95 results on '"Cusini A"'
Search Results
2. A Case of Possible Loiasis Contracted in Cameroon and Diagnosed in Milan, Italy, and Review of Cases Published in Dermatological Journals
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Luisa Lunardon, Maurizio Romagnuolo, Marco Cusini, and Stefano Veraldi
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loa loa ,loiasis ,calabar swellings ,diethylcarbamazine ,ivermectin ,albendazole ,Dermatology ,RL1-803 - Abstract
Loiasis is an infestation of the skin and eyes caused by the nematode Loa loa. We report a case of loiasis in a woman who contracted the infestation in Cameroon. The clinical picture was characterized by Calabar swellings on the upper limbs and axillary lymphadenopathy. Laboratory tests revealed persistent leucocytosis with neutropenia, lymphopenia, and eosinophilia. The search for microfilariae was always negative. The patient was successfully treated with ivermectin and albendazole. Follow-up (5 years) was negative for both clinical manifestations and laboratory tests.
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- 2021
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3. Pityriasis rosea and pityriasis rosea-like eruption after anti-SARS-CoV-2 vaccination: a report of five cases and review of the literature
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Stefano Veraldi, Vinicio Boneschi, Marco Cusini, and Carlo Alberto Maronese
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Anti-SARS-CoV-2 ,AZD1222 ,BNT162b2 ,mRNA-1273 ,Pityriasis rosea ,Pityriasis rosea-like eruption ,Dermatology ,RL1-803 - Abstract
Only some cases of pityriasis rosea (PR)/pityriasis rosea-like eruption (PRLE) after anti-SARS-CoV-2 vaccination have been reported. In the period May 2021 - February 2022 we observed five cases of clinically typical PR that appeared 2 to 3 weeks after anti-SARS-CoV-2 vaccination with BNT162b2 (3 patients) or mRNA-1273 (2 patients). In four patients PR appeared after the first vaccination; in one patient after the second one. In three patients a biopsy for histopathological examinations was carried out. Results were typical for PR. In all patients laboratory examinations were within normal ranges. All patients were treated with cetirizine. Complete remission was observed within 14-30 days. Four patients were subjected to the second vaccination, but no skin lesions appeared. All patients are currently in good general health. It is possible that a relationship anti-Sars-CoV-2 vaccination−PR/PRLE exists; however, it is very rare, in consideration of millions of vaccinated subjects and the low number of reported cases of PR/PRLE. The pathogenesis of this relationship is unknown. However, some hypotheses may be advanced: PR/PRLE following anti-Sars-CoV-2 vaccination may be just a coincidence; anti-Sars-CoV-2 vaccines cause a reactivation of HHV-6 and/or HHV-7; vaccines can induce a delayed hypersensitivity response clinically similar to drug-induced PRLE.
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- 2022
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4. Widespread Papules in a 70-year-old Man: A Quiz
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Italo F. Aromolo, Carlo A. Maronese, Giovanni Genovese, Marco Cusini, and Angelo V. Marzano
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papules ,mastocytosis ,lichen ,syringoma ,Dermatology ,RL1-803 - Abstract
Abstract is missing (Quiz)
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- 2022
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5. A Multicentre, Randomised Clinical Trial to Compare a Topical Nitrizinc® Complex Solution Versus Cryotherapy for the Treatment of Anogenital Warts
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Paolo Pontini, Luca Mastorino, Valeria Gaspari, Corinne Granger, Stefano Ramoni, Sergio Delmonte, Valeria Evangelista, and Marco Cusini
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Anogenital warts ,Cryotherapy ,Nitrizinc complex solution ,Treatment ,Dermatology ,RL1-803 - Abstract
Abstract Introduction Anogenital warts (AGW) are a relevant clinical issue in the field of sexually transmitted disease, and to date no treatment provides a satisfactory clearance rate. Treatment can be both medical and surgical, and be provided by a healthcare provider or by the patient. Cryotherapy (CRYO) is among the most common treatments for AGW. Nitrizinc® Complex solution (NZCS) is a solution containing organic acids, nitric acid and zinc and copper salts that is applied topically to warts, producing mummification of the damaged tissue. It is considered to be an effective and well-tolerated treatment for genital and common warts. The aim of our study was to compare NZCS to CRYO in the treatment of AGW. Methods We performed a prospective, multicentre, single-blind, randomised, superiority clinical study involving 120 patients, aged 18–55 years, diagnosed with a first episode of AGW, with each patient having from three to ten AGW. The patients were treated either with NZCS or CRYO for a maximum of four treatments. Primary endpoints were: (1) comparison of the clinical efficacy of CRYO and NZCS, based on response to treatment (clearance of AGW) within four treatment sessions; and (2) tolerability, assessed via a short questionnaire at the end of each treatment session. Secondary endpoints were: (1) number of treatments needed for clearance; and (2) recurrence at 1 and 3e months after confirmed clearance. The results were analysed on an intention-to-treat basis. Results A complete response was achieved in 89.7% of the NZCS group and in 75.4% of the CRYO group (p = 0.0443). NZCS was found to be better tolerated. There was no difference between the NZCS and CRYO treatment arms in the number of sessions needed to clear the lesions. Recurrence occurred after 1 month in 18.4% of the NZCS group and 38.1% of the CRYO group (p = 0.0356), and after 3 months in 25 and 40.6% of these groups, respectively (p = 0.1479). Conclusions Nitrizinc® Complex solution can be considered to be as effective as CRYO for the treatment of small (
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- 2020
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6. Cutaneous Clinico-Pathological Findings in three COVID-19-Positive Patients Observed in the Metropolitan Area of Milan, Italy
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Raffaele Gianotti, Stefano Veraldi, Sebastiano Recalcati, Marco Cusini, Massimo Ghislanzoni, Francesca Boggio, and Lindy P. Fox
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covid-19 ,italy ,Dermatology ,RL1-803 - Abstract
Abstract is missing (Short communication)
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- 2020
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7. Secondary syphilis with extra-genital condyloma lata: A case report and review of the literature
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Francesca Barei, Giulia Murgia, Stefano Ramoni, Marco Cusini, and Angelo V Marzano
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Male ,Adult ,Infectious Diseases ,Condylomata Acuminata ,Gastrointestinal Diseases ,Public Health, Environmental and Occupational Health ,Humans ,Female ,Pharmacology (medical) ,Syphilis ,Syphilis, Cutaneous ,Genitalia ,Dermatology - Abstract
Background Syphilis is known as the “great imitator” because of its polymorphic clinical manifestations. Condyloma lata are an uncommon mucocutaneous manifestation of secondary syphilis, generally localized in intertriginous areas, such as the genitals and anus. Extragenital localization of condyloma lata is considered unusual. Methods A case study of extra-genital condylomata is presented. To contextualise the case, a literature review of extra-genital condylomata lata was subsequently undertaken. The authors searched MEDLINE/PubMed, Scopus and Excerpta Medica/EMBASE English-language sources using the following keywords: “condyloma lata”, “condylomata lata”, and “condyloma latum”. Results Thirty-five papers (from 1940 to 2021) describing an extra-anogenital localization of condyloma lata were found and are summarized in Table 1. Patients were mainly males (82.1%), with a mean age of 31.9 years. Most of them showed other manifestations of secondary syphilis (53.9%). In a minority of cases (39.0%), concomitant anogenital condyloma lata were present, thus making the diagnosis easier. The toe web localization was the most documented (26.2%) followed by the oral cavity (23.8%). Conclusion In the presence of extra-genital condyloma lata, the differential diagnosis is not always clear, especially when no other muco-cutaneous lesions are observed. In the case of eroded or wet lesions involving any cutaneous fold, associated or not with other cutaneous manifestations, a sexual history should be obtained, and syphilis must be considered.
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- 2022
8. Response to Letter to the Editor Regarding 'A Multicentre, Randomised Clinical Trial to Compare a Topical Nitrizinc® Complex Solution Versus Cryotherapy for the Treatment of Anogenital Warts'
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Paolo Pontini, Luca Mastorino, Valeria Gaspari, Corinne Granger, Stefano Ramoni, Sergio Delmonte, Valeria Evangelista, and Marco Cusini
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Dermatology ,RL1-803 - Published
- 2020
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9. Herpes simplex virus viral shedding in patients diagnosed of monkeypox
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Serena Giacalone, Nicole Morini, Eleonora Quattri, Stefano Ramoni, Carlo Carrera, Marco Cusini, and Angelo Valerio Marzano
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Infectious Diseases ,Dermatology - Published
- 2023
10. Primary syphilis of the finger: report of four cases
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Stefano Ramoni, Davide Riva, Cristina B Spigariolo, and Marco Cusini
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Infectious Diseases ,Sexually Transmitted Diseases ,Public Health, Environmental and Occupational Health ,Anal Canal ,Humans ,Pharmacology (medical) ,Syphilis ,Dermatology ,Chancre - Abstract
Although primary syphilis generally involves the genitalia, literature reports that 12% of chancres are extragenital, with the anus and oral cavity as the most frequent locations. We present hereby a case series of four chancres of the finger observed at the sexually transmitted infection centre of Milan between 2010 and 2021.
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- 2022
11. A Case of Possible Loiasis Contracted in Cameroon and Diagnosed in Milan, Italy, and Review of Cases Published in Dermatological Journals
- Author
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L. Lunardon, Stefano Veraldi, Marco Cusini, and Maurizio Romagnuolo
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medicine.medical_specialty ,Dermatology ,Neutropenia ,medicine.disease_cause ,Albendazole ,Diethylcarbamazine ,Ivermectin ,Loiasis ,Case and Review ,Infestation ,parasitic diseases ,medicine ,Axillary Lymphadenopathy ,Eosinophilia ,biology ,integumentary system ,business.industry ,Calabar swellings ,biology.organism_classification ,medicine.disease ,Loa loa ,RL1-803 ,medicine.symptom ,business ,medicine.drug - Abstract
Loiasis is an infestation of the skin and eyes caused by the nematode Loa loa. We report a case of loiasis in a woman who contracted the infestation in Cameroon. The clinical picture was characterized by Calabar swellings on the upper limbs and axillary lymphadenopathy. Laboratory tests revealed persistent leucocytosis with neutropenia, lymphopenia, and eosinophilia. The search for microfilariae was always negative. The patient was successfully treated with ivermectin and albendazole. Follow-up (5 years) was negative for both clinical manifestations and laboratory tests.
- Published
- 2021
12. Clinical, dermoscopic and histopathological findings in localized human monkeypox: a case from northern Italy
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Carlo A. Maronese, Andrea Beretta, Gianluca Avallone, Francesca L. Boggio, Dario A. Marletta, Giulia Murgia, Marco Cusini, Andrea Gori, Carlo G. Carrera, Alessandra Di Benedetto, Stefano Ramoni, and Angelo V. Marzano
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Settore MED/35 - Malattie Cutanee e Veneree ,Italy ,Humans ,Dermoscopy ,Monkeypox ,Dermatology - Published
- 2022
13. Yellowish papules on the palms: a diagnostic challenge
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Carlo Alberto Maronese, Italo Francesco Aromolo, Francesca Boggio, Marco Cusini, Angelo Valerio Marzano, and Serena Giacalone
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Settore MED/35 - Malattie Cutanee e Veneree ,Dermatology - Published
- 2022
14. Case of penile white sponge nevus repeatedly treated as genital wart
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Serena Giacalone, Francesca L Boggio, Angelo Valerio Marzano, and Marco Cusini
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Infectious Diseases ,Dermatology - Published
- 2022
15. Chronic Nodular Dermatosis: A Quiz
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Marco Cusini, Stefano Ramoni, Vinicio Boneschi, and Sebastiano Recalcati
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Dermatology ,RL1-803 - Published
- 2017
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16. Background review for the ‘2020 European guideline for the diagnosis and treatment of gonorrhoea in adults’
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Jonathan D C Ross, Jørgen Skov Jensen, M. Gomberg, A. B. Serwin, Magnus Unemo, and Marco Cusini
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Adult ,medicine.medical_specialty ,Microbial Sensitivity Tests ,Dermatology ,Azithromycin ,urologic and male genital diseases ,medicine.disease_cause ,Gonorrhea ,Antibiotic resistance ,Humans ,Medicine ,Pharmacology (medical) ,business.industry ,Public health ,Incidence (epidemiology) ,Ceftriaxone ,Public Health, Environmental and Occupational Health ,Guideline ,Neisseria gonorrhoeae ,female genital diseases and pregnancy complications ,Anti-Bacterial Agents ,Infectious Diseases ,Family medicine ,business ,Nucleic Acid Amplification Techniques - Abstract
Gonorrhoea is a major public health concern globally. Increasing incidence and sporadic ceftriaxone-resistant cases, including treatment failures, are growing concerns. The 2020 European gonorrhoea guideline provides up-to-date evidence-based guidance regarding the diagnosis and treatment of gonorrhoea. The updates and recommendations emphasize significantly increasing gonorrhoea incidence; broad indications for increased testing with validated and quality-assured nucleic acid amplification tests (NAATs) and culture; dual antimicrobial therapy including high-dose ceftriaxone and azithromycin (ceftriaxone 1 g plus azithromycin 2 g) OR ceftriaxone 1 g monotherapy (ONLY in well-controlled settings, see guideline for details) for uncomplicated gonorrhoea when the antimicrobial susceptibility is unknown; recommendation of test of cure (TOC) in all gonorrhoea cases to ensure eradication of infection and identify resistance; and enhanced surveillance of treatment failures when recommended treatment regimens have been used. Improvements in access to appropriate testing, test performance, diagnostics, antimicrobial susceptibility surveillance and treatment, and follow-up of gonorrhoea patients are essential in controlling gonorrhoea and to mitigate the emergence and/or spread of ceftriaxone resistance and multidrug-resistant and extensively drug-resistant gonorrhoea. This review provides the detailed background, evidence base and discussions, for the 2020 European guideline for the diagnosis and treatment of gonorrhoea in adults (Unemo M, et al. Int J STD AIDS. 2020).
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- 2020
17. Faint pigment network in atypical vascular proliferation of the breast: A potential dermoscopic pitfall
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Carlo A Maronese, Francesca L Boggio, Francesco Barberi, Maurizio Romagnuolo, Davide Riva, Serena Giacalone, Angelo Cattaneo, Marco Cusini, and Angelo V Marzano
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Skin Neoplasms ,Humans ,Dermoscopy ,Dermatology ,Melanoma ,Skin Diseases ,Cell Proliferation - Published
- 2022
18. Varicella-like exanthem as a specific COVID-19–associated skin manifestation: Multicenter case series of 22 patients
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Giovanni Genovese, Valentina Caputo, Bianca Maria Piraccini, Pietro Rubegni, Piergiacomo Calzavara-Pinton, Angelo V. Marzano, Paolo D. Pigatto, Emilio Berti, Stefano Veraldi, Marco Cusini, Franco Rongioletti, Gabriella Fabbrocini, Giuseppe Monfrecola, Marzano, A. V., Genovese, G., Fabbrocini, G., Pigatto, P., Monfrecola, G., Piraccini, B. M., Veraldi, S., Rubegni, P., Cusini, M., Caputo, V., Rongioletti, F., Berti, E., Calzavara-Pinton, P., and Marzano AV, Genovese G, Fabbrocini G, Pigatto P, Monfrecola G, Piraccini BM, Veraldi S, Rubegni P, Cusini M, Caputo V, Rongioletti F, Berti E, Calzavara-Pinton P.
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2019-20 coronavirus outbreak ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Erythema ,viruses ,Pneumonia, Viral ,Coronavirus infections ,Dermatology ,Dengue ,Betacoronavirus ,Chickenpox ,medicine ,Humans ,Viral ,Pandemics ,Exanthem ,Coronavirus Infections ,Exanthema ,Varicella,COVID-19 ,integumentary system ,Betacoronaviru ,Pandemic ,business.industry ,Coronavirus Infection ,SARS-CoV-2 ,virus diseases ,COVID-19 ,Common cold ,Pneumonia ,medicine.disease ,Rash ,medicine.symptom ,business ,viral ,Human - Abstract
Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients
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- 2020
19. Hyperkeratosis lenticularis perstans (Flegel’s disease): our experience and review of the literature
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Marco Cusini, Stefano Veraldi, Paolo Bortoluzzi, and Gianluca Nazzaro
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Aged, 80 and over ,medicine.medical_specialty ,business.industry ,Papillary dermis ,Compact hyperkeratosis ,Keratosis ,Dermatology ,Disease ,Middle Aged ,Asymptomatic ,Lymphocytic Infiltrate ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Epidermal atrophy ,Hyperkeratosis lenticularis perstans ,030220 oncology & carcinogenesis ,Humans ,Medicine ,Female ,medicine.symptom ,business ,Histological examination - Abstract
Hyperkeratosis lenticularis perstans (HLP), or Flegel's disease (FD), is a rare disorder of keratinization first described in 1958 by Flegel. HLP is characterized by asymptomatic small papules distributed symmetrically on the dorsal feet and lower part of the legs. It typically presents in the fourth or fifth decade of life. FD has been reported more commonly in women, and little is known about the pathogenesis of this rare dermatosis. Histological examination is mandatory to confirm the diagnosis, and the characteristic features are: focal compact hyperkeratosis, thinned stratum malpighii, epidermal atrophy, and a dense, band-like lymphocytic infiltrate in the papillary dermis. The treatment of FD is challenging, and a fully effective standard therapy does not exist. We report four cases of HLP that have been diagnosed at the Dermatology Unit of IRCCS Ca' Granda Ospedale Maggiore Policlinico in Milan, Italy, and a literature review is enclosed.
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- 2020
20. Sudden Genital Ulceration in a Young Man: A Quiz
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Marco Cusini, Susanna Benardon, Michaela Brena, Stefano Ramoni, Vinicio Boneschi, and Raffaele Gianotti
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Dermatology ,RL1-803 - Published
- 2017
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21. 2021 European guideline on the management of Mycoplasma genitalium infections
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J.S. Jensen, M. Cusini, M. Gomberg, H. Moi, J. Wilson, and M. Unemo
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Male ,Urethritis ,Moxifloxacin ,Mycoplasma genitalium ,Dermatology ,Azithromycin ,Anti-Bacterial Agents ,Infectious Diseases ,Doxycycline ,Dysuria ,Drug Resistance, Bacterial ,Humans ,Female ,Mycoplasma Infections ,Macrolides - Abstract
Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men. In women, M. genitalium is associated with cervicitis and pelvic inflammatory disease (PID) in 10-25%. Transmission of M. genitalium occurs through direct mucosal contact.Asymptomatic infections are frequent. In men, urethritis, dysuria and discharge predominate. In women, symptoms include vaginal discharge, dysuria or symptoms of PID - abdominal pain and dyspareunia. Symptoms are the main indication for diagnostic testing. Diagnosis is achievable only through nucleic acid amplification testing and must include investigation for macrolide resistance mutations.Therapy for M .genitalium is indicated if M. genitalium is detected. Doxycycline has a cure rate of 30-40%, but resistance is not increasing. Azithromycin has a cure rate of 85-95% in macrolide-susceptible infections. An extended course of azithromycin appears to have a higher cure rate, and pre-treatment with doxycycline may decrease organism load and the risk of macrolide resistance selection. Moxifloxacin can be used as second-line therapy but resistance is increasing.Uncomplicated M. genitalium infection without macrolide resistance mutations or resistance testing: Azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral). Second-line treatment and treatment for uncomplicated macrolide-resistant M. genitalium infection: Moxifloxacin 400 mg od for 7 days (oral). Third-line treatment for persistent M. genitalium infection after azithromycin and moxifloxacin: Doxycycline or minocycline 100 mg bid for 14 days (oral) may cure 40-70%. Pristinamycin 1 g qid for 10 days (oral) has a cure rate of around 75%. Complicated M. genitalium infection (PID, epididymitis): Moxifloxacin 400 mg od for 14 days. MAIN CHANGES FROM THE 2016 EUROPEAN M.Due to increasing antimicrobial resistance and warnings against moxifloxacin use, indications for testing and treatment have been narrowed to primarily involve symptomatic patients. The importance of macrolide resistance-guided therapy is emphasised.
- Published
- 2021
22. Suppurative and granulomatous lesions of the skin following mesotherapy
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Cristina Beatrice Spigariolo, Cristiana Colonna, Raffaele Gianotti, Marco Cusini, Stefano Veraldi, and Gianluca Nazzaro
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medicine.medical_specialty ,Granuloma ,Suppuration ,business.industry ,Mesotherapy ,Dermatology ,Skin Aging ,Infectious Diseases ,medicine ,Humans ,business ,Granulomatous lesions ,Skin - Published
- 2021
23. Retronychia as a cause of opportunistic nail infections
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Stefano Veraldi, Valentina Benzecry, Marco Cusini, Gianluca Nazzaro, and Emanuela Passoni
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Nail Diseases ,medicine.medical_specialty ,Nail Infection ,Nails ,business.industry ,MEDLINE ,Humans ,Medicine ,Dermatology ,Opportunistic Infections ,business - Published
- 2021
24. Therapy of cutaneous leishmaniasis caused by Leishmania braziliensis with fluconazole
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Maurizio Romagnuolo, Carlo Alberto Maronese, Marco Cusini, and Stefano Veraldi
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Letter ,biology ,business.industry ,Leishmaniasis, Cutaneous ,Leishmaniasis ,Dermatology ,General Medicine ,medicine.disease ,biology.organism_classification ,Leishmania ,Leishmania braziliensis ,Virology ,Cutaneous leishmaniasis ,medicine ,Humans ,Letters ,business ,Fluconazole ,medicine.drug - Published
- 2021
25. Multiple nodules on the scrotal wall
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Marco Cusini, Giovanni Genovese, and Serena Giacalone
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Adult ,Male ,medicine.medical_specialty ,business.industry ,Calcinosis ,Dermatology ,Diagnosis, Differential ,Scrotal wall ,Scrotum ,Medicine ,Humans ,Radiology ,Genital Diseases, Male ,business - Published
- 2021
26. Position statement for the diagnosis and management of anogenital warts
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M.E. de las Heras-Alonso, Zekayi Kutlubay, M Gomberg, Mihael Skerlev, Electra Nicolaidou, Marco Cusini, M Tawara, A Alraddadi, A Stary, A. Al Hammadi, C O'Mahony, Server Serdaroğlu, Slawomir Majewski, and İÜC, Cerrahpaşa Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü
- Subjects
Male ,Position statement ,medicine.medical_specialty ,Guidelines and Position Statements ,MEDLINE ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Daily practice ,Humans ,Medicine ,Medical physics ,030212 general & internal medicine ,Position Statement ,Anus Diseases ,business.industry ,Papillomavirus Infections ,Frequently asked questions ,Checklist ,3. Good health ,Infectious Diseases ,Condylomata Acuminata ,Practice Guidelines as Topic ,Female ,Genital Diseases, Male ,business ,Genital Diseases, Female ,Relevant information ,Healthcare system - Abstract
Gomberg, Mikhail/0000-0002-1070-5229; Nicolaidou, Electra/0000-0002-8221-0217 WOS:000468972400005 PubMed ID: 30968980 Background Anogenital warts (AGW) can cause economic burden on healthcare systems and are associated with emotional, psychological and physical issues. Objective To provide guidance to physicians on the diagnosis and management of AGW. Methods Fourteen global experts on AGW developed guidance on the diagnosis and management of AGW in an effort to unify international recommendations. Guidance was developed based on published international and national AGW guidelines and an evaluation of relevant literature published up to August 2016. Authors provided expert opinion based on their clinical experiences. Results A checklist for a patient's initial consultation is provided to help physicians when diagnosing AGW to get the relevant information from the patient in order to manage and treat the AGW effectively. A number of frequently asked questions are also provided to aid physicians when communicating with patients about AGW. Treatment of AGW should be individualized and selected based on the number, size, morphology, location, and keratinization of warts, and whether they are new or recurrent. Different techniques can be used to treat AGW including ablation, immunotherapy and other topical therapies. Combinations of these techniques are thought to be more effective at reducing AGW recurrence than monotherapy. A simplified algorithm was created suggesting patients with 1-5 warts should be treated with ablation followed by immunotherapy. Patients with >5 warts should use immunotherapy for 2 months followed by ablation and a second 2-month course of immunotherapy. Guidance for daily practice situations and the subsequent action that can be taken, as well as an algorithm for treatment of large warts, were also created. Conclusion The guidance provided will help physicians with the diagnosis and management of AGW in order to improve the health and quality of life of patients with AGW. Meda Pharma S.p.A. a Mylan Company Medical writing support was funded by Meda Pharma S.p.A. a Mylan Company.
- Published
- 2019
27. Trend of main STIs during COVID-19 pandemic in Milan, Italy
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Pier Luca Mandolini, Livia Brignolo, Stefano Veraldi, Marco Cusini, Gianmarino Vidoni, and Susanna Benardon
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Gonorrhea ,sexual health ,Sexually Transmitted Diseases ,HIV Infections ,Mycoplasma genitalium ,Dermatology ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,Pandemic ,Medicine ,Humans ,Mycoplasma Infections ,030212 general & internal medicine ,Syphilis ,Social isolation ,epidemiology (general) ,Reproductive health ,030505 public health ,Herpes Genitalis ,business.industry ,SARS-CoV-2 ,Public health ,virus diseases ,Outbreak ,COVID-19 ,Chlamydia Infections ,medicine.disease ,Miscellaneous ,virology ,Infectious Diseases ,Italy ,Condylomata Acuminata ,medicine.symptom ,0305 other medical science ,business - Abstract
The outbreak of the COVID-19 pandemic (caused by SARS-CoV-2) is a public health emergency of magnitude.1 The rapid spread of the novel coronavirus in such a densely populated area as Lombardy threatened the capacity of the health system. All health facilities were reorganised to contain the spread of the virus. Unprecedented social isolation measures (lockdown) were adopted to control the epidemic.2 In relation to sexual health, one would assume that the lockdown should reduce the opportunity for sexual encounters and acquisition opportunities for STIs. In Milan, the main city of the Lombardy region, there are two main STI centres which account for about 80% of STI diagnosis. On 8 March, regional ordinance limited outpatient activity to acute cases only. The two STI centres remained open for ‘emergencies’. Patients …
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- 2020
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28. Clinical and laboratory features of 244 men with primary syphilis: a 5-year single-centre retrospective study
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Marco Cusini, Andrea Pastena, Giovanna Lunghi, Angelo V. Marzano, Giovanni Casazza, Giovanni Genovese, and Stefano Ramoni
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Adult ,Male ,medicine.medical_specialty ,Sexual Behavior ,Primary Syphilis ,HIV Infections ,Dermatology ,Men who have sex with men ,Serology ,medicine ,Humans ,Serologic Tests ,Syphilis ,Treponema pallidum ,Homosexuality, Male ,Retrospective Studies ,business.industry ,Clinical Laboratory Techniques ,Incidence (epidemiology) ,Retrospective cohort study ,Nucleic acid amplification technique ,Middle Aged ,medicine.disease ,Infectious Diseases ,medicine.symptom ,business ,Chancre - Abstract
BackgroundSyphilis incidence has exponentially increased in recent decades, particularly among men who have sex with men (MSM). Primary syphilis is characterised by a chancre appearing at the site of Treponema pallidum (TP) inoculation. Atypical morphological variants of syphilitic chancre are frequent. Clinical suspicion must be confirmed either by the demonstration of TP within the lesion through direct tests, such as dark field microscopy (DFM) or T. pallidum nucleic acid amplification technique (TP-NAAT), or by serological tests.ObjectivesTo analyse the clinical features, the sexual behaviour and the role of diagnostic tests in a cohort of men with primary syphilis in Milan.MethodsEpidemiological, clinical and laboratory data of male patients with primary syphilis seen at the STI Center of the University of Milan between 2015 and 2019 were retrospectively evaluated. Diagnosis was confirmed by at least one positive diagnostic test of either DFM, TP-NAAT or serology.ResultsAmong a total of 244 patients, 160 (65.6%) were MSM and 32 (13.1%) were living with HIV. One hundred twenty-four (50.8%) patients had a clinically atypical chancre. Chancres were exclusively extragenital in 30 (12.3%) patients, with MSM being more commonly affected (MSM vs heterosexuals: 16.3% vs 4.8%, respectively; p=0.012), and anal region the most frequently involved site. Chancres were multiple in 68/242 (28.1%) patients and morphologically atypical in 76/244 (31.1%). Diagnosis was obtained by (1) both serology and direct methods in 158/244 patients (64.7%), (2) serology solely in 47/244 (19.3%) and (3) direct methods solely in 39/244 (16%). DFM yielded positive results in 83/139 (59.7%) patients, while TP-NAAT gave positive results in 114/121 (94.2%) patients.ConclusionsPatients with primary syphilis frequently present with morphologically atypical chancres. Furthermore, MSM commonly exhibit extragenital involvement. A combined diagnostic approach including both direct and indirect tests is needed.
- Published
- 2020
29. Lymphocytic variant of hypereosinophilic syndrome presenting with polymorphic cutaneous manifestations and nonspecific histopathological findings
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Simona Muratori, Marco Cusini, Emilio Berti, Giuseppina Schinco, Giovanni Genovese, and Alessio Pizzati
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medicine.medical_specialty ,business.industry ,Hypereosinophilic syndrome ,MEDLINE ,Medicine ,Dermatology ,business ,medicine.disease - Published
- 2020
30. Primary Syphilis of the Neck Mimicking Pyodermatitis
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Andrea Pastena, Stefano Ramoni, Marco Cusini, and Giovanni Genovese
- Subjects
Microbiology (medical) ,medicine.medical_specialty ,030505 public health ,business.industry ,Incidence (epidemiology) ,Incidence ,Public Health, Environmental and Occupational Health ,Primary Syphilis ,Sexually Transmitted Diseases ,Dermatology ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Infectious Diseases ,medicine ,Humans ,Syphilis ,030212 general & internal medicine ,Presentation (obstetrics) ,0305 other medical science ,business - Abstract
The authors describe an atypical case of primary syphilis of the neck. The unusual clinical presentation and localization led to an initial diagnostic mistake. This case confirms the polymorphic character of syphilis. Considering the increased incidence of sexually transmitted infections worldwide, a high index of suspicion should be maintained by physicians.
- Published
- 2020
31. Cutaneous Clinico-Pathological Findings in three COVID-19-Positive Patients Observed in the Metropolitan Area of Milan, Italy
- Author
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Lindy P. Fox, Massimo Ghislanzoni, Sebastiano Recalcati, Marco Cusini, Raffaele Gianotti, Francesca Boggio, and Stefano Veraldi
- Subjects
Male ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pneumonia, Viral ,Dermatology ,Betacoronavirus ,italy ,Pandemic ,lcsh:Dermatology ,Medicine ,Humans ,Skin pathology ,Pandemics ,Skin ,Aged, 80 and over ,Hardware_MEMORYSTRUCTURES ,biology ,business.industry ,SARS-CoV-2 ,COVID-19 ,General Medicine ,lcsh:RL1-803 ,Middle Aged ,biology.organism_classification ,Metropolitan area ,Virology ,Erythema ,Clinico pathological ,Female ,business ,Coronavirus Infections - Abstract
is missing (Short communication)
- Published
- 2020
32. Skin infections by Mycobacterium chelonae following mesotherapy: A report of two cases and review of the literature
- Author
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Raffaele Gianotti, Cristina Beatrice Spigariolo, Marco Cusini, Stefano Veraldi, and Gianluca Nazzaro
- Subjects
medicine.medical_specialty ,integumentary system ,biology ,business.industry ,Mesotherapy ,Mycobacterium chelonae ,Mycobacterium Infections, Nontuberculous ,Dermatology ,Skin Diseases, Bacterial ,Skin infection ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,medicine ,bacteria ,Humans ,Nontuberculous mycobacteria ,business - Abstract
Mesotherapy is sometimes responsible for dermal and subcutaneous infections caused by nontuberculous mycobacteria. Mycobacterium chelonae, M abscessus, and M fortuitum are usually involved. We present two cases of deep skin infections caused by M chelonae following mesotherapy. A review of the literature is included.
- Published
- 2020
33. The Syphilis After the Year 2000
- Author
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Marco Cusini and Stefano Ramoni
- Subjects
Drug ,Systemic disease ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,education ,medicine.disease ,Dermatology ,Penicillin ,medicine ,Syphilis ,business ,medicine.drug ,media_common ,Cause of death - Abstract
Syphilis is a systemic disease that initially usually involves the skin and may subsequently spread to almost all internal organs. It has polymorphous manifestations and has been defined by French Dermatologists “la grande mime” because of its ability to mimic many other diseases. If untreated syphilis can be a cause of death many years after infection. Penicillin is still the drug of choice and no documented cases of clinical resistance have been reported.
- Published
- 2020
34. Should we be testing for urogenitalMycoplasma hominis,Ureaplasma parvumandUreaplasma urealyticumin men and women? – a position statement from the European<scp>STI</scp>Guidelines Editorial Board
- Author
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Magnus Unemo, Marco Cusini, Gilbert G.G. Donders, M. Gomberg, Paddy Horner, and Jørgen Skov Jensen
- Subjects
Male ,0301 basic medicine ,urologic and male genital diseases ,medicine.disease_cause ,Ureaplasma ,0302 clinical medicine ,Cystitis ,Mass Screening ,030212 general & internal medicine ,biology ,Age Factors ,female genital diseases and pregnancy complications ,Europe ,Mycoplasma hominis ,Infectious Diseases ,Ureaplasma parvum ,Practice Guidelines as Topic ,Urinary Tract Infections ,Female ,Ureaplasma urealyticum ,medicine.medical_specialty ,sexually transmitted infection (STI) ,Consensus ,cervicitis ,030106 microbiology ,Dermatology ,Unnecessary Procedures ,Risk Assessment ,Sensitivity and Specificity ,03 medical and health sciences ,Sex Factors ,Internal medicine ,medicine ,Humans ,Mycoplasma Infections ,Urethritis ,Mass screening ,business.industry ,urethritis ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Trichomonas vaginalis ,Human medicine ,business ,Chlamydia trachomatis - Abstract
At present, we have no evidence that we are doing more good than harm detecting and subsequently treating Mycoplasma hominis, Ureaplasma parvum and Ureaplasma urealyticum colonizations/infections. Consequently, routine testing and treatment of asymptomatic or symptomatic men and women for M. hominis, U. urealyticum and U. parvum are not recommended. Asymptomatic carriage of these bacteria is common, and the majority of individuals do not develop any disease. Although U. urealyticum has been associated with urethritis in men, it is probably not causal unless a high load is present (likely carriage in 40-80% of detected cases). The extensive testing, detection and subsequent antimicrobial treatment of these bacteria performed in some settings may result in the selection of antimicrobial resistance, in these bacteria, true' STI agents, as well as in the general microbiota, and substantial economic cost for society and individuals, particularly women. The commercialization of many particularly multiplex PCR assays detecting traditional non-viral STIs together with M. hominis, U. parvum and/or U. urealyticum has worsened this situation. Thus, routine screening of asymptomatic men and women or routine testing of symptomatic individuals for M. hominis, U. urealyticum and U. parvum is not recommended. If testing of men with symptomatic urethritis is undertaken, traditional STI urethritis agents such as Neisseria gonorrhoeae, Chlamydia trachomatis, M. genitalium and, in settings where relevant, Trichomonas vaginalis should be excluded prior to U. urealyticum testing and quantitative species-specific molecular diagnostic tests should be used. Only men with high U. urealyticum load should be considered for treatment; however, appropriate evidence for effective treatment regimens is lacking. In symptomatic women, bacterial vaginosis (BV) should always be tested for and treated if detected.
- Published
- 2018
35. 2017 European guideline for the management of pelvic inflammatory disease
- Author
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Jørgen Skov Jensen, Marco Cusini, Jonathan D C Ross, and Secondo Guaschino
- Subjects
Male ,medicine.medical_specialty ,Mycoplasma genitalium ,Dermatology ,03 medical and health sciences ,0302 clinical medicine ,Moxifloxacin ,Internal medicine ,Pelvic inflammatory disease ,medicine ,Humans ,Mycoplasma Infections ,Pharmacology (medical) ,030212 general & internal medicine ,Adverse effect ,Pelvis ,030219 obstetrics & reproductive medicine ,biology ,business.industry ,Public Health, Environmental and Occupational Health ,Salpingitis ,Guideline ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Sexual Partners ,Infectious Diseases ,medicine.anatomical_structure ,Doxycycline ,Practice Guidelines as Topic ,Female ,business ,Pelvic Infection ,Pelvic Inflammatory Disease ,medicine.drug - Abstract
The European guideline for the management of pelvic inflammatory disease includes evidence-based advice on the investigation and treatment of pelvic inflammatory disease (PID). It has been updated to acknowledge the role of Mycoplasma genitalium as an important cause of PID with testing now recommended for women presenting with possible PID and for the male partners of women with confirmed M. genitalium infection. Recent evidence suggests that serious adverse events are uncommon when using moxifloxacin and its use is now recommended as a first-line therapy, especially in those women with M. genitalium PID. The potential utility of MRI scanning of the pelvis in excluding differential diagnoses has been highlighted. The use of doxycycline is now suggested as empirical treatment for male partners of women with PID to reduce exposure to macrolide antibiotics, which has been associated with increased resistance in M. genitalium.
- Published
- 2017
36. Enhanced Molecular Typing of Treponema pallidum subspecies pallidum Strains From 4 Italian Hospitals Shows Geographical Differences in Strain Type Heterogeneity, Widespread Resistance to Macrolides, and Lack of Mutations Associated With Doxycycline Resistance
- Author
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Valeria Gaspari, Laura Colli, Stefano Ramoni, Giulia Ciccarese, Sergio Delmonte, Antonietta D'Antuono, Francesco Drago, Christian Puga-Salazar, Ivano Dal Conte, Marco Cusini, Lorenzo Giacani, Giacani, Lorenzo, Ciccarese, Giulia, Puga-Salazar, Christian, Dal Conte, Ivano, Colli, Laura, Cusini, Marco, Ramoni, Stefano, Delmonte, Sergio, D'Antuono, Antonietta, Gaspari, Valeria, and Drago, Francesco
- Subjects
Adult ,DNA, Bacterial ,Male ,0301 basic medicine ,Microbiology (medical) ,Adolescent ,Genotype ,Tetracycline ,030106 microbiology ,Anal Canal ,Treponema pallidum, molecular, typing, Italy ,Dermatology ,Drug resistance ,Subspecies ,urologic and male genital diseases ,Article ,Microbiology ,Bacterial genetics ,Young Adult ,03 medical and health sciences ,Drug Resistance, Multiple, Bacterial ,medicine ,Humans ,Point Mutation ,Syphilis ,Treponema pallidum ,Aged ,Skin ,Doxycycline ,Treponema ,biology ,Public Health, Environmental and Occupational Health ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Virology ,Hospitals ,female genital diseases and pregnancy complications ,Anti-Bacterial Agents ,Molecular Typing ,Infectious Diseases ,Italy ,Female ,Macrolides ,medicine.drug - Abstract
BACKGROUND: Although syphilis rates have been relatively high in Italy for over 15 years, no data on the molecular types of Treponema pallidum subsp. pallidum (T. pallidum) circulating in this country are yet available. Likewise, no data exist on how widespread is resistance to macrolide or tetracycline antibiotics in these strains. Such data would however promote comprehensive studies on the molecular epidemiology of syphilis infections in Italy and inform future interventions aiming at syphilis control in this and other European countries. GOALS AND STUDY DESIGN: Swabs from oral, genital, cutaneous, or anal lesions were obtained from 60 syphilis patients attending dermatology clinics in Milan, Turin, Genoa, and Bologna. Molecular typing of T. pallidum DNA was performed to provide a snapshot of the genetic diversity of strains circulating in Northern Italy. Samples were also screened for mutations conferring resistance to macrolides and tetracyclines. RESULTS: T. pallidum DNA was detected in 88.3% of the specimens (53/60) analyzed. Complete and partial T. pallidum typing data were obtained for 77.3% (41/53) and 15.0% (8/53) of samples, respectively, while four samples could not be typed despite T. pallidum DNA being detected. The highest strain type heterogeneity was seen in samples from Bologna and Milan, followed by Genoa. Minimal diversity was detected in samples from Turin, in spite of the highest number of typeable samples collected there. Resistance to macrolides was detected in 94.3% (50/53) of the strains, but no known mutations associated with tetracycline resistance were found. CONCLUSIONS: Genetic diversity among T. pallidum strains circulating in Northern Italy varies significantly among geographical areas regardless of physical distance. Resistance to macrolides is widespread.
- Published
- 2018
37. Response to Letter to the Editor Regarding 'A Multicentre, Randomised Clinical Trial to Compare a Topical Nitrizinc® Complex Solution Versus Cryotherapy for the Treatment of Anogenital Warts'
- Author
-
Luca Mastorino, Valeria Gaspari, Valeria Evangelista, Sergio Delmonte, Stefano Ramoni, Paolo Pontini, Corinne Granger, and Marco Cusini
- Subjects
medicine.medical_specialty ,Letter to the editor ,business.industry ,medicine.medical_treatment ,MEDLINE ,Cryotherapy ,Dermatology ,Clinical trial ,Plastic surgery ,RL1-803 ,medicine ,Oral and maxillofacial surgery ,business ,Quality of Life Research - Published
- 2020
38. Clinical and laboratory features of 244 men with primary syphilis: a 5-year single-centre retrospective study.
- Author
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Ramoni, Stefano, Genovese, Giovanni, Pastena, Andrea, Casazza, Giovanni, Lunghi, Giovanna, Marzano, Angelo Valerio, and Cusini, Marco
- Subjects
HIV infection epidemiology ,DIAGNOSIS of syphilis ,SYPHILIS epidemiology ,CLINICAL pathology ,HIV infections ,SYPHILIS ,SERODIAGNOSIS ,HUMAN sexuality ,RETROSPECTIVE studies ,HOMOSEXUALITY ,BACTERIA - Abstract
Background: Syphilis incidence has exponentially increased in recent decades, particularly among men who have sex with men (MSM). Primary syphilis is characterised by a chancre appearing at the site of Treponema pallidum (TP) inoculation. Atypical morphological variants of syphilitic chancre are frequent. Clinical suspicion must be confirmed either by the demonstration of TP within the lesion through direct tests, such as dark field microscopy (DFM) or T. pallidum nucleic acid amplification technique (TP-NAAT), or by serological tests.Objectives: To analyse the clinical features, the sexual behaviour and the role of diagnostic tests in a cohort of men with primary syphilis in Milan.Methods: Epidemiological, clinical and laboratory data of male patients with primary syphilis seen at the STI Center of the University of Milan between 2015 and 2019 were retrospectively evaluated. Diagnosis was confirmed by at least one positive diagnostic test of either DFM, TP-NAAT or serology.Results: Among a total of 244 patients, 160 (65.6%) were MSM and 32 (13.1%) were living with HIV. One hundred twenty-four (50.8%) patients had a clinically atypical chancre. Chancres were exclusively extragenital in 30 (12.3%) patients, with MSM being more commonly affected (MSM vs heterosexuals: 16.3% vs 4.8%, respectively; p=0.012), and anal region the most frequently involved site. Chancres were multiple in 68/242 (28.1%) patients and morphologically atypical in 76/244 (31.1%). Diagnosis was obtained by (1) both serology and direct methods in 158/244 patients (64.7%), (2) serology solely in 47/244 (19.3%) and (3) direct methods solely in 39/244 (16%). DFM yielded positive results in 83/139 (59.7%) patients, while TP-NAAT gave positive results in 114/121 (94.2%) patients.Conclusions: Patients with primary syphilis frequently present with morphologically atypical chancres. Furthermore, MSM commonly exhibit extragenital involvement. A combined diagnostic approach including both direct and indirect tests is needed. [ABSTRACT FROM AUTHOR]- Published
- 2021
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39. Annular secondary syphilis
- Author
-
Andrea Pastena, Marco Cusini, Stefano Ramoni, Alessandra Ponziani, and Vinicio Boneschi
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,medicine ,MEDLINE ,Syphilis ,Dermatology ,Secondary syphilis ,medicine.disease ,business - Published
- 2019
40. 2018 European guideline on the organization of a consultation for sexually transmitted infections
- Author
-
S. Benardon, Airi Poder, K W Radcliffe, M. Cusini, Sarah Flew, and D. Gamoudi
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Sexually Transmitted Diseases ,Physical examination ,Dermatology ,Guideline ,Infectious Diseases ,Family medicine ,medicine ,Humans ,Contact Tracing ,business ,Medical History Taking ,Physical Examination ,Referral and Consultation ,Contact tracing ,Confidentiality - Published
- 2018
41. Secondary syphilis masquerading as lupus vulgaris in an HIV-infected patient: A diagnosis suggested by histology
- Author
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Antonella Coggi, Gianluca Nazzaro, Raffaele Gianotti, Stefano Ramoni, Marco Cusini, and Giovanni Genovese
- Subjects
Male ,medicine.medical_specialty ,Physical examination ,HIV Infections ,Dermatology ,Asymptomatic ,Injections, Intramuscular ,Serology ,Diagnosis, Differential ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,medicine ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Syphilis ,Treponema pallidum ,Lupus Vulgaris ,Treponema ,integumentary system ,medicine.diagnostic_test ,biology ,Lupus vulgaris ,business.industry ,Public Health, Environmental and Occupational Health ,medicine.disease ,biology.organism_classification ,Anti-Bacterial Agents ,Infectious Diseases ,Treatment Outcome ,Penicillin G Benzathine ,Bisexuality ,Histopathology ,medicine.symptom ,Differential diagnosis ,business - Abstract
We report a case of secondary syphilis mimicking lupus vulgaris in an HIV-infected patient. A 21-year-old Brazilian man presented with a two-month history of asymptomatic cutaneous lesions accompanied by fever and fatigue. Dermatological evaluation revealed an erythematous, crusted, large plaque on the neck with the ‘apple jelly’ sign on diascopy and two smaller scaly elements on the trunk and left palm. Bacteriological examinations for bacteria and mycobacteria gave negative results. Histology revealed psoriasiform epidermal hyperplasia and dermal lymphoplasmacytic infiltrate. Serology for syphilis was positive, and immunohistochemistry confirmed the presence of Treponema pallidum in lesional skin. A diagnosis of secondary syphilis was made, and the patient was successfully treated with benzathine penicillin G. Cutaneous manifestations of secondary syphilis are protean and skin tuberculosis may be considered in the differential diagnosis, especially in HIV-infected patients. In the current case, clinical examination, and particularly, ‘apple jelly’ sign positivity, was suggestive of lupus vulgaris, but only typical histopathology and immunohistochemistry led to the correct diagnosis of secondary syphilis.
- Published
- 2018
42. Anogenital warts treatment options: a pratical approach
- Author
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Simone Ribero, Marco Cusini, Caterina Cariti, Stefano Ramoni, Sergio Delmonte, and Susanna Benardon
- Subjects
medicine.medical_specialty ,business.industry ,Public health ,Papillomavirus Infections ,MEDLINE ,Sexually Transmitted Diseases ,Treatment options ,Dermatology ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Order (business) ,Condylomata Acuminata ,Epidemiology ,medicine ,Effective treatment ,Humans ,Intensive care medicine ,business ,Papillomaviridae - Abstract
Anogenital warts (AGWs) are an important issue for public health centers dealing with Sexually Transmitted Infections. They are epidemiologically relevant, with significant morbidity and an established effective treatment is lacking. In this article, we examine the epidemiological, diagnostic, and therapeutic aspect of the problem in order to give an up to date picture of the situation and a practical clue for the management of AGWs.
- Published
- 2018
43. Vegetating Nodules Following Erosions on the Oral Cavity: A Quiz
- Author
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Marco Cusini, Claudia Menicanti, Sebastiano Recalcati, Carlo Crosti, and Angelo V. Marzano
- Subjects
Larynx ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Pharynx ,Nodule (medicine) ,Dermatology ,General Medicine ,medicine.disease ,Dysphagia ,Stenosis ,medicine.anatomical_structure ,Prednisone ,Tongue ,Biopsy ,medicine ,medicine.symptom ,business ,medicine.drug - Abstract
Acta Derm Venereol 95 © 2015 The Authors. doi: 10.2340/00015555-1936 Journal Compilation © 2015 Acta Dermato-Venereologica. ISSN 0001-5555 A 68-year-old Italian man presented with a 7-month history of multiple erosions on the trunk as well as lips and oral cavity. Before admission to our department, he was treated in another institution with systemic corticosteroids (oral prednisone at the initial dose of 1 mg/kg/day, with progressively tapering dosages for 2 months) and other immunosuppressants, such as azathioprine (1.25 mg/kg/ day for 2 months), intravenous immunoglobulins (one cycle consisting of one infusion of 400 mg/kg/day for 5 consecutive days), and rituximab (one cycle consisting of one infusion of 375 mg/m2/every week for 4 weeks), achieving resolution of the cutaneous manifestations but without control of the oral involvement. Upon admission, he had multiple lip and oral erosions (Fig. 1a). In the following days, he developed erythematous-violaceous vegetating nodules that coalesced into ulcerated plaques on the lips and tongue (Fig. 1b). The patient’s general condition was compromised; he was asthenic and, due to dysphagia, had lost about 15 kg in the last 3 months. Staging fibroscopy revealed nodules that induced marked stenosis of the larynx and pharynx (Fig. 1c). Within a few days, an emergency tracheotomy was required because of acute dyspnea. Biopsy specimens from a nodule were submitted for histology (Fig. 1d).
- Published
- 2015
44. Chronic Nodular Dermatosis: A Quiz
- Author
-
Vinicio Boneschi, Marco Cusini, Stefano Ramoni, and Sebastiano Recalcati
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bacteriological Techniques ,business.industry ,Biopsy ,Leprostatic Agents ,Dermatology ,General Medicine ,Diagnosis, Differential ,Leprosy, Lepromatous ,Mycobacterium leprae ,Treatment Outcome ,Predictive Value of Tests ,RL1-803 ,Medicine ,Humans ,business ,Skin - Published
- 2017
45. Atypical syphilitic chancre of the tongue in a HIV-positive patient: the diagnostic role of NAATS
- Author
-
Marco Cusini, Vinicio Boneschi, and Stefano Ramoni
- Subjects
medicine.medical_specialty ,business.industry ,Human immunodeficiency virus (HIV) ,Dermatology ,Nucleic acid amplification technique ,medicine.disease ,medicine.disease_cause ,Positive patient ,Infectious Diseases ,medicine.anatomical_structure ,Tongue disease ,Tongue ,Syphilitic chancre ,medicine ,Syphilis ,medicine.symptom ,business ,Chancre - Published
- 2017
46. 2016 European guideline on Mycoplasma genitalium infections
- Author
-
M. Gomberg, Jørgen Skov Jensen, Harald Moi, and Marco Cusini
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Josamycin ,030106 microbiology ,Cervicitis ,Mycoplasma genitalium ,Dermatology ,urologic and male genital diseases ,Azithromycin ,Asymptomatic ,Gastroenterology ,03 medical and health sciences ,Moxifloxacin ,Internal medicine ,Pelvic inflammatory disease ,medicine ,Humans ,Urethritis ,Mycoplasma Infections ,biology ,business.industry ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,female genital diseases and pregnancy complications ,Anti-Bacterial Agents ,Europe ,Infectious Diseases ,Immunology ,Female ,Macrolides ,medicine.symptom ,business ,medicine.drug - Abstract
Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men. In women, M. genitalium is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. Asymptomatic infections are frequent. In women, symptoms include vaginal discharge, dysuria or symptoms of PID - abdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Besides symptoms, indication for laboratory test is a high-risk sexual behaviour. Diagnosis is achievable only through nucleic acid amplification testing (NAAT). If available, NAAT diagnosis should be followed with an assay for macrolide resistance. Therapy for M. genitalium is indicated if M. genitalium is detected or on an epidemiological basis. Doxycycline has a low cure rate of 30-40%, but does not increase resistance. Azithromycin has a cure rate of 85-95% in macrolide susceptible infections. An extended course appears to have a higher cure rate. An increasing prevalence of macrolide resistance, most likely due to widespread use of azithromycin 1 g single dose without test of cure, is drastically decreasing the cure rate. Moxifloxacin can be used as second-line therapy, but resistance is increasing. Uncomplicated M. genitalium infection should be treated with azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral), or josamycin 500 mg three times daily for 10 days (oral). Second line treatment and treatment for uncomplicated macrolide resistant M. genitalium infection is moxifloxacin 400 mg od for 7-10 days (oral). For third line treatment of persistent M. genitalium infection after azithromycin and moxifloxacin doxycycline 100 mg two times daily for 14 days can be tried and may cure 30%. Pristinamycin 1 g four times daily for 10 days (oral) has a cure rate of app. 90%. Complicated M. genitalium infection (PID, epididymitis) is treated with moxifloxacin 400 mg od for 14 days.
- Published
- 2016
47. Background review for the 2016 European guideline on Mycoplasma genitalium infections
- Author
-
Harald Moi, Jørgen Skov Jensen, M. Gomberg, and Marco Cusini
- Subjects
0301 basic medicine ,Vaginal discharge ,Male ,medicine.medical_specialty ,Venereology ,030106 microbiology ,Cervicitis ,Mycoplasma genitalium ,Dermatology ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Pelvic inflammatory disease ,medicine ,Dysuria ,Humans ,Urethritis ,Mycoplasma Infections ,030212 general & internal medicine ,Gynecology ,biology ,business.industry ,Guideline ,biology.organism_classification ,medicine.disease ,female genital diseases and pregnancy complications ,Europe ,Infectious Diseases ,Practice Guidelines as Topic ,Female ,medicine.symptom ,business - Abstract
Mycoplasma genitalium is a cause of 10-35% of non-chlamydial non-gonococcal urethritis in men and in women, and is associated with cervicitis and pelvic inflammatory disease (PID). Transmission of M. genitalium occurs through direct mucosal contact. In women, symptoms include vaginal discharge, dysuria or symptoms of PID - abdominal pain and dyspareunia. In men, urethritis, dysuria and discharge predominates. Asymptomatic infections are frequent. In this review, we present the evidence base for the recommendations in the 2016 European guideline on M. genitalium infections and describe indications for testing, recommended diagnostic methods, treatment and patient management. The guideline was prepared on behalf of the European branch of The International Union against Sexually Transmitted Infections; the European Academy of Dermatology and Venereology; the European Dermatology Forum; the European Society of Clinical Microbiology and Infectious Diseases; the Union of European Medical Specialists. The European Centre for Disease Prevention and Control and the European Office of the World Health Organisation also contributed to their development.
- Published
- 2016
48. European guideline for the organization of a consultation for sexually transmitted infections, 2012
- Author
-
Airi Poder, Sarah Flew, K W Radcliffe, and M. Cusini
- Subjects
medicine.medical_specialty ,Service delivery framework ,business.industry ,Medical record ,Sexually Transmitted Diseases ,Public Health, Environmental and Occupational Health ,Disease Management ,Dermatology ,Guideline ,Medical Records ,Europe ,Infectious Diseases ,Family medicine ,Humans ,Medicine ,Pharmacology (medical) ,Contact Tracing ,Disease management (health) ,business ,Physical Examination ,Referral and Consultation ,Contact tracing - Abstract
This guideline is intended to serve as a framework for those working in any location where sexually transmitted infections (STIs) are managed. It offers recommendations which will need to be adapted depending on local facilities and policies, and is not intended to be all encompassing. This guideline should be read in conjunction with other European guidelines on the management of specific infections (see http://www.iusti.org/ ).
- Published
- 2012
49. Sudden Genital Ulceration in a Young Man: A Quiz
- Author
-
Susanna Benardon, Vinicio Boneschi, Michaela Brena, Stefano Ramoni, Marco Cusini, and Raffaele Gianotti
- Subjects
Male ,medicine.medical_specialty ,Penile Diseases ,Biopsy ,Silicones ,MEDLINE ,Cosmetic Techniques ,Dermatology ,medicine.disease_cause ,Injections ,Young Adult ,Streptococcal Infections ,Skin Ulcer ,medicine ,lcsh:Dermatology ,Humans ,Sex organ ,Young adult ,medicine.diagnostic_test ,business.industry ,Coitus ,General Medicine ,Skin ulcer ,lcsh:RL1-803 ,Anti-Bacterial Agents ,Treatment Outcome ,Superinfection ,Staphylococcal Skin Infections ,medicine.symptom ,business - Published
- 2017
50. Therapy for Gonococcal and Non-gonococcal Genital Infections is a Major Problem for Clinicians
- Author
-
Marco Cusini
- Subjects
Gynecology ,Male ,medicine.medical_specialty ,business.industry ,Genital infections ,Chlamydia trachomatis ,Mycoplasma genitalium ,Dermatology ,General Medicine ,Azithromycin ,Chlamydia Infections ,Anti-Bacterial Agents ,medicine ,Humans ,Female ,Mycoplasma Infections ,business - Published
- 2015
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