Publications by authors named "Emanuele Trovato"

12 Publications

  • Page 1 of 1

Psoriasis successfully treated with guselkumab in a patient with systemic lupus erythematosus and acquired hemophilia A.

Ital J Dermatol Venerol 2021 Jul 20. Epub 2021 Jul 20.

Dermatology Unit, Department of Medical, Surgical and Neurological sciences, Santa Maria alle Scotte Hospital, Siena University, Siena, Italy.

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http://dx.doi.org/10.23736/S2784-8671.21.07054-7DOI Listing
July 2021

Teledermatology in 2020: past, present and future perspectives.

Ital J Dermatol Venerol 2021 Apr;156(2):198-212

Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.

Born in 1995, teledermatology (TD) turns 25 years old today. Since then, TD evolved according to patients and physicians needs. The present review aimed to summarize all the efforts and experiences carried out in the field of TD and its subspecialties, the evolution and the future perspectives. A literature search was conducted in PubMed and Google Scholar. The state of the art of the "tele-dermo research" included TD and clinical trials, TD/TDS web platforms, TDS and artificial intelligence studies. Finally, the future perspective of TD/TDS in the era of social distancing was discussed. Using TD in specific situations adds several benefits including time-effectiveness of intervention and reduction in the waiting time for the first visit, reduced travel-costs, reduced sanitary costs, equalization of access from patient to specialistic consult. The communication technologies devices currently available can adequately support the growing needs of tele-assistance. A main limit is the current lack of a common clear European regulation for practicing TD, encompassing privacy issues and data management. The pandemic lockdown of 2020 has highlighted the importance of performing TD for all those patient, elderly and/or fragile, where the alternative would be no care at all. Many efforts are needed to develop efficient workflows and TD programs to facilitate the interplay among the different TD actors, along with practice guidelines or position statements.
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http://dx.doi.org/10.23736/S2784-8671.21.06731-6DOI Listing
April 2021

Ixekizumab as treatment of erythrodermic psoriasis.

Dermatol Ther 2021 03 19;34(2):e14868. Epub 2021 Feb 19.

Dermatology Unit, Department of Medical, Surgical, and Neurosciences, University of Siena, Siena, Italy.

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.
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http://dx.doi.org/10.1111/dth.14868DOI Listing
March 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 Jul 1;37(4):334-342. Epub 2021 Feb 1.

SOD Clinica di Dermatologia, Azienza Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, 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
July 2021

An unusual triple association: Superficial granulomatous pyoderma, subcorneal pustular dermatosis, IgA multiple myeloma.

J Cutan Pathol 2021 Mar 27;48(3):461-463. Epub 2020 Oct 27.

Department of Medical, Surgical and Neurological Science, Section of Dermatology, University of Siena, Siena, Italy.

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http://dx.doi.org/10.1111/cup.13848DOI Listing
March 2021

Sézary syndrome during anti-IL17 treatment.

Dermatol Ther 2020 11 28;33(6):e14321. Epub 2020 Sep 28.

Dermatology Section, Department of Medical, Surgical, and Neurological Sciences, Santa Maria Alle Scotte Hospital, Siena, Italy.

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http://dx.doi.org/10.1111/dth.14321DOI Listing
November 2020

Neurothekeomas: Dermoscopic Features of 3 Cases.

Dermatol Pract Concept 2019 Oct 31;9(4):322-324. Epub 2019 Oct 31.

Dermatology Section, Department of Medical Science, Surgery and Neurological Sciences, University of Siena, Siena, Italy.

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http://dx.doi.org/10.5826/dpc.0904a21DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830546PMC
October 2019

Meeting a rare disease: bullous ichthyosiform erythroderma.

G Ital Dermatol Venereol 2020 Dec 10;155(6):783-784. Epub 2018 Jul 10.

Division of Medical, Surgical and Neurosciences, Department of Dermatology, University of Siena, Siena, Italy.

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http://dx.doi.org/10.23736/S0392-0488.18.06058-3DOI Listing
December 2020

BCC and vismodegib: can we treat and remold at the same time?

G Ital Dermatol Venereol 2020 Feb 16;155(1):119-120. Epub 2018 May 16.

Section of Dermatology, Department of Clinical Medicine and Immunological Science, University of Siena, Siena, Italy.

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http://dx.doi.org/10.23736/S0392-0488.18.06043-1DOI Listing
February 2020

Sinecatechins 10% ointment for genital warts: Case report of a beneficial reaction in an HIV-positive woman.

Int J STD AIDS 2018 09 5;29(10):1033-1035. Epub 2018 Apr 5.

Dermatology Unit, Department of Medical, Surgical and Neuro-Sciences, University of Siena, Siena, Italy.

Patients with HIV infection are more likely to develop anogenital warts compared to HIV-negative people and are susceptible to treatment failures and recurrences. We report a case of extensive vulvar warts in an HIV-positive woman successfully treated with sinecatechins ointment. After the failure of a combination of cryotherapy and imiquimod 5% cream, we started therapy with sinecatechins 10% ointment. The patient developed an intense local inflammatory reaction after three weeks that induced the discontinuation of the therapy. After two weeks, we observed a complete regression of inflammation and a reduction of genital warts. The lesions completely regressed within a few weeks, with no relapse after eight months. Sinecatechins is a standardized extract of green tea leaves, effective in the treatment of external genital and perianal warts in immunocompetent patients, but their role has not been yet studied for immunocompromised people. Our case may represent a starting point for further studies, in order to evaluate the relation between treatment dosage, side effects, and drug response in immunocompromised patients.
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http://dx.doi.org/10.1177/0956462418763888DOI Listing
September 2018

Clinical and histological evaluation in patients with mycosis fungoides treated with UVA1.

G Ital Dermatol Venereol 2020 Jun 24;155(3):306-311. Epub 2018 Jan 24.

Unit of Dermatology, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy.

Background: UVA1 phototherapy is a valid therapeutic alternative for skin lymphoproliferative disorders, although there are few studies concerning its role in mycosis fungoides (MF). Our aim was to evaluate and confirm the effectiveness of UVA1 phototherapy in patients in early stage MF.

Methods: We enrolled 12 patients, 9 males and 3 females (mean age 54.83±9.99, range 36-74) with a histological diagnosis of mycosis fungoides at early stage. All patients were treated with UVA1 for 22 sessions with two different protocols (3 times or 5 times per week) at the dose of 45 J/cm2. A punch biopsy was performed before and after the treatment, to evaluate the variation of histological features and of the proliferation index (Ki67/MIB1).

Results: At the end of the study, we found a marked clinical improvement in all patients, associated to a statistically significant reduction of the proliferation index Ki67/MIB1. Five patients achieved a complete clinical and histological response, while six a partial one and only one a minimal response.

Conclusions: Although in recent years the number of the therapeutic options available for all types of skin lymphoproliferative disorders, in particular mycosis fungoides, has increased considerably, there are few studies concerning UVA1 phototherapy. Our results represent a starting point for further studies, in order to investigate the role that these UV-rays can play either alone or in combination with other therapeutic regimens.
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http://dx.doi.org/10.23736/S0392-0488.18.05867-4DOI Listing
June 2020

[Apheresis in dermatologic diseases].

G Ital Nefrol 2012 Jan-Feb;29 Suppl 54:S119-24

Dipartimento di Medicina Clinica e Scienze Immunologiche, Universita' degli Studi di Siena, Ospedale Le Scotte, Siena, Italy.

This report discusses the different types of apheresis used to treat skin diseases and focuses specifically on photopheresis or ECP (extracorporeal photochemotherapy). ECP is a systemic immunomodulatory therapy used successfully to treat many different, mainly autoimmune diseases such as cutaneous T-cell lymphomas, graft-versus-host disease, systemic sclerosis, atopic dermatitis, and pemphigus vulgaris. It has also proved effective against graft rejection after transplant. The exact mechanism by which the ECP performs its therapeutic activity is not yet entirely clear. However, at least 2 mechanisms have been identified that may explain the therapeutic effect. Firstly, ECP is able to induce downregulation of the self-allogeneic immune response that occurs in graft-versus-host disease, systemic sclerosis and atopic dermatitis, and secondly, it can stimulate an immune response against the neoplastic clones in patients with cutaneous T-cell lymphomas. At the Dermatology Clinic of the University of Siena, more than 100 patients with different immune-mediated diseases were treated with ECP. The results obtained are very interesting and our 20 years of experience confirm that the treatment is well tolerated. ECP can therefore be considered of great utility in the modulation of the immune system.
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June 2012
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