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Super-high (x400) magnification dermoscopy (D400) is a new non-invasive imaging technique that has been shown to add information for the differential diagnosis of melanocytic lesions in a pilot study. Our study aimed to confirm if D400 can add details for the discrimination of clinically atypical nevus and melanoma. This is a retrospective observational, multicentric study enrolling patients who received an x20 (D20) and x400 (D400) magnification dermoscopic examination of pigmented skin lesions. Dermoscopic images were retrospectively evaluated by three observers for the presence/absence of nine D20 and twenty D400 dermoscopic features defined in the previous pilot study. Univariate and multivariate analyses were carried out to find predictors of benign and malignant behaviors. At D20 atypical pigment network, blue-whitish veil, atypical vascular pattern, regression, and homogenous pattern were more frequent in melanoma than in nevi (p

Nail psoriasis (NP) is often considered disfiguring for patients with a relevant impact on quality of life (QoL). It is also difficult to treat for dermatologists who are often frustrated by the scarcity of effective therapeutic alternatives in this particular location. Topical therapies are often used as the first-line treatment for mild NP, but efficacy is the modest. Conventional disease-modifying antirheumatic drugs (cDMARDs) (e.g., cyclosporine, methotrexate, acitretin, and dimethyl fumarate) are generally avoided in NP without general cutaneous involvement. Biologics represent, to date, a concrete possibility for the management of these patients. The data from the clinical trials are encouraging, although there are still few data in real-life. Here, we report a study conducted at Siena University Hospital on 20 patients with NP on both hands and feet treated with anti-IL23 for 52 weeks. No differences were evaluated from baseline to week 4 of anti-IL-23 treatment. NAPSI greatly improved at week 24 with almost 60% of patients reaching NAPSI75 and 40% NAPSI50. At week 52, almost 75% of patients reached NAPSI90. No adverse effects were reported in the patients in the study. The clinical response observed in these patients suggests that treatments that target interleukin-23 may be an effective option for NP, especially when refractory to conventional therapies.

Erytrhodermic psoriasis (EP) is a rare subset of psoriasis that is considered a dermatologic emergency. Due to its limited clinical evidence, pathogenesis is largely unknown and its treatment represents a challenge. Conventional therapies such as methotrexate, cyclosporine, and acitretin are still considered first-line of treatment but it is necessary to study the efficacy and safety of biologics, including antitumor necrosis factor (TNF), anti-interleukin (IL)-23, and anti-IL17 agents to define new guidelines of treatment. Here, we report two cases of patients with EP treated with ixekizumab.

The shoulder’s traumatology in recent decades has seen a major increase in surgical compared to conservative treatment even if recent studies and meta-analyzes do not confirmed that surgical treatment leads to better functional results. The interest in the surgical accesses, expecially in mininvasive surgery, for the treatment of fractures of the proximal humerus had a new birth. The aim of this work is to illustrate the most commonly used surgical technique in traumatology of proximal humerus.