Publications by authors named "Ilaria Proietti"

63 Publications

Real world data of cemiplimab in locally advanced and metastatic cutaneous squamous cell carcinoma.

Eur J Cancer 2021 Sep 15;157:250-258. Epub 2021 Sep 15.

University of Brescia, Department of Medical-Surgical Specialties, Radiological Sciences and Public Health, Medical Oncology, ASST-Spedali Civili, Brescia, Lombardia, Italy. Electronic address:

Background: Cutaneous squamous cell carcinoma (cSCC) has an overall favourable outcome, except for patients with an advanced stage disease. The programmed death protein-1 (PD-1) inhibitor cemiplimab has been approved for use in advanced cSCC. We report clinical outcomes from the named patient programme-compassionate use of cemiplimab for patients with advanced cSCC in Italy.

Methods: This is a retrospective, observational, multicentre study. We analysed medical records of patients with advanced cSCC treated with cemiplimab between May 2019 and February 2020 in 17 referral Italian centres. We assessed the safety profile according to the Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE v 5.0), the clinical activity in terms of response rate, clinical benefit and duration of response and baseline clinical-pathologic characteristics associated with response.

Results: 131 patients were included, with a median age of 79 years. Of them, 9.2% had a concurrent chronic lymphoproliferative disease and 8.5% a concomitant autoimmune disease. Some 42.7% of the total patients had at least one treatment-related adverse events (AEs); out of above, 9.2% had grade 3-4 adverse events, and there were two fatal adverse events. The overall response rate (ORR) was 58%, and the disease control rate (DCR) was 71.7%. Cutaneous squamous cell carcinomas (cSCCs) arising on the head and neck area (p = 0.007) and haemoglobin values in normal range (p = 0.034) were significantly associated with a better response, while cSCCs on the genitalia (p = 0.041), treatment with any systemic antibiotic within 1 month of cemiplimab initiation (p = 0.012), performance status ≥1 (p = 0.012), chronic corticosteroids therapy (p = 0.038), previous radiation therapy to lymph nodes (p = 0.052) and previous chemotherapy (p = 0.0020) were significantly associated with a worse response.

Conclusions: Our real-world study showed safety and effectiveness results comparable to those obtained in clinical trials. We identified some clinical and biochemical factors potentially associated with response to cemiplimab.
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http://dx.doi.org/10.1016/j.ejca.2021.08.018DOI Listing
September 2021

Safety and Impact of Anti-COVID-19 Vaccines in Psoriatic Patients Treated with Biologics: A Real Life Experience.

J Clin Med 2021 Jul 29;10(15). Epub 2021 Jul 29.

Dermatology Unit "D. Innocenzi", Sapienza University of Rome, Polo Pontino, 04100 Terracina, Italy.

Since all clinical trials conducted during the development of anti-COVID-19 vaccines have adopted among the exclusion criteria the presence of immunodepression or immunomodulating therapy, to date, the effects of vaccination against the new coronavirus 2 in people under such conditions have yet to be clearly defined. The primary objective of the study is to assess the safety of treatment with biotechnological drugs in patients suffering from moderate-severe psoriasis and subjected to the prophylactic vaccination against SARS-Cov-2. Additionally, the secondary objective of the research is to investigate the existence of a possible impact of anti-COVID-19 vaccination on the natural chronic-relapsing course and the severity of the psoriatic disease. The study included 436 patients with moderate-severe psoriasis, both male and female, in treatment with biologics. The data were collected using the direct interview method. A reduction of 74.13% of average Psoriasis Area Severity Index (PASI )compared to baseline (T0) was found in all subjects; this does not differ significantly from the group that underwent vaccination (73.4%). Moreover; at the end of the study, neither mild nor severe adverse events (ADR) were observed among them. In conclusion, biotechnological drugs used in the management of patients with moderate-severe psoriasis demonstrate a high safety profile also in subjects immunized against SARS-Cov-2.
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http://dx.doi.org/10.3390/jcm10153355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347527PMC
July 2021

Long-Term Maintained Response to Selective Internal Radiation Therapy in an Oligometastatic Uveal Melanoma Patient Treated with Concomitant Anti-PD-1 Therapy.

Life (Basel) 2021 Jul 14;11(7). Epub 2021 Jul 14.

Dermatology Unit "Daniele Innocenzi", "A. Fiorini" Hospital, Via Firenze, 1, 04019 Terracina, Italy.

Uveal melanoma (UM) is a primary neoplasm of the eye arising from the melanocytes residing in the iris, ciliary body or choroid. It is the most frequent intraocular malignancy and often determines metastases at distant sites, with a peculiar tropism for the liver. Metastatic UM has a poor prognosis, as any treatment affects the natural course of this fatal disease. Herein, we report a case of a UM metastatic to the liver in a 54 year-old female patient, initially treated with nivolumab without success. The patient was then scheduled for selective internal radiation therapy (SIRT) while continuing immunotherapy. This combination led to a complete and durable response and the patient is currently free of disease, two years after the diagnosis of the hepatic metastases. The association between SIRT and immunotherapy (IT) has very promising perspectives for metastatic UM, especially considering the disappointing or contradictory results of classic chemotherapies, IT alone and targeted therapies. Furthermore, this combination has been shown to have a good security profile. However, further studies are needed to confirm the efficacy of associating SIRT and IT and to clarify some unsolved problems, such as the timing of administration of these two therapies.
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http://dx.doi.org/10.3390/life11070692DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307638PMC
July 2021

Correction to: Oropharyngeal Dysphagia After Hospitalization for COVID-19 Disease: Our Screening Results.

Dysphagia 2021 Jul 30. Epub 2021 Jul 30.

Department of Head and Neck Sciences, Catholic University of Sacred Heart, Policlinico "A. Gemelli" Foundation, L.go "A. Gemelli" 8, 00168, Rome, Italy.

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http://dx.doi.org/10.1007/s00455-021-10342-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8322828PMC
July 2021

An Open-label Study Comparing Oral Zinc to Lymecycline in the Treatment of Acne Vulgaris.

J Clin Aesthet Dermatol 2021 May 1;14(5):56-58. Epub 2021 May 1.

All authors are with the Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, at the Sapienza University of Rome in Polo Pontino, Latina, Italy.

Acne is a chronic multifactorial skin disease with a high prevalence among adolescents. The therapeutic approach for mild to moderate papulopustular acne includes the use of systemic tetracycline. Increased risk of antibiotic resistance necessitates research into alternative therapeutic approaches, such as zinc sulphate. Efficacy of zinc sulphate in acne treatment is widely reported in the literature, but drug comparison studies are lacking. We sought to compare the efficacy and safety of zinc sulphate to lymecycline for the treatment of mild to moderate papulopustular acne. One hundred patients were equally randomized to receive either zinc sulphate or lymecycline. Acne severity was evaluated using the subjective Global Acne Grading System (GAGS) and the Acne-specific Quality of Life (AQoL) questionnaire at baseline and after four and 12 weeks. Both zinc sulphate and lymecycline induced a statistically significant reduction in GAGS scores at four and 12 weeks of treatment. The improvements in AQoL scores in patients treated with zinc sulphate were significantly higher than those in the lymecycline group. Our study suggests that zinc sulphate is a valid alternative therapeutic approach in the treatment of mild to moderate papulopustular acne relative to lymecycline in terms of clinical efficacy, tolerability, and the occurrence of side effects.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8211333PMC
May 2021

Oropharyngeal Dysphagia After Hospitalization for COVID-19 Disease: Our Screening Results.

Dysphagia 2021 Jun 24. Epub 2021 Jun 24.

Department of Head and Neck Sciences, Catholic University of Sacred Heart, Policlinico "A. Gemelli" Foundation, L.go "A. Gemelli" 8, 00168, Rome, Italy.

A high percentage of patients suffered symptoms also after recovery from the Coronavirus Disease-2019 (COVID-19) infection. It is not well clear what are the specific long-term sequelae (complications and symptoms). During the acute phase the patients may develop a multi-organ system pathology including aerodigestive tract. As the pathophysiology of COVID-19 emerges, the aim of our study was to describe the prevalence of oropharyngeal dysphagia after COVID-19 disease. From March to July 2020 we enrolled patients recovered from SARS-CoV-2 infection who had been previously hospitalized for the disease. They were screened for dysphagia by mean of the Eating Assessment Tool-10 (EAT-10). The cases with EAT-10 score > 3 were graded for the aspiration risk by applying the Gugging Swallowing Screen (GUSS) and were submitted to the Swal-QoL questionnaire. The cases with a GUSS score > 19 were subjected to FEES. 8/117 (7%) patients had positive screening result. 4/8 (50%) revealed an abnormal health related quality of life in oropharyngeal dysphagia with a mean Swal-QoL score of 69.73. The most affected domain was the "time of meals" (mean score 65) following by the "sleep" (mean score 66) and "eating desire" (mean score 72). 1/8 cases showed increased risk for aspiration and did not showed endoscopic signs of oropharyngeal dysphagia. Our results showed that the prevalence of upper dysphagia after hospitalization for SARS-CoV-2 is not anecdotal and that probably this long-lasting sequela has a psychogenic etiology.
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http://dx.doi.org/10.1007/s00455-021-10325-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8222948PMC
June 2021

Metastatic penile squamous cell carcinoma successfully treated with cemiplimab in an HIV patient.

Dermatol Ther 2021 03 17;34(2):e14744. Epub 2021 Jan 17.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Rome, Italy.

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http://dx.doi.org/10.1111/dth.14744DOI Listing
March 2021

Molecular imaging in immuno-oncology: current status and translational perspectives.

Expert Rev Mol Diagn 2020 12 7;20(12):1199-1211. Epub 2020 Dec 7.

Department of Nuclear Medicine, Santa Maria Goretti Hospital, AUSL , Latina, Italy.

: Only 20-40% of patients respond to therapy with immune checkpoint inhibitors (ICIs). Therefore, the early identification of subjects that can benefit from such therapeutic regimen is mandatory. : The immunobiological mechanisms of ICIs are briefly illustrated. Furthermore, the limitations of traditional radiological approaches are covered. Then, the pros and cons of molecular imaging through positron emission computed tomography (PET/CT) are reviewed, with a particular focus on f-fluorodeoxyglucose (F-FDG) and PET-derived metabolic parameters. Lastly, translational perspective of radiopharmaceuticals others than F-FDG such as zirconium (Zr) or fluorine-18 (F) labeled monoclonal antibodies (e.g.Zr-atezolizumab, Zr-nivolumab) binding to specific biomarkers are discussed. : Molecular imaging presents a prominent role for the management of oncological patients treated with ICIs. Preliminary clinical data indicate that PET/CT with F-FDG is useful for assessing the response to treatment and for the imaging of immune-related adverse effects. Nevertheless, the methodological approach (iPERCIST, PERCIMT, or others) to be used for an optimal diagnostic accuracy and patients' evaluation is still a debated issue. PET/CT with radioligands directed toward ICIs biomarkers, although is still in a translational phase, holds the promise of accurately predicting the response to treatment and revealing the acquired resistance to immunotherapy.
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http://dx.doi.org/10.1080/14737159.2020.1854090DOI Listing
December 2020

Do Diet and Lifestyles Play a Role in the Pathogenesis of NMSCs?

Nutrients 2020 Nov 11;12(11). Epub 2020 Nov 11.

Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy.

Background And Aims: Literature highlights the role of risk factors like age, body mass index (BMI), tobacco smoking, alcohol intake and diet in the pathogenesis of several cancer types but little is known for non-melanoma skin cancers (NMSC). The aim of this epidemiological study was to evaluate the correlation between modifiable risk factors (BMI, metabolic panel, diet, lifestyle, medical history) and not modifiable risk factors (gender, age) and NMSC development.

Methods: From February 2018 to September 2019, 162 patients affected by NMSC were compared to a group of 167 controls. A univariate and multivariate analysis was conducted to elaborate the data collected through face-to-face interviews.

Results: While our evidence did not always reach statistical significance, NMSC study group patients exhibited high rates of analyzed risk factors (male gender aging over 55 years, high BMI, reduced physical activity) compared to the control group.

Conclusions: Our study indicates that practicing more than 30 min of physical activity daily could be a protective factor against the NMSC onset. Other risk factors were not correlated with NMSC, but more evidence is needed to establish a possible link.
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http://dx.doi.org/10.3390/nu12113459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697298PMC
November 2020

Efficacy and safety of systemic isotretinoin treatment for moderate to severe acne (insights from the real-life clinical setting).

Dermatol Ther 2020 11 2;33(6):e14392. Epub 2020 Nov 2.

Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, Terracina, Italy.

Acne is a chronic inflammatory relapsing disease that affect predominantly adolescents, with scarring as a frequent sequele. Early and appropriate therapy allows better management of the disease, longer remission, scars risk reduction, and improvement of quality of life. According to therapeutic algorithm, systemic isotretinoin can be used in severe acne and also in moderate forms resistant to other systemic treatments. The aims of this real-life observational study were to determine and compare the effectiveness of isotretinoin evaluated by Global Acne Grading System and Acne Quality of Life in moderate and in severe acne, correlation between efficacy and cumulative dose of isotretinoin, tolerability, and recurrence rate. Moreover, the differences in efficacy and tolerability between male and female patients were compared. The treatment with systemic isotretinoin led to an improvement in acne severity and quality of life in all observed subjects.
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http://dx.doi.org/10.1111/dth.14392DOI Listing
November 2020

Mechanisms of Acquired BRAF Inhibitor Resistance in Melanoma: A Systematic Review.

Cancers (Basel) 2020 Sep 29;12(10). Epub 2020 Sep 29.

Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy.

This systematic review investigated the literature on acquired v-raf murine sarcoma viral oncogene homolog B1 (BRAF) inhibitor resistance in patients with melanoma. We searched MEDLINE for articles on BRAF inhibitor resistance in patients with melanoma published since January 2010 in the following areas: (1) genetic basis of resistance; (2) epigenetic and transcriptomic mechanisms; (3) influence of the immune system on resistance development; and (4) combination therapy to overcome resistance. Common resistance mutations in melanoma are BRAF splice variants, amplification, neuroblastoma RAS viral oncogene homolog (NRAS) mutations and mitogen-activated protein kinase kinase 1/2 (MEK1/2) mutations. Genetic and epigenetic changes reactivate previously blocked mitogen-activated protein kinase (MAPK) pathways, activate alternative signaling pathways, and cause epithelial-to-mesenchymal transition. Once BRAF inhibitor resistance develops, the tumor microenvironment reverts to a low immunogenic state secondary to the induction of programmed cell death ligand-1. Combining a BRAF inhibitor with a MEK inhibitor delays resistance development and increases duration of response. Multiple other combinations based on known mechanisms of resistance are being investigated. BRAF inhibitor-resistant cells develop a range of 'escape routes', so multiple different treatment targets will probably be required to overcome resistance. In the future, it may be possible to personalize combination therapy towards the specific resistance pathway in individual patients.
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http://dx.doi.org/10.3390/cancers12102801DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7600801PMC
September 2020

Recurrent erythrodermic psoriasis and polycythemia successfully treated with brodalumab.

Dermatol Ther 2020 11 8;33(6):e14338. Epub 2020 Oct 8.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy.

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http://dx.doi.org/10.1111/dth.14338DOI Listing
November 2020

Therapeutic Options for the Treatment of Actinic Keratosis with Scalp and Face Localization.

Acta Dermatovenerol Croat 2020 Aug;28(2):93-101

Nicoletta Bernardini, MD, PhD, "Daniele Innocenzi" Dermatology Unit Dept of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome Fiorini Hospital, Via Firenze snc Polo Pontino, 04019 Terracina, Italy;

Actinic keratosis (AK) is a common skin disease related to ultraviolet chronic exposure, that is now considered a squamous cell carcinoma in situ. Primary skin cancer prevention strategies should be recommended for high risk patients. There is a wide spectrum of treatment options available for AKs, and several variables should be taken into account regarding the best therapeutic choice for each patient. The purpose of this article is to review the current treatment strategies for AKs localized on the face and scalp, with a focus on the practical point of view that could be useful for choosing the best therapeutic option. The two main therapeutic approaches will be distinguished first: lesion-directed and field-directed. Afterwards, the treatment based on clinical type and patient comorbidity will be discussed.
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August 2020

Polymorphic eruption of pregnancy as a possible COVID-19 manifestation.

Dermatol Ther 2020 11 3;33(6):e14117. Epub 2020 Sep 3.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy.

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http://dx.doi.org/10.1111/dth.14117DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436318PMC
November 2020

Auricle perniosis as a manifestation of Covid-19 infection.

Dermatol Ther 2020 11 16;33(6):e14089. Epub 2020 Aug 16.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome Polo Pontino, Rome, Italy.

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http://dx.doi.org/10.1111/dth.14089DOI Listing
November 2020

Urticaria in an infant with SARS-CoV-2 positivity.

Dermatol Ther 2020 11 13;33(6):e14043. Epub 2020 Aug 13.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Terracina, Italy.

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http://dx.doi.org/10.1111/dth.14043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7404499PMC
November 2020

Evaluation of Cardiovascular Risk in Hidradenitis Suppurativa Patients Using Heart Rate Variability (HRV) Analysis.

Cardiovasc Ther 2020 27;2020:1321782. Epub 2020 Jun 27.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease associated with elevated prevalence of comorbidities, especially metabolic and cardiovascular diseases. We used a tool called Heart Rate Variability (HRV) in order to assess the correlation between HS and alterations of the sympathetic-vagal equilibrium in the autonomic cardiovascular regulation system. We found increased sympathetic activity, associated with a higher risk of cardiovascular disease. HS, according to our results, is an independent cardiovascular risk factor.
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http://dx.doi.org/10.1155/2020/1321782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7349464PMC
September 2020

BRAF Inhibitors: Molecular Targeting and Immunomodulatory Actions.

Cancers (Basel) 2020 Jul 7;12(7). Epub 2020 Jul 7.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, 04100 Latina, Italy.

The BRAF inhibitors vemurafenib, dabrafenib and encorafenib are used in the treatment of patients with BRAF-mutant melanoma. They selectively target BRAF kinase and thus interfere with the mitogen-activated protein kinase (MAPK) signalling pathway that regulates the proliferation and survival of melanoma cells. In addition to their molecularly targeted activity, BRAF inhibitors have immunomodulatory effects. The MAPK pathway is involved in T-cell receptor signalling, and interference in the pathway by BRAF inhibitors has beneficial effects on the tumour microenvironment and anti-tumour immune response in BRAF-mutant melanoma, including increased immune-stimulatory cytokine levels, decreased immunosuppressive cytokine levels, enhanced melanoma differentiation antigen expression and presentation of tumour antigens by HLA 1, and increased intra-tumoral T-cell infiltration and activity. These effects promote recognition of the tumour by the immune system and enhance anti-tumour T-cell responses. Combining BRAF inhibitors with MEK inhibitors provides more complete blockade of the MAPK pathway. The immunomodulatory effects of BRAF inhibition alone or in combination with MEK inhibition provide a rationale for combining these targeted therapies with immune checkpoint inhibitors. Available data support the synergy between these treatment approaches, indicating such combinations provide an additional beneficial effect on the tumour microenvironment and immune response in BRAF-mutant melanoma.
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http://dx.doi.org/10.3390/cancers12071823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408709PMC
July 2020

Efficacy of nivolumab in HIV patient with melanoma brain metastases.

AIDS 2020 07;34(9):1433-1435

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit 'Daniele Innocenzi', Sapienza University of Rome, Polo Pontino.

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http://dx.doi.org/10.1097/QAD.0000000000002554DOI Listing
July 2020

Melanoma: Double BRAF mutation, double chance to treat?

Dermatol Ther 2020 11 6;33(6):e13820. Epub 2020 Jul 6.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy.

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http://dx.doi.org/10.1111/dth.13820DOI Listing
November 2020

A case of hidradenitis suppurativa successfully treated with apremilast in a patient with psoriasis and SAMPUS.

Dermatol Ther 2020 05 8;33(3):e13448. Epub 2020 May 8.

Department of Medical-Surgical Sciences and Biotechnologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Polo Pontino, Italy.

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http://dx.doi.org/10.1111/dth.13448DOI Listing
May 2020

Transitory auricular nodules: a peculiar adverse reaction in actinic keratosis field treatment.

Int J Dermatol 2020 Aug 19;59(8):e279-e281. Epub 2020 Apr 19.

Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Polo Pontino, Italy.

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http://dx.doi.org/10.1111/ijd.14882DOI Listing
August 2020

Improving skin quality in patients with dermatologic conditions using the hyaluronic acid filler VYC-12.

G Ital Dermatol Venereol 2020 Mar 3. Epub 2020 Mar 3.

Dermatology Unit "Daniele Innocenzi", Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Terracina, Rome, Italy.

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http://dx.doi.org/10.23736/S0392-0488.19.06453-8DOI Listing
March 2020

Black and Pink: Single Lesion or Double Diagnosis?

Dermatol Pract Concept 2020 31;10(1):e2020025. Epub 2019 Dec 31.

Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.

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http://dx.doi.org/10.5826/dpc.1001a25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936632PMC
December 2019

Ingenol mebutate therapy in erythroplasia of Queyrat: a new approach.

Ital J Dermatol Venerol 2021 Jun 4;156(3):388-391. Epub 2019 Dec 4.

Unit of Dermatology Daniele Innocenzi, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Fiorini Hospital - Polo Pontino, Rome, Italy.

Background: Erythroplasia of Queyrat (EQ) is a rare squamous cell carcinoma in situ, usually occurring on the glans penis, the prepuce, or the urethral meatus. Therapy is mandatory because it can progress to invasive carcinoma in up to 30% of cases. Treatment options include 5-fluorouracil, curettage, cryotherapy, radiotherapy, laser, partial or total penectomy, and microsurgery, as also with imiquimod and photodynamic therapies.

Methods: Between 2015 to 2018 we treated five patients, with histologically confirmed EQ, with ingenol mebutate (IM) 0.015% gel applied for 3 days consecutively.

Results: Three patients showed complete response at one year follow up. Two patients showed partial response after two months, so they received a second course of therapy with IM. At one-year follow-up, one of them showed complete response, the other partial response.

Conclusions: Our experience demonstrated that IM may be considered as an effective and safe treatment option in EQ. IM offers various advantages such as easy and fast application, rapid complete remission, better compliance, few side effects and excellent cosmetical results. The authors call for further exploitation in bigger trials.
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http://dx.doi.org/10.23736/S0392-0488.19.06371-5DOI Listing
June 2021

On the role of skin biopsy in the diagnosis of calcific uremic arteriolopathy: a case-based discussion.

J Nephrol 2020 Aug 2;33(4):859-865. Epub 2019 Dec 2.

Dialysis Unit at ICOT Hospital, Latina, Italy.

Calciphylaxis is a rare disease characterized by ectopic calcification of skin arterioles resulting in ischemia, thrombosis and necrosis. Since end stage renal disease patients are those mainly affected, the term calcific uremic arteriolopathy (CUA) is also suggested. Early clinical manifestations are subtle, while overt necrotic ulcers may quickly spread and become infected so as to result in ominous outcome. Diagnosis might not be easy due to the number of other ischemic and non-ischemic skin lesions observed in uraemia. Skin biopsy, has been proposed as the diagnostic test and is often considered, but not systematically performed due to the hypothetical risk of further spreading of the lesions. Such ambiguity could be responsible for misdiagnosis or underdiagnosis. We review here five consecutive cases recorded in our Unit, all submitted to skin biopsy but with inconsistent results which generated some clinical frustration. Thus, we decided to carefully re-evaluate all of them together with pathologists and dermatologists. However, even after this ex-post discussion, we could not reach a complete agreement on the final diagnosis. In the meanwhile, papers were published in the literature that started to shed some light on the role of skin biopsy in the diagnosis of CUA.
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http://dx.doi.org/10.1007/s40620-019-00678-zDOI Listing
August 2020

IL-17 and its role in inflammatory, autoimmune, and oncological skin diseases: state of art.

Int J Dermatol 2020 Apr 30;59(4):406-411. Epub 2019 Oct 30.

Dermatology Unit "Daniele Innocenzi", Department of Medico-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Teracina, Italy.

Recent data support the theory of the involvement of IL-17 in the pathogenesis of several chronic inflammatory skin diseases (psoriasis, atopic dermatitis, acne, hidradenitis suppurativa) and autoimmune skin diseases (alopecia areata, vitiligo, bullous diseases). Even if the role of IL-17 in inflammatory and autoimmune diseases has been reported extensively, its role in tumor is still controversial. Some reports show that Th17 cells eradicate tumors, while others reveal that they promote the initiation and early growth of tumors. Herein, we review the role of IL-17 in the involvement of some common dermatologic diseases: psoriasis, atopic dermatitis, hidradenitis suppurativa, acne, vitiligo, melanoma, and nonmelanoma skin cancers.
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http://dx.doi.org/10.1111/ijd.14695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216999PMC
April 2020

Eruptive Blue Nevi of the Scalp in a Patient with Mayer-Rokitansky-Küster-Hauser Syndrome during Isotretinoin Therapy.

Indian J Dermatol 2019 Jul-Aug;64(4):339

Department of Medical-Surgical Sciences and Bio-Technologies, Dermatology Unit "Daniele Innocenzi", Sapienza University of Rome, Fiorini Hospital, Polo Pontino, Terracina, Italy. E-mail:

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http://dx.doi.org/10.4103/ijd.IJD_188_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714184PMC
September 2019

The Skin in Celiac Disease Patients: The Other Side of the Coin.

Medicina (Kaunas) 2019 Sep 9;55(9). Epub 2019 Sep 9.

Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.

Celiac disease (CD) is an autoimmune enteropathy that primarily affects the small intestine and is characterized by atrophy of intestinal villi. The manifestations of the disease improve following a gluten-free diet (GFD). CD is associated with various extra-intestinal diseases. Several skin manifestations are described in CD patients. The present paper reviews all CD-associated skin diseases reported in the literature and tries to analyze the pathogenic mechanisms possibly involved in these associations. Different hypotheses have been proposed to explain the possible mechanisms involved in every association between CD and cutaneous manifestations. An abnormal small intestinal permeability seems to be implicated in various dermatological manifestations. However, most of the associations between CD and cutaneous diseases is based on case reports and case series and a few controlled studies. To better assess the real involvement of the cutaneous district in CD patients, large multicentric controlled clinical trials are required.
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http://dx.doi.org/10.3390/medicina55090578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780714PMC
September 2019
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