Publications by authors named "Mauro Alaibac"

150 Publications

An expert consensus report on Mycosis fungoides in Italy: epidemiological impact and diagnostic-therapeutic pathway.

Ital J Dermatol Venerol 2021 May 26. Epub 2021 May 26.

UOC Dermatologia, Dipartimento di Medicina Interna Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.

Mycosis fungoides (MF) is a rare neoplasm representing the most frequent form of primary cutaneous T-cell lymphoma (CTCL). Diagnosis of MF is generally complex, often requiring integration of clinical, histological, immunophenotypic and molecular data. Currently, there are no epidemiological data supported by registries or local studies on MF in Italy. Moreover, the clinical management of MF in Italy is heterogeneous, and differs according to the geographical area and experience of the physician who manages the disease. Considering the uncertainties in the current scenario for MF in Italy, a consensus project involving experts on CTCL was initiated to define the epidemiological impact of MF and obtain information about the current diagnostic and therapeutic pathway of this disease in Italy. The prevalence of MF in Italy was estimated to be 6,800 patients, 4,900 of whom with early stage of disease; the estimated incidence ranged between 270 and 330 new cases per year. Among the clinical figures involved in the multidisciplinary management of MF, dermatologists were recognised as a reference point for both diagnosis and therapeutic decisions. These findings suggest the importance of monitoring both the disease and its management; it is, therefore, interesting to set up regional registries for monitoring and recognition of rare tumor status for MF. The results further indicate the need to train physicians to favour more rapid diagnosis and simplify the pathway for referring patients to reference centres with adequate diagnostic and treatment standards. In light of the forthcoming introduction of new therapies, the development of a nationwide PDTA (Path of Diagnostic Therapeutic Care, in Italian defined as Percorso Diagnostico-Terapeutico Assistenziale) is also of substantial importance.
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http://dx.doi.org/10.23736/S2784-8671.20.06668-7DOI Listing
May 2021

Management of PD-1/PD-L1 blockade immune-related skin toxicities: perspectives and issues.

Immunotherapy 2021 Jul 6;13(10):795-798. Epub 2021 May 6.

Department of Medicine-DIMED, Unit of Dermatology, University of Padova, Padova, Italy.

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http://dx.doi.org/10.2217/imt-2021-0071DOI Listing
July 2021

Complete remission of primary cutaneous anaplastic large cell lymphoma after a short course of brentuximab vedotin.

Mol Clin Oncol 2021 Jun 15;14(6):121. Epub 2021 Apr 15.

Unit of Dermatology, University of Padua, Padova I-35128, Italy.

Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare CD30 lymphoproliferative disorder characterized by the development of lesions ranging from papules to large tumors. Most cases present as localized disease, however multifocal and generalized involvement of the skin can occur. Several treatments have been proposed for PCALCL; however a highly effective standard approach to multifocal disease has not yet been elucidated. The disease expression of CD30 antigen in at least 75% of the tumor makes it an optimal target for immunotherapy. The current study presents a case of a 62-year-old male referred to the University of Padua Dermatology Clinic complaining about nodular and ulcerated lesions involving the frontal area and scalp that were 8 cm in diameter. Doses of 180 mg brentuximab vedotin (BV), which is an antibody drug conjugate binding CD30 antigen, were administered every 21 days. A 75% decrease in dimensions after the first infusion and a complete remission after the second was observed. Disease response appeared to be dose-related and adverse reactions, in particular peripheral neuropathy, may be an effect of cumulative toxicity, meaning that treatment cycle reduction should be considered. Based on the present results, A high dose, short course of BV is recommended as a cost-effective approach for PCALCL. However, further studies are required to assess the efficacy and other potential advantages of this therapeutic regimen.
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http://dx.doi.org/10.3892/mco.2021.2283DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8082231PMC
June 2021

Melanoma of Unknown Primary: Evaluation of the Characteristics, Treatment Strategies, Prognostic Factors in a Monocentric Retrospective Study.

Front Oncol 2021 5;11:627527. Epub 2021 Mar 5.

Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.

Background: Melanoma of unknown primary (MUP), accounts for up to 3% of all melanomas and consists of a histologically confirmed melanoma metastasis to either lymph nodes, (sub)cutaneous tissue, or visceral sites without any evidence of a primary cutaneous, ocular, or mucosal melanoma. This study aimed to investigate the characteristics, treatment strategies, and prognostic factors of MUP patients, in order to shed some light on the clinical behavior of this malignancy.

Methods: All the consecutive patients with a diagnosis of MUP referring to our institutions between 1985 and 2018 were considered in this retrospective cohort study. The records of 173 patients with a suspected diagnosis of MUP were retrospectively evaluated for inclusion in the study. Patient selection was performed according to the Das Gupta criteria, and a total of 127 MUP patients were finally included in the study, representing 2.7% of the patients diagnosed with melanoma skin cancer at our institutions during the same study period. A second cohort of all consecutive 417 MKP patients with AJCC stages IIIB-IV, referring tions in the period considered (1985-2018), was included in the study to compare survival between MUP and MKP patients. All the diagnoses were based on histopathologic, cytologic and immunohistochemical examination of the metastases. All tumors were re-staged according to the 2018 American Joint Committee on Cancer (AJCC) 8 Edition.

Results: Median follow-up was 32 months (IQR: 15-84). 3-year progression-free survival (PFS) was 54%, while 3-year overall survival (OS) was 62%. Worse OS and PFS were associated with older age (P = 0.0001 for OS; P = 0.008 for PFS), stage IV (P < 0.0001 for OS; P = 0.0001 for PFS) and higher Charlson Comorbidity Index (P < 0.0001 for OS and P = 0.01 for PFS). Patients with lymph node disease showed longer PFS (P = 0.001) and OS (P = 0.0008) than those with (sub)cutis disease. Complete lymph node dissection (CLND) was the most common surgical treatment; a worse OS in these patients was associated with the number of positive lymph nodes (P = 0.01), without significant association with the number of retrieved lymph nodes (P = 0.79). Survival rates were lower in patients undergoing chemotherapy (CT) and target therapy (TT), and higher in those receiving immunotherapy (IT). 417 patients with AJCC stages IIIB-IV of Melanoma Known Primary (MKP) were included for the survival comparison with MUP. 3-year PFS rates were 54 and 58% in MUP and MKP, respectively (P = 0.30); 3-year OS rates were 62 and 70% in MUP and MKP, respectively (P = 0.40).

Conclusions: The most common clinical scenario of our series was a male patient around 59 years with lymph node disease. We report that CLND associated with IT was the best treatment in terms of survival outcome. In the current era of IT and TT for melanoma, new studies have to clarify the impact of novel drugs on MUP.
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http://dx.doi.org/10.3389/fonc.2021.627527DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977284PMC
March 2021

A rare case of early-onset lymphomatoid papulosis refractory to brentuximab vedotin.

Dermatol Ther 2021 May 18;34(3):e14943. Epub 2021 Mar 18.

Unit of Dermatology, Department of Medicine-DIMED, University of Padova, Padova, Italy.

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http://dx.doi.org/10.1111/dth.14943DOI Listing
May 2021

Association between melanoma and exposure to sex hormones in puberty: A possible window of susceptibility (Review).

Mol Clin Oncol 2021 Apr 8;14(4):66. Epub 2021 Feb 8.

Dermatology Unit, Department of Medicine, University of Padova, I-35128 Padova, Italy.

The risk factors for melanoma in adolescents are similar to those in adults; however, it remains unclear whether these risk factors are also associated with melanoma in children. Epidemiological studies in the literature have reported a logarithmic increase in melanoma incidence after the age of 10 years. This may, in part, reflect the acute and chronic exposure to solar ultraviolet (UV) radiation during childhood. However, it appears unlikely that the cumulative exposure to UV radiation alone could explain such a sharp increase in melanoma incidence at the beginning of adolescence. It has been suggested that circulating sex hormones, the levels of which increase during puberty, may play a role in melanoma initiation and progression in predisposed individuals through binding to specific sex steroid receptors. The association between a longer cumulative exposure to sex hormones and the risk of melanoma may be supported by the reported epidemiological association between melanoma and several other sex hormone-related types of cancer, such as breast and prostate cancer, in which the enhanced exposure to androgens and estrogens was found to be directly associated with pubertal onset. Therefore, determining the association between pubertal onset and melanoma development may improve the current understanding of melanoma pathophysiology.
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http://dx.doi.org/10.3892/mco.2021.2228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7890437PMC
April 2021

The safety profile of hydroxychloroquine: major cutaneous and extracutaneous adverse events.

Clin Exp Rheumatol 2021 Feb 15. Epub 2021 Feb 15.

Division of Dermatology, San Bortolo Hospital, Vicenza, and Centro Studi GISED, Bergamo, Italy.

Hydroxychloroquine is an established therapy for several rheumatological disorders, and very recently it has been proposed as a possible treatment for the new coronavirus disease 2019 even if recent randomised trials did not prove any benefit. Notably, hydroxychloroquine has been associated with a heterogeneous range of cutaneous and extra-cutaneous adverse events. We carried out a narrative review of the literature up to November 1st, 2020, related to the safety of hydroxychloroquine. In particular, cutaneous and extra-cutaneous adverse events associated with hydroxychloroquine were reviewed. The following databases were consulted: PubMed, Embase, Google Scholar and ResearchGate. The research of articles was conducted by using the following search terms: ''hydroxychloroquine," ''adverse event/effect,'' "cutaneous", "skin", "cardiotoxicity", "retinopathy", gastrointestinal and neurological toxicity". The main indication for which hydroxychloroquine was used in the reports was an immune mediated disorder. Adverse events were described mostly in females over 50 years of age. The most common cutaneous adverse effect was maculopapular and erythematous rash occurring within 4 weeks of initiating hydroxychloroquine and disappearing within few weeks of discontinuation. Gastrointestinal symptoms and headache were the most frequent extracutaneous manifestations. Rarer cutaneous manifestations include hyperpigmentation, psoriasiform dermatitis, photodermatitis, stomatitis, melanonychia and hair loss. More severe conditions were acute generalised exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, Stevens-Johnson syndrome/toxic epidermal necrolysis, and among extra-cutaneous adverse events cardiotoxicity and retinopathy. Since hydroxychloroquine is widely prescribed in rheumatology, it is important for rheumatologists to be familiar with its safety profile.
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February 2021

Management of melanoma patients during COVID-19 pandemic in an Italian skin unit.

Dermatol Ther 2021 05 8;34(3):e14908. Epub 2021 Mar 8.

Melanoma and Sarcoma Surgical Oncology Unit, Veneto Institute of Oncology (IRCCS), Padova, Italy.

Due to the COVID-19 crisis, many scheduled medical and surgical activities have been suspended. This interruption to the healthcare system can negatively affect the diagnosis and management of melanoma. Neglecting melanoma throughout the outbreak may be associated with increased rates of mortality, morbidity, and healthcare expenses. We performed a retrospective review of all dermatological and surgical activity performed in our Melanoma Skin Unit between 23 February 2020 and 21 May 2020 and compared these data with those from the same period in 2019. During the lockdown period, we observed a decrease in dermatologic follow-up (DFU) (-30.2%) and in surgical follow-up (SFU) (-37%), and no modification of melanoma diagnosis (-3%). Finally, surgical excisions (SE) (+ 31.7%) increased, but sentinel lymph node biopsy (SLNB) (-29%) and lymph node dissections(LND) (-64%) decreased compared to the same period in 2019. Our experience supports the continuation of surgical and diagnostic procedures in patients with melanoma during the COVID-19 pandemic. Surgical and follow-up procedures for the diagnosis and treatment of melanoma should not be postponed considering that the pandemic is lasting for an extended period.
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http://dx.doi.org/10.1111/dth.14908DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995113PMC
May 2021

Persistence of superficial basal cell carcinoma during pembrolizumab treatment for metastatic melanoma.

Eur J Dermatol 2021 Feb;31(1):99-100

Unit of Dermatology, University of Padua, Padua, Italy.

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http://dx.doi.org/10.1684/ejd.2020.3958DOI Listing
February 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.

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
January 2021

Skin cancers in Italian lung transplant recipients: Incidence and risk factors analysis.

Dermatol Ther 2021 03 13;34(2):e14749. Epub 2021 Jan 13.

Unit of Dermatology, Department of Medicine, University of Padova, Padova, Italy.

Only a few studies reported the incidence and risk factors of skin cancers in lung transplant recipients. The aim of this study was to determine the cumulative incidence of skin cancers in a cohort of patients undergoing lung transplantation and to define predictors of their development. About 247 consecutive patients receiving lung transplantation at the Thoracic Surgery Unit of University Hospital of Padova between May 1995 and October 2016 were studied. Cumulative incidence of skin cancers was estimated considering death as a competing event. The effect of potential predictors was evaluated with univariate and multivariable Cox models for competing risks. About 37 (15.0%) patients developed skin tumors. The cumulative incidence of any skin cancer was 14.2% at 5 years, 21.4% at 10 years, and 24.3% at 15 years posttransplantation. Age at transplantation, male gender, phototype II, and voriconazole use were independent risk factors for development of squamous cell carcinoma. Only male gender and phototype II were independent risk factors for development of basal cell carcinoma. Since lung transplant recipients have a greater risk of developing skin cancers, the management of these patients needs a multidisciplinary approach, in which dermatologists and transplant physicians have a primary role.
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http://dx.doi.org/10.1111/dth.14749DOI Listing
March 2021

Editorial: Cutaneous B-Cell Lymphomas.

Front Oncol 2020 9;10:619709. Epub 2020 Dec 9.

Unit of Dermatology, University of Turin, Turin, Italy.

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http://dx.doi.org/10.3389/fonc.2020.619709DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756111PMC
December 2020

Near infrared photoimmunotherapy targeting the cutaneous lymphocyte antigen for mycosis fungoides.

Expert Opin Biol Ther 2021 Jul 23;21(7):977-981. Epub 2020 Dec 23.

Unit of Dermatology, University of Padua, Padova, Italy.

: Mycosis fungoides (MF) is a low-grade T-cell lymphoma with primary cutaneous involvement accounting for more than half of all primary cutaneous lymphomas. The treatment of MF is very challenging due to the limited therapies available. Near-infrared photoimmunotherapy (NIR-PIT) is a newly developed and highly selective cancer treatment that employs a monoclonal antibody conjugated to a photo-absorber dye, the hydrophilic phthalocyanine IRdye 700DX® (IR700), and near infrared light. In this study, we investigated the effect of NIR-PIT on MF targeting the cell-surface antigen cutaneous lymphocyte antigen (CLA): MF derived My-La CD4+ cells were incubated with the anti-CLA antibody conjugated to IR700 and then irradiated with a 690 nm near-infrared light. Cell death was evaluated by propidium iodide staining and flow cytometry 24 hours after irradiation.: Treatment with anti-CLA or light irradiation exhibited very modest pro-death effects, whereas treatment with the anti-CLA antibody conjugated to IR700 and then irradiation with a 690 nm near-infrared light induced a substantial increase in death in the MF cell line.: NIR-PIT targeting CLA to treat MF showed marked antitumour effects. As such, CLA-targeted NIR-PIT could be a promising treatment for MF and, possibly, other cutaneous diseases characterized by CLA+ skin infiltrating T-cells.
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http://dx.doi.org/10.1080/14712598.2021.1858791DOI Listing
July 2021

Primary Cutaneous B-Cell Lymphomas in Patients With Impaired Immunity.

Front Oncol 2020 11;10:1296. Epub 2020 Sep 11.

Unit of Dermatology, University of Padua, Padua, Italy.

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http://dx.doi.org/10.3389/fonc.2020.01296DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7517940PMC
September 2020

Melanoma Inhibitory Activity (MIA) Is Able to Induce Vitiligo-Like Depigmentation in an Mouse Model by Direct Injection in the Tail.

Front Med (Lausanne) 2020 21;7:430. Epub 2020 Aug 21.

Unit of Dermatology, University of Padua, Padua, Italy.

In the complex pathogenesis of vitiligo, the exact mechanism of the dermatosis is still to be clarified. We previously demonstrated that a protein called melanoma inhibitory activity (MIA) is present in non-segmental vitiligo skin and seems to cause the detachment of melanocytes, consequently creating the depigmented macules. In this study, we present an animal model of vitiligo on the basis of the ability of the MIA protein to induce vitiligo-like lesions. Twenty pigmented mice were chosen for the experiments and received injections in the tail with saline (control group) or with saline + MIA protein (treated group). The control group did not show any sign of depigmentation. The treated group showed, instead, clear zones of complete depigmentation in the injected areas in each mouse, with the appearance of white patches with whitening of the hair and a clear-cut edge. Histological examination of the tail in the treated zone showed the absence of melanocytes, without the presence of any inflammatory cell or any sign of skin inflammation patterns, confirming the detachment of the melanocyte operated by the MIA protein. These data seem to confirm a possible role played by the MIA protein in the pathogenesis of vitiligo and may support the development of treatments able to inhibit its action as an alternative therapeutic strategy for this disorder.
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http://dx.doi.org/10.3389/fmed.2020.00430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7472393PMC
August 2020

Bullous pemphigoid and renal graft rejection: is there a causative link?

Eur J Dermatol 2020 Aug;30(4):441-442

Unit of Dermatology, Department of Medicine (DIMED), University of Padua, via Vincenzo Gallucci 4, 35128, PadovaItaly.

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http://dx.doi.org/10.1684/ejd.2020.3837DOI Listing
August 2020

A Monocentric Retrospective Observational Study of Comorbidities in Patients Affected by Autoimmune Bullous Diseases.

In Vivo 2020 Jul-Aug;34(4):2113-2118

Unit of Dermatology, University of Padua, Padua, Italy

Background/aim: Autoimmune bullous diseases (AIBDs) of the skin and mucosae include a heterogeneous group of chronic diseases, which could be associated with various comorbidities. The purpose of this study was to evaluate the comorbidity profiles of patients affected by AIBDs, who referred to the Dermatological Clinic of Padua from December 2015 to June 2018.

Patients And Methods: A monocentric retrospective observational study was conducted on 157 patients with diagnosis of AIBDs. Patients' comorbidities were investigated during the periodic visits of follow-up and through the analysis of computerized medical records.

Results: Among the 157 patients, 40 (25.5%) were diagnosed with PV, 15 (9.6%) with PF, and 102 (64.9%) with BP. Nine different comorbidities were observed, but only two of these were statistically significantly associated with BP: type 2 diabetes (p=0.0142) and neuropsychiatric disorders (p=0.015).

Conclusion: BP is statistically significantly associated with type 2 diabetes mellitus and neuropsychiatric diseases. The correlation with neuropsychiatric pathologies is interesting for the possible bidirectional role in their etiology. The association with type 2 diabetes mellitus could suggest more caution in the administration of systemic corticosteroids, especially in elderly patients.
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http://dx.doi.org/10.21873/invivo.12016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439873PMC
June 2021

How to Deal With Post-viral Cutaneous Eruptions in the Era of Coronavirus Infection.

Front Med (Lausanne) 2020 12;7:224. Epub 2020 May 12.

Unit of Dermatology, University of Padua, Padua, Italy.

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http://dx.doi.org/10.3389/fmed.2020.00224DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235413PMC
May 2020

A Therapeutic and Diagnostic Multidisciplinary Pathway for Merkel Cell Carcinoma Patients.

Front Oncol 2020 15;10:529. Epub 2020 Apr 15.

Surgical Oncology Unit, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.

Merkel Cell Carcinoma (MCC) is a highly aggressive neuroendocrine neoplasm of the skin. Due to its rarity, the management of MCC is not standardized across centers. In this article, we present the experience of the Veneto region in the North-East of Italy, where a committee of skin cancer experts has proposed a clinical pathway for the diagnosis and treatment of MCC. Putting together the evidence available in the international literature, we outlined the best approach to the management of patients affected with this malignancy step- by- step for each possible clinical situation. Crucial in this pathway is the role of the multidisciplinary team to deal with the lack of robust information on each aspect of the management of this disease.
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http://dx.doi.org/10.3389/fonc.2020.00529DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174780PMC
April 2020

Small-molecule-based immunotherapy for immunologically mediated skin conditions.

Immunotherapy 2020 04 19;12(6):417-429. Epub 2020 Apr 19.

Unit of Dermatology, University of Padua, Via Gallucci 4, 35128 Padova, Italy.

A better understanding of the molecular pathogenesis of cutaneous immune disorders, together with advances in pharmaceutical drug development, led to the introduction of small-molecule inhibitors in the therapeutic management of a large spectrum of skin immune conditions. Small molecules are agents with a low molecular weight that are capable of affecting proinflammatory pathways through modulation of intracellular targets. These agents promise to improve the therapeutic management of many skin immune disorders due to their easy administration, high bioavailability and favorable safety profile. Here, we review the major small-molecule inhibitors targeting receptor-associated kinases, second messengers and transcription factors in development for the treatment of cutaneous immune conditions.
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http://dx.doi.org/10.2217/imt-2019-0190DOI Listing
April 2020

Female Patients with Dermatitis Herpetiformis Show a Reduced Diagnostic Delay and Have Higher Sensitivity Rates at Autoantibody Testing for Celiac Disease.

Biomed Res Int 2019 29;2019:6307035. Epub 2019 Dec 29.

GISED (Italian Group for Epidemiological Studies in Dermatology) Group and Italian Group for Cutaneous Immunopathology, Italy.

Objective: Our objective was to characterize the demographic information, clinical features, and laboratory data of patients with dermatitis herpetiformis (DH).

Methods: In this multicentre cross-sectional study, consecutive patients with a new diagnosis of DH that referred to nine different Italian centers between 2011 and 2016 were characterized assessing demographic, clinical and laboratory findings, and evaluating gender and age differences across selected variables.

Results: A total of 151 patients were included. Among them, 81 (53.6%) were males and 70 (46.4%) were females, with a male to female ratio of 1.2 : 1. The median age at the time of diagnosis was 41 years (range 0-85). Males had a significant longer diagnostic delay if compared to females (9 vs. 3 months, respectively; = 0.01). Direct immunofluorescence was positive in 94.7% of the patients, while duodenal biopsy showed partial to total villous atrophy in 70.1% of patients. All the females resulted positive to at least one of the antibodies tested, while a total of 12 male patients (10.5%) tested negative to celiac-specific antibodies. Female patients had a high rate (14.1%) of autoimmune thyroiditis.

Conclusions: Our study confirmed some of the most relevant data regarding DH that have been previously reported in the literature. In addition, we found a reduced diagnostic delay in females with respect to males, possibly related to the higher sensitivity of serologic testing in females with DH compared to males. Finally, we demonstrated that intestinal involvement could be severe in patients with DH and that females should be tested for thyroiditis.
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http://dx.doi.org/10.1155/2019/6307035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7024079PMC
August 2020

Ultra-low dose rituximab for refractory pemghigus vulgaris: a pilot study.

Expert Opin Biol Ther 2020 06 13;20(6):673-678. Epub 2020 Feb 13.

Unit of Dermatology, University of Padua, Padua, Italy.

: Pemphigus vulgaris is an autoimmune blistering disease affecting the skin and mucous membranes. Current treatments for pemphigus vulgaris include anti-inflammatory and immunosuppressive agents. Rituximab, an anti-CD20 monoclonal antibody, has been shown to be effective for the treatment of pemphigus vulgaris. However, the optimal dosage of rituximab for the treatment of this autoimmune bullous disease has not been clearly defined.The aim of this study was to investigate the clinical efficacy and adverse effects of an ultra-low dosage regimen of rituximab for pemphigus vulgaris.: We performed a prospective non-randomized open case series including eight patients affected by pemphigus vulgaris. Patients were treated with an ultra-low dosage of rituximab (a single infusion of 200 mg).: All patients had a positive response after infusion. At the end of the follow-up period, 5 patients achieved a complete remission and 3 a partial remission. Except for one case of sepsis due to and a pneumonia due to , no adverse events were documented in our patients.: Data from our study suggest that an ultra-low dosage of rituximab could be an effective treatment for pemphigus vulgaris. Consequently, there is a need for a larger, confirmatory, randomized, multicenter trial.
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http://dx.doi.org/10.1080/14712598.2020.1727440DOI Listing
June 2020

Targeting the cutaneous lymphocyte antigen (CLA) in inflammatory and neoplastic skin conditions.

Expert Opin Biol Ther 2020 03 21;20(3):275-282. Epub 2020 Jan 21.

Unit of Dermatology, University of Padua, Padova, Italy.

: The cutaneous lymphocyte antigen interacts with E-selectin on endothelial cells and is expressed on 15% of circulating T-cells. Skin-homing T-cells express the cutaneous lymphocyte antigen and play a role in local cutaneous immunity in inflammatory reactions and neoplastic conditions.: Lymphocyte extravasation is the essential para-physiological mechanism enabling immune surveillance of tissues for tumors as well as effector cell recruitment to inflammatory sites.The authors focused on skin inflammatory disorders, on cutaneous lymphoproliferative disease, and on other skin malignancies.: Interfering with leukocyte extravasation has been regarded as an attractive strategy in skin disorders, in the past for inflammatory conditions and more recently for cutaneous T-cell lymphomas. Therapeutic blocking of skin-homing interactions has been attempted in psoriasis and atopic dermatitis and has been achieved in the treatment of cutaneous T-cell lymphomas. Cutaneous lymphocyte antigen is a potential molecular target for both systemic and skin-directed therapy for cutaneous T-cell lymphomas.
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http://dx.doi.org/10.1080/14712598.2020.1715937DOI Listing
March 2020

Reflectance Confocal Microscopy in Evaluating Skin Cancer: A Clinicians's Perspective.

Front Oncol 2019 19;9:1457. Epub 2019 Dec 19.

Unit of Dermatology, University of Padua, Padua, Italy.

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http://dx.doi.org/10.3389/fonc.2019.01457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930914PMC
December 2019

Eruptive Melanocytic Nevi Secondary to Encorafenib for BRAF Mutant Metastatic Colorectal Cancer.

In Vivo 2020 Jan-Feb;34(1):441-445

Unit of Dermatology, University of Padua, Padua, Italy

A 59-year-old woman, undergoing treatment with encorafenib for metastatic BRAF mutated colorectal cancer, developed during the first two months of therapy multiple eruptive nevi and changes in pre-existing nevi. Development of eruptive nevi has increasingly been reported in association with medications, most frequently conventional immunosuppressants and biologics. Some drugs are associated with eruptive nevi through an indirect effect of their mechanism of action, whereas other drugs are directly implicated in melanocyte proliferation. In this regard, BRAF inhibitors have been demonstrated to activate the MAPK pathway, and to promote cellular proliferation and survival, therefore leading to the development of new melanocytic nevi and to an increase in the size and hyperpigmentation of pre-existing nevi. A dermatological assessment and follow-up should be recommended in all patients presenting with eruptive nevi, regardless of the pathogenesis, because a high number of acquired melanocytic nevi may represent an adjunctive risk factor for melanoma.
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http://dx.doi.org/10.21873/invivo.11793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6984112PMC
June 2020

Two-years of home based functional electrical stimulation recovers epidermis from atrophy and flattening after years of complete Conus-Cauda Syndrome.

Medicine (Baltimore) 2019 Dec;98(52):e18509

Interdepartmental Research Center of Myology, Department of Biomedical Sciences, University of Padova.

To evaluate progression of skin atrophy during 8 years of complete Conus-Cauda Syndrome and its recovery after 2 years of surface Functional Electrical Stimulation a cohort study was organized and implemented.Functional assessments, tissue biopsies, and follow-up were performed at the Wilhelminenspital, Vienna, Austria; skin histology and immunohistochemistry at the University of Padova, Italy on 13 spinal cord injury persons suffering up to 10 years of complete conus/cauda syndrome. Skin biopsies (n. 52) of both legs were analyzed before and after 2 years of home-based Functional Electrical Stimulation delivered by large anatomically shaped surface electrodes placed on the skin of the anterior thigh. Using quantitative histology we analyzed: 1. Epidermis atrophy by thickness and by area; 2. Skin flattening by computing papillae per mm and Interdigitation Index of dermal-epidermal junctions; 3. Presence of Langerhans cells.Linear regression analyses show that epidermal atrophy and flattening worsen with increasing years post- spinal cord injury and that 2 years of skin electrostimulation by large anatomically shaped electrodes reverses skin changes (pre-functional Electrical Stimulation vs post-functional Electrical Stimulation: thickness 39%, P < .0001; area 41%, P < .0001; papillae n/mm 35%, P < 0.0014; Interdigitation index 11%, P < 0.018), producing a significant recovery to almost normal levels of epidermis thickness and of dermal papillae, with minor changes of Langerhans cells, despite 2 additional years of complete Conus-Cauda Syndrome.In complete Conus-Cauda Syndrome patients, the well documented beneficial effects of 2 years of surface h-b Functional Electrical Stimulation on strength, bulk, and muscle fiber size of thigh muscles are extended to skin, suggesting that electrical stimulation by anatomically shaped electrodes fixed to the skin is also clinically relevant to counteract atrophy and flattening of the stimulated skin. Mechanisms, pros and cons are discussed.
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http://dx.doi.org/10.1097/MD.0000000000018509DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946537PMC
December 2019

Biological Approaches to Aggressive Cutaneous B-Cell Lymphomas.

Front Oncol 2019 13;9:1238. Epub 2019 Nov 13.

Unit of Dermatology, University of Padua, Padua, Italy.

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http://dx.doi.org/10.3389/fonc.2019.01238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6864397PMC
November 2019

Immunomodulation in Cutaneous T Cell Lymphoma.

Front Oncol 2019 9;9:1025. Epub 2019 Oct 9.

Unit of Dermatology, University of Padua, Padua, Italy.

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http://dx.doi.org/10.3389/fonc.2019.01025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794804PMC
October 2019