Publications by authors named "Annalisa Patrizi"

429 Publications

The impact of psoriasis on marriage.

Ital J Dermatol Venerol 2021 May 28. Epub 2021 May 28.

Department of Experimental, Diagnostic and Specialty Medicine, Dermatology, IRCCS Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy.

Background: Psoriasis frequently affects partners and intimacy and sometimes leads to a break in relationships. The aim of this study was to evaluate the possible negative impact of psoriasis on married life through the use of the Quality Marriage Index (QMI), a score used to assess marital satisfaction.

Methods: In this prospective case-control study married or divorced patients with moderate-to-severe plaque psoriasis were compared to a control group made up of married or divorced healthy patients without psoriasis. Each patient enrolled in the study was given the questionnaire to assess the QMI.

Results: 201 patients were included in the study sample: 100 suffered from moderate-tosevere plaque psoriasis and the other 101 did not. A significantly higher number of psoriatic patients was divorced than patients without psoriasis. By analyzing the QMI questionnaire, patients with psoriasis scored lower than patients without psoriasis in all single questions and in the total QMI value. By assessing how much each question weighed in the QMI final score, a significant difference between the two groups of patients was found in questions 3 and 6: the first one regarding the strength of marriage weighed more in psoriatic patients, while the second one regarding the happiness of marriage weighed more in non-psoriasis patients.

Conclusions: Psoriasis can contribute to marriage breakdown in affected patients. The concept of happiness seems to be greatly affected by the repercussions of psoriasis, while the strength of marriage plays a fundamental role in these patients.
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http://dx.doi.org/10.23736/S2784-8671.21.06974-7DOI Listing
May 2021

Basal cell carcinoma of the eyelid margin: Dermoscopic clues in a case series.

Dermatol Ther 2021 May 27:e15006. Epub 2021 May 27.

Division of Melanoma Surgery, Sarcoma and Rare Tumors, IRCCS, Istituto Europeo di Oncologia, Milan, Italy.

Basal cell carcinoma (BCC) can sometimes affect the eyelids and in particular the eyelid margin, where it can often be misdiagnosed, mimicking other benign, more common diseases. Dermoscopy may provide additional diagnostic criteria for an earlier diagnosis of eyelid margin BCC, although the dermoscopic features of BCC affecting this anatomical site have seldom been reported. We highlight the peculiar presence of linear vessels perpendicular to the eyelid margin in BCCs of the eyelid margin. Our article represents the first report of these dermoscopic findings in a series of BCCs of the eyelid margin.
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http://dx.doi.org/10.1111/dth.15006DOI Listing
May 2021

Factors related to the onset and recurrence of flares in hidradenitis suppurativa patients treated with adalimumab.

Ital J Dermatol Venerol 2021 May 13. Epub 2021 May 13.

Dermatology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Background: Hidradenitis suppurativa (HS) is characterized by periodic worsening of symptoms. However, clinical parameters associated with flare are still to be established. The aim was too investigate factors associated with flare outbreak in HS patients in treatment with adalimumab.

Methods: Moderate-severe HS patients were included in this retrospective analysis. In total, 115 HS patients treated with adalimumab from 5 Italian centers were reviewed. Gender, ages at onset/baseline, therapeutic delay, family history, body mass index, smoking, comorbidities, phenotypes, body areas involved, Hurley stage, International Hidradenitis Suppurativa Severity Score System (IHS4), Dermatology Life Quality Index (DLQI) and Visual Analogue Scale for pain (pain-VAS) were collected at baseline. Flares were modelled with baseline features using univariate and multivariate Coxregression. The factors significantly correlated with flares in the univariate model were analyzed using a recurrent event survival analysis (Andersen-Gill model) to assess the relation between them and flares recurrence.

Results: During the observation period 80.9% of patients developed flares, detecting 252 flares, overall. A univariate model identified five risk factors associated with the outbreak of flares: age, therapeutic delay, groin involvement, Hurley III, higher IHS4, whereas, from multivariate model, only IHS4 resulted to be significantly correlated. Additionally, flares were positively associated with higher DLQI and pain-VAS. Finally, the Andersen-Gill model showed four factors correlated with flares recurrence: age, therapeutic delay, Hurley III and higher IHS4. The limitations are: study's retrospective design, absence of a consensus about flare definition.

Conclusions: An early treatment of HS may prevent both the disease progression and reduce the recurrence of flares.
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http://dx.doi.org/10.23736/S2784-8671.21.06966-8DOI Listing
May 2021

Unraveling the role of microRNA/isomiR network in multiple primary melanoma pathogenesis.

Cell Death Dis 2021 May 12;12(5):473. Epub 2021 May 12.

Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.

Malignant cutaneous melanoma (CM) is a potentially lethal form of skin cancer whose worldwide incidence has been constantly increasing over the past decades. During their lifetime, about 8% of CM patients will develop multiple primary melanomas (MPMs), usually at a young age and within 3 years from the first tumor/diagnosis. With the aim of improving our knowledge on MPM biology and pathogenesis, we explored the miRNome of 24 single and multiple primary melanomas, including multiple tumors from the same patient, using a small RNA-sequencing approach. From a supervised analysis, 22 miRNAs were differentially expressed in MPM compared to single CM, including key miRNAs involved in epithelial-mesenchymal transition. The first and second melanoma from the same patient presented a different miRNA profile. Ten miRNAs, including miR-25-3p, 149-5p, 92b-3p, 211-5p, 125a-5p, 125b-5p, 205-5p, 200b-3p, 21-5p, and 146a-5p, were further validated in 47 single and multiple melanoma samples. Pathway enrichment analysis of miRNA target genes revealed a more differentiated and less invasive status of MPMs compared to CMs. Bioinformatic analyses at the miRNA isoform (isomiR) level detected a panel of highly expressed isomiRs belonging to miRNA families implicated in human tumorigenesis, including miR-200, miR-30, and miR-10 family. Moreover, we identified hsa-miR-125a-5p|0|-2 isoform as tenfold over-represented in melanoma than the canonical form and differentially expressed in MPMs arising in the same patient. Target prediction analysis revealed that the miRNA shortening could change the pattern of target gene regulation, specifically in genes implicated in cell adhesion and neuronal differentiation. Overall, we provided a putative and comprehensive characterization of the miRNA/isomiR regulatory network of MPMs, highlighting mechanisms of tumor development and molecular features differentiating this subtype from single melanomas.
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http://dx.doi.org/10.1038/s41419-021-03764-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8115306PMC
May 2021

Drug Intake and Actinic Keratosis: A Case-Control Study.

Dermatol Pract Concept 2021 Mar 12;11(2):e2021031. Epub 2021 Apr 12.

Dermatology, IRCCS Policlinico di Sant'Orsola. Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Italy.

Background: Actinic keratosis (AK) is a form of premalignant keratinocyte dysplasia. Recently, the role of photosensitizing drugs in the development of AK has been postulated.

Objective: This study evaluated a possible association between the use of photosensitizing drugs and the development of AK. A secondary aim was to identify a possible association between any medication other than those primarily examined and AK.

Methods: A single-center, case-control study assessed the cumulative drug exposure of 90 patients with AK and 90 controls visiting a dermatology service for other skin ailments. Before the visit, patients were interviewed to collect data on daily therapy and the lag-time of discontinued drugs within the last 2 years, and to record the drug's active ingredient, dosage, and duration of therapy. In addition, sociodemographic characteristics including age, sex, educational level, skin phototype, and cumulative sun exposure habits were gathered.

Results: By logistic regression, exposures to angiotensin II receptor blockers (ARBs) and antiplatelet agents were identified as independent risk factors for the development of AK. ARB intake was associated with AK only at high exposure (OR = 13.6; 95% CI, 2.0-93.8). The use of antiplatelet drugs was borderline, yet not significant, at low exposure (OR = 3.31; 95% CI, 0.86-12.7), but increased in a dose-dependent manner. The strongest correlation was found at the highest cumulative dose (>1100 dose unit-years (OR = 4.38; 95% CI, 1.16-16.6).

Conclusions: High exposure to ARBs and antiplatelet agents may promote AK carcinogenesis in at-risk patients.
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http://dx.doi.org/10.5826/dpc.1102a31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8060000PMC
March 2021

Erythroderma: psoriasis or lymphoma? A diagnostic challenge and therapeutic pitfall.

Ital J Dermatol Venerol 2021 Apr 29. Epub 2021 Apr 29.

Division of Dermatology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Background: Psoriasis and lymphoma risk is widely debated, but few is known about misdiagnosis risk between erythrodermic psoriasis and lymphoma . In fact erythroderma might represent a clinical presentation of psoriasis, cutaneous T cell lymphomas and skin dissemination of systemic lymphomas.

Methods: All patients referred to psoriasis outpatient service with a diagnosis of erythrodermic psoriasis were re-examined. Among them, all the patients with a subsequent lymphoma diagnosis were included. For each patient data concerning age, gender, age at erythroderma onset, age at lymphoma diagnosis, immune-suppressive therapy, type of lymphoma and relative stage, lymphoma treatment and outcome were obtained.

Results: Twenty-five patients (15 females and 10 males) with a diagnosis of erythrodermic psoriasis were retrieved. Among them, 9 patients (5 males and 4 females) were affected by erythrodermic lymphoma, including 4 patients with Sèzary syndrome, 3 with mycosis fungoides, and 2 with peripheral T-cell lymphoma not otherwise specified. Prior to lymphoma diagnosis all the patients (9/9) received cyclosporine, two (2/9) of them methotrexate, one (1/9) azatioprine, and two (2/9) systemic corticosteroids. The prognosis of our patients was poor, due to immune-suppressive drugs administration in patients with undiagnosed lymphoma. The only exception was one (1/9) patient with Sèzary syndrome still alive with disease after 120 months of follow up.

Conclusions: In case of patients with erythroderma, multiple skin biopsies and specific peripheral blood studies like flow cytometry and T-cell receptor gene rearrangement analysis are required in order to avoid misdiagnosis risk between psoriasis and lymphoma.
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http://dx.doi.org/10.23736/S2784-8671.21.06891-7DOI Listing
April 2021

Mortality of patients with bullous pemphigoid in Italy: a retrospective study of a monocentric experience.

Ital J Dermatol Venerol 2021 Apr 29. Epub 2021 Apr 29.

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

Background: Mortality of bullous pemphigoid(BP) is a variable parameter,depending especially on the area where the study was conducted.The 1-year mortality rate and the identification of clinictherapeutic factors with potential prognostic value in patients with BP were evaluated in a cohort from a single referral center.

Methods: We have reviewed medical records of patients with BP diagnosed at the Sant'Orsola-Malpighi Hospital in Bologna(Italy) between 2005 and 2019.Data collected included sex,age at diagnosis,laboratory findings,severity of disease,dosage of systemic treatments,age at death and comorbidities.Only patients who had at least 1 year of follow-up were included.

Results: 85 patients were included; the mortality rate was 7.1%.The mortality rate of patients treated with a moderate dosage of corticosteroids was no higher than that of patients treated with a low dosage.The log-rank test showed a statistically significant correlation between mortality and patients aged≥85,BP230 positive,and CCIS≥4.

Conclusions: Compared with similar studies,our results show a lower 1-year mortality rate.Advanced age at diagnosis and CCIS were confirmed as major independent factors associated with poor prognosis in BP.Administration of moderate dosage of oral corticosteroids seems to have an overall positive benefit-risk ratio,providing a good control of the disease and minimizing the risk of hospitalization,possible related complications and the mortality rate.
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http://dx.doi.org/10.23736/S2784-8671.21.06840-1DOI Listing
April 2021

Concomitant Onychomadesis and Skin Rash in a 3-Year-Old Child Affected by Hand, Foot, and Mouth Disease.

Indian J Dermatol 2021 Jan-Feb;66(1):106-108

Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. E-mail:

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http://dx.doi.org/10.4103/ijd.IJD_325_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8061493PMC
April 2021

Increasing the dose of secukinumab in suboptimal responders: a possible therapeutic strategy.

Ital J Dermatol Venerol 2021 Apr 23. Epub 2021 Apr 23.

Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy.

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http://dx.doi.org/10.23736/S2784-8671.21.06931-5DOI Listing
April 2021

Basal cell carcinoma arising in surgical drain insertion sites.

Ital J Dermatol Venerol 2021 Apr 23. Epub 2021 Apr 23.

Division of Dermatology, Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy -

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http://dx.doi.org/10.23736/S2784-8671.21.06911-XDOI Listing
April 2021

Post-traumatic panniculitis: skin sign of torture.

Ital J Dermatol Venerol 2021 Apr 23. Epub 2021 Apr 23.

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

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http://dx.doi.org/10.23736/S2784-8671.21.06868-7DOI Listing
April 2021

Verruköse erythematöse Papeln und Plaques am Arm einer Italienerin.

J Dtsch Dermatol Ges 2021 Apr;19(4):624-627

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

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http://dx.doi.org/10.1111/ddg.14273_gDOI Listing
April 2021

Insights into Mycoplasma-associated mucocutaneous disease.

Clin Exp Allergy 2021 Apr 4. Epub 2021 Apr 4.

Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), IRCCS Azienda Ospedaliero-Universitaria di Bologna, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1111/cea.13879DOI Listing
April 2021

Vulvar Basal Cell Carcinoma: Ultrasound and Dermoscopic Features.

Dermatol Surg 2021 Mar 5. Epub 2021 Mar 5.

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

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http://dx.doi.org/10.1097/DSS.0000000000002775DOI Listing
March 2021

Genitale Papeln bei einem Kind.

J Dtsch Dermatol Ges 2021 Mar;19(3):469-470

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/ddg.14188_gDOI Listing
March 2021

Tinea corporis incognito due to Microsporum Gypseum: Report of eight cases in children.

Pediatr Dermatol 2021 Mar 12. Epub 2021 Mar 12.

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

Microsporum gypseum is a geophilic saprophyte for which soil is the natural habitat. Tinea corporis caused by Microsporum gypseum is rare and usually occurs after direct contact with the soil or healthy carrier animals. We present a case series of eight children with tinea corporis caused by M gypseum, with unusual clinic presentations mimicking dermatitis.
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http://dx.doi.org/10.1111/pde.14573DOI Listing
March 2021

Viral rashes mimicking drug reaction with eosinophilia and systemic symptoms syndrome in children after β-lactams intake: a diagnostic challenge.

Eur J Pediatr 2021 Jul 9;180(7):2327-2332. Epub 2021 Mar 9.

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

In cases of skin eruptions over the course of antibiotic therapy and concomitant viral infection, differential diagnosis is often challenging. Confirming or ruling out drug hypersensitivity is not always a clear-cut question. Drug reaction with eosinophilia and systemic symptoms (DRESS) cases, for example, is classified as severe cutaneous adverse reactions due to drugs, but frequently the clinical manifestations do not completely fit into the diagnosis of DRESS. The aim of the present paper is to highlight similarities and differences among DRESS syndrome and DRESS-like rashes during viral infections and amoxicillin intake in children, in order to highlight those aspects that can help clinicians in early detection. We describe the dermatological, clinical, and laboratory characteristics of five patients hospitalized for DRESS-like skin rashes appearing roughly 1 week since the start of an amoxicillina course for upper respiratory tract infection (URTI) symptoms. The data are compared with those of 3 patients with early-onset DRESS syndrome. The absence of eosinophilia might be an initial marker to help identifying DRESS-like rashes; a quick clinical improvement and the confirmation of a viral infection able to explain the symptoms can help to finally rule out DRESS syndrome. Conclusion: A rapid, correct diagnosis of such DRESS-like rashes during viral infections allows more appropriate management and avoids unnecessary, life-long exclusion of useful and effective antibiotics because of a falsely "amoxicillin-allergy" labelling. What is Known: • Viral infections are common causes of skin rashes in children during antibiotic intake and may require differential diagnosis with drug reactions. • Early-onset DRESS syndrome is usually induced by antibiotics and appears ≤15 days after drug intake. What is New: • Prominent midface edema, maculopapular rash, and mild-to-moderate systemic symptoms may appear in children during viral illnesses treated with amoxicillin few days after drug intake, and may require differential diagnosis with early-onset DRESS. • In such cases, absence of eosinophilia, low (2-3) RegiSCAR score, confirmation of viral etiology, and a rapid resolution of the rash (2-5 days) might help to rule out DRESS; conversely, at an early stage, the presence of eosinophilia should suggest a diagnosis of DRESS.
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http://dx.doi.org/10.1007/s00431-021-04010-5DOI Listing
July 2021

Clinical, dermoscopic and histopathological features of solitary nevus lipomatosus cutaneous superficialis.

Indian J Dermatol Venereol Leprol 2021 May-Jun;87(3):399-401

Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.25259/IJDVL_399_19DOI Listing
May 2019

The impact of the COVID-19 pandemic on dermatologic practice: an Italian survey.

Eur J Dermatol 2021 Feb;31(1):55-59

Division of Dermatology, IRCCS Policlinico di Sant'Orsola, Bologna, Italy, Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy.

Background: Since December 2019, the global population has been experiencing an unprecedented challenge due to Corona virus disease (COVID-19). A pandemic was declared by the World Health Organization on March 11 2020, with an escalation of new cases worldwide. Dermatology units experienced a reorganization of regular activity, also providing clinical diagnosis and medical assistance to COVID-19-positive patients who developed cutaneous manifestations.

Objective: To evaluate the impact of the COVID-19 pandemic on Italian dermatologic clinical practice.

Materials & Methods: This was a prospective online survey, consisting of a questionnaire with 35 multiple-choice questions uploaded on the website of the Italian Society of Dermatology and Venereology - SIDeMaST.

Results: A total of 136 dermatologists, 78 women (57%) and 58 men (43%), participated in the survey. The mean age was 58 ± 14 years. In total, 60% of participants reported an impact of the pandemic on their practice, in most cases consisting of a remarkable reduction in routine clinical activity (58%). Concern regarding possible infection was evaluated with a score ranging from 0 (no concern) to 5 (extremely concerned): the fear of becoming infected was high (≥3 in 40%), as was the fear of infecting families, colleagues or patients (≥3 points in 45%).

Conclusion: The COVID-19 pandemic is having a strong impact on dermatology practice in Italy. The identification of critical points may help scientific societies to improve the clinical scenario and create specific strategies to overcome the emergency.
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http://dx.doi.org/10.1684/ejd.2021.3970DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8120755PMC
February 2021

Blau-graue Plaque am Gesäß.

J Dtsch Dermatol Ges 2021 Feb;19(2):296-299

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

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http://dx.doi.org/10.1111/ddg.14231_gDOI Listing
February 2021

Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations.

J Ultrasound 2021 Feb 1. Epub 2021 Feb 1.

Division of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University Hospital of Bologna Sant' Orsola-Malpighi Polyclinic, Via Massarenti, 1, 40138, Bologna, Italy.

A single-center retrospective study reviewed the following sonographic features of 18 confirmed cases of localized cutaneous leishmaniasis to identify shared presentation patterns: echotexture, lesion borders, hypodermal involvement, soft-tissue changes, and vascular pattern. A second objective was to correlate these patterns with clinical characteristics, including sex, age, anatomical location, nodule vs. plaque presentation, raised borders, granulation tissue, swelling, hyperkeratotic crusting, disease onset, and healing time. Two main patterns were identified with high-frequency ultrasonography. The first pattern was characterized by a high level of inflammation and deep hypodermal involvement, while the second variant showed involvement limited to the dermis, with minimal inflammation. The "inflammatory pattern" showed ill-defined borders, mixed echotexture, prominent vascularity with central distribution, and was correlated with clinical signs of ulceration, granulation tissue, raised borders, and longer healing time (p < 0.05). The "pauci-inflammatory pattern" presented a well-defined structure with decreased echogenicity, reduced or absent vascularity with minimal soft-tissue changes, and was associated with a shorter healing time (p < 0.05).
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http://dx.doi.org/10.1007/s40477-020-00537-9DOI Listing
February 2021

Cutaneous and Mucosal Melanomas of Uncommon Sites: Where Do We Stand Now?

J Clin Med 2021 Jan 28;10(3). Epub 2021 Jan 28.

Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, 67100 L'Aquila, Italy.

Melanomas arising at uncommon sites include a group of lesions related to unusual localizations in specific ethnic groups. The rarity of the disease often represents a limit to the participation of patients in specific trials. However, this peculiar genetic scenario has important therapeutic implications regarding new oncologic therapies. The aim of this article is to review the clinical features, somatic alterations and therapeutic options for melanomas of uncommon sites. They can be classified as cutaneous and mucosal lesions affecting the nail apparatus, palms/soles, oral mucosa, genital area and scalp. The prognosis may be worse compared to melanomas of other districts, and a prompt diagnosis may dramatically influence the outcome. Dermatologists and oncologists should therefore distinguish this melanoma subgroup in terms of surgical intervention and medical treatment. Due to the lack of mutations in genes usually found in cutaneous melanomas, the discovery of novel targets is required to develop new strategies and to change the prognosis of non-responders or wild-type patients.
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http://dx.doi.org/10.3390/jcm10030478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866093PMC
January 2021

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

A 10-Year Single Centre Experience of Erosive Pustular Dermatosis of the Leg: A Possible Correlation with Atopic Dermatitis?

Dermatology 2021 Jan 21:1-3. Epub 2021 Jan 21.

Dermatologia - IRCCS Policlinico di S.Orsola, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy.

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http://dx.doi.org/10.1159/000513352DOI Listing
January 2021

The clinical spectrum of COVID-19-associated cutaneous manifestations: An Italian multicenter study of 200 adult patients.

J Am Acad Dermatol 2021 05 18;84(5):1356-1363. Epub 2021 Jan 18.

Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy.

Background: COVID-19 is associated with a wide range of skin manifestations.

Objective: To describe the clinical characteristics of COVID-19-associated skin manifestations and explore the relationships among the 6 main cutaneous phenotypes and systemic findings.

Methods: Twenty-one Italian Dermatology Units were asked to collect the demographic, clinical, and histopathologic data of 200 patients with COVID-19-associated skin manifestations. The severity of COVID-19 was classified as asymptomatic, mild, moderate, or severe.

Results: A chilblain-like acral pattern was significantly associated with a younger age (P < .0001) and, after adjusting for age, significantly associated with less severe COVID-19 (P = .0009). However, the median duration of chilblain-like lesions was significantly longer than that of the other cutaneous manifestations taken together (P < .0001). Patients with moderate/severe COVID-19 were more represented than those with asymptomatic/mild COVID-19 among the patients with cutaneous manifestations other than chilblain-like lesions, but only the confluent erythematous/maculo-papular/morbilliform phenotype was significantly associated with more severe COVID-19 (P = .015), and this significance disappeared after adjustment for age.

Limitations: Laboratory confirmation of COVID-19 was not possible in all cases.

Conclusions: After adjustment for age, there was no clear-cut spectrum of COVID-19 severity in patients with COVID-19-related skin manifestations, although chilblain-like acral lesions were more frequent in younger patients with asymptomatic/pauci-symptomatic COVID-19.
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http://dx.doi.org/10.1016/j.jaad.2021.01.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7816892PMC
May 2021

Disease burden and treatment history among adults with atopic dermatitis receiving systemic therapy: baseline characteristics of participants on the EUROSTAD prospective observational study.

J Dermatolog Treat 2021 Mar 18;32(2):164-173. Epub 2021 Jan 18.

Sanofi Genzyme, Cambridge, MA, USA.

Background: Insights into the real-world treatment paradigm and long-term burden of atopic dermatitis (AD) are needed to inform clinical and health policy decisions.

Methods: The prospective, observational EUROSTAD study enrolled adults with moderate-to-severe AD starting or switching systemic therapy (51 sites in 10 European countries). We report the baseline characteristics, treatment patterns, and outcomes of these patients using descriptive statistics.

Results: A 12-month enrollment period of EUROSTAD was completed and 308 patients were enrolled: average age 37 years, AD duration 25 years, 43% were female. Most patients reported use of systemic therapy (93%) and ≥1 atopic comorbidity (82%). Mean [standard deviation] disease severity/burden measures were high: Investigator's Global Assessment (3.1 [0.8]), Eczema Area and Severity Index (16.2 [10.9]), Peak Pruritus Numerical Rating Scale (5.5 [2.5]), sleep impairment Visual Analog Scale (49.8 [31.6]) scores, and time lost from work (4.1 [13.7] days/year) or usual activities (16.8 [38.7] days/year). Most patients showed borderline or clinical levels of anxiety (59%) and/or depression (63%) using the Hospital Anxiety and Depression Scale.

Conclusions: Adults with moderate-to-severe AD starting/switching systemic treatment enrolled in EUROSTAD have a high burden of longstanding disease despite continuous use of topical drugs, emollients, and systemic therapies.
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http://dx.doi.org/10.1080/09546634.2020.1866741DOI Listing
March 2021

Filaggrin Loss-of-Function Mutations Are Risk Factors for Severe Food Allergy in Children with Atopic Dermatitis.

J Clin Med 2021 Jan 11;10(2). Epub 2021 Jan 11.

Division of Pediatrics, IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy.

Atopic dermatitis is frequently associated with the onset of other allergic conditions, such as asthma, rhino-conjunctivitis and food allergy. The etiology of atopic dermatitis is marginally understood in spite of the number of predisposing factors, above all, mutations in the gene ). In this study, the association between loss-of-function variants in the gene and other allergic manifestations, in particular food allergy, was evaluated in an Italian pediatric population affected by atopic dermatitis. The 10 more frequently mutated loci in the gene were genotyped in 238 children affected by atopic dermatitis and tested for association with clinical features of allergic disorders by a multivariate logistic regression model. R501X and 2282del4 were the only two mutations identified; 12.2% of children carry one of these variants, corresponding to an allelic frequency of 6.5%. According to multivariate statistical analysis, loss-of-function variants in the gene represent a risk factor for the onset of severe manifestations of food allergy (OR = 8.9; CI: 3.1-28.3). Peanut and hazelnut were identified as high-risk foods in patients with mutations. This study demonstrates that atopic children carrying mutations represent a high-risk population due to their predisposition to develop severe food allergy reactions, such as anaphylaxis.
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http://dx.doi.org/10.3390/jcm10020233DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7827548PMC
January 2021

Severe hidradenitis suppurativa in a patient affected by Hermansky-Pudlak Syndrome type 9: possible shared pathogenetic aspects.

Ital J Dermatol Venerol 2021 Apr 11;156(2):254-255. Epub 2021 Jan 11.

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

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http://dx.doi.org/10.23736/S0392-0488.20.06602-XDOI Listing
April 2021

Refractory palmo-plantar discoid lupus erythematosus successfully treated with mycophenolate mofetil: Unusual localization and literature review.

Dermatol Ther 2021 03 12;34(2):e14743. Epub 2021 Jan 12.

Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

Palmo-plantar lesions in discoid lupus erythematosus (DLE) can be considered a very distinct rarity, generally refractory to conventional treatments. We present a 47-year-old African female patient with a 6-month clinical history of palm and soles erosions. Clinical examination revealed painful multiple, well defined, erosions with an erythematous and scaly central area and peripherical post-inflammatory hyperchromic border bilaterally distributed on the palmo-plantar surfaces. Pterygium inversum unguis involved all nails of both hands. Histological analysis and direct immunofluorescence study confirmed palmo-plantar DLE. Therapy with mycophenolate mofetil (MMF) was initiated with a progressive clearing of palmo-plantar lesions and a drastic reduction of pain. Therapy was well tolerated, neither side effects nor altered laboratory investigations were observed. Our case and literature review confirm that MMF may be an effective approach for the management of refractory palmo-plantar DLE with a safer profile than Azathioprine regarding adverse effects and cutaneous malignancies risk.
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http://dx.doi.org/10.1111/dth.14743DOI Listing
March 2021