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1. Diagnosis and management of cutaneous and anogenital lichen sclerosus: Recommendations from the Italian Society of Dermatology (SIDemaSt)

Author

Papini, M, Russo, A, Simonetti, O, Borghi, A, Corazza, M, Piaserico, S, Feliciani, C, Calzavara-Pinton, P, Amendolagine, G, Arisi, M, Babino, G, Bardazzi, F, Belloni Fortina, A, Cac-Cavale, S, Campanati, A, Campione, E, Caposiena, C, Carugno, A, Coati, I, Cinotti, E, D'Antuono, A, Dattola, A, Dika, E, Fai, D, Fusano, M, Galluzzo, M, Ganzetti, G, Gisondi, P, Hansel, K, Lora, V, Maione, V, Mandel, V, Menni, S, Negosanti, M, Neri, I, Offidani, A, Parodi, A, Patrizi, A, Peserico, A, Rossi, M, Rivetti, N, Saccani, E, Stan, T, Stingeni, L, Talamonti, M, Vascellaro, A, Vezzoli, P, Virgili, A, Zanca, A, Papini M., Russo A., Simonetti O., Borghi A., Corazza M., Piaserico S., Feliciani C., Calzavara-Pinton P., Amendolagine G., Arisi M., Babino G., Bardazzi F., Belloni Fortina A., Cac-Cavale S., Campanati A., Campione E., Caposiena C. D., Carugno A., Coati I., Cinotti E., D'Antuono A., Dattola A., Dika E., Fai D., Fusano M., Galluzzo M., Ganzetti G., Gisondi P., Hansel K., Lora V., Maione V., Mandel V. D., Menni S., Negosanti M., Neri I., Offidani A., Parodi A., Patrizi A., Peserico A., Rossi M., Rivetti N., Saccani E., Stan T. R., Stingeni L., Talamonti M., Vascellaro A., Vezzoli P., Virgili A., Zanca A., Papini, M, Russo, A, Simonetti, O, Borghi, A, Corazza, M, Piaserico, S, Feliciani, C, Calzavara-Pinton, P, Amendolagine, G, Arisi, M, Babino, G, Bardazzi, F, Belloni Fortina, A, Cac-Cavale, S, Campanati, A, Campione, E, Caposiena, C, Carugno, A, Coati, I, Cinotti, E, D'Antuono, A, Dattola, A, Dika, E, Fai, D, Fusano, M, Galluzzo, M, Ganzetti, G, Gisondi, P, Hansel, K, Lora, V, Maione, V, Mandel, V, Menni, S, Negosanti, M, Neri, I, Offidani, A, Parodi, A, Patrizi, A, Peserico, A, Rossi, M, Rivetti, N, Saccani, E, Stan, T, Stingeni, L, Talamonti, M, Vascellaro, A, Vezzoli, P, Virgili, A, Zanca, A, Papini M., Russo A., Simonetti O., Borghi A., Corazza M., Piaserico S., Feliciani C., Calzavara-Pinton P., Amendolagine G., Arisi M., Babino G., Bardazzi F., Belloni Fortina A., Cac-Cavale S., Campanati A., Campione E., Caposiena C. D., Carugno A., Coati I., Cinotti E., D'Antuono A., Dattola A., Dika E., Fai D., Fusano M., Galluzzo M., Ganzetti G., Gisondi P., Hansel K., Lora V., Maione V., Mandel V. D., Menni S., Negosanti M., Neri I., Offidani A., Parodi A., Patrizi A., Peserico A., Rossi M., Rivetti N., Saccani E., Stan T. R., Stingeni L., Talamonti M., Vascellaro A., Vezzoli P., Virgili A., and Zanca A.

Abstract

Lichen sclerosus (LS) is a disabling chronic inflammatory disease of skin and genital mucous membrane causing itch, pain, dysuria and restriction of micturition, and significant sexual dysfunction and dyspareunia both in women and men. If left untreated, LS is associated with a high degree of sclerosis and scarring, as well as with an elevated risk of cancer in the genital area. Although a central role of autoimmunity is suggested, the pathogenesis of LS is still not clearly understood and the disease remains difficult to treat. The goals of treatment of LS are to alleviate symptoms and discomfort, prevent anatomical changes and prevent malignant transformation. this guideline has been developed by an Italian group of experts. It summarizes evidence-based and expert- based recommendations. The highest level of evidence favors the use of topical high potency corticosteroids; second- and third-line treatments include topical calcineurin inhibitors and topical retinoids, respectively. Surgical treatment has become the treatment of choice in male genital LS with persistent phimosis not responsive to medical treatment. The aim of this paper is to offer evidence-based and easily applicable recommendations for the management of lS.

Published
2021

2. Diagnosis and management of cutaneous and anogenital lichen sclerosus: Recommendations from the Italian Society of Dermatology (SIDemaSt)

Author

Papini, M., Russo, A., Simonetti, O., Borghi, A., Corazza, M., Piaserico, S., Feliciani, C., Calzavara-Pinton, P., Amendolagine, G., Arisi, M., Babino, G., Bardazzi, F., Belloni Fortina, A., Cac-Cavale, S., Campanati, A., Campione, E., Caposiena, C. D., Carugno, A., Coati, I., Cinotti, E., D'Antuono, A., Dattola, A., Dika, E., Fai, D., Fusano, M., Galluzzo, M., Ganzetti, G., Gisondi, P., Hansel, K., Lora, V., Maione, V., Mandel, V. D., Menni, S., Negosanti, M., Neri, I., Offidani, A., Parodi, A., Patrizi, A., Peserico, A., Rossi, M., Rivetti, N., Saccani, E., Stan, T. R., Stingeni, L., Talamonti, M., Vascellaro, A., Vezzoli, P., Virgili, A., Zanca, A., Papini, M., Russo, A., Simonetti, O., Borghi, A., Corazza, M., Piaserico, S., Feliciani, C., Calzavara-Pinton, P., Amendolagine, G., Arisi, M., Babino, G., Bardazzi, F., Belloni Fortina, A., Caccavale, S., Campanati, A., Campione, E., Caposiena, C. D., Carugno, A., Coati, I., Cinotti, E., D'Antuono, A., Dattola, A., Dika, E., Fai, D., Fusano, M., Galluzzo, M., Ganzetti, G., Gisondi, P., Hansel, K., Lora, V., Maione, V., Mandel, V. D., Menni, S., Negosanti, M., Neri, I., Offidani, A., Parodi, A., Patrizi, A., Peserico, A., Rossi, M., Rivetti, N., Saccani, E., Stan, T. R., Stingeni, L., Talamonti, M., Vascellaro, A., Vezzoli, P., Virgili, A., Zanca, A., Papini, M, Russo, A, Simonetti, O, Borghi, A, Corazza, M, Piaserico, S, Feliciani, C, Calzavara-Pinton, P, Amendolagine, G, Arisi, M, Babino, G, Bardazzi, F, Belloni Fortina, A, Cac-Cavale, S, Campanati, A, Campione, E, Caposiena, C, Carugno, A, Coati, I, Cinotti, E, D'Antuono, A, Dattola, A, Dika, E, Fai, D, Fusano, M, Galluzzo, M, Ganzetti, G, Gisondi, P, Hansel, K, Lora, V, Maione, V, Mandel, V, Menni, S, Negosanti, M, Neri, I, Offidani, A, Parodi, A, Patrizi, A, Peserico, A, Rossi, M, Rivetti, N, Saccani, E, Stan, T, Stingeni, L, Talamonti, M, Vascellaro, A, Vezzoli, P, Virgili, A, Zanca, A, Papini M., Russo A., Simonetti O., Borghi A., Corazza M., Piaserico S., Feliciani C., Calzavara-Pinton P., Amendolagine G., Arisi M., Babino G., Bardazzi F., Belloni Fortina A., Cac-Cavale S., Campanati A., Campione E., Caposiena C.D., Carugno A., Coati I., Cinotti E., D'Antuono A., Dattola A., Dika E., Fai D., Fusano M., Galluzzo M., Ganzetti G., Gisondi P., Hansel K., Lora V., Maione V., Mandel V.D., Menni S., Negosanti M., Neri I., Offidani A., Parodi A., Patrizi A., Peserico A., Rossi M., Rivetti N., Saccani E., Stan T.R., Stingeni L., Talamonti M., Vascellaro A., Vezzoli P., Virgili A., and Zanca A.

Subjects
Male, medicine.medical_specialty, Calcineurin Inhibitors, Socio-culturale, Disease, Dermatology, Lichen sclerosus, Guideline, Settore MED/35, Lichen sclerosus et atrophicu, medicine, Dysuria, Humans, Sex organ, Drug therapy, Lichen sclerosus et atrophicus, Operative surgical procedures, Rare diseases, Vulvar lichen sclerosus, Female, Italy, Mometasone Furoate, Lichen Sclerosus et Atrophicus, Calcineurin Inhibitor, business.industry, Mucous membrane, Evidence-based medicine, medicine.disease, Infectious Diseases, medicine.anatomical_structure, Sexual dysfunction, Operative surgical procedure, Vulvar lichen sclerosu, medicine.symptom, business, Rare disease, Human
Abstract

Lichen sclerosus (LS) is a disabling chronic inflammatory disease of skin and genital mucous membrane causing itch, pain, dysuria and restriction of micturition, and significant sexual dysfunction and dyspareunia both in women and men. If left untreated, LS is associated with a high degree of sclerosis and scarring, as well as with an elevated risk of cancer in the genital area. Although a central role of autoimmunity is suggested, the pathogenesis of LS is still not clearly understood and the disease remains difficult to treat. The goals of treatment of LS are to alleviate symptoms and discomfort, prevent anatomical changes and prevent malignant transformation. This guideline has been developed by an Italian group of experts. It summarizes evidence-based and expert- based recommendations. The highest level of evidence favors the use of topical high potency corticosteroids; second- and third-line treatments include topical calcineurin inhibitors and topical retinoids, respectively. Surgical treatment has become the treatment of choice in male genital LS with persistent phimosis not responsive to medical treatment. The aim of this paper is to offer evidence-based and easily applicable recommendations for the management of LS.

Published
2021

5. Italian guidelines in pemphigus - adapted from the European Dermatology Forum (EDF) and European Academy of Dermatology and Venerology (EADV)

Author

Feliciani C, Cozzani E, Marzano AV, Caproni M, Di Zenzo G, Calzavara-Pinton P, 'Cutaneous Immunology\\' group of SIDeMaST (Alaibac M, Antiga E, Arisi M, Assalve D, Atzori L, Babino G, Balato A, Balato N, Barbagallo T, Belloni Fortina A, Berardesca E, Berti E, Borghi A, Brazzelli V, Brumana MB, Brusati C, Caccavale S, Caldarola G, Campanati A, Caposiena Caro RD, Coati I, Conti A, Costanzo A, Dattola A, De Simone C, Di Cesare A, Di Lernia V, Di Zenzo GM, Fania L, Filosa G, Filotico R, Fusano M, Gerarda Galluccio A, Ganzetti G, Gisondi P, Guarneri F, Hansel K, Javor S, La Placa M, Liberati G, Lora V, Merlo G, Nasca MR, Nigro A, Noal C, Offidani A, Papini M, Parodi A, Patrizi A, Peserico A, Piaserico S, Prignano F, Quaglino P, Rossi M, Satta R, Schena D, Sena P, Simonetti O, Stan TR, Stingeni L, Talamonti M, Tavecchio S, Tognetti L, Vascellaro A, Vassallo C, Venturini M, Zampetti A, Zanca A)., Feliciani, Claudio, Cozzani, Emanuele, Marzano, Angelo V., Caproni, Marzia, Di Zenzo, Giovanni, Calzavara-Pinton, Piergiacomo, La placa M, Patrizi a, Feliciani, C, Cozzani, E, Marzano, Av, Caproni, M, Di Zenzo, G, Calzavara-Pinton, P, 'Cutaneous Immunology' group of SIDeMaST (Alaibac, M, Antiga, E, Arisi, M, Assalve, D, Atzori, L, Babino, G, Balato, A, Balato, N, Barbagallo, T, Belloni Fortina, A, Berardesca, E, Berti, E, Borghi, A, Brazzelli, V, Brumana, Mb, Brusati, C, Caccavale, S, Caldarola, G, Campanati, A, Caposiena Caro, Rd, Coati, I, Conti, A, Costanzo, A, Dattola, A, De Simone, C, Di Cesare, A, Di Lernia, V, Di Zenzo, Gm, Fania, L, Filosa, G, Filotico, R, Fusano, M, Gerarda Galluccio, A, Ganzetti, G, Gisondi, P, Guarneri, F, Hansel, K, Javor, S, La Placa, M, Liberati, G, Lora, V, Merlo, G, Nasca, Mr, Nigro, A, Noal, C, Offidani, A, Papini, M, Parodi, A, Patrizi, A, Peserico, A, Piaserico, S, Prignano, F, Quaglino, P, Rossi, M, Satta, R, Schena, D, Sena, P, Simonetti, O, Stan, Tr, Stingeni, L, Talamonti, M, Tavecchio, S, Tognetti, L, Vascellaro, A, Vassallo, C, Venturini, M, Zampetti, A, and Zanca, A).

Subjects
Male, medicine.medical_specialty, Venereology, Pemphigus - Guidelines - Skin diseases, Vesiculobullous, Autoantibodies, Evidence-Based Medicine, Female, Humans, Italy, Pemphigus, Skin, Socio-culturale, Dermatology, Desmoglein, Pemphigu, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Settore MED/35, Medicine, Skin pathology, skin and connective tissue diseases, Vesiculobullou, integumentary system, business.industry, Guideline, Evidence-based medicine, medicine.disease, Autoantibodie, 2708, 030220 oncology & carcinogenesis, Pemphigus - Guidelines - Skin disease, business, Blistering disease, Human
Abstract

Pemphigus is a life threatening autoimmune epidermal blistering disease involving skin and mucous membranes. Pemphigus usually affects middle age men and women involving oral mucosa first and then spreading on the skin. It is caused by the presence of autoantibodies (IgG and less frequently by IgA) directed against desmogleins, and/or other glycoproteins that plays a critical role in cell-cell attachment. Upon a predisposing genetic background, different agents have been shown to act as triggers for the pathogenesis of pemphigus. This guideline for the diagnosis and treatment of pemphigus has been developed by an Italian group of experts taking in account the Italian legislation and local pharmacological governance. Guidelines are adapted from the original article under the guidance of the European Dermatology Forum in collaboration with the European Academy of Dermatology and Venereology. It summarizes evidence-based and expert-based recommendations (S2 level).

Published
2018

6. HIDRAdisk: validation of an innovative visual tool to assess the burden of hidradenitis suppurativa

Author

Peris, Ketty, Lo Schiavo, A., Fabbrocini, G., Dini, Veronica, Patrizi, A., Fusano, M., Bianchi, L., Guanziroli, Eleonora, Guarneri, C., Parodi, A., Bertoldi, A., Musumeci, M. L., Offidani, A., Rongioletti, F., Pistone, G., Malara, G., Potenza, C., Casari, A., Franchi, C., Ardigo, M., Cusano, F., Stingeni, L., Amerio, P., Mancini, L. L., Prignano, F., Deboli, T., Gualberti, G., Saragaglia, V., Bettoli, V., Peris K. (ORCID:0000-0002-5237-0463), Dini V., Guanziroli E., Peris, Ketty, Lo Schiavo, A., Fabbrocini, G., Dini, Veronica, Patrizi, A., Fusano, M., Bianchi, L., Guanziroli, Eleonora, Guarneri, C., Parodi, A., Bertoldi, A., Musumeci, M. L., Offidani, A., Rongioletti, F., Pistone, G., Malara, G., Potenza, C., Casari, A., Franchi, C., Ardigo, M., Cusano, F., Stingeni, L., Amerio, P., Mancini, L. L., Prignano, F., Deboli, T., Gualberti, G., Saragaglia, V., Bettoli, V., Peris K. (ORCID:0000-0002-5237-0463), Dini V., and Guanziroli E.

Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disease characterized by painful inflamed nodules, recurrent abscesses and fistulas located in apocrine gland–bearing body sites. The negative impact of HS on patient's quality of life (QoL) has been reported to be greater than other dermatologic conditions as psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for HS and generic dermatologic questionnaires are used. Objective: The objective of this study was to demonstrate the validity, reliability and responsiveness of HIDRAdisk, a new innovative tool designed for rapid assessment of HS burden and, at the same time, an intuitive graphic visualization of the measurement outcome. Methods: A multicentre, longitudinal, observational study was conducted to validate the HIDRAdisk compared with other validated questionnaires [Skindex-16, Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment–General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of HS severity, as measured by Hurley stage and HS Physician Global Assessment (HS-PGA). Results: A total of 140 patients (59% women; mean age 34.9 ± 11.0 years) were enrolled in 27 dermatologic centres. HIDRAdisk showed a strong correlation with Skindex-16 and DLQI, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and HS-PGA. Very good internal consistency (Cronbach coefficient >0.80; intraclass correlation coefficient >0.6), with correlation between the 10 items, good test–retest reliability (Spearman correlation coefficient, 0.8331; P < 0.0001) and responsiveness to changes were demonstrated. Conclusion: Our study shows that HIDRAdisk, a short and innovativ

Published
2019

7. Bullous pemphigoid: Italian guidelines adapted from the EDF/EADV guidelines

Author

Cozzani, Emanuele, Marzano, Angelo V, Caproni, Marzia, Feliciani, Claudio, Calzavara-Pinton, Piergiacomo, Alaibac, M, Antiga, E, Arisi, M, Assalve, D, Atzori, L, Babino, G, Balato, A, Balato, N, Barbagallo, T, Belloni Fortina, A, Berardesca, E, Berti, E, Borghi, A, Brazzelli, V, Brumana, Mb, Brusati, C, Caccavale, S, Caldarola, G, Calzavara-Pinton, P, Campanati, A, Caposiena Caro RD, Caproni, M, Coati, I, Conti, A, Costanzo, A, Cozzani, E, Dattola, A, De Simone, C, Di Cesare, A, Di Lernia, V, Di Zenzo GM, Fania, L, Filosa, G, Filotico, R, Fusano, M, Gerarda Galluccio, A, Ganzetti, G, Gisondi, P, Guarneri, F, Hansel, K, Javor, S, La Placa, M, Liberati, G, Lora, V, Marzano, Av, Merlo, G, Nasca, Mr, Nigro, A, Noal, C, Offidani, A, Papini, M, Parodi, A, Patrizi, A, Peserico, A, Piaserico, S, Prignano, F, Quaglino, P, Rossi, M, Satta, R, Schena, D, Sena, P, Simonetti, O, Stan, Tr, Stingeni, L, Talamonti, M, Tavecchio, S, Tognetti, L, Vascellaro, A, Vassallo, C, Venturini, M, Zampetti, A, Zanca, A., Cozzani, Emanuele, Marzano, Angelo V., Caproni, Marzia, Feliciani, Claudio, Calzavara-Pinton, Piergiacomo, Alaibac, Mauro, Antiga, Emiliano, Arisi, Mariachiara, Assalve, Danilo, Atzori, Laura, Babino, Graziella, Balato, Anna, Balato, Nicola, Barbagallo, Tania, Fortina, Anna Belloni, Berardesca, Enzo, Berti, Emilio, Borghi, Alessandro, Brazzelli, Valeria, Brumana, Marta B., Brusati, Carlo, Caccavale, Stefano, Caldarola, Giacomo, Campanati, Anna, Caro, Raffaele D. Caposiena, Coati, Ilaria, Conti, Andrea, Costanzo, Antonio, Dattola, Annunziata, De Simone, Clara, Di Cesare, Antonella, Di Lernia, Vito, Di Zenzo, Giovanni M., Fania, Luca, Filosa, Giorgio, Filotico, Raffaele, Fusano, Marta, Galluccio, Antonia Gerarda, Ganzetti, Giulia, Gisondi, Paolo, Guarneri, Fabrizio, Hansel, Katharina, Javor, Sanja, Laplaca, Michelangelo, Liberati, Giulia, Lora, Viviana, Merlo, Giulia, Nasca, Maria R., Nigro, Anna, Noal, Cecilia, Offidani, Annamaria, Papini, Manuela, Parodi, Aurora, Patrizi, Annalisa, Peserico, Andrea, Piaserico, Stefano, Prignano, Francesca, Quaglino, Pietro, Rossi, Mariateresa, Satta, Rosanna, Schena, Donatella, Sena, Paolo, Simonetti, Oriana, Stan, Teodora R., Stingeni, Luca, Talamonti, Marina, Tavecchio, Simona, Tognetti, Linda, Vascellaro, Annalisa, Vassallo, Camilla, Venturini, Marina, Zampetti, Anna, Zanca, Arianna, and La placa, Michelangelo

Subjects
Pemphigoid, Disease, Guideline, 030207 dermatology & venereal diseases, Pruritu, 0302 clinical medicine, Quality of life, Pemphigoid, Bullous, skin and connective tissue diseases, Evidence-Based Medicine, integumentary system, Bullous, Rare diseases, Bullous lesions, Infectious Diseases, Italy, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Bullou, Bullous pemphigoid, Human, medicine.medical_specialty, Venereology, Consensus, Socio-culturale, Consensu, Dermatology, Aged, Humans, Pruritus, Quality of Life, 2708, 03 medical and health sciences, Pemphigoid, Bullou, Settore MED/35, medicine, business.industry, Evidence-based medicine, medicine.disease, eye diseases, business, Rare disease
Abstract

Bullous pemphigoid is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or generalized bullous lesions. In up to 20% of affected patients blister may be completely absent, and only excoriations, prurigo-like lesions, eczematous lesions, urticated lesions, and/or infiltrated plaques are observed. The disease is significantly associated with neurological disorders. The morbidity of bullous pemphigoid and its impact on the quality of life are significant. So far, a limited number of national treatment guidelines have been proposed, but no common European consensus has emerged. This guideline for the treatment of bullous pemphigoid has been developed by an Italian group of experts taking in account the Italian legislation and local pharmacological governance. Guidelines are adapted from the original article under the guidance of the European Dermatology Forum (EDF) in collaboration with the European Academy of Dermatology and Venereology (EADV). It summarizes evidence-based and expert-based recommendations (S2 level).

Published
2018

11. HIDRAdisk: validation of an innovative visual tool to assess the burden of hidradenitis suppurativa

Author

Peris, K., primary, Lo Schiavo, A., additional, Fabbrocini, G., additional, Dini, V., additional, Patrizi, A., additional, Fusano, M., additional, Bianchi, L., additional, Guanziroli, E., additional, Guarneri, C., additional, Parodi, A., additional, Bertoldi, A., additional, Musumeci, M.L., additional, Offidani, A., additional, Rongioletti, F., additional, Pistone, G., additional, Malara, G., additional, Potenza, C., additional, Casari, A., additional, Franchi, C., additional, Ardigò, M., additional, Cusano, F., additional, Stingeni, L., additional, Amerio, P., additional, Mancini, L.L., additional, Prignano, F., additional, Deboli, T., additional, Gualberti, G., additional, Saragaglia, V., additional, and Bettoli, V., additional

Published
2019
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16. Clinical, histological and high‐frequency ultrasonographic evaluation (50 MHz) of morphoea treated with ultraviolet A1 phototherapy.

Author

Arisi, M., Lorenzi, L., Incardona, P., Fusano, M., Zanca, A., Rossi, M. T., Tomasi, C., Calzavara‐Pinton, P. G., and Venturini, M.

Abstract

Summary: Background: There are few studies in the literature correlating the ultrasonographic findings, clinical scoring systems or histological findings in morphoea after ultraviolet (UV)A1 phototherapy. Aims: To evaluate the quantitative and morphological aspects of high‐frequency ultrasonography in the treatment of plaque morphoea in response to UVA1 phototherapy, and to correlate these with clinical and histological scores. Methods: In total, 17 patients with morphoea were studied. Initially and at study end, high‐frequency ultrasonography (50 MHz) was performed on the edge of a morphoea lesion treated with UVA1 phototherapy. A quantitative and qualitative analysis of dermal features was performed and compared with the features of healthy skin. Skin biopsy specimens were obtained from lesions analysed at the beginning and end of the study, assessing dermal sclerosis and dermal inflammatory infiltrate and their distribution. Results: All affected skin showed a statistically significant increase in dermal thickness and hypoechogenicity, corresponding to a reduction in dermal density by ultrasonography compared with healthy skin. Morphological evaluation identified undulations of the dermis in 11 of 17 lesions (64.7%) and in 5 healthy skin areas (29.4%) (P = 0.08), while 'yoyo' figures were identified in 8 lesions (47%) but only 1 healthy skin area (5.9%) (P = 0.02). Ultrasonographic morphological analysis highlighted an improvement in dermal hyperechogenic bands and disappearance of yoyo figures after UVA1 treatment. Histology revealed a reduction in dermal sclerosis and inflammation, although this was not statistically significant. Conclusions: Ultrasonographic pattern analysis of morphoea is a suitable technique for monitoring UVA1 phototherapy response. [ABSTRACT FROM AUTHOR]

Published
2019
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20. HIDRAdisk: validation of an innovative visual tool to assess the burden of hidradenitis suppurativa

Author

Elena Guanziroli, Vincenzo Bettoli, Maria Letizia Musumeci, Francesco Cusano, A. Bertoldi, Annalisa Patrizi, Francesca Prignano, Claudio Guarneri, Alice Casari, V. Saragaglia, T. Deboli, Concetta Potenza, L.L. Mancini, A. Lo Schiavo, Paolo Amerio, Luca Bianchi, Marco Ardigò, Franco Rongioletti, Gabriella Fabbrocini, Chiara Franchi, Ketty Peris, Andrea Parodi, Luca Stingeni, Valentina Dini, Giuseppe Pistone, A. M. Offidani, G. Malara, Marta Fusano, Giuliana Gualberti, Peris K, Lo Schiavo A, Fabbrocini G, Dini V, Patrizi A, Fusano M, Bianchi L, Guanziroli E, Guarneri C, Parodi A, Bertoldi A, Musumeci ML, Offidani A, Rongioletti F, Pistone G, Malara G, Potenza C, Casari A, Franchi C, Ardigò M, Cusano F, Stingeni L, Amerio P, Mancini LL, Prignano F, Deboli T, Gualberti G, Saragaglia V, Bettoli V., Peris, K, Lo Schiavo, A, Fabbrocini, G, Dini, V, Patrizi, A, Fusano, M, Bianchi, L, Guanziroli, E, Guarneri, C, Parodi, A, Bertoldi, A, Musumeci, M L, Offidani, A, Rongioletti, F, Pistone, G, Malara, G, Potenza, C, Casari, A, Franchi, C, Ardigò, M, Cusano, F, Stingeni, L, Amerio, P, Mancini, L L, Prignano, F, Deboli, T, Gualberti, G, Saragaglia, V, Bettoli, V, Peris, K., Lo Schiavo, A., Fabbrocini, G., Dini, V., Patrizi, A., Fusano, M., Bianchi, L., Guanziroli, E., Guarneri, C., Parodi, A., Bertoldi, A., Musumeci, M. L., Offidani, A., Rongioletti, F., Pistone, G., Malara, G., Potenza, C., Casari, A., Franchi, C., Ardigo, M., Cusano, F., Stingeni, L., Amerio, P., Mancini, L. L., Prignano, F., Deboli, T., Gualberti, G., Saragaglia, V., and Bettoli, V.

Subjects
Male, Psychometrics, Visual Analog Scale, Intraclass correlation, Acne ‐ Rosacea, HIDRAdisk, Longitudinal Studie, Severity of Illness Index, 030207 dermatology & venereal diseases, 0302 clinical medicine, Quality of life, Surveys and Questionnaires, Hidradenitis suppurativa, 030212 general & internal medicine, Longitudinal Studies, IMPACT IMPAIRMENT VALIDITY DISEASE, HIDRAdisk, Hidradenitis Suppurativa, Quality of Life, Validation study, Visual tool, Validation study, Dermatology Life Quality Index, Middle Aged, humanities, Infectious Diseases, Hidradenitis Suppurativa, Quality of Life, Visual tool, Italy, hidradenitis suppurativa, visual analog scale, quality of Life, Female, Original Article, Settore MED/35 - MALATTIE CUTANEE E VENEREE, Psychometric, Human, Adult, medicine.medical_specialty, Visual analogue scale, Reproducibility of Result, Dermatology, 03 medical and health sciences, Young Adult, Cronbach's alpha, Internal medicine, Severity of illness, medicine, Humans, business.industry, Reproducibility of Results, medicine.disease, business
Abstract

Background: Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disease characterized by painful inflamed nodules, recurrent abscesses and fistulas located in apocrine gland–bearing body sites. The negative impact of HS on patient's quality of life (QoL) has been reported to be greater than other dermatologic conditions as psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for HS and generic dermatologic questionnaires are used. Objective: The objective of this study was to demonstrate the validity, reliability and responsiveness of HIDRAdisk, a new innovative tool designed for rapid assessment of HS burden and, at the same time, an intuitive graphic visualization of the measurement outcome. Methods: A multicentre, longitudinal, observational study was conducted to validate the HIDRAdisk compared with other validated questionnaires [Skindex-16, Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment–General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of HS severity, as measured by Hurley stage and HS Physician Global Assessment (HS-PGA). Results: A total of 140 patients (59% women; mean age 34.9±11.0years) were enrolled in 27 dermatologic centres. HIDRAdisk showed a strong correlation with Skindex-16 and DLQI, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and HS-PGA. Very good internal consistency (Cronbach coefficient >0.80; intraclass correlation coefficient >0.6), with correlation between the 10 items, good test–retest reliability (Spearman correlation coefficient, 0.8331; P&nbsp

Published
2019

21. Correlation between chronic skin ulcers dimension and burden of suffering evaluated with PRISM test

Author

Giulio Gualdi, Mario Puviani, Stefano Caccavale, Ruggero Moro, Marta Fusano, Paola Monari, Carlotta Baraldi, Cosimo Misciali, Daniela Olezzi, Alberico Motolese, Caravello Simone, Monari, P., Fusano, M., Moro, R., Simone, C., Misciali, C., Baraldi, C., Puviani, M., Olezzi, D., Caccavale, S., Motolese, A., and Gualdi, G.

Subjects
medicine.medical_specialty, Disease, Dermatology, Correlation, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Internal medicine, Surveys and Questionnaires, Skin Ulcer, Medicine, Surveys and Questionnaire, Humans, Prospective Studies, Prospective cohort study, business.industry, Size reduction, Significant difference, Test (assessment), Chronic skin ulcers, Prospective Studie, Infectious Diseases, Chronic Disease, Quality of Life, business, Wounds and injurie, Human
Abstract

Background In the practice of dermatology, many tools are available to help the physician measure the patient's quality of life. "Pictorial Representation of Illness and Self Measure" (PRISM) is a novel and simple method to measure personal suffering. Methods The aim of our study is to evaluate, through the use of PRISM, whether the reduction of the ulcers' size positively correlates with an improvement of the patients' suffering. This is a multicenter national prospective study. 143 patients from five dermatological centers were enrolled in the study. At times T0 and T1 (after 1 month), the size of the ulcers was collected for each patient. At the same time, the PRISM test was also administered, in order to calculate the Self-Illness-Separation (SIS). Results First, a substantial decrement of the size of the ulcer seems to correlate with a significant difference between the SIS score obtained at T0 and T1. On the contrary, the duration of the wound doesn't seem to influence the SIS value. No relationship between the age of the patient and the SIS value was found either. Conclusions Our study shows that the decrease in the wound dimension positively affects the patient's suffering. In fact, ulcer's size reduction is correlated with an improvement in the patient's disease perception.

Published
2019

22. Evaluation of the incidence of melanoma and non-melanoma skin cancer in patients with systemic lupus erythematosus and systemic sclerosis.

Author

Fusano M, Soglia S, Franceschini F, Cavazzana I, Fredi M, Tomasi C, Calzavara-Pinton I, Arisi M, Licata G, Mezzana S, Rossi M, Venturini M, and Calzavara-Pinton P

Subjects
Humans, Female, Male, Middle Aged, Incidence, Adult, Carcinoma, Basal Cell epidemiology, Carcinoma, Basal Cell etiology, Risk Factors, Aged, Surveys and Questionnaires, Scleroderma, Systemic epidemiology, Scleroderma, Systemic complications, Skin Neoplasms epidemiology, Lupus Erythematosus, Systemic complications, Lupus Erythematosus, Systemic epidemiology, Melanoma epidemiology
Abstract

Background: The incidence of skin cancer in patients with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) has only been investigated with retrospective studies enrolling a low number of patients. The aims of our study were to assess the incidence of skin cancer in two large cohorts of patients, one with SLE and the other with SSc and investigating possible risk factors., Methods: Ninety SLE, 53 SSc patients and 392 control subjects were enrolled. A questionnaire including personal and medical details was fulfilled. The severity of photoaging, photosensitivity and sun exposure habits was assessed. Skin lesions were evaluated using a video-dermatoscope. Suspicious lesions were surgically removed., Results: The incidence of skin cancer was not different to those of controls. However, a decrease in the incidence of basal cell carcinoma was found in patients with SLE. This finding associated negatively with photosensitivity. SSc patients with skin malignancies did not report photosensitivity and did not adopt a careful photoprotection. A positive association was found between skin cancer and diffuse cutaneous sclerosis, pitting scars, severe photoaging and treatment with Iloprost., Conclusions: Regular avoidance of sun exposure and photoprotection are effective in reducing the development of skin cancer in patients with autoimmune diseases.

Published
2024
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23. Time interval between pulse dye laser treatments of port-wine stains: 30 years of experience.

Author

Fusano M, Bencini PL, Toffanetti JN, and Galimberti MG

Subjects
Humans, Treatment Outcome, Lasers, Dye therapeutic use, Port-Wine Stain radiotherapy, Port-Wine Stain surgery, Laser Therapy methods
Abstract

Port-wine stains (PWS) are frequently refractory to laser treatments. The aim of this study is to evaluate the role of treatment interval time. From 1990, 216 patients underwent Pulsed Dye Laser sessions. The laser sessions were scheduled at a minimum interval of 4 weeks to a maximum of 48 weeks. Clinical outcomes were assessed 8 weeks after the last laser session. Better results were obtained with 8 weeks interval time between therapy session, and high efficacies were also found for intervals of 4, 6 and 10 weeks. For greater interval instead, the effectiveness is significantly lower.

Published
2023
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24. Veganism in acne, atopic dermatitis, and psoriasis: Benefits of a plant-based diet.

Author

Fusano M

Subjects
Humans, Diet, Vegan, Diet, Dermatitis, Atopic prevention & control, Psoriasis, Skin Diseases, Acne Vulgaris
Abstract

Plant-based diets and veganism are receiving increased attention for many reasons. Leading international nutrition organizations have determined that a well-planned and balanced plant-based diet is protective against such chronic diseases as obesity, diabetes, and cardiovascular diseases. Many physicians may be unaware of its potential advantages, especially in the field of dermatology, and for this reason the vegan diet is often discouraged. Although the literature about diet in dermatology is limited, the introduction of foods of plant origin, vitamin B12 supplements, and elimination of animal products may have a protective role in skin diseases. There may be many benefits of a vegan diet for patients with acne, psoriasis, and atopic dermatitis., Competing Interests: Conflict of interest The author declares no conflict of interest., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2023
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25. Alopecia areata after COVID- 19 vaccination: Two cases and review of the literature.

Author

Fusano M, Zerbinati N, and Bencini PL

Abstract

Alopecia Areata (AA) is an autoimmune disorder characterized by hair loss, due to a T-lymphocyte-mediated inflammatory response targeting anagen-phase hair follicles. Former studies have suggested that vaccination and viral infections may play a role in the onset of AA through a variety of different mechanisms. We report here two cases of AA following COVID-19 vaccination., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest., (©Copyright: the Author(s).)

Published
2022
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26. The influence of social media on patients' perception of aesthetic treatment outcome. Satisfaction with tattoo removal: A model.

Author

Fusano M, Bencini PL, Zerbinati N, Zerbinati U, and Galimberti MG

Abstract

The level of patient satisfaction following tattoo removal often varies and frequently diverge from clinical objectivity. This study assesses how much social media can influence patient satisfaction after picosecond laser (PSL) tattoo removal, in light of the growing influence they have on consumers. Twenty-seven patients were treated with PSL for removal of professional black tattoo. Two groups of patients were identified: those who were already being treated at our institute or had been referred by other physicians (group 1) and those who found us through social media (group 2). Clinical improvement was evaluated 8 weeks after the final laser session and patients' satisfaction was assessed. In both groups, clinical results were homogeneous; however, Group 2 patients' subjective Global Aesthetic Improvement Scale scores were lower than those reported by clinicians (p=0.035), while Group 1 was globally more satisfied (p<0.001). We can affirm that the influence of social media on the perceptions and expectations of patients can affect their level of satisfaction. Particularly for people who are influenced by social media, it is essential to provide explanations prior to laser treatments, in order to clarify what may actually be expected from laser sources., Competing Interests: Conflict of interest: The authors declare no potential conflict of interest., (©Copyright: the Author(s).)

Published
2022
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27. Hybrid fractional laser treatment for photodamaged facial skin rejuvenation 6 years following fractional CO 2 : Comparison of clinical outcome and patients' satisfaction.

Author

Fusano M, Bencini PL, and Galimberti MG

Subjects
Carbon Dioxide, Female, Humans, Patient Satisfaction, Rejuvenation, Treatment Outcome, Laser Therapy methods, Lasers, Solid-State therapeutic use, Skin Aging
Abstract

Objectives: Fractional carbon dioxide (CO 2 ) laser resurfacing is considered an effective treatment for skin rejuvenation. The request for clinical effectiveness with shorter downtime has led to the development of new hybrid technologies, including a traditional Er:YAG (erbium-doped yttrium aluminium garnet) fractional laser 2940 nm combined with a simultaneous nonablative 1470 nm wavelength. The aim of this study is to compare clinical outcomes and patients' satisfaction with face resurfacing performed with both the CO 2  laser and the hybrid laser., Methods: Nineteen women underwent ultrapulsed CO 2 fractional resurfacing for photodamaged facial skin; the same patients underwent the hybrid laser after almost 6 years. Clinical outcomes and patients' satisfaction were evaluated 6 months after the treatment and compared between the two technologies., Results: After both CO 2 and hybrid treatment a significant improvement was found in terms of fine lines (p < 0.001 and p = 0.004, respectively), tactile roughness (p < 0.001 and p = 0.002, respectively), and mottled pigmentation (both p < 0.001). Healing times and complications were greater with the CO 2 laser. Comparing the two technologies, patients showed better results with the CO 2 laser for each score's item, but greater satisfaction with the hybrid laser (p = 0.012)., Conclusions: The present study confirms CO 2 laser as the most effective treatment; however, the new hybrid technology revealed good results associated with faster healing and less discomfort., (© 2022 Wiley Periodicals LLC.)

Published
2022
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28. Microneedle fractional radiofrequency for atrophic acne scars: In vivo evaluation of results by 3D analysis and reflectance confocal microscopy.

Author

Fusano M and Bencini PL

Subjects
Atrophy, Cicatrix diagnosis, Cicatrix etiology, Cicatrix radiotherapy, Humans, Microscopy, Confocal, Needles, Treatment Outcome, Acne Vulgaris complications, Acne Vulgaris therapy, Connective Tissue Diseases
Abstract

The efficacy of microneedle fractional radiofrequency (MFR) for the treatment of atrophic acne scars has been recently described, but accurate in vivo microscopic documentation of the processes occurring has never been reported. The aim of this study is to describe in vivo morphological atrophic acne scars' variations after treatment with MFR by means reflectance confocal microscopy (RCM) and three-dimensional (3D) imaging. A total of 11 patients requiring treatment for atrophic facial acne scars were treated with four monthly sessions of MFR. 3D imaging and RCM were assessed at baseline and 1 month after last session. Clinical improvement, according to Global Assessment Improvement Scale, and patients' satisfaction were evaluated. Clinical improvement was observed in all the treated patients, although better results were obtained for boxcar scars (p = 0.043). 3D imaging revealed a significant improvement in terms of mean scars' depth (p < 0.001). Otherwise, RCM highlighted collagen remodeling with restoration of a reticular structure. Our study confirms the efficacy and safety of MFR in acne scars' treatment and provides the microscopic description of the results using RCM., (© 2022 Wiley Periodicals LLC.)

Published
2022
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29. Laser removal of tattoos in vegan and omnivore patients.

Author

Fusano M, Galimberti MG, and Bencini PL

Subjects
Diet, Vegan, Humans, Lasers, Vegans, Laser Therapy, Tattooing
Abstract

Background: Clinical outcomes of tattoo removal vary widely among different patients; it is known that tattoo-related features (such as pigments' type or quality, the use of multicolored inks, tattoo location size, location, layering, and duration) and personal habits (as smoking or skin phototype) could influence the clinical response to treatment, the possible role of nutrition in affecting the laser treatment of tattoos has never been investigated., Aims: This study aims to compare the clinical response of tattoos removal between omnivore and vegan patients treated with Q-switched laser (QSL)., Patients/methods: Twenty omnivore and twenty vegan patients treated for professional black tattoo removal with Nd:YAG QSL were enrolled in this study. The number of laser sessions and the median days required for complete healing were recorded; clinical improvement was evaluated 4 weeks after the last laser session., Results: The two groups were not different at the baseline in terms of sex, age, skin phototype, tattoos' age, location, and density. Vegans needed more laser sessions (p < 0.001) to achieve the best outcome, showed worst clinical responses (p = 0.001) and needed more days for complete healing (p = 0.006) compared to omnivores., Conclusion: The results of this study point out the influence of vegan diet on QLS removal of tattoos., (© 2021 Wiley Periodicals LLC.)

Published
2022
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30. Ultrapulsed CO 2 Resurfacing of Photodamaged Facial Skin in Vegan and Omnivore Patients: A Multicentric Study.

Author

Fusano M, Bencini PL, Fusano I, Bencini M, Zane C, Zerbinati N, and Galimberti MG

Subjects
Carbon Dioxide, Female, Humans, Prospective Studies, Treatment Outcome, Ultraviolet Rays, Vegans, Laser Therapy, Skin Aging
Abstract

Background and Objectives: Skin photoaging is related to extrinsic environmental exposures, mainly represented by ultraviolet radiation. One of the treatment options is laser resurfacing. As nutritional status is involved in cutaneous photodamage, we evaluated whether dietary patterns can also influence the response to facial resurfacing. Our prospective multicentric study involves three dermatologic centers specialized in laser therapy in northern Italy. The study aims to compare the outcome of a CO 2 ablative laser therapy between omnivore and vegan patients., Study Design/materials and Methods: Fifty-three omnivore and fifty-three vegan women undergoing ultrapulsed CO 2 resurfacing for photodamaged facial skin were enrolled in this study. Clinical improvement was evaluated 3 and 6 months after the treatment using the modified Dover score., Results: After laser treatment, vegans showed slower complete re-epithelialization (P < 0.001*) and disappearance of the erythema (P < 0.001*). After 3 and 6 months, vegans showed worse outcomes in terms of fine lines (P < 0.001* and P < 0.001*, respectively) and tactile roughness (P = 0.003* and ​​​​P = 0.002*, respectively) compared with omnivores, while they did not differ in mottled pigmentation., Conclusions: The present study suggests that diet influences the clinical outcome of fractioned CO 2 laser treatment. Lasers Surg. Med. © 2021 Wiley Periodicals LLC., (© 2021 Wiley Periodicals LLC.)

Published
2021
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31. Picosecond Laser treatment of Striae Distensae: In vivo Evaluation of Results by 3D Analysis, Reflectance Confocal Microscopy, and Patient's Satisfaction.

Author

Fusano M, Galimberti MG, Bencini M, Guida S, and Bencini PL

Subjects
Humans, Lasers, Microscopy, Confocal, Personal Satisfaction, Treatment Outcome, Patient Satisfaction, Striae Distensae diagnostic imaging
Abstract

Background and Objectives: The efficacy of picosecond laser (PSL) in the treatment of striae distensae (SD) has been recently reported; otherwise, the base for this improvement has not been clarified yet. The aim of this study is to treat long-lasting SD with PLS and to describe their in vivo morphological variations after treatment using three-dimensional (3D) imaging and reflectance confocal microscopy (RCM)., Study Design/materials and Methods: A total of 27 patients asking for treatment for SD were treated with four monthly sessions of PLS. Clinical improvement was estimated through a blinded evaluation performed by two independent dermatologists, Global Assessment Improvement Scale (GAIS), patients' satisfaction, 3D imaging, and RCM assessments at baseline and 6 months after the last laser session., Results: Although a clinical improvement of SD was observed in 81.4% of patients according to physicians' GAIS, only 66.6% of patients reported subjective improvement and satisfaction after treatment (P = 0.04). 3D imaging revealed a significant improvement in terms of skin texture (P < 0.001) and mean SD depth (P < 0.001). Otherwise, RCM highlighted collagen remodeling and the appearance of new dermal papillae in all the treated SD compared with baseline., Conclusions: The present study confirms that PLS represents a safe treatment option for SD; herein, we report morphological documentation of skin variations after PLS treatment. Lasers Surg. Med. © 2021 Wiley Periodicals LLC., (© 2021 Wiley Periodicals LLC.)

Published
2021
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32. Comparison of microfocused ultrasound with visualization for skin laxity among vegan and omnivore patients.

Author

Fusano M, Galimberti MG, Bencini M, Fusano I, and Bencini PL

Subjects
Diet, Vegan, Female, Humans, Patient Satisfaction, Vegans, Skin Aging, Ultrasonic Therapy
Abstract

Background: The aging of facial structures depends on genetic, anatomic, chronologic, and environmental factors that affect the skin and underlying tissues. Microfocused ultrasound with visualization (MFU-V) has emerged as a safe and effective treatment for skin laxity. As the nutritional status may contribute to skin aging, it would be interesting to evaluate whether different dietary patterns can also influence the response to MFU-V treatment for skin laxity., Aims: The aim of this study is to compare the outcome of MFU-V therapy between omnivore and vegan patients., Methods: Twenty-seven vegan and twenty-seven omnivorous women who underwent MFU-V treatment for laxity of lower face and neck were enrolled. The clinical outcome was evaluated using the FLR (Facial Laxity Rating) scale after 3 and 6 months from treatment., Results: At baseline, no significant differences were found in terms of FLR scale in both treated sites. After 3 months, reduction in FLR scale was significantly lower for vegans both on face (P = .04) and neck (P = .004). At 6 months, vegan patients had a worse clinical outcome on lower face (P = .001) and neck (P < .001)., Conclusion: The present study suggests that a vegan diet may negatively influence the outcome of a MFU-V treatment., (© 2021 Wiley Periodicals LLC.)

Published
2021
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33. Dermoscopy and reflectance confocal microscopy of balloon cell nevi: a series of 10 cases.

Author

Fusano M, Soglia S, Gianotti R, and Bencini PL

Subjects
Dermoscopy, Diagnosis, Differential, Humans, Microscopy, Confocal, Melanoma diagnosis, Nevus diagnosis, Skin Neoplasms diagnostic imaging
Abstract

Background: Balloon cell nevus (BCN) is a rare histopathological entity. It is usually represented by an asymptomatic brown smooth or polypoid lesion, but no clinical features allow differentiation from other melanocytic nevi. Moreover, dermoscopy and reflectance confocal microscopy (RCM) aspects of BCN have been described in a few single cases. This study aims to describe a wider BCN series with dermoscopic and RCM features to assess the most frequent patterns., Methods: Ten patients who underwent a BCN surgical excision with histological diagnosis were included in this study. Dermatoscopy and RCM were performed for each lesion, searching for the features described in literature., Results: Each nevus presented as an asymptomatic, smooth brownish lesion. Regarding dermoscopy, four balloon cell nevi showed yellow globules, eight white globules, eight a light-brown network at the periphery, and eight a structureless central area; moreover, we found a hyperpigmented central blotch in four cases. RCM examination highlighted aggregates of dense nests at superficial dermis level in all BCNs, characterized by the presence of a dark nucleus surrounded by vacuolized cytoplasm. Moreover, multiple melanophages were seen at the dermal-epidermal junction in one case and superficial epidermal dendritic cells in one case., Conclusions: This series of 10 BCNs improves the dermoscopic and confocal microscopic knowledge of this rare entity. We also reported a new dermoscopic aspect represented by central hyperpigmented blotch. A correct identification of BCN with noninvasive techniques allows to avoid unnecessary surgical excision., (© 2021 the International Society of Dermatology.)

Published
2021
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34. Allergic contact versus irritant contact dermatitis in patients with hard-to-heal leg ulcer: clinical and diagnostic approach.

Author

Monari P, Fusano M, Moro R, Baiguini I, Calzavara-Pinton P, Vascellaro A, and Gualdi G

Subjects
Dermatitis, Irritant epidemiology, Dermatitis, Irritant etiology, Humans, Irritants, Italy epidemiology, Leg Ulcer diagnosis, Leg Ulcer epidemiology, Bandages adverse effects, Dermatitis, Irritant diagnosis, Leg Ulcer therapy, Wound Healing physiology
Abstract

Background: Dermatitis of surrounding skin may complicate hard-to-heal leg ulcers, delaying wound healing. The coexistence of hard-to-heal leg ulcers and irritant or allergic contact dermatitis may create difficulties for both diagnostic and therapeutic management., Objective: The aim of our study was to evaluate the incidence of dermatitis occurring in the surrounding skin in a population affected by hard-to-heal leg ulcers during treatment, and to differentiate between allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) with the use of a patch test. Furthermore, we investigated which medications were most probably related to these conditions., Method: We conducted an observational study from 21 February to 21 July 2017, enlisting all patients affected by hard-to-heal leg ulcers who attended the Wound Care Service of the Dermatologic Department of ASST, Spedali Civili, Brescia, Italy., Results: We enrolled 95 patients; 81 patients did not develop dermatitis, while 14 patients developed dermatitis of the surrounding skin. These patients underwent a patch test which gave a positive result in seven patients, permitting the diagnosis of ACD., Conclusion: Our study confirmed the incidence of dermatitis of the surrounding skin reported in the literature but reassessed the incidence of ACD as opposed to ICD.

Published
2021
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35. Capillaroscopy and reflectance confocal microscopy characterization of refractory port-wine stains.

Author

Fusano M and Bencini PL

Subjects
Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Prospective Studies, Treatment Outcome, Young Adult, Microscopic Angioscopy, Microscopy, Confocal, Port-Wine Stain diagnostic imaging
Abstract

Port-wine stains (PWS) are frequently refractory to laser treatments. Although previous data highlight prognostic factors and biological events related to poor outcomes, no previous publications correlate their capillaroscopic and architectural features. The aim of the present study is to describe refractory port-wine stains performing capillaroscopy and reflectance confocal microscopy (RCM) to describe their morphological and microscopic aspects. This is a prospective cohort study. All the consecutive patients with PWS poor responsive to previous treatment were included. Clinical assessment, capillaroscopy, and reflectance confocal microscopy were performed. A total of 65 patients were included, 12 with a capillaroscopic Type II pattern patients and 53 with Type III. At RCM examination, PWS with a capillaroscopic Type III pattern showed deeper-located blood vessels (p < 0.001) with a higher diameter (p < 0.042) compared with Type II. At the dynamic evaluation, 3 RCM patterns can be distinguished: Subset A, characterized by linear vessels with reduced diameter; Subset B, formed by enlarged vessels; and Subset C, characterized by deep and large aneurysmatic dilatation connected to small vessels. We defined 3 RCM patterns of refractory PWS.

Published
2021
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36. Photodynamic therapy for actinic keratosis in vegan and omnivore patients: the role of diet on skin healing.

Author

Fusano M, Zane C, Calzavara-Pinton P, and Bencini PL

Subjects
Aged, Aminolevulinic Acid therapeutic use, Erythema etiology, Female, Humans, Keratosis, Actinic pathology, Male, Middle Aged, Photochemotherapy adverse effects, Severity of Illness Index, Treatment Outcome, Vegans, Diet, Keratosis, Actinic drug therapy, Photosensitizing Agents therapeutic use
Abstract

Background: Photodynamic therapy (PDT) is an approved and effective treatment for actinic keratosis (AK). The time of complete skin healing is estimated to range between 5 and 10 days, but the role of nutrition in influencing it has never been evaluated. Objective: The aim of this study was to compare the time of skin healing and side effects in omnivores and vegans treated with PDT for AK. Materials and methods: Thirty omnivore and thirty vegan patients, treated with PDT for AK, were enrolled. Side effects, according to local skin response (LSR) score, were compared after 3, 7, and 30 days; the time of complete skin healing was recorded. Results: At day 3, day 7, and day 30 post treatment, vegan group showed higher total LSR score ( p  = .008, p  < .001, p  < .001, respectively), highlighting higher edema and vesiculation at day 3 ( p  < .001, p  = .002, respectively), erythema, desquamation, edema, and vesiculation at day 7 ( p  < .001, p  < .001, p  < .001, p  < .001, respectively) and erythema and desquamation after 30 days ( p  < .001, p  < .001, respectively). The difference of complete skin healing was statistically significant ( p  < .001). Conclusions: The present study suggests that diet may have a prognostic and predictive role on PDT outcomes in term of side effects and time of skin repair.

Published
2021
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37. Correlation between chronic skin ulcers dimension and burden of suffering evaluated with PRISM test.

Author

Monari P, Fusano M, Moro R, Simone C, Misciali C, Baraldi C, Puviani M, Olezzi D, Caccavale S, Motolese A, and Gualdi G

Subjects
Chronic Disease, Humans, Prospective Studies, Surveys and Questionnaires, Quality of Life, Skin Ulcer
Abstract

Background: In the practice of dermatology, many tools are available to help the physician measure the patient's quality of life. The Pictorial Representation of Illness and Self Measure (PRISM) is a novel and simple method to measure personal suffering. The aim of our study was to evaluate, using PRISM, whether the reduction of the ulcers' size positively correlated with an improvement of the patients' suffering., Methods: This was a multicenter national prospective study. 143 patients from five dermatological centers were enrolled in the study. At times T0 and T1 (after 1 month), the size of the ulcers was collected for each patient. At the same time, the PRISM test was also administered, in order to calculate the Self-Illness-Separation (SIS)., Results: First, a substantial decrement of the size of the ulcer seemed to correlate with a significant difference between the SIS score obtained at T0 and T1. On the contrary, the duration of the wound did not seem to influence the SIS value. No relationship between the age of the patient and the SIS value was found either., Conclusions: Our study showed that the decrease in the wound dimension positively affects the patient's suffering. In fact, ulcer's size reduction is correlated with an improvement in the patient's disease perception.

Published
2021
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38. Comparison of Postsurgical Scars Between Vegan and Omnivore Patients.

Author

Fusano M, Fusano I, Galimberti MG, Bencini M, and Bencini PL

Subjects
Aged, Aged, 80 and over, Cicatrix blood, Cicatrix epidemiology, Cicatrix etiology, Female, Humans, Iron blood, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Skin Neoplasms surgery, Surgical Wound blood, Surgical Wound Dehiscence blood, Surgical Wound Dehiscence etiology, Vitamin B 12 blood, Wound Healing physiology, Cicatrix diagnosis, Diet, Vegan adverse effects, Feeding Behavior physiology, Surgical Wound complications, Surgical Wound Dehiscence epidemiology
Abstract

Background: Postsurgical skin healing can result in different scars types, ranging from a fine line to pathologic scars, in relation to patients' intrinsic and extrinsic factors. Although the role of nutrition in influencing skin healing is known, no previous studies investigated if the vegan diet may affect postsurgical wounds., Objective: The aim of this study was to compare surgical scars between omnivore and vegan patients., Methods and Materials: This is a prospective observational study. Twenty-one omnivore and 21 vegan patients who underwent surgical excision of a nonmelanoma skin cancer were enrolled. Postsurgical complications and scar quality were evaluated using the modified Scar Cosmesis Assessment and Rating (SCAR) scale., Results: Vegans showed a significantly lower mean serum iron level (p < .001) and vitamin B12 (p < .001). Wound diastasis was more frequent in vegans (p = .008). After 6 months, vegan patients had a higher modified SCAR score than omnivores (p < .001), showing the worst scar spread (p < .001), more frequent atrophic scars (p < .001), and worse overall impression (p < .001)., Conclusion: This study suggests that a vegan diet may negatively influence the outcome of surgical scars.

Published
2020
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39. Pediatric dermatologic surgery: our experience.

Author

Fabiano A, Moro R, Zane C, Caravello S, Fusano M, Calzavara-Pinton P, and Gualdi G

Subjects
Adolescent, Anesthesia, Local, Biopsy statistics & numerical data, Child, Child, Preschool, Cryosurgery statistics & numerical data, Curettage statistics & numerical data, Electrosurgery statistics & numerical data, Female, Humans, Infant, Infant, Newborn, Male, Procedures and Techniques Utilization, Retrospective Studies, Dermatologic Surgical Procedures statistics & numerical data, Pediatrics
Abstract

Background: Surgical treatment for pediatric skin disorders is used for diagnostic and therapeutic reasons. We underline these procedures are usually easy and uncomplicated without the need for general anesthesia. Objective of this study was to share our experience in the field of pediatric dermatologic surgery., Methods: We retrospectively analysed records of all pediatric patients receiving surgical therapy at the Dermatology Department of Spedali Civili of Brescia. Demographic data and treatments characteristics were recorded and analyzed., Results: During the study period of one year, 670 surgical treatments concerning pediatric patients were collected. Number of procedures progressively grows with increasing age. All treatments were performed under local anesthesia except for a dermatofibrosarcoma protuberans for which general anesthesia was needed., Conclusions: Our data show that cryosurgery, electrodessication and excisional surgery constitute with equal proportion almost the whole of surgical procedures in dermatologic pediatric patients. Dermatologist's habit to perform surgery in local anesthesia avoids the risk of overtreatments, limits discomfort, anxiety, and pain perception linked to procedures performed.

Published
2020
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41. A case of Pemphigus Vulgaris associated with cocaine snorting.

Author

Arisi M, Gelmetti A, Fusano M, Lorenzi L, Petrilli G, Pasolini G, Vascellaro A, Venturini M, and Calzavara-Pinton P

Subjects
Adult, Cocaine-Related Disorders drug therapy, Glucocorticoids therapeutic use, Humans, Male, Mouth Diseases drug therapy, Pemphigus drug therapy, Cocaine adverse effects, Cocaine-Related Disorders etiology, Mouth Diseases chemically induced, Pemphigus chemically induced
Published
2020
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43. Clinical and Spectrophotometric Evaluation of Skin Photoadaptation in Vitiligo Patients after a Short Cycle of NB-UVB Phototherapy.

Author

Arisi M, Rossi MT, Fusano M, Gualini A, Tomasi C, Moggio E, Caravello S, Calzavara-Pinton P, and Venturini M

Subjects
Adult, Aged, Erythema etiology, Female, Humans, Male, Middle Aged, Radiotherapy Dosage, Spectrophotometry, Adaptation, Physiological radiation effects, Pigmentation radiation effects, Skin radiation effects, Ultraviolet Therapy adverse effects, Vitiligo physiopathology, Vitiligo radiotherapy
Abstract

Background: The phenomenon of photoadaptation to narrow-band ultraviolet B (NB-UVB) radiation has been previously described in vitiligo and has usually been clinically measured by the assessment of the minimal erythema dose (MED) after phototesting., Objectives: To assess the photoadaptive response in vitiligo and healthy skin after NB-UVB phototherapy not only clinically, but also by spectrophotometry., Materials and Methods: Fourteen patients affected by generalized vitiligo underwent NB-UVB phototherapy twice weekly for 12 weeks. Before and after phototherapy, a phototesting procedure was administered on vitiligo patches and adjacent healthy skin with a solar simulated radiation (SSR). Visual assessment of the MED took place after 24 h. A spectrophotometer was used to assess the a* value and the melanin index (MI*), as signs of skin erythema and pigmentation. The photoadaptation factor (MED-PF) and the a* photoadaptation factor (a*-PF) were calculated., Results: After NB-UVB phototherapy, both vitiligo and healthy skin showed an increase in MED and MI* values and a reduction of skin erythema compared to baseline (p < 0.05). MED-PF data showed a photoadaptation in 10 (71.4%) vitiligo lesions and in 12 (85.7%) healthy skin areas. The assessment of the a*-PF showed a negative mean percentage value in all affected and unaffected skin areas., Conclusions: A short cycle of NB-UVB phototherapy can induce photoadaptation in vitiligo by increasing the MED and reducing skin erythema after stimulation with SSR. This is most likely due to the physical filter function induced by ultraviolet radiation., (© 2019 S. Karger AG, Basel.)

Published
2019
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44. A solitary cutaneous metastasis from colon adenocarcinoma: Dermoscopic and confocal microscopy features.

Author

Manganoni AM, Fusano M, Pavoni L, Pizzati L, Consoli F, Venturini M, Zanca A, and Calzavara-Pinton P

Subjects
Humans, Male, Microscopy, Confocal methods, Middle Aged, Adenocarcinoma diagnosis, Colonic Neoplasms diagnosis, Dermoscopy methods, Skin Neoplasms diagnosis, Skin Neoplasms secondary
Abstract

Competing Interests: There are no conflicts of interest

Published
2018
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45. Serum levels of tumor necrosis factor-alpha in patients with psoriasis before, during and after narrow-band UVB phototherapy.

Author

Rossi MT, Venturini M, Zanca A, Arisi M, Fusano M, Sottini A, Serana F, Imberti L, and Calzavara-Pinton P

Subjects
Adult, Aged, Cytokines immunology, Female, Humans, Male, Middle Aged, Psoriasis blood, Psoriasis physiopathology, Severity of Illness Index, Th1 Cells immunology, Th17 Cells immunology, Time Factors, Treatment Outcome, Young Adult, Psoriasis radiotherapy, Tumor Necrosis Factor-alpha blood, Ultraviolet Therapy methods
Abstract

Background: Narrow-band UVB (NB-UVB) phototherapy is widely used worldwide for moderate and severe psoriasis, which is a chronic autoimmune inflammatory disease characterized by skin infiltrates of Th1-, Th17- and Th22-cells releasing locally pro-inflammatory cytokines. We investigate serum levels of tumor necrosis factor-α (TNF-α) in psoriatic patients before and after NB-UVB phototherapy., Methods: Twenty-eight subjects with moderate/severe plaque type psoriasis were enrolled. The severity of skin involvement was rated according to the Psoriasis Area and Severity Index (PASI) score at baseline (T0) and after 4 (T1) and 12 (T2) weeks of NB-UVB treatment. At the same time points, blood samples were taken for evaluation of TNF-α levels. NB-UVB phototherapy was administered twice weekly on non-consecutive days until 12 weeks., Results: The median PASI score significantly decreased from 12.0 at baseline (T0), to 6.9 after 4 weeks (T1, P<0.001) and to 0 after 12 weeks (T2, P<0.001). TNF-a serum levels significantly increased in respect to the baseline after 12 weeks of therapy., Conclusions: NB-UVB phototherapy is highly effective against psoriasis but, as it increases the TNF-α serum level, it seems unlikely that it can decrease the chronic inflammatory state that is thought to be responsible of the systemic co-morbidities of psoriasis.

Published
2018
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