Publications by authors named "Alessandro Pileri"

82 Publications

Erythrodermie mit Brentuximab-Vedotin (Hautnebenwirkungen bei Mycosis fungoides).

J Dtsch Dermatol Ges 2021 01;19(1):99-102

Hematopathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.14197_gDOI Listing
January 2021

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

Photodermatol Photoimmunol Photomed 2021 Jan 18. Epub 2021 Jan 18.

Dip. Scienze della Salute, sezione Dermatologia, Universita' degli Studi di Firenze, Firenze, Italy.

Background: Phototherapy is a mainstay for the treatment of MF. However, there is scarce evidence for its use, mostly due to the lack of a unified schedule.

Aims: The primary aim of this study was to establish the first structured, expert-based consensus regarding the indications and technical schedules of NB-UVB and PUVA for MF. The secondary aim was to determine the consensus level for each specific item.

Materials & Methods: E-delphi study. Item-specific expert consensus was defined as the number of "Totally Agree" results to ≥80% of the panelists. Cronbach alpha index ≥0.7 was used as a measure of homogeneity in the responses among questions related to the same topic.

Results: Overall, there was a high homogeneity among responders (0.78). On specific topics, the highest grade was observed for technical items (0.8) followed by indications for early (0.73) and advanced stages (0.7).

Conclusions: Items related to the most canonical indications of phototherapy and to treatment schedules showed the highest agreements rates. There is consensus about the use of standardized treatment schedules for the induction and consolidation phases for NB-UVB and PUVA in MF.
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http://dx.doi.org/10.1111/phpp.12658DOI Listing
January 2021

Atopic dermatitis and mycosis fungoides in a child: an overlooked association.

G Ital Dermatol Venereol 2020 Dec 14. Epub 2020 Dec 14.

Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Azienda Ospedaliero-Universitaria di Bologna Policlinico Sant'Orsola-Malpighi, Bologna, Italy.

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http://dx.doi.org/10.23736/S0392-0488.20.06856-XDOI Listing
December 2020

Bullous Wells Syndrome: a needle in the haystack.

Int J Dermatol 2020 Dec 1. Epub 2020 Dec 1.

Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1111/ijd.15250DOI Listing
December 2020

Red dye-related tattoo reactions: Could optical coherence tomography be of help?

Skin Res Technol 2020 Nov 15. Epub 2020 Nov 15.

Dermatology Unit, Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.

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http://dx.doi.org/10.1111/srt.12966DOI Listing
November 2020

Phenotypical Markers, Molecular Mutations, and Immune Microenvironment as Targets for New Treatments in Patients with Mycosis Fungoides and/or Sézary Syndrome.

J Invest Dermatol 2021 Mar 5;141(3):484-495. Epub 2020 Nov 5.

Dermatologic Clinic, Department of Medical Sciences, University of Turin, Turin, Italy.

Primary cutaneous lymphomas encompass a wide spectrum of rare lymphoproliferative disorders originating in the skin, among which, mycosis fungoides (MF) is the most common subtype. The treatment of this disease is based on skin-directed therapies eventually in association with biologic response modifiers in the early phases, whereas in patients with the advanced stages, several therapeutic strategies can be used including mono and/or polychemotherapy and bone marrow transplantation. In recent years, the identification of specific markers (phenotypical, immunological, and molecular) has led to the development of several studies (including two randomized phase III trials). The results of these studies are modifying our therapeutic strategy toward a personalized treatment approach in which the clinical characteristics of the patients and tumor-node-metastasis-blood stage are considered together with the expression of specific markers (i.e., a CD30-positive expression for the use of brentuximab vedotin). This review will provide a comprehensive scenario of the main phenotypical, molecular, and immunological markers related to MF pathogenesis and disease evolution, which could represent the target for the development of innovative effective treatments in this disease.
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http://dx.doi.org/10.1016/j.jid.2020.07.026DOI Listing
March 2021

Role of chromatin assembly factor-1/p60 and poly [ADP-ribose] polymerase 1 in mycosis fungoides.

Virchows Arch 2020 Oct 24. Epub 2020 Oct 24.

Department of Advanced Biomedical Sciences, Pathology Section, School of Medicine, University of Naples "Federico II", Via Sergio Pansini, 5, 80131, Naples, Italy.

Mycosis fungoides (MF) represents the most common type of cutaneous lymphoma. In the majority of patients, the disease has a slow evolution and a protracted course; however, a subset of patients shows poor oncologic outcomes. Unfortunately, there are no reliable prognostic markers for MF, and the currently available treatments are only effective in a minority of patients. This study aimed to evaluate the expression and clinical significance of PARP-1 and CAF-1/p60 in MF. Sixty-four MF representatives of the different stages of disease were assessed by immunohistochemistry for PARP-1 and CAF-1/p60. The association of PARP-1 and CAF-1/p60 with the MF stage and outcome was assessed by using Fisher's exact test and Kaplan-Meier survival analysis with the Log-rank test; a p value < 0.05 was considered significant. PARP-1 was overexpressed in 57.9% of MF and was significantly associated with a MF stage > II (p = 0.034) but not with the risk of death (p = 0.237). CAF-1/p60 was overexpressed in 26.8% of MF and was significantly associated with decreased overall survival (p < 0.001) but not with the MF stage (p = 1). A significant association was found between PARP-1 overexpression and CAF-1/p60 overexpression (p = 0.0025). Simultaneous overexpression of PARP-1 and CAF-1/p60 was significantly associated with decreased overall survival (p < 0.001), although less strongly than CAF-1/p60 alone (χ = 14.916 vs 21.729, respectively). In MF, PARP-1 is overexpressed in advanced stages, while CAF-1/p60 is overexpressed in the cases with shorter overall survival, appearing as a significant prognostic marker. A role for PARP-1 inhibitors and anti-CAF-1/p60 targeted therapy may be reasonably hypothesized in MF.
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http://dx.doi.org/10.1007/s00428-020-02952-zDOI Listing
October 2020

Prognostic significance of Bcl-2 expression in primary cutaneous B-cell lymphoma: a reappraisal.

G Ital Dermatol Venereol 2020 Oct 16. Epub 2020 Oct 16.

Dermatology Unit, Department of Health Sciences, University of Florence Medical School, Florence, Italy.

Introduction: Bcl-2 family protein plays an important role in apoptosis and its overexpression is protects neoplastic cell from apoptotic stimuli. Cutaneous B-cell lymphoma are rare non-Hodgkin lymphomas and can be classified in primary forms, featuring an exclusive skin-involvement at diagnosis, and cutaneous spread of a nodal disease. Such a distinction is not trivial, owing to different prognosis (indolent vs. aggressive) and therapeutic management.

Evidence Acquisition: Bcl-2 expression at immunohistochemistry can be crucial in differential diagnosis between cutaneous and systemic disease, as well as between the different primary cutaneous forms.

Evidence Synthesis: In the last few years, an animated debate on the prognostic role of BCL-2 overexpression at molecular analysis have been developed in cutaneous B-cell lymphoma.

Conclusions: Bcl-2 expression have a diagnostic role more than prognostic in primary cutaneous B-cell lymphomas.
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http://dx.doi.org/10.23736/S0392-0488.20.06622-5DOI Listing
October 2020

A pink nodule on the left subscapular region in an 8-year-old girl.

J Dtsch Dermatol Ges 2020 Sep 10. Epub 2020 Sep 10.

Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.14269DOI Listing
September 2020

Is Dermoscopy Useful for the Diagnosis of Pseudolymphomas?

Dermatology 2020 Aug 27:1-4. Epub 2020 Aug 27.

Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1159/000508900DOI Listing
August 2020

Immune-Mediated Dermatoses in Patients with Haematological Malignancies: A Comprehensive Review.

Am J Clin Dermatol 2020 Dec;21(6):833-854

Department of Health Sciences, Section of Dermatology, University of Florence, Viale Michelangiolo 41, 50125, Florence, Italy.

Haematological malignancies induce important alterations of the immune system, which account for the high frequency of autoimmune complications observed in patients. Cutaneous immune-mediated diseases associated with haematological malignancies encompass a heterogeneous group of dermatoses, including, among others, neutrophilic and eosinophilic dermatoses, autoantibody-mediated skin diseases, vasculitis and granulomatous dermatoses. Some of these diseases, such as paraneoplastic pemphigus, are associated with an increased risk of death; others, such as eosinophilic dermatoses of haematological malignancies, run a benign clinical course but portend a significant negative impairment on a patient's quality of life. In rare cases, the skin eruption reflects immunological alterations associated with an unfavourable prognosis of the associated haematological disorder. Therapeutic management of immune-mediated skin diseases in patients with haematological malignancies is often challenging. Systemic corticosteroids and immunosuppressive drugs are considered frontline therapies but may considerably augment the risk of serious infections. Indeed, developing a specific targeted therapeutic approach is of crucial importance for this particularly fragile patient population. This review provides an up-to-date overview on the immune-mediated skin diseases most frequently encountered by patients with onco-haematological disorders, discussing new pathogenic advances and therapeutic options on the horizon.
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http://dx.doi.org/10.1007/s40257-020-00553-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7679319PMC
December 2020

Cutaneous adverse-events in patients treated with Ibrutinib.

Dermatol Ther 2020 11 27;33(6):e14190. Epub 2020 Sep 27.

Division of Dermatology Azienda Ospedaliero, Universitaria di Bologna, Bologna, Italia.

Ibrutinib is a Burton tyrosine kinase inhibitor (BTKi) approved for the treatment of several hematologic malignancies. Analyze skin adverse events (SAE). All the patients treated with Ibrutinib featuring cutaneous adverse events were selected. Twenty five patients were retrieved with a median interval between Ibrutinib start and SAE time of onset of 120 days. Most common SAE observed involved hairs and nails. Eczematous reaction and leucocytoclastic vasculitis were also detected. One patient had a long-history Ibrutinib treatment and experienced numerous cutaneous adverse events. Infective disease such as superficial mycosis and impetigo were rarely present in our series. Despite the development of cutaneous SAE, all the patients continued their concomitant drugs without the onset of any further SAE. Our data suggest Ibrutinib-associated rash should be distinguished in early and late events and a careful dermatologic management of patients should be scheduled.
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http://dx.doi.org/10.1111/dth.14190DOI Listing
November 2020

Erythroderma with brentuximab vedotin (skin side effects in mycosis fungoides).

J Dtsch Dermatol Ges 2021 Jan 27;19(1):99-102. Epub 2020 Jul 27.

Hematopathology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.14197DOI Listing
January 2021

Pityriasis lichenoides getriggert durch eine Masern-Mumps-Röteln-Impfung.

J Dtsch Dermatol Ges 2020 Jul;18(7):758-760

Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.14153_gDOI Listing
July 2020

Pityriasis lichenoides triggered by measles-mumps-rubella vaccine injection.

J Dtsch Dermatol Ges 2020 Jul 12;18(7):758-760. Epub 2020 Jul 12.

Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.14153DOI Listing
July 2020

Iatrogenic Kaposi sarcoma during tumor necrosis factor alpha inhibitors.

G Ital Dermatol Venereol 2020 Jun 15. Epub 2020 Jun 15.

Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.23736/S0392-0488.20.06595-5DOI Listing
June 2020

Herpes zoster in COVID-19-positive patients.

Int J Dermatol 2020 Aug 12;59(8):1028-1029. Epub 2020 Jun 12.

Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1111/ijd.15001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7307064PMC
August 2020

Second neoplasm in cutaneous T-cell lymphoma patients: a marker of worse prognosis?

G Ital Dermatol Venereol 2019 Dec 4. Epub 2019 Dec 4.

Dermatology Unit, Department of Health Sciences, University of Florence Medical School, Florence, Italy.

Background: Epidemiologic studies have shown that cutaneous T-cell lymphoma (CTCL) patients have an increased risk of the development of a second neoplasm (SN). The aim of our study was to evaluate the risk of SN and to correlate any possible change in CTCL course after the diagnosis of a subsequent neoplasm.

Methods: A ten-year retrospective study was carried out in two centres (Bologna and Florence) all the patients who developed a SN six months at least after a CTCL were included. Two groups were selected: Group 1 featuring patients who developed a SN and Group 2 characterised by patients affected by MF age and sex-matched with Group 1 (control group). Data concerning any stage change after SN, time between MF and SN onset, modified Severity Weighted Assessment Tool (mSWAT) score before and after SN, concerning Group 1 and after a median time of 36 months in Group 2 were analysed.

Results: Thirteen patients were detected. Before SN onset, early MF patients were mainly present, while SN cases in advanced-stage (ten patients) were observed. SN type predominant was lung cancer, along with prostate and pancreatic cancer, while isolated cases presenting with vulvar, colon, mammalian, prostate cancer along with Hodgkin's Lymphoma. Mean mSWAT at MF diagnosis and after SN showed a significant difference (p value=0.0037). After SN diagnosis, nine patients experienced an MF stage progression and ten patient died at follow up.

Conclusions: In all the instances, statistical analysis showed that mean mSWAT score before/after SN diagnosis had a significantly difference (p value=0.0037) suggesting that patients with a SN may have a worse clinical outcome. By secreting immunosuppressive cytokines or recruiting immunosuppressive cells, a sort of mutual help between the two neoplasms may be prompted. Our data suggest that SN development in MF patients may be regarded as a worse prognostic marker.
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http://dx.doi.org/10.23736/S0392-0488.19.06510-6DOI Listing
December 2019

Mycosis fungoides involving the genital area.

G Ital Dermatol Venereol 2019 Sep 12. Epub 2019 Sep 12.

Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.23736/S0392-0488.19.06445-9DOI Listing
September 2019

Sézary Syndrome without erythroderma featuring a CD30+ progression.

G Ital Dermatol Venereol 2019 Aug;154(4):494-495

Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.23736/S0392-0488.17.05793-5DOI Listing
August 2019

Asymptomatische bräunliche Läsionen an Armen und Beinen.

J Dtsch Dermatol Ges 2019 Jun;17(6):659-662

Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.13858_gDOI Listing
June 2019

Primary cutaneous CD8+ CD30+ lymphoproliferative disorder in a patient with acquired CD4 immunodeficiency.

G Ital Dermatol Venereol 2019 Jun 12. Epub 2019 Jun 12.

Dermatology Unit, Department of Health Sciences, University of Florence Medical School, Florence, Italy.

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http://dx.doi.org/10.23736/S0392-0488.19.06367-3DOI Listing
June 2019

Brownish asymptomatic lesions on the arms and legs.

J Dtsch Dermatol Ges 2019 Jun 22;17(6):659-662. Epub 2019 May 22.

Dermatology Unit, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.13858DOI Listing
June 2019

Blastic Plasmacytoid Dendritic Cell Neoplasm: State of the Art and Prospects.

Cancers (Basel) 2019 Apr 28;11(5). Epub 2019 Apr 28.

Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an extremely rare tumour, which usually affects elderly males and presents in the skin with frequent involvement of the bone-marrow, peripheral blood and lymph nodes. It has a dismal prognosis, with most patients dying within one year when treated by conventional chemotherapies. The diagnosis is challenging, since neoplastic cells can resemble lymphoblasts or small immunoblasts, and require the use of a large panel of antibodies, including those against CD4, CD56, CD123, CD303, TCL1, and TCF4. The morphologic and in part phenotypic ambiguity explains the uncertainties as to the histogenesis of the neoplasm that led to the use of various denominations. Recently, a series of molecular studies based on karyotyping, gene expression profiling, and next generation sequencing, have largely unveiled the pathobiology of the tumour and proposed the potentially beneficial use of new drugs. The latter include SL-401, anti-CD123 immunotherapies, venetoclax, BET-inhibitors, and demethylating agents. The epidemiologic, clinical, diagnostic, molecular, and therapeutic features of BPDCN are thoroughly revised in order to contribute to an up-to-date approach to this tumour that has remained an orphan disease for too long.
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http://dx.doi.org/10.3390/cancers11050595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562663PMC
April 2019

Blastic plasmacytoid dendritic cell neoplasm: genomics mark epigenetic dysregulation as a primary therapeutic target.

Haematologica 2019 04 31;104(4):729-737. Epub 2018 Oct 31.

Division of Haematopathology, IEO European Institute of Oncology IRCCS, Milan, Italy.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy for which there is still no effective therapy. In order to identify genetic alterations useful for a new treatment design, we used whole-exome sequencing to analyze 14 BPDCN patients and the patient-derived CAL-1 cell line. The functional enrichment analysis of mutational data reported the epigenetic regulatory program to be the most significantly undermined (<0.0001). In particular, twenty-five epigenetic modifiers were found mutated (e.g. was the most frequently affected (28.6% of cases). To evaluate the impact of the identified epigenetic mutations at the gene-expression and Histone H3 lysine 27 trimethylation/acetylation levels, we performed additional RNA and pathology tissue-chromatin immunoprecipitation sequencing experiments. The patients displayed enrichment in gene signatures regulated by methylation and modifiable by decitabine administration, shared common H3K27-acetylated regions, and had a set of cell-cycle genes aberrantly up-regulated and marked by promoter acetylation. Collectively, the integration of sequencing data showed the potential of a therapy based on epigenetic agents. Through the adoption of a preclinical BPDCN mouse model, established by CAL-1 cell line xenografting, we demonstrated the efficacy of the combination of the epigenetic drugs 5'-azacytidine and decitabine in controlling disease progression .
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http://dx.doi.org/10.3324/haematol.2018.202093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442957PMC
April 2019

Plaques und Tumoren unter der Therapie mit Mogamulizumab bei einer Patientin mit refraktärem Sézary-Syndrom.

J Dtsch Dermatol Ges 2018 Oct;16(10):1263-1266

Department of Specialized, Diagnostic and Experimental Medicine, Hematopathology Unit, Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.13656_gDOI Listing
October 2018

Plaques and tumors in a patient with refractory Sézary syndrome treated with mogamulizumab.

J Dtsch Dermatol Ges 2018 Oct 1;16(10):1263-1265. Epub 2018 Oct 1.

Department of Specialized, Diagnostic and Experimental Medicine, Hematopathology Unit, Bologna, Italy.

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http://dx.doi.org/10.1111/ddg.13656DOI Listing
October 2018