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1. Research Techniques Made Simple: Latent Class Analysis.

Author

Naldi L and Cazzaniga S

Subjects
Bayes Theorem, Dermatology statistics & numerical data, Humans, Models, Statistical, Research Design, Risk Factors, Skin Diseases diagnosis, Skin Diseases epidemiology, Skin Diseases therapy, Data Interpretation, Statistical, Dermatology methods, Latent Class Analysis
Abstract

Latent class analysis (LCA) is a statistical technique that allows for identification, in a population characterized by a set of predefined features, of hidden clusters or classes, that is, subgroups that have a given probability of occurrence and are characterized by a specific and predictable combination of the analyzed features. Compared with other methods of so called data segmentation, such as hierarchical clustering, LCA derives clusters using a formal probabilistic approach and can be used in conjunction with multivariate methods to estimate parameters. The optimal number of classes is the one that minimizes the degree of relationship among cases belonging to different classes, and it is decided by relying on methods such as the Bayesian Information Criterion that capitalize on the value of the negative log-likelihood function, a well-established measure of the goodness of fit of a statistical model. LCA has not been extensively used in dermatology. The areas of application are manifold, from the phenotype classification to the analysis of behavior in relation with risk factors to the performance of diagnostic tests., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2020
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2. [Dermatology: experience with the disease registry for the treatment of psoriasis].

Author

Naldi L and Cazzaniga S

Subjects
Humans, Italy, Dermatology, Psoriasis drug therapy, Registries
Abstract

Introduction: The Psocare project started in August 2005, integrating several activities: a survey of the management of psoriasis in Italy, the institution of a network of reference centres for psoriasis in Italy, the activation of a registry and outcome research project of moderate-to-severe psoriasis involving the centres., Methods: Data collection is through a web-based data collection form. As of December 31, 2010, a total of 167 centres participated and provided data about a total of 20,170 patients., Results: Etanercept and cyclosporine were the drugs most frequently prescribed at entry. Among the others, the outcome research study documented that drug survival was better for biologicals than for conventional treatment, that hospitalization rates were reduced in patients receiving biologicals as compared with patients on conventional treatment, and that body mass index influenced response to treatment irrespective of the treatment considered., Discussion: The Psocare programme had a role in improving clinical management of psoriasis in Italy by establishing reference centres and by promoting long-term structured care for the disease.

Published
2013
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3. Registry research in dermatology.

Author

Naldi L and Chatenoud L

Subjects
Humans, Incidence, Dermatology, Registries, Skin Diseases epidemiology
Abstract

A medical "registry" is a systematic collection of information from cases of a particular disease or other health relevant condition. Hospital-based registries primarily address prognosis, whereas population-based registries provide estimates of disease incidence. Opportunities to establish and investigate dermatology hospital- and population-based registries abound.

Published
2009
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4. Feasibility of a web-based continuing medical education program in dermatology: the DermoFAD experience in Italy.

Author

Naldi L, Manfrini R, Martin L, Deligant C, and Dri P

Subjects
Feasibility Studies, Italy, Dermatology education, Internet
Abstract

Background: Web-based systems are increasingly being considered for medical education. A draft legislation on distance-learning programs was licensed in Italy by the National Commission for Continuous Education in November 2003. A series of pilot studies were developed, among these the DermoFAD project, based on five simulated clinical cases of acne and a systematic appraisal of the evidence for their clinical management. From July 1 to August 27, 2004, a total of 500 medical doctors participated in a free of charge evaluation program of the project., Observations: Users were distributed all over Italy. Two hundred and eighty-one (56.2%) were primary care physicians, 83 (16.6%) dermatologists, and 136 (27.2%) other medical specialists. A wide range of connecting times was observed. The pass rate of each individual case, at first attempt, ranged from 44 to 77%. When asked to assess the overall distance-learning experience, 98% of the doctors considered it to be enjoyable. A total of 2,152 continuing medical education (CME) credits were awarded. Over 50% of the users stated they would still use the system if they had to pay for it., Conclusions: Our experience shows that distance learning is feasible and is well accepted by physicians. The DermoFAD program was an efficient means of delivering CME to the Italian medical community at large.

Published
2006
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5. Conflicts of interest in dermatology.

Author

Williams HC, Naldi L, Paul C, Vahlquist A, Schroter S, and Jobling R

Subjects
Authorship, Clinical Trials as Topic economics, Humans, Publishing, Conflict of Interest, Dermatology, Drug Industry economics, Research Support as Topic
Abstract

Conflicts of interest exist in dermatology when professional judgement concerning a primary interest, such as research validity, may be influenced by a secondary interest, such as financial gain from a for-profit organization. Conflict of interest is a condition and not a behaviour, although there is clear evidence that gifts influence behaviour. Little has been written about conflicts of interest in dermatology. This series of papers raises awareness of the subject by exploring it in greater depth from the perspective of a dermatology researcher, an industry researcher, a dermatology journal editor, a health services researcher and a patient representative. Collectively, they illustrate the many ways in which conflicts can pervade the world of dermatology publications and patient support group activities.

Published
2006
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6. A new era in the management of psoriasis? Promises and facts.

Author

Naldi L

Subjects
Clinical Trials as Topic, Humans, Dermatologic Agents therapeutic use, Dermatology trends, Psoriasis drug therapy
Abstract

A number of new systemic agents, collectively termed as 'biologicals,' are made available for the treatment of psoriasis. We can display cautious optimism as to the role of these new agents, provided that further studies will be conducted in reasonable time. Rates of relapse on drug withdrawal, predictive factors for treatment failure and extensive data on drug safety are additional pieces of information required. Comparative effectiveness is also of concern. Advancements in clinical research, including severity assessment and outcome measures, should parallel improvements in the understanding of the pathomechanisms of psoriasis. A number of controversial areas exist concerning the management of psoriasis, where no direct interest from pharmaceutical companies is involved. The role of interventions like education and psychological support as an adjunct to conventional treatment is just one example. Independent research networks may be required to address these controversial areas.

Published
2005
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7. Dermoscopy of pigmented seborrheic keratosis: a morphological study.

Author

Braun RP, Rabinovitz HS, Krischer J, Kreusch J, Oliviero M, Naldi L, Kopf AW, and Saurat JH

Subjects
Biopsy, Needle, Cohort Studies, Diagnosis, Differential, Female, Humans, Incidence, Keratosis, Seborrheic pathology, Male, Melanoma pathology, Prognosis, Prospective Studies, Risk Assessment, Severity of Illness Index, Skin Neoplasms pathology, Dermatology methods, Keratosis, Seborrheic diagnosis, Melanoma diagnosis, Skin Neoplasms diagnosis
Abstract

Objectives: To describe morphological features of seborrheic keratosis as seen by dermoscopy and to investigate their prevalence., Design: Prospective cohort study using macrophotography and dermoscopy for the documentation of seborrheic keratosis., Settings: Seborrheic keratoses were prospectively collected in 2 sites: a private practice in Plantation, Fla (site 1), and the Department of Dermatology at the University Hospital Geneva in Switzerland (site 2)., Patients: A total of 203 pigmented seborrheic keratoses (from 192 patients) with complete documentation were collected (111 from site 1 and 93 from site 2)., Interventions: Screening for new morphological features of seborrheic keratosis and evaluation of all lesions for the prevalence of these criteria., Main Outcome Measures: Identification of new morphological criteria and evaluation of frequency., Results: A total of 15 morphological dermoscopic criteria were identified. Standard criteria such as milialike cysts and comedolike openings were found in a high number of cases (135 and 144, respectively). We found network and networklike structures to be present in 94 lesions (46%). Using standard diagnostic criteria for seborrheic keratosis, 30 lesions would not have been diagnosed as such., Conclusions: The classic dermoscopic criteria for seborrheic keratosis (milialike cysts and comedolike openings) have a high prevalence but the use of additional dermoscopic criteria such as fissures, hairpin blood vessels, sharp demarcation, and moth-eaten borders improves the diagnostic accuracy. The proper identification of pigment network and networklike structures is important for the correct diagnosis.

Published
2002
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8. Evidence-based dermatology: a need to reset the agenda.

Author

Naldi L, Braun R, and Saurat JH

Subjects
Humans, Switzerland, Dermatology methods, Evidence-Based Medicine, Research Design
Abstract

Evidence-based medicine (EBM) emphasises the role of clinical research in guiding clinical decisions. The aim is to integrate medical research into clinical practice in the most efficient way. In spite of EBM pointing to basic requirements for optimal patient care, the formalisation of an EBM approach is still at a developing stage in many areas of medicine, including dermatology. EBM should avoid becoming a specialised separate discipline with its own jargon and peculiar literature, i.e. secondary publications and systematic reviews. Ideally, the emphasis should be moved from so-called secondary to primary research, and an agreement on what constitutes research priorities should be reached on an international level with large-scale independent clinical studies being mounted by the dermatological community on unaddressed issues., (Copyright 2002 S. Karger AG, Basel)

Published
2002
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11. Psoriasis severity matters when dealing with all-cause mortality in psoriasis patients

Author

Pezzolo, Elena, Ciampichini, Roberta, Cazzaniga, Simone, Sampietro, Giuseppe, Zucchi, Alberto, Naldi, Luigi, and Epidemiology

Subjects
Adult, Male, medicine.medical_specialty, Population, Comorbidity, Dermatology, Disease, Severity of Illness Index, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Cause of Death, Internal medicine, Psoriasis, medicine, Electronic Health Records, Humans, 610 Medicine & health, education, Health Education, Aged, Retrospective Studies, education.field_of_study, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Northern italy, Italy, 030220 oncology & carcinogenesis, Female, Health education, business, Record linkage
Abstract

Psoriasis has been linked with several comorbidities and increased all-cause mortality compared with the general population. Data are still limited concerning mortality especially from Southern European countries. Between January 2012 and December 2018, we conducted a retrospective cohort study on psoriasis patients and population controls in Northern Italy. Through record linkage of health-care databases, psoriasis cases were identified, and their morbidity and mortality were compared with the general population. The Charlson index was used as an index of comorbidities. Standardized mortality ratios (SMR) were estimated for overall psoriasis cases and for patients with mild vs moderate-to-severe disease, separately. We identified 12,693 psoriasis patients (mean age: 60.8 ± 16.3 years). They had a significantly higher Charlson index compared with the general population (p < 0.001). In spite of the higher rate of comorbidities, age-specific SMR was not increased in the psoriasis population as a whole (1.04 (95% CI 0.89–1.20)) or in people with mild psoriasis. However, a 40% higher than the expected risk of all-cause mortality was documented in individuals with moderate-to-severe psoriasis (SMR: 1.41; 95% CI 1.12–1.75). Notably, an excess mortality in these patients occurred as early as age 40-49 years. The proportion of deaths from malignancies and cardiovascular diseases was remarkably high. Our results support the notion that psoriasis severity influences mortality and indicate that patients with psoriasis, especially those with severe disease, should receive appropriate screening and health education.

Published
2021

12. Vaccine hesitancy and access to psoriasis care during the COVID-19 pandemic: findings from a global patient-reported cross-sectional survey

Author

Bechman, Katie, Cook, Emma S., Dand, Nick, Yiu, Zenas Z.N., Tsakok, Teresa, Meynell, Freya, Coker, Bolaji, Vincent, Alexandra, Bachelez, Herve, Barbosa, Ines, Brown, Matthew A., Capon, Francesca, Contreras, Claudia R., De La Cruz, Claudia, Meglio, Paola Di, Gisondi, Paolo, Jullien, Denis, Kelly, Jade, Lambert, Jo, Lancelot, Camille, Langan, Sinead M., Mason, Kayleigh J., McAteer, Helen, Moorhead, Lucy, Naldi, Luigi, Norton, Sam, Puig, Lluís, Spuls, Phyllis I., Torres, Tiago, Urmston, Dominic, Vesty, Amber, Warren, Richard B., Waweru, Hoseah, Weinman, John, Griffiths, Christopher E.M., Barker, Jonathan N., Smith, Catherine H., Galloway, James B., Mahil, Satveer K., PsoProtect study group, [missing], Dermatology, APH - Methodology, AII - Inflammatory diseases, and APH - Quality of Care

Subjects
RL, education, Vaccination, R735, COVID-19, Dermatology, R1, Cross-Sectional Studies, RA0421, Medicine and Health Sciences, Humans, Psoriasis, Patient Reported Outcome Measures, Vaccination Hesitancy, RA, Pandemics
Abstract

Background COVID-19 vaccination is efficacious at protecting against severe COVID-19 outcomes in the general population. However, vaccine hesitancy (unwillingness for vaccination despite available vaccination services) threatens public health. Individuals taking immunosuppression for psoriasis have been prioritised for COVID-19 vaccination, however there is a paucity of information on vaccine hesitancy in this population, including contributing factors. While global healthcare has been severely disrupted in the pandemic, the impact on access to psoriasis care and whether this may negatively influence vaccine uptake, is underexplored.Objectives To explore organisational and individual factors associated with COVID-19 vaccine hesitancy in individuals with psoriasis.Methods Individuals with psoriasis, identified through global patient organisations and social media, completed a cross-sectional self-reported online survey. The primary outcome was COVID-19 vaccine hesitancy. Logistic regression was used to examine the association between predictor variables (organisational and individual factors) and outcome.Results Self-reported data from 802 individuals with psoriasis across 89 countries were available (65.6% female, median age 51 years [IQR 37-61], 43.7% taking systemic immunosuppression). Eight percent (n=63) reported vaccine hesitancy. Those reporting vaccine hesitancy were younger, more likely to be of non-white ethnicity, non-UK resident, have a lower BMI, not taking systemic immunosuppression and with shorter disease duration compared to those not reporting vaccine hesitancy. The commonest reasons for vaccine hesitancy were concerns regarding vaccine side-effects, that the vaccine is too new or that psoriasis may worsen post-vaccination. Forty percent (n=322) reported that their psoriasis care had been disrupted by the pandemic. These individuals were younger, of non-white ethnicity, with shorter duration and more severe psoriasis. Disruption to psoriasis care was associated with vaccine hesitancy (unadjusted OR 2.97 (95%CI 1.23-7.13), p=0.015), although not statistically significant in the adjusted model.Conclusion A minority of individuals with psoriasis from our study reported COVID-19 vaccine hesitancy. Similar to general population trends, vaccine hesitancy in our psoriasis sample is most common in younger age and ethnic minority groups. Our data highlight patient concerns regarding COVID-19 vaccination, which are important to address during patient-clinician interactions to help optimise vaccine uptake and mitigate risks from the ongoing pandemic in individuals with psoriasis.What’s already known about this topic?The COVID-19 vaccine is highly efficacious at protecting against severe COVID-19 outcomes in the general population. Vaccine hesitancy (unwillingness to receive vaccination despite available vaccination services) poses a major threat to global public health and is more common in women, younger age and ethnic minority groups in the general population.Individuals with psoriasis taking systemic immunosuppression were considered at high risk of severe COVID-19 outcomes and prioritised for vaccination, however there is a paucity of information on vaccine hesitancy in this group, including contributing factors.While global healthcare has been severely disrupted by the COVID-19 pandemic, access to psoriasis care and its potential impact on vaccine hesitancy is underexplored.What does this study add?A substantial proportion (40%) of individuals with psoriasis reported disrupted access to psoriasis care during the COVID-19 pandemic. Disrupted care was most commonly reported in younger age and ethnic minority groups.COVID-19 vaccine hesitancy was reported by a minority (8%) of individuals with psoriasis. Those reporting vaccine hesitancy were younger and more likely to be of non-white ethnicity, in keeping with trends in the general population.The commonest reasons for vaccine hesitancy were concerns regarding vaccine side effects, that the vaccine is too new or that psoriasis may worsen post-vaccination. These concerns are important to address during patient-clinician interactions to help mitigate risks from the ongoing pandemic in individuals with psoriasis.Competing Interest StatementNothing to disclose: Dr Bechman, Ms Cook, Dr Dand, Prof. Langan, Dr. Norton, Dr. Tsakok, Dr. Yiu, Dr De La Cruz, Dr. Contreras, Ms. Vesty, Ms. Vincent, Mr. Bola Coker, Ms. Meynell, Dr. Lambert, Prof. Brown, Prof. Naldi. Prof. Barker reports grants and personal fees from Abbvie, grants and personal fees from Novartis, grants and personal fees from Lilly, grants and personal fees from J&J, from null, during the conduct of the study. Prof. Griffiths reports grants and personal fees from AbbVie, grants from Amgen, grants from BMS, grants and personal fees from Janssen, grants from LEO, grants and personal fees from Novartis, grants from Pfizer, grants from Almirall, grants and personal fees from Lilly, grants and personal fees from UCB Pharma, outside the submitted work. Prof. Jullien reports personal fees and non-financial support from Abbvie, personal fees and non-financial support from Novartis, personal fees and non-financial support from Janssen-Cilag, personal fees and non-financial support from Lilly, personal fees and non-financial support from Leo-Pharma, personal fees and non-financial support from MEDAC, personal fees and non-financial support from Celgene, personal fees from Amgen, outside the submitted work. Dr. Capon reports consultancy fees from AnaptysBio, grants from Boheringer-Ingelheim, outside the submitted work. Prof. Bachelez reports personal fees from Abbvie, personal fees from Janssen, personal fees from LEO Pharma, personal fees from Novartis, personal fees from UCB, personal fees from Almirall, personal fees from Biocad, personal fees from Boehringer-Ingelheim, personal fees from Kyowa Kirin, personal fees from Pfizer, outside the submitted work. Prof. Gisondi reports personal fees from Abbvie, Amgen, Eli Lilly, Janssen, Novartis, Pierre Fabre, Sandoz, UCB, outside the submitted work. Dr. Galloway reports personal fees from Abbvie, personal fees from Sanofi, personal fees from Novartis, personal fees from Pfizer, grants from Eli Lilly, personal fees from Janssen, personal fees from UCB, outside the submitted work. Prof. Weinmann has presented talks for Abbvie, Abbott, Bayer, Chiesi, Boehringer Ingelheim, Roche and Merck. Dr. Mason reports personal fees from LEO Pharma and Novartis, outside the submitted work. Ms. Moorhead reports personal fees from Abbvie, personal fees from Celgene, personal fees from Janssen, personal fees from LEO Pharma, personal fees from Novartis, personal fees from UCB, outside the submitted work. Dr. Puig reports grants and personal fees from AbbVie, grants and personal fees from Almirall, grants and personal fees from Amgen, grants and personal fees from Boehringer Ingelheim, personal fees from Bristol Myers Squibb, personal fees from Fresenius-Kabi, grants and personal fees from Janssen, grants and personal fees from Lilly, personal fees from Mylan, grants and personal fees from Novartis, personal fees from Pfizer, personal fees from Sandoz, personal fees from Sanofi, personal fees from Samsung-Bioepis, grants and personal fees from UCB, outside the submitted work. Dr. Mahil reports departmental income from Abbvie, Almirall, Eli Lilly, Janssen-Cilag, Novartis, Sanofi, UCB, outside the submitted work. Dr. Di Meglio reports grants and personal fees from UCB, personal fees from Novartis, personal fees from Janssen, outside the submitted work. Prof. Warren reports grants and personal fees from Abbvie, grants and personal fees from Celgene, grants and personal fees from Eli Lilly, grants and personal fees from Novartis, personal fees from Sanofi, grants and personal fees from UCB|, grants and personal fees from Almirall, grants and personal fees from Amgen, grants and personal fees from Janssen, grants and personal fees from Leo, grants and personal fees from Pfizer, personal fees from Arena, personal fees from Avillion, personal fees from Bristol Myers Squibb, personal fees from Boehringer Ingelheim, outside the submitted work. Prof. Smith reports grants from Abbvie, Sanofi, Novartis, and Pfizer and through consortia with multiple academic partners (psort.org.uk, BIOMAP-IMI.eu), outside the submitted work. Dr. Torres reports grants and personal fees from AbbVie, Almirall, Amgen, Arena Pharmaceuticals, Biogen, Biocad, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, LEO Pharma, MSD, Novartis, Pfizer, Samsung-Bioepis, Sandoz, during the conduct of the study. Dr. Waweru is on the Board of the International Federation of Psoriasis Associations who have received grants from Abbvie, Almirall, Amgen, Bristol Meyers Squibb, Boehringer Ingelheim, Celgene, Janssen, Leo Pharma, Eli Lilly, Novartis, Sun Pharma, Pfizer, and UCB, outside the submitted work. Mr. Urmston reports grants from Almirall, grants from Abbvie, grants from Amgen, grants from Celgene, grants from Dermal Laboratories, grants from Eli Lilly, grants from Janssen, grants from LEO Pharma, grants from T and R Derma, grants from UCB, outside the submitted work. Ms. McAteer reports grants from Abbvie, grants from Almirall, grants from Amgen, grants from Celgene, grants from Dermal Laboratories, grants from Eli Lilly, grants from Janssen, grants from LEO Pharma, grants from UCB, grants from T and R Derma, outside the submitted work. Prof. Spuls has done consultancies in the past for Sanofi 111017 and AbbVie 041217 (unpaid), received a departmental independent research grant for TREAT NL registry LeoPharma December 2019; is involved in performing clinical trials with many pharmaceutical industries that manufacture drugs used for the treatment of diseases such as psoriasis and atopic dermatitis, for which financial compensation is paid to the department/hospital; and is chief investigator of the

Published
2022

13. Lack of Evidence for an Increased Risk of Severe COVID-19 in Psoriasis Patients on Biologics: A Cohort Study from Northeast Italy

Author

Piaserico, Stefano, Gisondi, Paolo, Cazzaniga, Simone, and Naldi, Luigi

Subjects
Adult, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Pneumonia, Viral, Dermatology, Cohort Studies, Betacoronavirus, Young Adult, Pharmacotherapy, Psoriasis, Internal medicine, medicine, Humans, Viral, Young adult, 610 Medicine & health, Aged, Biological Therapy, COVID-19, Coronavirus Infections, Female, Italy, Middle Aged, Pandemics, SARS-CoV-2, Tumor Necrosis Factor Inhibitors, Letter to the Editor, business.industry, Pneumonia, General Medicine, medicine.disease, Increased risk, business, Cohort study
Published
2020
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14. European consensus statement on phenotypes of pustular psoriasis

Author

Navarini, A. A., Burden, A. D., Capon, F., Mrowietz, U., Puig, L., Köks, S., Kingo, K., Smith, C., Barker, J. N., Bachelez, Hervé, Chiricozzi, Andrea, Costanzo, Antonio, Eyerich, Kilian, French, Lars E., Ghoreschi, Kamran, Gilliet, Michel, Girolomoni, Giampiero, Gniadecki, Robert, Griffiths, Christopher, Koh, Hong Yi, Lipsker, Dan, Naldi, Luigi, Prans, Ele, Prinz, Jörg, Reich, Kristian, Röcken, Martin, Skov, Lone, Sorin, George, Ståhle, Mona, Stingl, Georg, Van de Kerkhof, Peter, and Warren, Richard

Subjects
Adult, Male, 0301 basic medicine, medicine.medical_specialty, Consensus, Palmoplantar pustulosis, Dermatology, Systemic inflammation, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Psoriasis, medicine, Humans, Child, Prospective cohort study, business.industry, Acrodermatitis, medicine.disease, Pathophysiology, Europe, Clinical trial, Phenotype, 030104 developmental biology, Generalized pustular psoriasis, Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5], Female, medicine.symptom, Settore MED/35 - MALATTIE CUTANEE E VENEREE, business
Abstract

Item does not contain fulltext Pustular psoriasis (PP) is a group of inflammatory skin conditions characterized by infiltration of neutrophil granulocytes in the epidermis to such an extent that clinically visible sterile pustules develop. Because of clinical co-incidence, PP is currently grouped with psoriasis vulgaris (PV). However, PP and PV are phenotypically different, respond differently to treatments and seem to be distinct on the genetic level. In contrast to PV, the phenotypes of PP are not well defined. Descriptions of each form of PP are discordant among standard dermatology textbooks [Saurat Dermatologie 2016, Rook's Dermatology 2016, Fitzpatrick's 2012 and Braun-Falco 2012], encumbering the collection of phenotypically well-matched groups of patients as well as clinical trials. The European Rare and Severe Psoriasis Expert Network (ERASPEN) was founded to define consensus criteria for diagnosis, deeply phenotype large groups of PP patients, analyse the genetics and pathophysiology and prepare for prospective clinical trials. This work reviews historical aspects of these conditions, new genetic findings and presents our initial considerations on the phenotypes of PP and a consensus classification of clinical phenotypes that will be used as a baseline for further, prospective studies of PP. Generalized pustular psoriasis (GPP) is defined as primary, sterile, macroscopically visible pustules on non-acral skin (excluding cases where pustulation is restricted to psoriatic plaques). GPP can occur with or without systemic inflammation, with or without PV and can either be a relapsing (>1 episode) or persistent (>3 months) condition. Acrodermatitis continua of Hallopeau (ACH) is characterized by primary, persistent (>3 months), sterile, macroscopically visible pustules affecting the nail apparatus. Palmoplantar pustulosis (PPP) has primary, persistent (>3 months), sterile, macroscopically visible pustules on palms and/or soles and can occur with or without PV.

Published
2017

15. Chronic hand eczema: A prospective analysis of the Swiss CARPE registry focusing on factors associated with clinical and quality of life improvement

Author

Cazzaniga, Simone, Ballmer-Weber, Barbara K, Gräni, Nora, Spring, Philippe, Bircher, Andreas, Anliker, Mark, Sonntag, Anne-Katharina, Piletta, Pierre, Huber, Caroline, Diepgen, Thomas L, Apfelbacher, Christian, Naldi, Luigi, Borradori, Luca, Simon, Dagmar, University of Zurich, and Simon, Dagmar

Subjects
2708 Dermatology, 2723 Immunology and Allergy, 10177 Dermatology Clinic, Immunology and Allergy, 610 Medicine & health, Dermatology
Abstract

BACKGROUND Hand eczema (HE) is common and may follow a chronic disease course. So far, prospective studies investigating the risk factors for disease progression as a prerequisite for targeted prevention are scarce. OBJECTIVE To evaluate the overall association of HE-associated factors with clinical and quality of life (QoL) improvement during a follow-up of 2 years. METHODS Data of the prospective patient cohort (N = 199) followed by the Swiss chronic HE (CHE) registry on long-term patient management (CARPE-CH) were analysed by means of both classic regression and semantic map analyses. RESULTS Both severity of HE and QoL significantly improved over the period of 2 years (P

Published
2018

16. Emergency Consultations in Dermatology in a Secondary Referral Hospital in Southern Switzerland: A Prospective Cross-Sectional Analysis.

Author

Pelloni, Lorenzo, Cazzaniga, Simone, Naldi, Luigi, Borradori, Luca, and Mainetti, Carlo

Subjects
CROSS-sectional method, MELANOMA, ECZEMA, DEMOGRAPHIC characteristics, DERMATOLOGY, EMERGENCIES
Abstract

Background/aims: The spectrum of dermatological emergencies is broad. Only a few studies have assessed the profile of dermatological conditions resulting in an emergency visit in a referral hospital. We sought to assess the conditions prompting an urgent dermatological visit and to compare the diagnoses with those made during the regular scheduled encounters.Methods: We performed a cross-sectional study of all patients with a cutaneous problem attending our emergency consultation during a 7-month period. The study variables were gender, age, duration of symptoms, diagnosis, need for hospitalization and/or follow-up. We further evaluated patients attending scheduled visits to compare the demographic characteristics and diagnoses between the two groups.Results: Six hundred fifty-two consecutive patients with an urgent dermatological consultation were included. Three hundred sixty (55.2%) were women and 292 (44.8%) were men. Infectious diseases (32.8%) as well as various forms of eczema (24.8%) constituted the most frequent causes for an emergency visit. Approximately 40% of emergency visits took place more than 1 week after the development of the cutaneous manifestations. The most frequent disorders seen in the 1,738 control patients included benign melanocytic and nonmelanocytic tumors (27.2%) and malignant skin lesions (11.5%).Conclusions: Our study indicates that the dermatological diagnoses in the emergency visits significantly differ from those of the routinely scheduled appointments. In a significant portion of patients, the use of an emergency consultation was not justified. This study provides support to the idea that a specific training is required to manage dermatological emergencies and that efforts should be made to reduce unjustified emergency visit use. [ABSTRACT FROM AUTHOR]

Published
2019
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17. Treatment of Psoriasis

Author

Nast, Alexander, Spuls, Phyllis, Nijsten, Tamar, Williams, Hywel C., Bigby, Michael, Herxheimer, Andrew, Naldi, Luigi, Rzany, Berthold, Dellavalle, Robert P., Ran, Yuping, Furue, Masutaka, Amsterdam institute for Infection and Immunity, Amsterdam Public Health, and Dermatology

Subjects
medicine.medical_specialty, business.industry, medicine.disease, Dermatology, Infliximab, Acitretin, Psoriasis, Ustekinumab, Acropustulosis, medicine, Adalimumab, Generalized pustular psoriasis, business, Guttate psoriasis, medicine.drug
Abstract

The chapter talks about the treatment of psoriasis, which is associated with two relatively uncommon conditions that may cause long-lasting disability as a result of severe inflammation and pustulation affecting the hands and feet. The first is now more commonly referred to as palmoplantar pustulosis, but is still widely known as chronic palmoplantar pustular psoriasis. Acropustulosis (acrodermatitis continua of Hallopeau), on the other hand, may be associated with generalized pustular psoriasis. The chapter discusses the prevalence, etiology and prognosis of the psoriasis. It describes the topical treatment of chronic plaque-type psoriasis, and focuses on effectiveness of different types of phototherapies for chronic plaque-type psoriasis. Acitretin, methotrexate, cyclosporine, adalimumab, etanercept, ustekinumab and infliximab are used for systemic treatments for limited stable chronic plaque psoriasis. The chapter also describes effective treatments for guttate psoriasis and systemic treatments for acropustulosis.

Published
2014

18. 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

19. Comparing Cutaneous Research Funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with 2010 Global Burden of Disease Results.

Author

Karimkhani, Chante, Boyers, Lindsay N., Margolis, David J., Naghavi, Mohsen, Hay, Roderick J., Williams, Hywel C., Naldi, Luigi, Coffeng, Luc E., Weinstock, Martin A., Dunnick, Cory A., Pederson, Hannah, Vos, Theo, Murray, Christopher J. L., and Dellavalle, Robert P.

Subjects
SKIN cancer, DERMATOLOGY, SCIENCE & state, EPIDEMIOLOGY, ACNE
Abstract

Importance: Disease burden data helps guide research prioritization. Objective: To determine the extent to which grants issued by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) reflect disease burden, measured by disability-adjusted life years (DALYs) from Global Burden of Disease (GBD) 2010 project. Design: Two investigators independently assessed 15 skin conditions studied by GBD 2010 in the NIAMS database for grants issued in 2013. The 15 skin diseases were matched to their respective DALYs from GBD 2010. Setting: The United States NIAMS database and GBD 2010 skin condition disability data. Main Outcome(s) and Measure(s): Relationship of NIAMS grant database topic funding with percent total GBD 2010 DALY and DALY rank for 15 skin conditions. Results: During fiscal year 2013, 1,443 NIAMS grants were issued at a total value of $424 million. Of these grants, 17.7% covered skin topics. Of the total skin disease funding, 82% (91 grants) were categorized as “general cutaneous research.” Psoriasis, leprosy, and “other skin and subcutaneous diseases” (ie; immunobullous disorders, vitiligo, and hidradenitis suppurativa) were over-represented when funding was compared with disability. Conversely, cellulitis, decubitus ulcer, urticaria, acne vulgaris, viral skin diseases, fungal skin diseases, scabies, and melanoma were under-represented. Conditions for which disability and funding appeared well-matched were dermatitis, squamous and basal cell carcinoma, pruritus, bacterial skin diseases, and alopecia areata. Conclusions and Relevance: Degree of representation in NIAMS is partly correlated with DALY metrics. Grant funding was well-matched with disability metrics for five of the 15 studied skin diseases, while two skin diseases were over-represented and seven were under-represented. Global burden estimates provide increasingly transparent and important information for investigating and prioritizing national research funding allocations. [ABSTRACT FROM AUTHOR]

Published
2014
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20. The clinical spectrum of psoriasis

Author

Naldi, Luigi and Gambini, Daniele

Subjects
*SKIN diseases, *PSORIASIS, *DERMATOLOGY, *BEHCET'S disease
Abstract

Abstract: The clinical picture of psoriasis is not uniform. Being one of the most common chronic inflammatory skin disorders, psoriasis may present in many different forms and may include extracutaneous manifestations. Classifications have been proposed based on disease onset or the clinical course of psoriasis. Chronic plaque psoriasis occurs in a variety of clinical forms primarily distinguished by size, distribution, and dynamics of psoriatic plaques. In addition, psoriasis inversa, localized and generalized pustular forms, erythrodermic psoriasis, as well as a number of more uncommon forms have been recognized, a distinction on clinical grounds that is relevant for the overall prognosis and impact on the patients'' quality of life as well as for the choice of therapy. The broad and rather colorful clinical spectrum of psoriasis as well as implications for clinical practice will be comprehensively reviewed in this article. [Copyright &y& Elsevier]

Published
2007
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21. Number of Nevi at a Specific Anatomical Site and Its Relation to Cutaneous Malignant Melanoma.

Author

Randi, Giorgia, Naldi, Luigi, Gallus, Silvano, Di Landro, Anna, and La Vecchia, Carlo

Subjects
*MELANOMA, *DERMATOLOGY, *ANATOMY, *DERMATOLOGISTS, *FACE, *NECK
Abstract

The risk of cutaneous malignant melanoma (CMM) is strongly associated with total number of nevi. Scanty information is available on the association between CMM at a specific anatomical site and number of nevi at the same site. We analyzed data from a case–control study conducted in Italy between 1992 and 1994, on 542 cases of CMM and 538 hospital controls. Cases and controls were examined by trained dermatologists who counted the number of melanocytic nevi. We derived multivariate odds ratios (ORs) and 95% confidence intervals (95% CIs) of site-specific risk of CMM for high versus low number of nevi at the corresponding site. The ORs of CMM for the highest versus the lowest tertile of number of nevi at the corresponding site was 1.4 (95% CIs: 0.7–2.8) at face and neck, 2.3 (95% CIs: 1.1–4.9) at anterior trunk, 4.9 (95% CIs: 2.9–8.4) at posterior trunk, 2.9 (95% CIs: 1.2–6.6) at upper limbs and 5.0 (95% CIs: 2.9–8.5) at lower limbs. In a case–case analysis, comparing CMM cases at a specific site and CMM cases at all other sites, the only excess risk was found for the posterior trunk, the ORs being 2.1 (95% CIs: 1.2–3.6) for the highest versus the lowest tertile of number of nevi. Our data do not support the hypothesis of a specific effect of nevi at each single anatomical site.Journal of Investigative Dermatology (2006) 126, 2106–2110. doi:10.1038/sj.jid.5700334; published online 27 April 2006 [ABSTRACT FROM AUTHOR]

Published
2006
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22. Dermoscopic Features of Congenital Melanocytic Nevus and Becker Nevus in an Adult Male Population: An Analysis with a 10-Fold Magnification.

Author

Ingordo, Vito, Iannazzone, Silvia S., Cusano, Francesco, and Naldi, Luigi

Subjects
SKIN disease diagnosis, DERMATOLOGY, NEVUS, SKIN, SKIN diseases
Abstract

Background: Dermoscopic features of congenital melanocytic nevi (CMN) have been mostly assessed by high-resolution videodermoscopy. However, optical dermoscopy with the 10-fold magnification is largely available. In some instances, the differential diagnosis between large CMN and Becker nevus (BN) may be difficult. Objective: The aims of this work were: (1) to assess by dermoscopy with the 10-fold magnification the morphological features which have been previously suggested as useful for the identification of CMN in high-resolution videodermoscopy; (2) to search and point out the dermoscopic features of BN; (3) to explore dermoscopic differences between CMN and BN. Methods: The subjects were observed among about 23,000 consecutive young men assessed at the Draft Council’s Medical Unit of the Italian Navy in Taranto for compulsory recruitment and referred to the Department of Dermatology of the Italian Navy Hospital for dermatological examination. Lesions were examined by the same observer using a dermatoscope with a 10-fold magnification, and both the dermoscopic criteria stated by the international Consensus Net Meeting on Dermoscopy and dermoscopic features previously suggested as useful for the identification of CMN by videodermoscopy were recorded in a predisposed patient’s card. Results: There were 127 male subjects, median age 19 years, with 127 CMN, measuring ≥1.5 to ≤19.9 cm in 78% and ≥20 cm in 22% of cases, and 64 male subjects, median age 19 years, with 64 BN. In the sample of medium-sized and large CMN, dermoscopic features previously identified as characteristic of congenital lesions (i.e. target network, focal thickening of network lines, target globules, skin furrow hypopigmentation, focal hypopigmentation, hair follicles, perifollicular hypopigmentation, vessels and target vessels) were observed in sufficiently high rates. In the BN group, network, focal hypopigmentation, skin furrow hypopigmentation, hair follicles, perifollicular hypopigmentation and vessels were the main dermoscopic features. Focal thickening of network lines, globules, target globules, homogeneous diffuse pigmentation, hyperpigmented areas, blotches and target vessels were more frequently observed in CMN than in BN. Conclusions: (1) The same dermoscopic features observed in small and medium-sized CMN by videodermoscopy with high magnifications are also detectable in medium-sized and large CMN, employing the dermoscopy with the 10-fold magnification. (2) Network, focal, skin furrow and perifollicular hypopigmentation, hair follicles and vessels could be considered as peculiar dermoscopic features of BN. (3) Major differences in the frequency of dermoscopic characteristics were detected between CMN and BN, and dermoscopy seems to provide some diagnostic aid in differentiating CMN from BN in equivocal cases. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Published
2006
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24. The Cochrane Skin Group: Preparing, Maintaining, and Disseminating Systematic Reviews of Clinical Interventions in Dermatology.

Author

Williams, Hywel, Adetugbo, Kayode, Po, Alain Li Wan, Naldi, Luigi, Diepgen, Thomas, and Murrell, Dédée

Subjects
MEDICAL societies, DERMATOLOGY
Abstract

In 1979, Prof Archie Cochrane challenged the medical profession to produce a critical summary of randomized controlled clinical trials according to specialty, which should be updated periodically. The Cochrane Collaboration, an international voluntary group of reviewers and researchers from a range of professional backgrounds dedicated to producing systematic reviews, was established in 1992 in response to Cochrane's challenge. Systematic reviews produced by the Cochrane Collaboration start with individuals who formulate questions that are important to the care of patients. Every effort is then made to locate published and unpublished evidence to answer the question, and explicit criteria are used to select studies for inclusion in the review and to assess their quality. If appropriate, meta-analysis is used to combine results from several smaller studies to produce an overall result. Reviews are published in the Cochrane Library, an electronic publication (CD-ROM or diskette form), and the reviews are updated quarterly. In December 1997, a Cochrane Skin Group was registered with the Cochrane Collaboration to prepare, maintain, and disseminate reviews on the effects of health care for people with dermatological conditions. Currently, 25 titles and 9 review protocols have been registered with the Cochrane Skin Group, and the first set of dermatological reviews will be available before the end of 1999. The Cochrane Skin Group aims to become the best source of unbiased external evidence for summarizing the effects of dermatological care. [ABSTRACT FROM AUTHOR]

Published
1998
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25. Number of Nevi at a Specific Anatomical Site and Its Relation to Cutaneous Malignant Melanoma

Author

Randi, Giorgia, Naldi, Luigi, Gallus, Silvano, Landro, Anna Di, Vecchia, Carlo La, and on behalf of the Oncology Study Group of the Italian Group for Epidemiologic Research in Dermatology (GISED)

Subjects
Adult, Male, medicine.medical_specialty, Pathology, Skin Neoplasms, Dermatology, Biochemistry, Predictive Value of Tests, Risk Factors, Humans, Medicine, Nevus, Melanoma, Molecular Biology, Aged, business.industry, Case-control study, Absolute risk reduction, Cell Biology, Odds ratio, Middle Aged, medicine.disease, Trunk, Confidence interval, Case-Control Studies, Predictive value of tests, Multivariate Analysis, Female, business
Abstract

The risk of cutaneous malignant melanoma (CMM) is strongly associated with total number of nevi. Scanty information is available on the association between CMM at a specific anatomical site and number of nevi at the same site. We analyzed data from a case-control study conducted in Italy between 1992 and 1994, on 542 cases of CMM and 538 hospital controls. Cases and controls were examined by trained dermatologists who counted the number of melanocytic nevi. We derived multivariate odds ratios (ORs) and 95% confidence intervals (95% CIs) of site-specific risk of CMM for high versus low number of nevi at the corresponding site. The ORs of CMM for the highest versus the lowest tertile of number of nevi at the corresponding site was 1.4 (95% CIs: 0.7-2.8) at face and neck, 2.3 (95% CIs: 1.1-4.9) at anterior trunk, 4.9 (95% CIs: 2.9-8.4) at posterior trunk, 2.9 (95% CIs: 1.2-6.6) at upper limbs and 5.0 (95% CIs: 2.9-8.5) at lower limbs. In a case-case analysis, comparing CMM cases at a specific site and CMM cases at all other sites, the only excess risk was found for the posterior trunk, the ORs being 2.1 (95% CIs: 1.2-3.6) for the highest versus the lowest tertile of number of nevi. Our data do not support the hypothesis of a specific effect of nevi at each single anatomical site.

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26. Assessing the Impact of Psoriasis and the Relevance of Qualitative Research.

Author

Jobling, Ray and Naldi, Luigi

Subjects
*PSORIASIS, *SKIN diseases, *THERAPEUTICS, *QUALITY of life, *DERMATOLOGY
Abstract

Living with psoriasis is a lifetime experience. The lack of a cure combines with a peculiar public response of disinterest if not prejudice and stigmatization. Various factors account for changes in quality of life measures that seem independent from disease severity and effectiveness of treatment. Merging a qualitative and individual case analysis with assessment of quality of life would represent a direction for future studies.Journal of Investigative Dermatology (2006) 126, 1438–1440. doi:10.1038/sj.jid.5700223 [ABSTRACT FROM AUTHOR]

Published
2006
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27. Global mortality from conditions with skin manifestations.

Author

Boyers, Lindsay N., Karimkhani, Chante, Naghavi, Mohsen, Sherwood, David, Margolis, David J., Hay, Roderick J., Williams, Hywel C., Naldi, Luigi, Coffeng, Luc E., Weinstock, Martin A., Dunnick, Cory A., Pederson, Hannah, Vos, Theo, and Dellavalle, Robert P.

Abstract

Background Global Burden of Disease Study is a research database containing systematically compiled information from vital statistics and epidemiologic literature to inform research, public policy, and resource allocation. Objective We sought to compare mortality among conditions with skin manifestations in 50 developed and 137 developing countries from 1990 to 2010. Methods This was a cross-sectional study to calculate mean age-standardized mortality (per 100,000 persons) across countries for 10 disease categories with skin manifestations. We compared differences in mortality from these disorders by time period (year 1990 vs year 2010) and by developing versus developed country status. Results Melanoma death rates were 5.6 and 4.7 times greater in developed compared with developing countries in 1990 and 2010, respectively. Measles death rates in 1990 and 2010 were 345 and 197 times greater in developing countries, and corresponding syphilis death rates were 33 and 45 times greater. Limitations Inability to adjust for patient-, provider-, and geographic-level confounders may limit the accuracy and generalizability of these results. Conclusion The mortality burden from skin-related conditions differs between developing and developed countries, with the greatest differences observed for melanoma, measles, and syphilis. These results may help prioritize and optimize efforts to prevent and treat these disorders. [ABSTRACT FROM AUTHOR]

Published
2014
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28. Keratotic Skin Lesions and Other Risk Factors Are Associated with Skin Cancer in Organ-Transplant Recipients: A Case–Control Study in The Netherlands, United Kingdom, Germany, France, and Italy.

Author

Bouwes Bavinck, Jan N., Euvrard, Sylvie, Naldi, Luigi, Nindl, Ingo, Proby, Charlotte M., Neale, Rachel, Abeni, Damiano, Tessari, Gian P., Feltkamp, Mariet C. W., Claudy, Alain, Stockfleth, Eggert, and Harwood, Catherine A.

Subjects
*BASAL cell carcinoma, *SKIN cancer, *SKIN diseases, *BURNS & scalds, *SKIN injuries, *DERMATOLOGY
Abstract

This study examines the association of keratotic skin lesions with the development of skin cancer in 915 solid organ-transplant recipients in five European countries. In a hospital-based case–control study, cases with squamous- and basal-cell carcinoma were compared with controls without skin cancer. Questionnaires, scrutiny of medical charts, and skin examination were delivered according to a standardized protocol. Keratotic skin lesions and viral warts were counted on different body sites. Keratotic skin lesions were strongly associated with an increased risk of squamous-cell carcinoma, with adjusted odds ratios of 4.1 (2.4;7.0) and 12.1 (6.1;24) for 1–49 and 50 and more keratotic skin lesions compared with no lesions, respectively. Keratotic skin lesions were also associated with basal-cell carcinoma with adjusted odds ratios of 2.9 (1.7;4.9) and 4.0 (1.7;9.2) for 1–49 and 50 and more lesions, respectively. Lighter skin types and painful sunburns were also significantly associated with an increased risk of squamous- and basal-cell carcinoma. Keratotic skin lesions are strongly associated with skin cancer and are, thus, an important clinical criterion for identifying those organ-transplant recipients at an increased risk of skin cancers who should be offered more intensive skin surveillance.Journal of Investigative Dermatology (2007) 127, 1647–1656; doi:10.1038/sj.jid.5700776; published online 22 March 2007 [ABSTRACT FROM AUTHOR]

Published
2007
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29. Risk Factors for Histological Types and Anatomic Sites of Cutaneous Basal-Cell Carcinoma: An Italian Case–Control Study.

Author

Pelucchi, Claudio, Di Landro, Anna, Naldi, Luigi, and La Vecchia, Carlo

Subjects
*BASAL cell carcinoma, *SKIN diseases, *DERMATOLOGY, *CANCER, *ETIOLOGY of diseases
Abstract

Different clinico-pathologic subtypes and anatomic sites of basal-cell carcinoma (BCC) may display distinct characteristics and mechanisms of development. However, scanty information exists on potential differences in etiological factors for BCC according to histotype and anatomic location. Thus, we analyzed data from an Italian case–control study, including 528 subjects with newly diagnosed, histologically confirmed BCC and 512 controls admitted to the same hospitals with acute conditions. The multivariate odds ratio (OR) of nodular (OR=1.53) but not superficial (OR=0.71) BCC was increased for occupational exposure to sunlight. Considering the anatomic site of BCC, the corresponding values were 1.46 for head/neck and 0.74 for truncal location. Direct associations were observed with recreational sunlight exposure, eye color, red hair, and number and early age of severe sunburn episodes, along with some differences in risk between histotypes and anatomic sites. This study confirmed the role of (intermittent) sun exposure and phenotypic characteristics as risk factors for BCC, and suggested etiological differences between nodular and superficial histotypes and between head/neck and truncal locations.Journal of Investigative Dermatology (2007) 127, 935–944. doi:10.1038/sj.jid.5700598; published online 19 October 2006 [ABSTRACT FROM AUTHOR]

Published
2007
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30. Treat-to-Target Approach for the Management of Patients with Moderate-to-Severe Plaque Psoriasis: Consensus Recommendations

Author

Luca Stingeni, Andrea Chiricozzi, Piergiorgio Malagoli, Anna Campanati, Marina Venturini, Antonio Costanzo, Anna Balato, Paolo Gisondi, Clara De Simone, Giampiero Girolomoni, Maria Letizia Musumeci, Aurora Parodi, Franco Rongioletti, Angelo Cattaneo, Claudia Lasagni, Santo Raffaele Mercuri, Valentina Dini, Francesca Prignano, Federico Bardazzi, Concetta Potenza, Claudio Guarneri, Ada Lo Schiavo, Ketty Peris, A. M. Offidani, Manuela Papini, Paolo Dapavo, Francesco Loconsole, Maria Laura Flori, Francesco Cusano, Maria Concetta Fargnoli, Stefano Piaserico, Marco Galluzzo, Paolo Amerio, Piergiacomo Calzavara Pinton, Luca Bianchi, Marina Talamonti, Luigi Naldi, Rossana Tiberio, G. Malara, Gisondi, Paolo, Talamonti, Marina, Chiricozzi, Andrea, Piaserico, Stefano, Amerio, Paolo, Balato, Anna, Bardazzi, Federico, Calzavara Pinton, Piergiacomo, Campanati, Anna, Cattaneo, Angelo, Dapavo, Paolo, De Simone, Clara, Dini, Valentina, Fargnoli, Maria C, Flori, Maria L, Galluzzo, Marco, Guarneri, Claudio, Lasagni, Claudia, Loconsole, Francesco, Lo Schiavo, Ada, Malagoli, Piergiorgio, Malara, Giovanna, Mercuri, Santo R, Musumeci, Maria L, Naldi, Luigi, Papini, Manuela, Parodi, Aurora, Potenza, Concetta, Prignano, Francesca, Rongioletti, Franco, Stingeni, Luca, Tiberio, Rossana, Venturini, Marina, Bianchi, Luca, Costanzo, Antonio, Cusano, Francesco, Girolomoni, Giampiero, Offidani, Anna M, Peris, Ketty, Gisondi, P., Talamonti, M., Chiricozzi, A., Piaserico, S., Amerio, P., Balato, A., Bardazzi, F., Calzavara Pinton, P., Campanati, A., Cattaneo, A., Dapavo, P., De Simone, C., Dini, V., Fargnoli, M. C., Flori, M. L., Galluzzo, M., Guarneri, C., Lasagni, C., Loconsole, F., Lo Schiavo, A., Malagoli, P., Malara, G., Mercuri, S. R., Musumeci, M. L., Naldi, L., Papini, M., Parodi, A., Potenza, C., Prignano, F., Rongioletti, F., Stingeni, L., Tiberio, R., Venturini, M., Bianchi, L., Costanzo, A., Cusano, F., Girolomoni, G., Offidani, A. M., and Peris, K.

Subjects
Quality of life, Moderate to severe, medicine.medical_specialty, Consensus, Delphi method, Consensu, Dermatology, Plaque psoriasis, Systemic inflammation, Treat-to-target, 030207 dermatology & venereal diseases, 03 medical and health sciences, Settore MED/35, 0302 clinical medicine, Quality of life (healthcare), Psoriasis Area and Severity Index, Psoriasis, consensus, plaque psoriasis, quality of life, systemic inflammation, treatto-target, medicine, Intensive care medicine, Original Research, business.industry, Treat to target, Dermatology Life Quality Index, medicine.disease, Plaque psoriasi, 030220 oncology & carcinogenesis, Settore MED/35 - MALATTIE CUTANEE E VENEREE, business
Abstract

Introduction: Treat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project ‘Treat to Target Italia’ was launched by a scientific board (SB) of 10 psoriasis experts to generate expert consensus recommendations. Methods: On the basis of the published literature, their clinical experience, and the results of a survey among Italian dermatologists, the SB identified four relevant topics: (1) clinical remission; (2) quality of life; (3) abrogation of systemic inflammation; (4) safety. They drafted 20 statements addressing these four topics and submitted them to a panel of 28 dermatologists, in a Delphi process, to achieve consensus (greater than 80% agreement). Results: Consensus was reached on all statements. Treatment goals defining clinical remission should include a 90% improvement from baseline in the Psoriasis Area and Severity Index (PASI90 response) or an absolute PASI score of less than or equal to 3. Patient’s quality of life and satisfaction are important targets. If PASI targets are achieved, there should be no or very low impact of psoriasis on quality of life [Dermatology Life Quality Index (DLQI) score less than or equal to 3]. If PASI or DLQI goals are not achieved within 3–4months, treatment should be changed. Abrogation of systemic inflammation may be crucial for preventing or delaying inflammatory comorbidities. Safety is an equally important target as efficacy. Conclusion: These 20 consensus statements define the parameters of a treat-to-target strategy for psoriasis in Italy. It is hoped that use of these in the management of patients with psoriasis will improve treatment outcomes and patient health-related quality of life.

Published
2021

31. Cutaneous squamous cell carcinoma. Italian Guidelines by SIDeMaST adapted to and updating EADO/EDF/EORTC guidelines

Author

Piergiacomo Calzavara-Pinton, Maria Concetta Fargnoli, Alessandro Di Stefani, Giulio Gualdi, Iris Zalaudek, Luigi Naldi, Caterina Longo, Vincenzo Valentini, Ketty Peris, Giuseppe Argenziano, Pietro Sollena, Marzia Salgarello, Mauro Alaibac, Pasquale Frascione, Pietro Quaglino, Nicola Pimpinelli, Elvira Moscarella, Giovanni Pellacani, Peris, K, Alaibac, M, Argenziano, G, Di Stefani, A, Fargnoli, Mc, Frascione, P, Gualdi, G, Longo, C, Moscarella, E, Naldi, Laura, Pellacani, G, Pimpinelli, N, Quaglino, P, Salgarello, M, Sollena, P, Valentini, V, Zalaudek, I, Calzavara Pinton, Pg, Peris, Ketty, Alaibac, Mauro, Argenziano, Giuseppe, Di Stefani, Alessandro, Fargnoli, Maria C, Frascione, Pasquale, Gualdi, Giulio, Longo, Caterina, Moscarella, Elvira, Naldi, Luigi, Pellacani, Giovanni, Pimpinelli, Nicola, Quaglino, Pietro, Salgarello, Marzia, Sollena, Pietro, Valentini, Vincenzo, Zalaudek, Iri, and Calzavara Pinton, Pier G

Subjects
medicine.medical_specialty, Cutaneous squamous cell carcinoma, Skin Neoplasms, SQUAMOUS CEL, CARCINOMA, Disease treatment, Population, MEDLINE, Dermatology, Guidelines, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Diagnosis, medicine, Carcinoma, Humans, Significant risk, education, Squamous cell, Carcinoma, Squamous Cell, Italy, Neoplasm Staging, Quality of Life, education.field_of_study, business.industry, Incidence (epidemiology), medicine.disease, 030220 oncology & carcinogenesis, Skin cancer, business, 2708
Abstract

Based on recent progress in histologicaldiagnosis and prognostic stratification of cutaneous Squamous Cell Carcinoma (cSCC), the implications of therapeutic managementrequire new national guidelines.These guidelines outlineall aspects of cSCC management,from the clinical and histologicaldiagnosis of primary tumorto the systemic treatment of the advanced or metastatic disease. Mucosal type of SCC(e.g. located either in thegenital or in the labial area)and cSCC of the head andneckregion willnot be considered. These guidelines will help Italianhealthcare providers in managingcSCC patients based on current standards of treatment and according to evidence based medicine.The reported data and therapies should be assessedwith cautionsincethe results deriving fromfuture studies mightchange the conclusions or recommendations reported in this text. Furthermore, depending onindividual patientsor specificcircumstances,deviationfrom these guidelines may be necessary. Adherence toTheseguidelines will not constitutedefence in the attempt to avoidany liability arising from professional negligence, as well as anydeviation does not.

Published
2018

32. Adult female acne and associated risk factors: Results of a multicenter case-control study in Italy

Author

Di Landro A, Cazzaniga S, Cusano F, Bonci A, Carla C, Ml, Musumeci, Patrizi A, Bettoli V, Pezzarossa E, Caproni M, Anna Belloni Fortina, Campione E, Ingordo V, Naldi L, Group for Epidemiologic Research in Dermatology Acne Study Group, Di Landro, Anna, Cazzaniga, Simone, Cusano, Francesco, Bonci, Angela, Carla, Cardinali, Musumeci, Maria Letizia, Patrizi, Annalisa, Bettoli, Vincenzo, Pezzarossa, Enrico, Caproni, Marzia, Fortina, Anna Belloni, Campione, Elena, Ingordo, Vito, and Naldi, Luigi

Subjects
Adult, Hirsutism, medicine.medical_specialty, Pediatrics, Multivariate analysis, Adolescent, case-control study, Gravidity, Dermatology, 030207 dermatology & venereal diseases, 03 medical and health sciences, stress, 0302 clinical medicine, Recurrence, Acne Vulgaris, Vegetables, medicine, Humans, risk factors, 030212 general & internal medicine, Occupations, Family history, adult female acne, diet, family history, 610 Medicine & health, Prospective cohort study, hirsutism, Acne, Gynecology, Adult female, business.industry, Case-control study, Odds ratio, medicine.disease, Italy, Seafood, risk factor, Unemployment, Case-Control Studies, Fruit, Female, business, Stress, Psychological
Abstract

BACKGROUND: The reasons for the appearance of acne in adulthood are largely unknown. OBJECTIVE: We explored the role of personal and environmental factors in adult female acne. METHODS: We conducted a multicenter case-control study in the outpatient departments of 12 Italian cities. Cases (n = 248) were consecutive women ≥25 years of age with newly diagnosed acne of any grade. Controls (n = 270) were females diagnosed with conditions other than acne. RESULTS: In multivariate analysis, a history of acne in parents (odds ratio [OR] = 3.02) or siblings (OR = 2.40), history of acne during adolescence (OR = 5.44), having no previous pregnancies (OR = 1.71), having hirsutism (OR = 3.50), being an office worker versus being unemployed or being a housewife (OR = 2.24), and having a high level of reported psychological stress (OR = 2.95) were all associated with acne. A low weekly intake of fruits or vegetables (OR = 2.33) and low consumption of fresh fish (OR = 2.76) were also associated with acne. LIMITATIONS: We did not establish an onset date for acne. Some of our associations may reflect consequences of established acne. CONCLUSION: Lifestyle factors may play an important role for acne development in adulthood, but their role should be further assessed in prospective studies.

Published
2016

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