moreover, we observed that six of the seven dead patients had HLA-DQB1∗05; the phenotypic frequency of this HLA allele, in dead and long survivors patients, was 85.7% and 23.0% respectively (P = 0.004; OR = 20). Conclusion Our observations suggest that the presence of the HLA-DQB1∗05 alleles characterizes the patients with the poorest prognosis in MF. In addition, absence of the KIR-ligand epitope HLA-B Bw4 showed a trend of being more prominent in MF patients with the poorest prognosis.

Published
2016

9. Secukinumab shows high efficacy irrespective of HLA-Cw6 status in patients with moderate-to-severe plaque-type psoriasis. SUPREME study

Author

Costanzo, A., Bianchi, L., Flori, M. L., Malara, G., Stingeni, L., Bartezaghi, M., Carraro, L., Castellino, G., Bottoni, U, Brazzelli, V, Burlando, M, Cantoresi, F, Capo, A, Cattaneo, A, Cusano, F, Dapavo, P, Del Giglio, M, Di Lernia, V, Di Nuzzo, S, Dusi, D, Fargnoli, Mc, Franchi, C, Galluzzo, M, Ghilardi, A, Hansel, K, Loconsole, F, Lora, V, Malagoli, P, Mastrandrea, V, Megna, M, Mercuri, Sr, Letizia Musumeci, M, Naldi, L, Narcisi, A, Offidani, A, Pagnanelli, G, Papini, M, Patrizi, A, Pau, M, Pellacani, G, Peris, K, Persechino, S, Piaserico, S, Pietroleonardo, L, Prignano, F, Reseghetti, A, Romanelli, M, Russo, F, Sirna, R, Skroza, N, Stinco, G, Trevisini, S, Zane, C, Zichichi, L, Zini, A., Costanzo, A., Bianchi, L., Flori, M. L., Malara, G., Stingeni, L., Bartezaghi, M., Carraro, L., Castellino, G., Persechino, Severino, Pau, Monica, Cusano, Francesco, Russo, Filomena, Stinco, Giuseppe, Ghilardi, Alberto, Del Giglio, Micol, De Luca, Giuseppe, Brazzelli, Valeria, Fargnoli, Maria Concetta, Capo, Alessandra, Mastrandrea, Valentina, Piaserico, Stefano, Franchi, Chiara, Zane, Cristina, Cattaneo, Angelo, Galluzzo, Marco, La Selva, Roberta, Di Nuzzo, Sergio, Megna, Matteo, Pellacani, Giovanni, Peris, Ketty, Patrizi, Annalisa, Trevisini, Sara, Pagnanelli, Gianluca, Skroza, Nevena, Malagoli, Piergiorgio, Resghetti, Alberto, Burlando, Martina, Loconsole, Francesco, Offidani, Anna Maria, Albertini, Giuseppe, Mercuri, Santo Raffaele, Bottoni, Ugo, Dusi, Daniele, Zini, Antonio, Pietroleonardo, Lucia, Cantoresi, Franca, Sirna, Riccardo, Lora, Viviana, Hansel, Katharina, Prignano, Francesca, and Natalini, Ylenia

Subjects
Adult, Male, medicine.medical_specialty, Psoriasis, secukinumab, Genotyping Techniques, Dermatology, HLA-C Antigens, Antibodies, Monoclonal, Humanized, Severity of Illness Index, Antibodies, 030207 dermatology & venereal diseases, 03 medical and health sciences, Antibodies, Monoclonal, Biomarkers, Female, Genetic Predisposition to Disease, Humans, Interleukin-17, Italy, Middle Aged, Prospective Studies, Psoriasis, Treatment Outcome, 0302 clinical medicine, Internal medicine, Severity of illness, Monoclonal, medicine, Clinical endpoint, Adverse effect, Prospective cohort study, Humanized, Settore MED/35 - Malattie Cutanee e Veneree, business.industry, medicine.disease, Confidence interval, 030220 oncology & carcinogenesis, Secukinumab, Interleukin 17, business
Abstract

Background Understanding genetic variations is important in predicting treatment response and forms the basis for identifying new pharmacogenetic and pharmacogenomic targets for psoriasis treatment. There are limited data on the efficacy of secukinumab in relation to genetic markers. Objectives To evaluate the efficacy and safety of secukinumab 300 mg in HLA-Cw6-positive (Cw6-POS) and HLA-Cw6-negative (Cw6-NEG) patients with moderate-to-severe chronic plaque-type psoriasis. Methods SUPREME was a 24-week, phase IIIb study with an extension period up to 72 weeks. Primary end point was Psoriasis Area Severity Index (PASI) 90 response rate after 16 weeks. Results In total, 434 patients were recruited: 185 (42·6%) were Cw6-POS and 246 (56·7%) were Cw6-NEG (three not assessed). Mean ± SD age was 45·2 ± 13·2 years (Cw6-POS 42·7 ± 13·1; Cw6-NEG 47·2 ± 12·9). The baseline PASI score was comparable between the cohorts [Cw6-POS 20·7 ± 8·99; Cw6-NEG 21·5 ± 9·99 (P = 0·777)]. At week 16, PASI 90 was achieved in 80·4% of Cw6-POS and 79·7% of Cw6-NEG patients (difference 0·76; 95% confidence interval -7·04 to 8·23). No differences in absolute PASI at week 16 (Cw6-POS 1·36 ± 3·58; Cw6-NEG 1·18 ± 2·29) were observed. The overall safety profile of secukinumab was consistent with that previously reported. No statistically significant difference was detected in the rate of treatment-emergent adverse events [Cw6-POS 42·7%; Cw6-NEG 49·6% (P = 0·295)]. A high PASI 90 response was achieved with secukinumab with a fast reduction in absolute PASI. Conclusions Determination of HLA-Cw6 status for secukinumab therapy is unnecessary, as it is highly effective regardless of HLA-Cw6 status.

Published
2018

10. Intralesional vinblastine injections for treatment of Classic Kaposi sarcoma in diabetic patients

Author

Vassallo, C, Carugno, A, Derlino, F, Ciocca, O, Brazzelli, V, Borroni, G, Vassallo C., Carugno A., Derlino F., Ciocca O., Brazzelli V., Borroni G., Vassallo, C, Carugno, A, Derlino, F, Ciocca, O, Brazzelli, V, Borroni, G, Vassallo C., Carugno A., Derlino F., Ciocca O., Brazzelli V., and Borroni G.

Abstract

Classic Kaposi sarcoma (KS) usually is a localized and slowly progressing disease that mainly affects elderly patients; therefore, local treatment generally is recommended. In this study, we evaluated the clinical efficacy of intralesional vinblastine (VNB) for the treatment of classic KS in 6 participants with type 2 diabetes mellitus. Results indicated that intralesional VNB injections may be an effective alternative treatment of classic KS in diabetic patients.

Published
2015

11. Eruptive xanthomas after extensive tattooing: A case report and literature review

Author

Brazzelli, V, Rivetti, N, Carugno, A, Barruscotti, S, Croci, G, Perani, G, Borroni, G, Brazzelli, V., Rivetti, N., Carugno, A., Barruscotti, S., Croci, G. A., Perani, G., Borroni, G., Brazzelli, V, Rivetti, N, Carugno, A, Barruscotti, S, Croci, G, Perani, G, Borroni, G, Brazzelli, V., Rivetti, N., Carugno, A., Barruscotti, S., Croci, G. A., Perani, G., and Borroni, G.

Published
2015

12. Immunogenetic factors in mycosis fungoides: Can the HLA system influence the susceptibility and prognosis of the disease? Long-term follow-up study of 46 patients

Author

Brazzelli, V, Rivetti, N, Badulli, C, Carugno, A, Grasso, V, De Silvestri, A, Martinetti, M, Borroni, G, Brazzelli V., Rivetti N., Badulli C., Carugno A., Grasso V., De Silvestri A., Martinetti M., Borroni G., Brazzelli, V, Rivetti, N, Badulli, C, Carugno, A, Grasso, V, De Silvestri, A, Martinetti, M, Borroni, G, Brazzelli V., Rivetti N., Badulli C., Carugno A., Grasso V., De Silvestri A., Martinetti M., and Borroni G.

Abstract

Background Mycosis fungoides (MF) is the most common and one of the least aggressive forms of cutaneous T-cell lymphoma. Several studies have demonstrated the influence of human leucocyte antigen (HLA) genes on the susceptibility of MF, highlighting the importance of certain alleles but, until today, no studies have evaluated the relationship between HLA alleles and the prognosis of patients with MF. Objectives The aim of this retrospective cohort study was to evaluate the polymorphism of HLA class I and class II alleles in a group of 46 MF Caucasian patients, looking for their influence in susceptibility and prognosis of the disease. Methods Study population included a case-cohort sample of 46 Caucasian patients with MF that, between 1993 and 1997, underwent HLA class I and II genomic typing. All patients were diagnosed and followed up from 1977 to 2012 (mean follow-up of 11 years) and they were divided into three groups according to the evolution of the disease. Results Molecular typing at low-resolution level revealed that HLA-A24, A68, A69, B35 and DQB105:02 alleles were involved in susceptibility to MF. Correspondence analysis underlined that long-lasting remission was characterized by HLA-A24 and HLA-A25 alleles, frequent relapse by HLA-DRB101, DQA101:01, DQB105:01 alleles and death by HLA-A68, HLA-B08, HLA-B35, HLA-C03 alleles. Conclusion This study suggests that the prognosis of MF patients is not only correlated with clinical/pathological/serological/immunological variables but it also relies on specific HLA alleles.

Published
2014

13. Pompholyx of the hands after intravenous immunoglobulin therapy for clinically isolated syndrome: A paediatric case

Author

Brazzelli, V, Grassi, S, Savasta, S, Ruffinazzi, G, Carugno, A, Barbaccia, V, Marseglia, G, Borroni, G, Brazzelli, V., Grassi, S., Savasta, S., Ruffinazzi, G., Carugno, A., Barbaccia, V., Marseglia, G. L., Borroni, G., Brazzelli, V, Grassi, S, Savasta, S, Ruffinazzi, G, Carugno, A, Barbaccia, V, Marseglia, G, Borroni, G, Brazzelli, V., Grassi, S., Savasta, S., Ruffinazzi, G., Carugno, A., Barbaccia, V., Marseglia, G. L., and Borroni, G.

Abstract

Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. It has a multifactorial etiology, including genetic determinants, allergy to metals, and id reaction; rarely it is a drug-related side effect. We report a paediatric case of pompholyx of the hands related to the intravenous immunoglobulin (IVIG) therapy for Clinically Isolated Syndrome (CIS). A 10-year-old boy, received an IVIG therapy (Venital®, Kedrion Spa, Italy) at a dose of 400 mg/kg daily for five days. The fifth day of IVIG infusion, a symmetrical vesicular eruption appeared on the palms of the hands and on lateral aspects of the fingers. The lesions improved with application of topical steroids in few days. The mechanism of induction of pompholyx by IVIG therapy is unknown. A review of the Literature suggests the hypothesis that dyshidrotic eczematous reactions may be related not only to the type of IVIG, to the dose and the rates of infusion, but also to an allergic response to excipients and preservatives contained in the drug, probably elicited by an underlying neurological disease in some cases.

Published
2014

14. Age at disease onset has a major impact on clinical characteristics and course of mastocytosis

Author

Rabenhorst, A., Sperr, W., Elberink, J. Oude, Lange, M., Gleixner, K., Brazzelli, V., Fontana, E., Vos, B., Gorska, A., Reiter, A., Schwaab, J., Zanotti, R., Bonadonna, P., Triggiani, M., Gotlib, J., Doubek, M., Jakob, T., Kilbertus, A., Sabato, V., Zink, A., Bretterklieber, A., Jaekel, N., Sotlar, K., Horny, H., Fortina, A. Belloni, Merante, S., Niedoszytko, M., Kluin-Nelemans, H., Valent, P., Hartmann, K., Rabenhorst, A., Sperr, W., Elberink, J. Oude, Lange, M., Gleixner, K., Brazzelli, V., Fontana, E., Vos, B., Gorska, A., Reiter, A., Schwaab, J., Zanotti, R., Bonadonna, P., Triggiani, M., Gotlib, J., Doubek, M., Jakob, T., Kilbertus, A., Sabato, V., Zink, A., Bretterklieber, A., Jaekel, N., Sotlar, K., Horny, H., Fortina, A. Belloni, Merante, S., Niedoszytko, M., Kluin-Nelemans, H., Valent, P., and Hartmann, K.

Published
2017

15. Impact of allergic disorders and anaphylaxis in mastocytosis: Preliminary data from a study of the European Competence Network on Mastocytosis (ECNM) registry

Author

Niedoszytko, M., Gorska, A., Nedoszytko, B., Rabenhorst, A., Sperr, W., Elberink, Oude J., Lange, M., Gleixner, K., Brazzelli, V, Fontana, E., Vos, B., Reiter, A., Schwaab, J., Zanotti, R., Bonadonna, P., Triggiani, M., Gotlib, J., Doubek, M., Jakob, T., Fuchs, D., Sabato, V, Zink, A., Bretterklieber, A., Jaekel, N., Sotlar, K., Horny, H., Fortina, Belloni A., Merante, S., Kluin-Nelemans, H., Valent, P., Hartmann, K., Niedoszytko, M., Gorska, A., Nedoszytko, B., Rabenhorst, A., Sperr, W., Elberink, Oude J., Lange, M., Gleixner, K., Brazzelli, V, Fontana, E., Vos, B., Reiter, A., Schwaab, J., Zanotti, R., Bonadonna, P., Triggiani, M., Gotlib, J., Doubek, M., Jakob, T., Fuchs, D., Sabato, V, Zink, A., Bretterklieber, A., Jaekel, N., Sotlar, K., Horny, H., Fortina, Belloni A., Merante, S., Kluin-Nelemans, H., Valent, P., and Hartmann, K.

Published
2017

16. The body mass index is an indicator of advanced systemic mastocytosis: preliminary results from a registry project of the European Competence Network on Mastocytosis (ECNM) registry

Author

Gorska, A., Gruchala-Niedoszytko, M., Niedoszytko, M., Rabenhorst, A., Sperr, W., Elberink, Oude J., Lange, M., Gleixner, K., Brazzelli, V, Fontana, E., Vos, B., Reiter, A., Schwaab, J., Zanotti, R., Bonadonna, P., Triggiani, M., Gotlib, J., Doubek, M., Jakob, T., Fuchs, D., Sabato, V, Zink, A., Bretterklieber, A., Jaekel, N., Sotlar, K., Horny, H., Fortina, Belloni A., Merante, S., Kluin-Nelemans, H., Valent, P., Hartmann, K., Gorska, A., Gruchala-Niedoszytko, M., Niedoszytko, M., Rabenhorst, A., Sperr, W., Elberink, Oude J., Lange, M., Gleixner, K., Brazzelli, V, Fontana, E., Vos, B., Reiter, A., Schwaab, J., Zanotti, R., Bonadonna, P., Triggiani, M., Gotlib, J., Doubek, M., Jakob, T., Fuchs, D., Sabato, V, Zink, A., Bretterklieber, A., Jaekel, N., Sotlar, K., Horny, H., Fortina, Belloni A., Merante, S., Kluin-Nelemans, H., Valent, P., and Hartmann, K.

Published
2017

17. IgA anti-epidermal transglutaminase autoantibodies: A sensible and sensitive marker for diagnosis of dermatitis herpetiformis in adult patients

Author

Borroni, G, Biagi, F, Ciocca, O, Vassallo, C, Carugno, A, Cananzi, R, Campanella, J, Bianchi, P, Brazzelli, V, Corazza, G, Borroni G, Biagi F, Ciocca O., Vassallo C., Carugno A., Cananzi R., Campanella J., Bianchi P. I., Brazzelli V., Corazza G. R., Borroni, G, Biagi, F, Ciocca, O, Vassallo, C, Carugno, A, Cananzi, R, Campanella, J, Bianchi, P, Brazzelli, V, Corazza, G, Borroni G, Biagi F, Ciocca O., Vassallo C., Carugno A., Cananzi R., Campanella J., Bianchi P. I., Brazzelli V., and Corazza G. R.

Abstract

Background Dermatitis herpetiformis (DH) is a rare gluten-sensitive blistering itchy skin disease, strictly related to coeliac disease (CD). Direct immunofluorescence, demonstrating IgA granular deposits localized either in the dermal papillae or along the dermo-epidermal junction, is currently the gold standard for diagnosis of DH. It has been shown that DH immunocomplexes contain epidermal transglutaminase (eTG) and that sera from patients with DH contain antibodies specifically directed against eTG. Objectives We studied the usefulness of serum eTG antibodies in discriminating between DH, CD and other gastrointestinal and dermatologic diseases. Methods eTG antibodies were tested in 308 adult patients' sera: 44 patients with untreated dermatitis herpetiformis (UDH), 99 patients with untreated coeliac disease (UCD), 70 dermatological controls and 95 gastrointestinal controls. Results In UDH eTG antibody levels were significantly higher than in DH patients on gluten-free diet, UCD, gastrointestinal controls and dermatological controls. In UCD eTG antibodies strongly correlated with tissue transglutaminase (tTG) antibodies, whereas in UDH no significant correlation was observed. Conclusion Serum IgA eTG antibody determination can efficiently distinguish UDH from other dermatological itchy diseases and is highly sensitive to gluten-free diet.

Published
2013

19. Hepatitis C infection in Italian psoriatic patients: Prevalence and correlation with patient age and psoriasis severity

Author

Brazzelli, V, Carugno, A, Alborghetti, A, Cananzi, R, Sangiovanni, L, Barbarini, G, De Silvestri, A, Borroni, R, Brazzelli V., Carugno A., Alborghetti A., Cananzi R., Sangiovanni L., Barbarini G., De Silvestri A., Borroni R. G., Brazzelli, V, Carugno, A, Alborghetti, A, Cananzi, R, Sangiovanni, L, Barbarini, G, De Silvestri, A, Borroni, R, Brazzelli V., Carugno A., Alborghetti A., Cananzi R., Sangiovanni L., Barbarini G., De Silvestri A., and Borroni R. G.

Published
2012

20. Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry

Author

Piaserico, Stefano, Cazzaniga, Simone, Chimenti, Sergio, Giannetti, Alberto, Maccarone, Mara, Picardo, Mauro, Peserico, Andrea, Naldi, Luigi, Griseta, V., Miracapillo, A., Azzini, M., Mocci, L., Michelini, M., Offidani, A., Bernardini, L., Campanati, A., Ricotti, G., Giacchetti, A., Norat, M., Gualco, F., Castelli, A., Cuccia, A., Diana, A., Roncarolo, G., Belli, M. A., Baldassarre, M. A., Santoro, G., Vena, G. A., Lo Console, F., Filotico, R., Mastrandrea, V., Brunetti, B., Musumeci, F., Carrabba, E., Dal Mas, P., Annicchiarico, F., Benvegnã¹, B., Spaziani, G., Cusano, F., Saletta Iannazzone, S., Galluccio, A., Pezza, M., Marchesi, L., Imberti, G., Reseghetti, A., Barbera, C., Reggiani, M., Lanzoni, A., Patrizi, A., Bardazzi, F., Antonucci, A., De Tommaso, S., Balestri, R., Wallnofer, W., Ingannamorte, F., Calzavara-Pinton, P., Iannazzi, S., Zane, C., Capezzera, R., Bassisi, S., Rossi, M. T., Altamura, V., Vigl, W., Nobile, C., Aste, N., Murgia, S., Mugheddu, C., Scuderi, G., Baglieri, F., Di Dio, C., Cilioni Grilli, E., Mastronardi, C., Agnusdei, C. P., Antrilli, A., Aulisa, L., Raimondo, U., Scotto di Luzio, G., Battarra, V. C., Farro, P., Plaitano, R., Micali, G., Musumeci, M. L., Massimino, D., Li Calzi, M., La Greca, S., Pettinato, M., Sapienza, G., Valenti, G., De Giacomo, P. F., D’amico, D., Arcangeli, F., Brunelli, D., Ghetti, E., Tulli, A., Assi, G., Amerio, P., Laria, G., Prestinari, F., Spadafora, S., Coppola, M., Caresana, G., Pezzarossa, E., Domaneschi, E., Felisi, C., Donato, L., Bertero, M., Musso, L., Pa lazzini, S., Bruscino, P., Agozzino, U. C., Ottaviani, M., Simoncini, C., Virgili, A., Osti, F., Fabbri, P., Volpi, W., Caproni, M., Lotti, T., Prignano, F., Buggiani, G., Troiano, M., Fenizi, G., Altobella, A., Amoruso, A., Condello, M., Goffredo, A., Righini, M. G., Alessandrini, F., Satolli, F., Zampetti, M., Bertani, E., Fossati, S., Parodi, A., Burlando, M., Fiorucci, C., Nigro, A., Ghigliotti, G., Massone, L., Moise, G. M., Serrai, M., Cannata, G., Campagnoli, A. M., Daly, M., Leporati, C., Peila, R., Filosa, G., Bugatti, L., Nicolini, M., Nazzari, G., Cestari, R., Anastasio, F., Larussa, F. M., Pollice, N., De Francesco, F., Mazzocchetti, G., Peris, K., Fargnoli, M. C., Di Cesare, A., De Angelis, L., Flati, G., Biamonte, A. S., Quarta, G., Congedo, M., Carcaterra, A., Strippoli, D., Fideli, D., Marsili, F., Celli, M., Ceccarini, M., Bachini, L., D’oria, M., Schirripa, V., De Filippi, C., Martini, P., Lapucci, E., Mazzatenta, C., Ghilardi, A., Simonacci, M., Bettacchi, A., Gasco, R., Zanca, A., Battistini, S., Dattola, S., Vernaci, R., Postorino, F., Zampieri, P. F., Padovan, C., González Intchaurraga, M. A., Ladurner, J., Guarneri, B., Cannavo', S., Manfrã, C., Borgia, F., Puglisi Guerra, A., Sedona, P., Cattaneo, A., Carrera, C., Fracchiolla, C., Mozzanica, N., Prezzemolo, L., Menni, S., Lodi, A., Martino, P., Monti, M., Mancini, L., Sacrini, F., Altomare, G. F., Taglioni, M., Lovati, C., Mercuri, S. R., Schiesari, G., Giannetti, A., Conti, A., Lasagni, C., Greco, M., Ronsini, G., Schianchi, S., Fiorentini, C., Niglietta, S., Maglietta, R., Padalino, C., Crippa, D., Pini, M., Rossi, E., Tosi, D., Armas, M., Ruocco, V., Ayala, F., Balato, N., Gaudiello, F., Cimmino, G. F., Monfrecola, G., Gallo, L., Argenziano, G., Fulgione, E., Berruti, G., Ceparano, S., De Michele, I., Giorgiano, D., Leigheb, G., Deledda, S., Peserico, A., Alaibac, M., Piaserico, S., Schiesari, L., Dan, G., Mattei, I., Oro, E., Aricã², M., Bongiorno, M. R., Angileri, R., Amato, S., Todaro, F., Milioto, M., Bellastro, R., Di Nuzzo, S., De Panfilis, G., Zanni, M., Borroni, G., Cananzi, R., Brazzelli, V., Lisi, P., Stingeni, L., Hansel, K., Pierfelice, V., Donelli, S., Rastelli, D., Gasperini, M., Barachini, P., Cecchi, R., Bartoli, L., Pavesi, M., De Paola, S., Corradin, M. T., Ricciuti, F., Piccirillo, A., Viola, L., Tataranni, M., Mautone, M. G., Lo Scocco, G., Niccoli, M. C., Brunasso Vernetti, A. M. G., Gaddoni, G., Resta, F., Casadio, M. C., Arcidiaco, M. C., Luvarã , M. C., Albertini, G., Di Lernia, V., Guareschi, E., Catrani, S., Morri, M., De Simone, C., D’agostino, M., Agostino, I., Calvieri, S., Cantoresi, F., Richetta, A., Sorgi, P., Carnevale, C., Nicolucci, F., Berardesca, E., Ardigã², M., De Felice, C., Gubinelli, E., Chimenti, S., Talamonti, M., Camplone, G., Cruciani, G., Riccardi, F., Barbati, R., Zumiani, G., Pagani, W., Malagoli, P. G., Pellicano, R., Donadio, D., Di Vito, C., Cottoni, F., Montesu, M. A., Pirodda, C., Addis, G., Marongiu, P., Farris, A., Cacciapuoti, M., Verrini, A., Desirello, G., Gnone, M., Fimiani, M., Pellegrino, M., Castelli, G., Zappalã , L., Sesana, G., Ingordo, V., Vozza, E., Di Giuseppe, D., Fasciocco, D., Nespoli, P., Papini, M., Cicoletti, M., Bernengo, M. G., Ortoncelli, M., Bonvicino, A., Capella, G., Doveil, G. C., Forte, M., Peroni, A., Salomone, B., Savoia, P., Pippione, M., Zichichi, L., Frazzitta, M., De Luca, G., Tasin, L., Simonetto, D., Ros, S., Trevisan, G., Patamia, M., Miertusova, S., Patrone, P., Frattasio, A., Piccirillo, F., La Spina, S., Di Gaetano, L., Marzocchi, V., Motolese, A., Venturi, C., Gai, F., Pasquinucci, S., Bellazzi, R. M., Silvestri, T., Girolomoni, G., Gisondi, P., Veller Fornasa, C., Trevisan, G. P., Piaserico S, Cazzaniga S, Chimenti S, Giannetti A, Maccarone M, Picardo M, Peserico A, Naldi L, Psocare Study Group [.., Patrizi A, ], Piaserico, S, Cazzaniga, S, Chimenti, S, Giannetti, A, Maccarone, M, Picardo, M, Peserico, A, Naldi, L, Bongiorno, MR, Psocare Study Group, Monfrecola, Giuseppe, and Trevisan, Giusto

Subjects
Male, primary inefficacy, 75% improvement in the Psoriasis Area Severity Index score, PASI, PASI 75, Psoriasis Area Severity Index, TNF, biologics, efficacy, psoriasis, secondary loss of efficacy, switching, tumor necrosis factor, tumor necrosis factor-alfa inhibitors, Adult, Analysis of Variance, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Cohort Studies, Confidence Intervals, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Immunoglobulin G, Italy, Middle Aged, Multivariate Analysis, Predictive Value of Tests, Proportional Hazards Models, Psoriasis, Receptors, Tumor Necrosis Factor, Registries, Retrospective Studies, Risk Assessment, Severity of Illness Index, Treatment Outcome, Tumor Necrosis Factor-alpha, Young Adult, SWITHCES, psoriasis arthritis, pharmachological treatment, Etanercept, Monoclonal, Receptors, Settore MED/35 - Malattie Cutanee E Veneree, Humanized, Hazard ratio, Predictive value of tests, Drug, biologic, TNF-alpha, medicine.medical_specialty, Dermatology, Antibodies, Dose-Response Relationship, Settore MED/35, Internal medicine, Severity of illness, medicine, Adverse effect, psoriasi, Adalimumab, Infliximab, 2708, Proportional hazards model, business.industry, tumor necrosis factor-alfa inhibitor, Retrospective cohort study, medicine.disease, Confidence interval, Surgery, ANTI-TNFA, business
Abstract

Background: Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event. Objective: We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor. Methods: Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed. Results: In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis Area Severity Index score (PASI 75) was reached by 29% after 16 weeks and by 45.6% after 24 weeks. Patients who switched because of secondary loss of efficacy (loss of initial PASI 75 response) or adverse events/intolerance were more likely to reach PASI 75 than those who switched as a result of primary inefficacy (PASI 75 never achieved) (hazard ratio 2.7, 95% confidence interval 1.3-5.5 vs hazard ratio 2.0, 95% confidence interval 1.0-3.9 and 1, respectively). Limitations: There was a small number of patients with complete follow-up data. Conclusion: PASI 75 response in patients who switched from one antie-TNF-alfa agent to another was significantly reduced in patients who showed primary inefficacy of the first antie-TNF-alfa.

Published
2014

21. Usefulness of in vivo photodiagnosis for the identification of tumor margins in recurrent basal cell carcinoma of the face

Author

Borroni, R, Barruscotti, S, Carugno, A, Barbaccia, V, Arbustini, E, Brazzelli, V, Borroni, RG, Borroni, R, Barruscotti, S, Carugno, A, Barbaccia, V, Arbustini, E, Brazzelli, V, and Borroni, RG

Abstract

Background: Basal cell carcinoma (BCC) is the most frequent malignant tumor of the skin. The high prevalence of BCC, the risk of local recurrence, and the difficult clinical identification of the excision margins emphasize the importance of studying new approaches, ensuring complete surgical excision that allows preservation of normal tissue, especially for BCCs located on cosmetically important areas such as the mid face. Photodiagnosis (PD) is a pre-operative technique that allows a more accurate distinction of neoplastic lesions from surrounding healthy skin in vivo. Purpose: The aim of this study is to assess the usefulness of PD for the evaluation of tumor margins in 10 patients with recurrent BCC of the face. Methods: We study the red fluorescence emitted by neoplastic tissue under a Wood's lamp irradiation, after accumulation of methyl amino levulinate (MAL) cream in 10 patients with recurrent BCC. Results: Our histologic analysis of perilesional skin by PD allowed to delineate more precise tumor margins, thus achieving radical excision in 90% of patients. Conclusion: PD represents a diagnostic method that helps to distinguish between tumor tissue and surrounding healthy tissue especially in case of recurrent BCC of the face when the clinical delimitation is not clear.

Published
2015

22. Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: Evidence from the Italian Psocare Registry

Author

Gisondi, P., Cazzaniga, S., Chimenti, S., Giannetti, A., Maccarone, M, Picardo, M., Girolomoni, G., Naldi, L., Griseta, V, Miracapillo, A, Azzini, M, Mocci, L, Michelini, M, Offidani, A, Bernardini, L, Campanati, A, Ricotti, G, Giacchetti, A, Norat, M, Gualco, F, Castelli, A, Cuccia, A, Diana, A, Roncarolo, G, Belli, Ma, Baldassarre, Ma, Santoro, G, Vena, Ga, Lo Console, F, Filotico, R, Mastrandrea, V, Brunetti, B, Musumeci, F, Carrabba, E, Dal Mas, P, Annicchiarico, F, Benvegnù, B, Spaziani, G, Cusano, F, Saletta Iannazzone, S, Galluccio, A, Pezza, M, Marchesi, L, Imberti, G, Reseghetti, A, Barbera, C, Reggiani, M, Lanzoni, A, Patrizi, A, Bardazzi, F, Antonucci, A, De Tommaso, S, Balestri, R, Wallnofer, W, Ingannamorte, F, Calzavara-Pinton, P, Iannazzi, S, Zane, C, Capezzera, R, Bassisi, S, Rossi, Mt, Altamura, V, Vigl, W, Nobile, C, Aste, N, Murgia, S, Mugheddu, C, Scuderi, G, Baglieri, F, Di Dio, C, Cilioni Grilli, E, Mastronardi, C, Agnusdei, Cp, Antrilli, A, Aulisa, L, Raimondo, U, Scotto di Luzio, G, Battarra, Vc, Farro, P, Plaitano, R, Micali, G, Musumeci, Ml, Massimino, D, Li Calzi, M, La Greca, S, Pettinato, M, Sapienza, G, Valenti, G, De Giacomo PF, D'Amico, D, Arcangeli, F, Brunelli, D, Ghetti, E, Tulli, A, Assi, G, Amerio, P, Laria, G, Prestinari, F, Spadafora, S, Coppola, M, Caresana, G, Pezzarossa, E, Domaneschi, E, Felisi, C, Donato, L, Bertero, M, Musso, L, Pa lazzini, S, Bruscino, P, Agozzino, Uc, Ottaviani, M, Simoncini, C, Virgili, A, Osti, F, Fabbri, P, Volpi, W, Caproni, M, Lotti, T, Prignano, F, Buggiani, G, Troiano, M, Fenizi, G, Altobella, A, Amoruso, A, Condello, M, Goffredo, A, Righini, Mg, Alessandrini, F, Satolli, F, Zampetti, M, Bertani, E, Fossati, S, Parodi, A, Burlando, M, Fiorucci, C, Nigro, A, Ghigliotti, G, Massone, L, Moise, Gm, Serrai, M, Cannata, G, Campagnoli, Am, Daly, M, Leporati, C, Peila, R, Filosa, G, Bugatti, L, Nicolini, M, Nazzari, G, Cestari, R, Anastasio, F, Larussa, Fm, Pollice, N, De Francesco, F, Mazzocchetti, G, Peris, K, Fargnoli, Mc, Di Cesare, A, De Angelis, L, Flati, G, Biamonte, As, Quarta, G, Congedo, M, Carcaterra, A, Strippoli, D, Fideli, D, Marsili, F, Celli, M, Ceccarini, M, Bachini, L, D'Oria, M, Schirripa, V, De Filippi, C, Martini, P, Lapucci, E, Mazzatenta, C, Ghilardi, A, Simonacci, M, Bettacchi, A, Gasco, R, Zanca, A, Battistini, S, Dattola, S, Vernaci, R, Postorino, F, Zampieri, Pf, Padovan, C, González Intchaurraga MA, Ladurner, J, Guarneri, B, Cannavò, S, Manfrè, C, Borgia, F, Puglisi Guerra, A, Sedona, P, Cattaneo, A, Carrera, C, Fracchiolla, C, Mozzanica, N, Prezzemolo, L, Menni, S, Lodi, A, Martino, P, Monti, M, Mancini, L, Sacrini, F, Altomare, F, Taglioni, M, Lovati, C, Mercuri, Sr, Schiesari, G, Giannetti, A, Conti, A, Lasagni, C, Greco, M, Ronsini, G, Schianchi, S, Fiorentini, C, Niglietta, S, Maglietta, R, Padalino, C, Crippa, D, Pini, M, Rossi, E, Tosi, D, Armas, M, Ruocco, V, Ayala, F, Balato, N, Gaudiello, F, Cimmino, Gf, Monfrecola, G, Gallo, L, Argenziano, G, Fulgione, E, Berruti, G, Ceparano, I, De Michele, I, Giorgiano, D, Leigheb, G, Deledda, S, Peserico, A, Alaibac, M, Piaserico, S, Schiesari, L, Dan, G, Mattei, I, Oro, E, Aricò, M, Bongiorno, Mr, Angileri, R, Amato, S, Todaro, F, Milioto, M, Bellastro, R, Di Nuzzo, S, De Panfilis, G, Zanni, M, Borroni, G, Cananzi, R, Brazzelli, V, Lisi, P, Stingeni, L, Hansel, K, Pierfelice, V, Donelli, S, Rastelli, D, Gasperini, M, Barachini, P, Cecchi, R, Bartoli, L, Pavesi, M, De Paola, S, Corradin, Mt, Ricciuti, F, Piccirillo, A, Viola, L, Tataranni, M, Mautone, Mg, Lo Scocco, G, Niccoli, Mc, Brunasso Vernetti AM, Gaddoni, G, Resta, F, Casadio, Mc, Arcidiaco, Mc, Luvarà, Mc, Albertini, G, Di Lernia, V, Guareschi, E, Catrani, S, Morri, M, De Simone, C, D'Agostino, M, Agostino, I, Calvieri, S, Cantoresi, F, Richetta, A, Sorgi, P, Carnevale, C, Nicolucci, F, Berardesca, E, Gubinelli, E, Chimenti, S, Talamonti, M, Camplone, G, Cruciani, G, Riccardi, F, Barbati, R, Zumiani, G, Pagani, W, Malagoli, Pg, Pellicano, R, Donadio, D, Di Vito, C, Cottoni, F, Montesu, Ma, Pirodda, C, Addis, G, Marongiu, P, Farris, A, Cacciapuoti, M, Verrini, A, Desirello, G, Gnone, M, Fimiani, M, Pellegrino, M, Castelli, G, Zappalà, L, Sesana, G, Ingordo, V, Vozza, Dg, Di Giuseppe, D, Fasciocco, D, Nespoli, P, Papini, M, Cicoletti, M, Bernengo, Mg, Ortoncelli, M, Bonvicino, A, Capella, G, Doveil, Gc, Forte, M, Peroni, A, Salomone, B, Savoia, P, Pippione, M, Zichichi, L, Frazzitta, M, De Luca, G, Tasin, L, Simonetto, S, Ros, S, Trevisan, G, Patamia, M, Miertusova, S, Patrone, A, Frattasio, A, Piccirillo, F, La Spina, S, Di Gaetano, L, Udine, Marzocchi, V, Motolese, A, Venturi, C, Gai, F, Pasquinucci, S, Bellazzi, Rm, Silvestri, T, Girolomoni, G, Gisondi, P, Veller Fornasa, C, Trevisan, Gp., Gisondi, P, Cazzaniga, S, Chimenti, S, Giannetti, A, Maccarone, M, Picardo, M, Girolomoni, G, Naldi, L, Monfrecola, Giuseppe, Psocare Study, G. r. o. u. p., P., Gisondi, S., Cazzaniga, S., Chimenti, A., Giannetti, M., Maccarone, M., Picardo, G., Girolimoni, L., Naldi, Trevisan, Giusto, Psocare Study Group: [.., M. Reggiani, A. Lanzoni, A. Patrizi, F. Bardazzi, A. Antonucci, S. De Tommaso, R. Balestri, and ]

Subjects
Adult, Male, arterial hypertension, Adolescent, Antineoplastic Agents, Risk Assessment, Severity of Illness Index, Antibodies, Drug Administration Schedule, Cohort Studies, Dose-Response Relationship, Young Adult, Settore MED/35, Age Distribution, Metabolic Diseases, Monoclonal, metabolic disorders, Humans, Psoriasis, Prospective Studies, Registries, Sex Distribution, Antibodies, Monoclonal, Dose-Response Relationship, Drug, Evidence-Based Medicine, Female, Immunosuppressive Agents, Incidence, Italy, Treatment Outcome, 2708, Infectious Diseases, METABOLIC SYNDROME, psoriasis, metabolic abnormalities, Treatment, therapy, Metabolic abnormalitie, metabolic comorbidities, Metabolic abnormalities, Drug
Abstract

OBJECTIVE: To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees. DESIGN: Prospective cohort study. SETTING: Italian public referral centres for psoriasis treatment. PATIENTS: First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks. MAIN OUTCOME MEASURE: Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinically meaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartate amino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of new diagnoses of diabetes mellitus and arterial hypertension. RESULTS: Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin or cyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Mean transaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levels increased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treated patients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34) and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated with risk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanine amino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension and diabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88). CONCLUSION: Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed.

Published
2013

23. Risk of acute postoperative hypertension after topical photodynamic therapy for non-melanoma skin cancer

Author

Borroni, R, Carugno, A, Rivetti, N, Arbustini, E, Brazzelli, V, Borroni, RG, Borroni, R, Carugno, A, Rivetti, N, Arbustini, E, Brazzelli, V, and Borroni, RG

Abstract

Summary: Background: Topical photodynamic therapy with methyl aminolevulinate (MAL-PDT) is a non-surgical treatment for actinic keratoses, Bowen's disease and basal cell carcinoma. MAL-PDT is particularly useful in elderly patients, who often present co-morbidities and/or in whom surgical excision could be contraindicated. MAL-PDT is generally well tolerated; the most frequent acute adverse events include pain and burning sensation localized to the treatment area. We describe our observation of the occurrence of acute postoperative hypertension (APH) and hypertensive crisis, after a MAL-PDT. Methods: BP measurement was taken twice at 2-min intervals, both before and shortly after the MAL-PDT session. APH was defined as an increase in systolic BP by more than 20% or an increase in diastolic BP to above 110mmHg. Hypertensive crisis was defined as a systolic BP ≥180mmHg or a diastolic BP ≥110mmHg, with or without acute target organ involvement. Results: Prevalence of post-MAL-PDT APH was 22%; 11% of patients developed hypertensive crisis after MAL-PDT, requiring immediate treatment. Conclusion: We highlight the importance of blood pressure measurement both before and after MAL-PDT session to identify high-risk patients and to prevent potentially severe organ involvement subsequent to hypertensive crisis.

Published
2013

24. Narrowband UVB phototherapy for pediatric generalized pityriasis lichenoides

Author

Brazzelli, V, Carugno, A, Rivetti, N, Cananzi, R, Barruscotti, S, Borroni, G, Brazzelli, Valeria, Carugno, Andrea, Rivetti, Nicolo, Cananzi, Raffaello, Barruscotti, Stefania, Borroni, Giovanni, Brazzelli, V, Carugno, A, Rivetti, N, Cananzi, R, Barruscotti, S, Borroni, G, Brazzelli, Valeria, Carugno, Andrea, Rivetti, Nicolo, Cananzi, Raffaello, Barruscotti, Stefania, and Borroni, Giovanni

Published
2013

27. Prevalence, severity and clinical features of psoriasis in fingernails and toenails in adult patients: Italian experience

Author

Brazzelli, V, Carugno, A, Alborghetti, A, Grasso, V, Cananzi, R, Fornara, L, De Silvestri, A, Borroni, G, Brazzelli, V, Carugno, A, Alborghetti, A, Grasso, V, Cananzi, R, Fornara, L, De Silvestri, A, and Borroni, G

Abstract

Background Psoriasis is a chronic inflammatory skin disease affecting 2.0-6.5% of the European population. Although the most striking clinical features of psoriasis involve the skin, other organs including nails and joints may be affected in a substantial proportion of patients. Literature reports nail involvement in 10-56% of psoriatic patients, with common physical and social impairment. However, the precise prevalence of specific clinical features of nail psoriasis is somewhat under-reported. Objectives Our cross-sectional study aimed at describing the prevalence and the clinical features of nail involvement in adult psoriatic patients in a psoriasis referral centre in northern Italy. Methods A total of 178 (124 men, 54 women) consecutive adult patients (≤18 years old) with psoriasis were included. Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI) scores were calculated for each patient. Relevant medical history was recorded. Results Nail involvement was present in 137 (99 men, 38 women) patients (76.9%). The most common nail abnormality was onycholysis, followed by crumbling, subungual hyperkeratosis, pitting and discoloration. Pitting and onycholysis were the most prevalent patterns observed in fingernails, whereas onycholysis and crumbling were the most frequent changes detected in toenails. The most frequently and severely affected nails were the fourth fingernail and the first toenail. The average PASI score was higher in individuals with nail involvement (12.0 vs. 8.7, P = 0.06). Nail changes were present in 85.7% of patients with psoriatic arthritis. Conclusions Our study confirms that nail involvement may be overlooked in psoriasis patients. Different psoriatic patterns in the nail affect specific digits more frequently.

Published
2012

28. Narrowband ultraviolet B phototherapy in the treatment of cutaneous graft-versus-host disease in oncohaematological paediatric patients

Author

Brazzelli, V, Grasso, V, Muzio, F, Moggio, E, Zecca, M, Locatelli, Franco, Borroni, G, Locatelli, F (ORCID:0000-0002-7976-3654), Brazzelli, V, Grasso, V, Muzio, F, Moggio, E, Zecca, M, Locatelli, Franco, Borroni, G, and Locatelli, F (ORCID:0000-0002-7976-3654)

Abstract

Background Graft-versus-host disease (GVHD) represents an important complication following allogeneic bone marrow transplantation. In recent years, narrowband ultraviolet B (NB-UVB, 311-313 nm) has been found to be a beneficial adjuvant treatment in patients refractory to first-line immunosuppressive drugs.Objectives The aim of this study is to analyse retrospectively the clinical outcome of 10 GVHD paediatric patients treated with NB-UVB therapy.Patients and methods Ten paediatric patients (six girls and four boys: median age 12.5 years, range 4-20) with cutaneous GVHD were enrolled in the study: five patients with chronic GVHD and five patients with an overlap syndrome GVHD. All patients had already been shown to be resistant to first-choice immunosuppressive protocols, and were treated with NB-UVB phototherapy until a clinical remission of skin lesions occurred.Results A complete response (absence of lesions) was achieved in 80% of the cases (eight patients) after a median number of 29 treatments, corresponding to a median of 7.5 weeks (52 days) of treatment (range 3-13 weeks), with an average cumulative dose of 28.71 J cm(-2) (range 1.02-70.38 J cm(-2)). Only two patients reported a partial remission (< 18% of body surface area involved). During the follow-up period, a complete remission after 1 year was observed in 75% of patients and after 2 years in 71% of the evaluable patients.Conclusions This study provides evidence that NB-UVB phototherapy represents a valid second-line treatment in paediatric patients affected by GVHD and refractory to immunosuppressive first-line treatment.

Published
2010

29. Isomorphic cutaneous graft-versus-host disease reaction after ultraviolet exposure: clinical, histological and direct immunofluorescence studies of four allo-transplanted patients

Author

Vassallo, C, Brazzelli, V, Zecca, M, Locatelli, Franco, Alessandrino, P E, Borroni, Giulia, Locatelli, F (ORCID:0000-0002-7976-3654), Borroni, G, Vassallo, C, Brazzelli, V, Zecca, M, Locatelli, Franco, Alessandrino, P E, Borroni, Giulia, Locatelli, F (ORCID:0000-0002-7976-3654), and Borroni, G

Abstract

Background Acute and chronic graft-versus-host disease (GVHD) continues to be a major limitation to successful haematopoietic stem cell transplantation. If experimental studies and clinical observations could partially elucidate the pathophysiology of acute GVHD, the biology of chronic GVHD is still much less well understood.Objectives The aim of this study is to describe a peculiar photoinduced rash which triggered acute and then chronic lesions of GVHD in four allogenic haematopoietic-transplated patients and discuss the possible aetiology and treatment.Patients/methods Four patients, two children and two adults affected by either mild or severe chronic GVHD, developed an erythematous rash on sun-or narrow-band ultraviolet B-exposed area, which triggered the onset of acute lesions of GVHD. Any of the patients presented neither a history of photosensitivity nor circulating autoantibodies nor urinary/fecal porphyrine.Results The histopathologic findings were characterized by an interface dermatitis with sparse perivascular infiltrate of lymphocytes and scattered necrotic keratinocytes, especially in the upper part of epidermis. Direct immunofluorescence studies excluded lupus-like pattern, revealing nests of fluorescent bodies at the dermal-epidermal junction and in papillary dermis.Conclusions This peculiar isomorphic reaction of cutaneous GVHD after sun or narrow-band ultraviolet B exposures is described, and the possible mechanism involved is discussed. It may represent an interesting model of progression of chronic GVHD, starting with an acute stage and ending up with chronic clinical and histological findings, especially considering that there is no animal model that fully replicates all of the features of chronic GVHD in humans.

Published
2009

30. Bartonella-related pseudomembranous angiomatous papillomatosis of the oral cavity associated with allogeneic bone marrow transplantation and oral graft-versus-host disease

Author

Vassallo, C, Ardigò, Marco, Brazzelli, V, Zecca, M, Locatelli, Franco, Alessandrino, P E, Lazzarino, M, Corona, S, Lanzerini, P, Benazzo, M, Fabbi, M, Borroni, Giulia, Ardigò, M, Locatelli, F (ORCID:0000-0002-7976-3654), Borroni, G, Vassallo, C, Ardigò, Marco, Brazzelli, V, Zecca, M, Locatelli, Franco, Alessandrino, P E, Lazzarino, M, Corona, S, Lanzerini, P, Benazzo, M, Fabbi, M, Borroni, Giulia, Ardigò, M, Locatelli, F (ORCID:0000-0002-7976-3654), and Borroni, G

Abstract

Patients undergoing allogeneic stem cell transplantation are at high risk for infection with a variety of pathogens during different phases of the procedure. Human infections due to Bartonella spp. are viewed as emerging diseases typical in, although not exclusive to, immunosuppressed patients, in particular those with AIDS, organ transplants and haematological malignancies. We describe four patients, three children and one adult, who developed vegetating papillomatous lesions exclusively on the oral mucosae. They shared a history of haematological malignancy and allogeneic bone marrow/stem cell transplantation, and later developed chronic graft-versus-host disease, also involving the oral mucosae. Histopathologically, the vegetating lesions were characterized by a diffuse neoangiogenesis, granulation-like tissue, and a mixed cell infiltrate predominantly composed of neutrophils. Gram-negative bacteria were found in the endothelial cells of the vessels in the deeper portion of the corium by electron microscopy. In three cases, DNA of B. henselae was detected by polymerase chain reaction (PCR), and confirmed by sequencing of the PCR products. All the lesions healed after systemic antibiotic therapy, although some recurred after months, and regressed again after systemic antibiotic treatment associated with conservative surgical excision.

Published
2007

31. A long-term time course of colorimetric assessment of the effects of imatinib mesylate on skin pigmentation: a study of five patients

Author

Brazzelli, V, Prestinari, F, Barbagallo, T, Rona, C, Orlandi, E, Passamonti, F, Locatelli, Franco, Zecca, M, Villani, S, Borroni, Giulia, Locatelli, F (ORCID:0000-0002-7976-3654), Borroni, G, Brazzelli, V, Prestinari, F, Barbagallo, T, Rona, C, Orlandi, E, Passamonti, F, Locatelli, Franco, Zecca, M, Villani, S, Borroni, Giulia, Locatelli, F (ORCID:0000-0002-7976-3654), and Borroni, G

Abstract

Background Imatinib mesylate (IM), the first-line treatment of chronic myeloid leukaemia (CML), is a tyrosine kinase inhibitor that targets those proteins involved in BCR-ABL signal transduction in CML, c-kit (KIT) and platelet-derived growth-factor (PDGFR) receptor. The use of IM has been associated with cutaneous reactions. In the last 2 years numerous studies have focused the attention on hypopigmentations, depigmentations and photosensitivity developing after the initiation of IM therapy.Objective The aim of this study is to evaluate the effects of IM therapy on the skin pigmentation of five patients affected by CML.Methods Skin pigmentation measurements were performed with a Minolta CR-200 Chromameter.Results All the studied patients show the gradual lightening of the skin on unexposed areas over the treatment with IM. In particular, this explorative colorimetric study indicates the association between IM and skin depigmentation with a significant increase of luminance value (L*) (P = 0.001) and a significant decrease of the pigmentation value (b*) (P = 0.028).Coanclusion Even if we do not know the clinical significance of the skin depigmentation caused by IM, the regulatory role of KIT and its ligand stem cell factor in melanocyte development and survival seems to suggest an objective mechanism of action for IM in the pathogenesis of this cutaneous depigmentation.

Published
2007

35. POMPHOLYX OF THE HANDS AFTER INTRAVENOUS IMMUNOGLOBULIN THERAPY FOR CLINICALLY ISOLATED SYNDROME: A PAEDIATRIC CASE.

Author

BRAZZELLI, V., GRASSI, S., SAVASTA, S., RUFFINAZZI, G., CARUGNO, A., BARBACCIA, V., MARSEGLIA, G. L., and BORRONI, G.

Subjects
POMPHOLYX (Disease), INTRAVENOUS immunoglobulins, THERAPEUTIC use of immunoglobulins, TREATMENT of eczema, CENTRAL nervous system diseases
Abstract

Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. It has a multifactorial etiology, including genetic determinants, allergy to metals, and id reaction; rarely it is a drug-related side effect. We report a paediatric case of pompholyx of the hands related to the intravenous immunoglobulin (IVIG) therapy for Clinically Isolated Syndrome (CIS). A 10-year-old boy, received an IVIG therapy (Venital, Kedrion Spa, Italy) at a dose of 400 mg/kg daily for five days. The fifth day of IVIG infusion, a symmetrical vesicular eruption appeared on the palms of the hands and on lateral aspects of the fingers. The lesions improved with application of topical steroids in few days. The mechanism of induction of pompholyx by IVIG therapy is unknown. A review of the Literature suggests the hypothesis that dyshidrotic eczematous reactions may be related not only to the type of IVIG, to the dose and the rates of infusion, but also to an allergic response to excipients and preservatives contained in the drug, probably elicited by an underlying neurological disease in some cases. [ABSTRACT FROM AUTHOR]

Published
2015

38. Italian expert-based recommendations on the use of photo(chemo)therapy in the management of mycosis fungoides: Results of an e-Delphi consensus

Author

Karl P. Lawrence, Piergiacomo Calzavara-Pinton, Emanuele Cozzani, Paolo D. Pigatto, Roberta Piccinno, Emanuele Trovato, Antonello Baldo, Martina Burlando, Maria Concetta Fargnoli, Valeria Brazzelli, Giuseppe Monfrecola, Nicola Pimpinelli, Serena Rupoli, Elisa Molinelli, Vieri Grandi, Carlo Cota, Michele Pellegrino, Paola Savoia, Alberico Motolese, Marco Simonacci, Paolo Iacovelli, Silvia Alberti-Violetti, Emilio Berti, Daniele Gambini, Mauro Alaibac, Aurora Parodi, Marina Venturini, Alessia Pacifico, Pietro Quaglino, Caterina Longo, Giorgio Mozzicafreddo, Pier Luigi Bruni, Paolo Amerio, Alessandro Pileri, Annamaria Offidani, Grandi V., Baldo A., Berti E., Quaglino P., Rupoli S., Alaibac M., Alberti-Violetti S., Amerio P., Brazzelli V., Bruni P.L., Calzavara-Pinton P., Parodi A., Cozzani E., Burlando M., Fargnoli M.C., Gambini D., Iacovelli P., Pacifico A., Longo C., Monfrecola G., Motolese A., Mozzicafreddo G., Cota C., Pigatto P., Pileri A., Savoia P., Simonacci M., Venturini M., Offidani A., Molinelli E., Pellegrino M., Trovato E., Piccinno R., Lawrence K., and Pimpinelli N.

Subjects
mycosis fungoide, medicine.medical_specialty, Consensus, Skin Neoplasms, Delphi Technique, Immunology, Delphi method, Dermatology, delphi study, evidence-based medicine, guideline, mycosis fungoides, phototherapy, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Mycosis Fungoides, Cronbach's alpha, medicine, Immunology and Allergy, Humans, Radiology, Nuclear Medicine and imaging, Medical physics, PUVA Therapy, computer.programming_language, Mycosis fungoides, business.industry, Advanced stage, General Medicine, Evidence-based medicine, Guideline, medicine.disease, 030220 oncology & carcinogenesis, Chemo therapy, business, computer, Delphi
Abstract

Background Phototherapy is a mainstay for the treatment of MF. However, there is scarce evidence for its use, mostly due to the lack of a unified schedule. Aims The primary aim of this study was to establish the first structured, expert-based consensus regarding the indications and technical schedules of NB-UVB and PUVA for MF. The secondary aim was to determine the consensus level for each specific item. Materials & methods E-delphi study. Item-specific expert consensus was defined as the number of "Totally Agree" results to ≥80% of the panelists. Cronbach alpha index ≥0.7 was used as a measure of homogeneity in the responses among questions related to the same topic. Results Overall, there was a high homogeneity among responders (0.78). On specific topics, the highest grade was observed for technical items (0.8) followed by indications for early (0.73) and advanced stages (0.7). Conclusions Items related to the most canonical indications of phototherapy and to treatment schedules showed the highest agreements rates. There is consensus about the use of standardized treatment schedules for the induction and consolidation phases for NB-UVB and PUVA in MF.

Published
2021

39. Pseudomembranous angiomatoid papillomatosis of mucous membrane (PAPM) in bone marrow transplanted patients.

Author

Borroni, G., Ardig, M., De Giuli, L., Corona, S., Vassallo, C., and Brazzelli, V.

Subjects
*CUTANEOUS manifestations of general diseases, *BONE marrow transplant complications, *PATIENTS, *BARTONELLA, *BARTONELLA infections, *GRAFT versus host disease
Abstract

Cutaneous manifestation due to Bartonella spp. are regarded as severe, potentially life threatening disease especially in immunocompromised patients. AIDS patients, in particular, may present with the clinical pattern known as bacillary angiomatosis. We describe 3 patients, 2 children and an adult, who developed vegetating papillomatous lesions of oral mucosae, after bone marrow transplantation. They shared an identical history of haematologic disease, and all the three patients had received allogenic bone marrow transplantation. Later, they developed Graft versus Host Disease (GvHD), involving also oral mucosa. They were in relatively good general condition, and under Cyclosporine A treatment, associated with prednison (adult patient). All the patients, presented vegetating, pedunculated, exophytic lesions covered by yellowish membrane of fibrin on oral mucosa, associated with different severity of GvHD expression. Biopsies were taken in all three patients. Histology was characterized in all the cases by a granulation-like tissue with a mixed-cell infiltrate mostly composed by neutrophils with diffuse vascular proliferation. No vasculitis was present, although diffuse leukocytoclasis was noticeable. Despite their non-specific looking pattern, likely to be regarded as “granulation tissue secondary to focal ulceration of oral mucosa during oral GvHD”, their histopathology similitude with the histopathology of Bacillary angiomatosis, prompted us to search for organisms. In all the cases, DNA of Bartonella henselae was detected by PCR and confirmed by the study of PCR product with sequencing reaction. Gram negative bacteria were also found in the deep portion of the dermis by electron microscopy. In all the cases, the lesions responded to systemic antibiotic therapy, recurred after weeks or months, and responded again to further systemic antibiotic treatment. In conclusion, we define these cases as Pseudomembranous Angiomatoid Papillomatosis of Mucous membranes (PAPM), a mucosal pattern caused by Bartonella henselae infection. It may affect haematologic and immuno-compromised patients with a previous history of allogenic bone marrow transplantation and mucosal GvHD, under immunosuppressive treatment. [ABSTRACT FROM AUTHOR]

Published
2004
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40. Pompholyx of the hands after intravenous immunoglobulin therapy for clinically isolated syndrome: A paediatric case

Author

Andrea Carugno, Vincenzo Barbaccia, Valeria Brazzelli, Sara Grassi, Salvatore Savasta, Giovanni Borroni, Gian Luigi Marseglia, Giulia Ruffinazzi, Brazzelli, V, Grassi, S, Savasta, S, Ruffinazzi, G, Carugno, A, Barbaccia, V, Marseglia, G, and Borroni, G

Subjects
Male, medicine.medical_specialty, Pediatrics, Allergy, Side effect, Immunology, Eczema, Immunoglobulins, medicine.disease_cause, Administration, Cutaneous, Eczema, Dyshidrotic, Intravenous Immunoglobulin Therapy, Adrenal Cortex Hormones, hemic and lymphatic diseases, Medicine, Immunology and Allergy, Humans, Child, Pharmacology, Clinically isolated syndrome, biology, business.industry, Id reaction, Immunoglobulins, Intravenous, medicine.disease, Dermatology, IVIG therapy, Paediatric patient, Pompholyx, Demyelinating Diseases, Treatment Outcome, Cutaneous, Dyshidrotic, Allergic response, Administration, Etiology, biology.protein, Antibody, business, Intravenous
Abstract

Pompholyx is a common eruption of small vesicles on the palms, soles, and/or lateral aspects of the fingers. It has a multifactorial etiology, including genetic determinants, allergy to metals, and id reaction; rarely it is a drug-related side effect. We report a paediatric case of pompholyx of the hands related to the intravenous immunoglobulin (IVIG) therapy for Clinically Isolated Syndrome (CIS). A 10-year-old boy, received an IVIG therapy (Venital®, Kedrion Spa, Italy) at a dose of 400 mg/kg daily for five days. The fifth day of IVIG infusion, a symmetrical vesicular eruption appeared on the palms of the hands and on lateral aspects of the fingers. The lesions improved with application of topical steroids in few days. The mechanism of induction of pompholyx by IVIG therapy is unknown. A review of the Literature suggests the hypothesis that dyshidrotic eczematous reactions may be related not only to the type of IVIG, to the dose and the rates of infusion, but also to an allergic response to excipients and preservatives contained in the drug, probably elicited by an underlying neurological disease in some cases.

41. Cryptococcoid Sweet syndrome: a case report.

Author

Volonté M, Fiandrino G, Vassallo C, Barruscotti S, Giorgini C, Tomasini CF, and Brazzelli V

Abstract

Cryptococcoid Sweet syndrome (cSS) is a recently described clinical and histological variant of Sweet syndrome (SS). Its cutaneous presentation is similar to the classical form of SS but it includes atypical findings, such as capsular and yeast-like structures on microscopy that are reminiscent of Cryptococcus species. However, in cSS, fungal staining and cultural examination are negative, whereas myeloperoxidase (MPO) staining on biopsy specimens is typically positive. Due to the rarity and the diagnostic challenge represented by this disease, its extracutaneous involvement, and the latency in its diagnosis, this condition is frequently associated with poor prognosis. In this study, we report the case of a cSS patient with a positive outcome., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Volonté, Fiandrino, Vassallo, Barruscotti, Giorgini, Tomasini and Brazzelli.)

Published
2024
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42. Lipschütz ulcers due to SARS-CoV-2 infection: a neglected diagnosis in emergency room.

Author

Brambilla I, Bolcato V, Volonté M, Querzani A, Guarracino C, Tondina E, Marseglia GL, and Brazzelli V

Abstract

Background: Primary acute genital ulcers, or Lipschütz ulcers (LU), are nonsexually transmitted, painful, self-limiting, nonrecurrent vulvar ulcers with unclear pathogenesis, representing a challenging diagnosis in emergency setting. LU have recently been described in association with severe acute respiratory syndrome coronaVirus 2 (SARS-CoV-2) infection and vaccination., Objective: The aim of this study is to describe 2 cases of LU due to SARS-CoV-2 infection, highlighting the diagnostic process, differential diagnosis, disease course, and management options., Methods: We describe 2 young females (12 and 9 years old) who presented to pediatric emergency room with the sudden onset of well-demarcated, painful, vulvar ulcers with fibrinous necrotic center., Results: Both patients tested positive to SARS-CoV-2 nasal swab, and, at physical examination, no other lesions were found in other cutaneous or mucosal sites. Sexual abuse was excluded in both cases, as well as infectious and autoimmune diseases. Supportive analgesic therapy was administered, and complete remission of lesions was observed at follow-up visits without evidence of scarring., Limitations: The main limitation of this work is represented by the small number of cases described., Conclusion: Even though extremely rare, LU related to COVID-19 are an emerging entity to be considered in the diagnosis of acute genital ulcerations. Multidisciplinary diagnostic workup of genital ulcers must be established in order to exclude sexual child abuse, to ensure patient safety, and to avoid unnecessary treatment and familial anxiety., Competing Interests: None., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of Women’s Dermatologic Society.)

Published
2024
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43. Psoriasis and biological drugs at the time of SARS-CoV-2 infection: a mini review outlining risk of infection, seroprevalence, and safety and efficacy of the BNT162b2 vaccine.

Author

Railton J, Volonté M, Isoletta E, Bonelli A, Barruscotti S, and Brazzelli V

Subjects
Humans, Frailty, Seroepidemiologic Studies, Biological Products therapeutic use, BNT162 Vaccine, COVID-19 epidemiology, COVID-19 prevention & control, Psoriasis drug therapy, Psoriasis epidemiology
Abstract

Objective: The aim of this study is to review the life of patients with psoriasis on biologic therapy during the SARS-CoV-2 pandemic and the relevance of frailty within this context, reviewing studies that describe the course and severity of infection in patients with psoriasis on biologics, the seroprevalence of SARS-CoV-2, and the safety and efficacy of the BNT162b2 vaccine in these patients., Materials and Methods: The keywords "Psoriasis," "Biologics," "SARS-CoV-2," "COVID-19," and "BNT162b2 Vaccine" were used in various combinations on database engines to find relevant articles on this topic., Results: A total of 36 articles were found, with 20 concerning the course, severity, and seroprevalence of SARS-CoV-2 in patients with psoriasis on biologic therapy and 16 concerning safety and efficacy of BNT162b2 in these patients., Discussion: Patients with psoriasis on biologic therapy did not have increased seroprevalence compared with the general population, indicating that they were not at an increased risk of SARS-CoV-2 infection compared with the general population. Furthermore, the immunosuppressive action of biologics may be protective, as patients on biologic therapy had better outcomes and less risk of severe infection. The seroconversion rate against SARS-CoV-2 from the BNT162b2 vaccine was similar in both patients with psoriasis on biologics and the general population, indicating that efficacy is not hindered by the biologic therapy. However, the cellular response in population with psoriasis was significantly less intense, and the humoral immune response was weaker than that in the general population, demonstrating that the possibility of tighter vaccination schedules and additional doses may be advantageous in these patients., Competing Interests: VB has been registered for congresses for Sanofi Genzyme, Novartis, Almirall and has participated in clinical trials for Leo Pharma. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Railton, Volonté, Isoletta, Bonelli, Barruscotti and Brazzelli.)

Published
2024
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44. Circulating Mesenchymal Stromal Cells in Patients with Infantile Hemangioma: Evaluation of Their Functional Capacity and Gene Expression Profile.

Author

Abbà C, Croce S, Valsecchi C, Lenta E, Campanelli R, Codazzi AC, Brazzelli V, Carolei A, Catarsi P, Acquafredda G, Apicella A, Caliogna L, Berni M, Mannarino S, Avanzini MA, Rosti V, and Massa M

Subjects
Humans, Propranolol pharmacology, Propranolol therapeutic use, Propranolol metabolism, Transcriptome, Adipogenesis genetics, Mesenchymal Stem Cells metabolism, Hemangioma genetics, Hemangioma drug therapy, Hemangioma metabolism
Abstract

We previously published that in patients with infantile hemangioma (IH) at the onset (T0) colony forming unit-fibroblasts (CFU-Fs) are present in in vitro cultures from PB. Herein, we characterize these CFU-Fs and investigate their potential role in IH pathogenesis, before and after propranolol therapy. The CFU-F phenotype (by flow cytometry), their differentiation capacity and ability to support angiogenesis (by in vitro cultures) and their gene expression (by RT-PCR) were evaluated. We found that CFU-Fs are actual circulating MSCs (cMSCs). In patients at T0, cMSCs had reduced adipogenic potential, supported the formation of tube-like structures in vitro and showed either inflammatory (IL1β and ESM1 ) or angiogenic ( F3 ) gene expression higher than that of cMSCs from CTRLs. In patients receiving one-year propranolol therapy, the cMSC differentiation in adipocytes improved, while their support in in vitro tube-like formation was lost; no difference was found between patient and CTRL cMSC gene expressions. In conclusion, in patients with IH at T0 the cMSC reduced adipogenic potential, their support in angiogenic activity and the inflammatory/angiogenic gene expression may fuel the tumor growth. One-year propranolol therapy modifies this picture, suggesting cMSCs as one of the drug targets.

Published
2024
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45. A multidisciplinary dermatology-gastroenterology-rheumatology (DER.RE.GA) unit for the care of patients with immune-mediated inflammatory diseases: analysis of the first 5 years from the dermatologist's perspective.

Author

Brazzelli V, Bobbio Pallavicini F, Maggi P, Chętko Ł, Isoletta E, Di Giuli N, Bonelli A, and Fornaroli V

Abstract

Immune-mediated inflammatory diseases (IMIDs) constitute a heterogenous group of chronic and highly disabling conditions. The clinical challenges they often pose led to formation of numerous dermo-rheumatological interdisciplinary units around the world, which are reported to benefit their patients in various ways. The present paper describes our experience with a multidisciplinary dermatology-rheumatology-gastroenterology unit DERREGA at the IRCCS Foundation Policlinico San Matteo of Pavia over a period of 5 years of its activity (2017-2022). A digital database was created, containing the medical records of 146 patients referred to the dermatology unit only by rheumatologists or gastroenterologists belonging to the multidisciplinary unit DERREGA. Then, aspects such as demographics, initial basis of referral and final diagnosis among the patients were analyzed retrospectively. Patients were classified as either gastroenterological or rheumatological, and then categorized according to the specific basis of referral. Most of the gastroenterological patients (97%) were affected by inflammatory bowel diseases (IBDs). Rheumatological patients were divided in three subgroups, including patients referred with vasculitis, arthropathies (undifferentiated arthritis, psoriatic arthritis and other arthritis) and other rheumatological diseases. Then, final diagnoses were evaluated in each group. Almost a third of IBD patients received a diagnosis of paradoxical psoriasis. Dermatological examination allowed diagnosis of minimal psoriasis based on Caspar criteria in over 70% of the patients admitted with undifferentiated arthritis. A multidisciplinary approach is suggested to provide more effective management of IMIDs and, specifically, from a dermatological perspective, allows for the diagnosis of minimal manifestations of psoriasis in patients with a provisional diagnosis of undifferentiated arthritis., Competing Interests: VB has been registered at congresses for Sanofi Genzyme, Novartis, Almirall or has participated in clinical trials for Leo Pharma. The other authors have nothing to disclose. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Brazzelli, Bobbio Pallavicini, Maggi, Chętko, Isoletta, Di Giuli, Bonelli and Fornaroli.)

Published
2023
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46. Eosinophilic dermatosis of hematologic malignancy in patients with chronic lymphocytic leukemia/non-Hodgkin's B lymphoma: a single center prospective clinico-pathological study.

Author

Michelerio A, Tomasini C, Fiandrino G, De Amici M, Varettoni M, Defrancesco I, Cavalloni C, Brazzelli V, Derlino F, Paulli M, Arcaini L, and Vassallo C

Abstract

Background: The pathogenesis of eosinophilic dermatosis of hematologic malignancy (EDHM) is poorly understood. Previously thought to be a hypersensitivity reaction to insect bites, immune dysregulation and cytokine imbalance are now thought to be responsible. Its prognostic significance is unclear., Objective: To describe the clinical, pathological and immunological findings in a series of oncohematological patients with EDHM., Methods: An observational prospective cohort study of oncohematological patients receiving a diagnosis of EDHM between April 2017 and December 2018., Results: A total of 15 patients with EDHM (10 females and 5 males) were identified among 422 oncohematological patients. Disease presentation varied from firm erythematous papules to more polymorphic presentations. The lesions were most prevalent on the exposed sites, 8/15 patients recalled an insect bite. Lesion seasonality was reported in 13/15 patients. IgE levels were elevated in six patients, circulating IL-4 and IL-5 were within a normal range. Twelve out of 15 patients developed skin manifestations after chemotherapy. The infiltrate could be eosinophil-rich or lymphocytic-rich. Interestingly, the histopathologic findings were in accordance with arthropod bites., Conclusion: A role for insect bites in EDHM is supported by our findings. EDHM may be related to aggressive hematologic disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Michelerio, Tomasini, Fiandrino, De Amici, Varettoni, Defrancesco, Cavalloni, Brazzelli, Derlino, Paulli, Arcaini and Vassallo.)

Published
2023
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48. Atypical exanthem with acral involvement in adult patients associated with human herpesvirus 7 active replication: A case series.

Author

Michelerio A, Tchich A, Vassallo C, and Brazzelli V

Abstract

An "atypical exanthem" (AE) is an eruptive skin eruption that differs in morphology and etiology from classical exanthems and is often a reason for urgent medical evaluation. The most frequent cause of AEs is a viral infection, but an accurate etiology cannot be established basing on the sole clinical features. Human herpesviruses (HHV) have been often suspected as etiologic agents or cofactors in atypical rashes. We performed a retrospective analysis of adult patients presenting an atypical exanthem associated with HHV-7 active replication in our center. The charts of patients were reviewed and the demographic, clinical and laboratory data collected. Nine patients (six males and three females) were included in the study, with a mean age of 43 years for men and of 26 years for women. All patients presented active HHV-7 replication in plasma during the rash, which turned negative after the exanthem resolved. The exanthem displayed a maculopapular pattern involving the trunk, limbs and, notably, the acral regions, in six patients. In three cases the exanthem was confined to only the acral sites. In most cases, there was no fever and the inflammatory indices remained unchanged. Antihistamines, topical and systemic corticosteroids were used as treatment, with excellent symptom control. We propose adding skin manifestation associated with HHV-7 to the concept of atypical exanthems, in particular those localized to the acral regions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Michelerio, Tchich, Vassallo and Brazzelli.)

Published
2023
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49. Successful treatment with Omalizumab of a child affected by Systemic Mastocytosis: clinical and biological implications.

Author

Bossi G, Brazzelli V, De Amici M, Pietra D, Raviola C, Naso M, Regalbuto C, Boselli F, Fortina V, and Marseglia GL

Subjects
Humans, Child, Omalizumab therapeutic use, Quality of Life, Histamine Antagonists therapeutic use, Mastocytosis, Systemic complications, Mastocytosis, Systemic diagnosis, Mastocytosis, Systemic drug therapy, Mastocytosis chemically induced, Mastocytosis diagnosis, Mastocytosis drug therapy
Abstract

Background: Pediatric Mastocytosis is a rare and heterogeneous disease, characterized by accumulation of mast cells in the skin (Cutaneous Mastocytosis) and/or, less frequently, in other organs, mainly liver, spleen, bone marrow, lymph nodes and gastrointestinal tract (Systemic Mastocytosis). Patients affected by Systemic Mastocytosis show symptoms caused by  a massive release of mast cell mediators: itching, flushing, abdominal pain, generalized weakness, fatigue and neuropsychiatric disorders. Moreover, children with Systemic Mastocytosis are at greater risk of anaphylactic/anaphylactoid reactions, often poorly controlled by the conventional therapy with antihistamines, mast cells stabilizers and steroids. As a result, children affected by Systemic Mastocytosis have a poor quality of life and suffer the consequence of prolonged steroidal treatment., Case Presentation: A child with Systemic Mastocytosis and severe symptoms, refractory to symptomatic and steroidal therapy, has been successfully treated with Omalizumab, an anti-IgE monoclonal antibody usually employed in allergic patients with severe asthma and orticaria. The onset of clinical benefit of Omalizumab therapy was extraordinarily rapid, but proved to be strictly dependent on drug administration. The child has become completely and steadily asymptomatic. No other anaphylactic episodes have been reported. Steroid treatment could be definitively withdrawn after the second dose of Omalizumab, and all the other medications were later reduced. Twenty months after beginning, Omalizumab therapy is still ongoing with good symptomatology control; no side effects have been observed so far., Conclusions: In our experience, Omalizumab is an effective treatment for children affected by Systemic Mastocytosis not responding to conventional medical treatments. The main strengths of this therapy are its rapid and extraordinary efficacy to control the severe mast cells mediator-related symptoms, the lack of side effects and its steroid-sparing effect. However, more extensive and controlled studies in pediatric patients affected by Systemic Mastocytosis are needed to substantiate these promising findings., (© 2023. The Author(s).)

Published
2023
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50. SARS-CoV-2-specific IgG and NCP in vulnerable patients without symptoms.

Author

Asti AL, Lilleri D, Zelini P, Gregorini M, Morosini M, Pattonieri EF, Grignano MA, Libetta C, Sepe V, Di Toro A, Brazzelli V, and Rampino T

Subjects
Antibodies, Viral, Female, Humans, Immunoglobulin G, Pregnancy, Retrospective Studies, SARS-CoV-2, COVID-19, Pandemics
Abstract

Patients with severe COVID-19 both seroconvert earlier and develop higher concentrations of SARS- CoV-2-specific IgG than patients with mild symptoms. In this retrospective study we considered different categories of patients defined as "vulnerable" because affected by other pathologies, such as patients with genetic and cardiovascular diseases; patients with autoimmune dermatological dis- ease; kidney and lung transplant patients, and pregnant women because the prevalence of Covid-19 infection during pregnancy is not known. This study was performed at IRCCS San Matteo Hospital in Pavia, North Italy, a zone considered at high risk during the COVID-19 pandemic from June to December 2020. None of the positive screened patients had symptoms of COVID-19 infection at the time of inclusion in this study.

Published
2022

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