Publications by authors named "Torello Lotti"

568 Publications

The role of oxidative stress in onychomycosis: thiol/disulfide homeostasis.

Mycoses 2021 May 8. Epub 2021 May 8.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

Objectives: Onychomycosis is the general term to define fungal nail infections that arise from dermatophytes, non-dermatophytic molds, and yeasts. Thiol/disulfide homeostasis is a new indicator of oxidative stress. In this study, we aimed to investigate the role of thiol/disulfide balance in the pathogenesis of onychomycosis.

Methods: This cross-sectional study included adult patients with onychomycosis who were admitted to the dermatology department and healthy adult volunteers without any dermatologic or systemic condition. The patients and controls were evaluated in terms of native thiol, total thiol, and disulfide levels, and disulfide/native thiol, disulfide/total thiol, and native thiol/total thiol ratios. The possible association between these parameters and clinical subtypes of onychomycosis and demographic characteristics was also investigated.

Results: A total of 52 patients with onychomycosis and 50 healtyh subjects were enrolled in the study. The patient group showed lower levels of total thiol, native thiol, and native thiol/total thiol ratio, and higher ratios of disulfide/native thiol and disulfide/total thiol. No statistically significant relationship was found between the parameters, clinical subtypes of onychomycosis, and demographic characteristics (p>0.05).

Conclusion: Patients with onychomycosis showed a shifted thiol/disulfide homeostasis towards oxidative stress with a reduction in thiols and an increase in disulfide/native thiol, and disulfide/total thiol ratios. These findings may indicate the role of oxidative stress in the pathogenesis of onychomycosis.
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http://dx.doi.org/10.1111/myc.13299DOI Listing
May 2021

Treatment Update of Port-Wine Stain: A Narrative Review.

J Drugs Dermatol 2021 May;20(5):515-518

Background: Port-wine stain (PWS) is a congenital vascular malformation affecting 0.3–0.5% of normal population. These characteristic lesions arise due to the interplay of vascular, neural, and genetic factors. Treatment options include lasers, cosmetic tattooing, electrotherapy, cryosurgery, derma-abrasion, and skin grafting; however, none of these treatment alternatives appears to be satisfactory and is unable to provide consistent, satisfactory responses or even complete cures. Currently, laser is the treatment of choice, as it is comparatively safe and more effective than other procedures. The most commonly used modality is pulsed dye laser (PDL). The literature research includes peer-reviewed articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) to January 2020 and reference lists of respective articles. Only articles published in English language were included. J Drugs Dermatol. 20(5): doi:10.36849/JDD.5005.
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http://dx.doi.org/10.36849/JDD.5005DOI Listing
May 2021

Pseudomyogenic hemangioendothelioma: a challenging diagnosis of soft tissue pathology.

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

Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy.

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http://dx.doi.org/10.23736/S2784-8671.21.06896-6DOI Listing
April 2021

Comment on "Lipoatrophia semicircularis - a distinct entity?"

Int J Dermatol 2021 Apr 20. Epub 2021 Apr 20.

Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy.

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http://dx.doi.org/10.1111/ijd.15600DOI Listing
April 2021

The Potential Efficacy of β-Blockers on Melanoma Survival: A Narrative Review.

J Drugs Dermatol 2021 Apr;20(4):380-383

Melanoma is a common tumor accounting for around 3–5% of all cutaneous malignancies with worldwide increasing incidence. It is still associated with significant mortality despite the breakthrough of new innovative therapies within the last decade. A wide variety of treatment modalities is currently used for the management of melanoma, ranging from surgical excision of primary melanoma to adju-vant and palliative treatment with target molecules, including BRAF and MEK inhibitors, and immune checkpoint inhibitors. β-blockers have recently demonstrated in preclinical and clinical studies to reduce recurrence and to correlate with better overall survival in meta-static melanoma as an additional supportive treatment option, owing to their anti-tumor potential. Further investigation regarding their efficacy and safety profile is needed, since there are only few studies in the literature on this topic. Our aim is to evaluate the role and current status of β-blockers in melanoma management. The literature research includes peer-reviewed articles (clinical trials or scien-tific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) till May 2020 and reference lists of respective articles. Only articles published in English language were included. J Drugs Dermatol. 20(4):380-383. doi:10.36849/JDD.5673.
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http://dx.doi.org/10.36849/JDD.2021.5673DOI Listing
April 2021

A novel marker of systemic inflammation in psoriasis and related comorbidities: chitotriosidase.

Turk J Med Sci 2021 Apr 6. Epub 2021 Apr 6.

Background/aim: Chitotriosidase (ChT) is an enzyme secreted by activated macrophages and neutrophils in response to proinflammatory signals. There is growing evidence indicating that ChT activity reflects the systemic inflammatory status. This study aimed to investigate whether serum ChT activity increased in patients with psoriasis and related comorbidities.

Materials And Methods: This cross-sectional study included 53 (28 with associated comorbidities and 25 without comorbidities) patients with psoriasis and 52 healthy volunteers. All participants underwent laboratory investigations for serum ChT levels, complete blood count, erythrocyte sedimentation rate, C-reactive protein, and serum lipid levels.

Results: The patients with psoriasis showed significantly higher levels of ChT activity as compared to the healthy controls (23.5 ± 11.4 vs. 17.5 ± 10.4 ?mol/mL/hour; p = 0.015). Additionally, the ChT activity was significantly higher in patients with comorbidities than in those without (p = 0.042).

Conclusion: Our data support the pathogenetic role of inflammatory processes induced by macrophage activation in patients with psoriasis and related comorbidities. We believe that high ChT activity in patients with psoriasis may serve as an early prediction of the possible related comorbidities.
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http://dx.doi.org/10.3906/sag-2101-137DOI Listing
April 2021

Novel immunological and genetic factors associated with vitiligo: A review.

Exp Ther Med 2021 Apr 1;21(4):312. Epub 2021 Feb 1.

Dermatology Service, Jose Eleuterio Gonzalez Medicine School and University Hospital, Autonomous University of Nuevo León, Monterrey, Nuevo León 64460, Mexico.

Vitiligo is a skin disorder characterized by depigmentation of the skin due to a lack of melanin. This condition affects men and woman of all ages and its incidence is not restricted by ethnicity or region. Vitiligo is a multifactorial disease, in which melanocytes, which serve important functions in skin pigmentation and immune processes, are impaired. There is sufficient evidence that immunological and genetic factors are primarily responsible for the destruction and dysfunction of melanocytes. Therefore, genetic DNA sequence variants that participate in skin homeostasis, pigmentation and immune response regulation, as well as altered expression patterns, may contribute to the risk of developing vitiligo. The current review presented an overview of the mechanism of pigmentation and of currently known factors involved in depigmentation, as well as the classification, epidemiology, associated comorbidities, risk factors, immunopathogenesis and several genetic and molecular changes associated with vitiligo.
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http://dx.doi.org/10.3892/etm.2021.9743DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7885061PMC
April 2021

COVID-19 and human papillomavirus: Paradoxical immunity.

J Cosmet Dermatol 2021 Feb 24. Epub 2021 Feb 24.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

Coronavirus disease 2019 (COVID-19) is a multisystemic disease that can cause progressive lung failure, organ dysfunction, and coagulation disorder associated with high mortality and morbidity. COVID-19 is known to either primarily cause skin symptoms or increase existing skin diseases. Human papillomavirus (HPV) is a DNA virus that can cause benign and malignant neoplasms. Mucocutaneous verruca vulgaris are common benign lesions of HPV. Here, we report a case of verruca vulgaris regressed after COVID-19.
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http://dx.doi.org/10.1111/jocd.14022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014313PMC
February 2021

Axillary giant lipoma opening to the skin surface: A unique presentation mimicking accessory breast.

Dermatol Ther 2021 Mar 17;34(2):e14861. Epub 2021 Feb 17.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

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http://dx.doi.org/10.1111/dth.14861DOI Listing
March 2021

Simvastatin in vitiligo: an update with recent review of the literature.

Int J Dermatol 2021 Feb 7. Epub 2021 Feb 7.

Department of Dermatology, University Medical Center Mainz, Mainz, Germany.

Patients with vitiligo often seek medical attention, as it diminishes their quality of life resulting in significant morbidity. Several topical and systemic therapies are in vogue targeting the immunological aspect of this disease, but results are often unsatisfactory, and complete cure remains elusive. Recently, simvastatin, a 3-hydroxy-3-methylyglutaryl-coenzyme A (HMG-CoA) reductase inhibitor, is being evaluated for vitiligo management because of its multimodal action, easy availability, and low cost. The proposed multimodal actions range from anti-inflammatory, antioxidant, to immunomodulatory properties which may be of therapeutic benefit in vitiligo patients. The authors intend to evaluate the role of simvastatin as a novel therapeutic agent for vitiligo along with relevant review of literature.
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http://dx.doi.org/10.1111/ijd.15330DOI Listing
February 2021

Efficacy and tolerability of short contact therapy with tretinoin, clindamycin, and glycolic acid gel in acne: A randomized, controlled, assessor-blinded two-center trial: The MASCOTTE study.

Dermatol Ther 2021 Jan 6;34(1):e14724. Epub 2021 Jan 6.

Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy.

Retinoids and antibiotics topical treatments are commonly used as first line therapy in mild to moderate acne. However, irritant contact dermatitis is a common side effect of topical retinoids. A strategy to increase local tolerability is the "short contact therapy" (SCT) approach, consisting in the application of the product with the complete removal after 30 to 60 minutes using a non-aggressive cleanser. A gel containing tretinoin 0.02%, clindamycin 0.8%, and glycolic acid 4% in polyvinyl alcohol (MP-gel) has shown to be effective as monotherapy in mild to moderate acne with a tolerability profile similar to other topical retinoids. So far, no trials have been performed with this gel comparing the tolerability profile of SCT with standard application therapy (SAT). We conducted a 2-center randomized parallel groups, controlled, assessor-blinded study, comparing MP-gel applied as SCT in comparison with MP-gel used as SAT (The "MASCOTTE" trial). Forty-six subjects (nine men and 37 women, mean age 23 ± 4 years, range 18-31 years) with mild-to-moderate acne were enrolled, after their written informed consent in a randomized, parallel groups controlled, assessor-blinded 8-week trial. Twenty-three were assigned to MP-gel once daily (evening application) using the SCT approach (ie, complete removal of product after 1 hour using a gentle cleanser), and 23 were randomized to the SAT approach with the same gel. The primary endpoint was the evolution of the tolerability score (TS) assessed evaluating four items: erythema, dryness, stinging, and burning, using a 4-point score scale (from 0: no symptom to 3: severe symptom). Secondary endpoints were the evolution of global acne grading system (GAGS) score (range: from 0 to >39) and the investigator global assessment (IGA of acne severity) score (range from 0 to 4). TS was evaluated at 2, 4, and 8 weeks. GAGS and IGA scores were evaluated at baseline and at week eight. At week eight, an efficacy global score (EGS) (from 1: no efficacy to 4: very good efficacy) and a tolerability global score (TGS) (from 1: very low tolerability to 3: very good tolerability) evaluation were also done. All the evaluations were performed by an investigator unaware of treatment groups allocation (SCT or SAT). Thirty-eight subjects (83%) completed the 8-week treatment period. Eight subjects (two in the SCT group and six in the SAT group) dropped out prematurely due to low skin tolerability. In the SCT the TS at week two was 1.3 ± 1.7, in the SAT group TS was significantly higher (3.1 ± 1.7) (P = .028). TS was significantly lower in SCT group vs SAT also at weeks four and eight (P = .01; ANOVA test). The GAGS score at baseline was 19 ± 7 in the SCT group and 23 ± 4 in the SAT group (NS). At week 8 the GAGS score in SCT was significantly reduced to 8.5 ± 2.8 (-55%) (P = .001 vs baseline) and was also significantly lower in comparison with SAT group (8.5 vs 15; P = .0054). The IGA scores at baseline were 1.9 ± 0.6 in SCT and 2.4 ± 0.7 in SAT group. At week eight, in comparison with baseline values IGA score was reduced significantly by 48% in SCT and by 30% in SAT. EGS and TGS were significantly higher (better clinical efficacy and better tolerability) in SCT in comparison with SAT (3.6 ± 0.5 and 2.9 ± 0.3 vs 2.7 ± 0.6 and 1.5 ± 0.7; respectively). This tretinoin, clindamycin, glycolic acid gel, applied as SCT, has shown a better skin tolerability and at least a comparable clinical efficacy in comparison with the standard application modality in the treatment of mild-to-moderate acne. The SCT therefore could be an effective treatment strategy which could improve subjects' compliance and adherence.
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http://dx.doi.org/10.1111/dth.14724DOI Listing
January 2021

Psoriasis in Tigray, Ethiopia: Focusing on available treatments.

Dermatol Ther 2020 Dec 27:e14718. Epub 2020 Dec 27.

San Gallicano Dermatological Institute IRCCS, Rome, Italy.

Psoriasis has been reported to be rare in people with skin of color. However, the actual prevalence is probably underestimated by the lack of wide epidemiological studies. The aim of the study is to present our experience in Tigray, Ethiopia, focusing on the issues related to diagnosis, clinical features and therapies. A total of 1288 people affected by psoriasis were visited and 954 were included in a retrospective analysis through the review of medical records of patients attending at three Dermatologic Centers in Ethiopia from 2005 to 2016. The most common clinical form is plaque psoriasis (62.9%), followed by guttate (13.9%), pustular (9.5%), inverse (7.5%), and erythrodermic (6.1%) ones. The prevalence of psoriatic arthritis is 17%. It is often diagnosed late resulting in particularly deforming and debilitating disease. Patients with severe psoriasis often require hospitalization due to the reduced availability of effective treatments and appropriate skin care, resulting in a prolonged recurrence rate or decreased disease-free interval. In poorer rural areas, patients use some traditional African plants such as Kigelia africana which have been shown to have partial benefits in the treatment of psoriasis. Unfortunately, the only available conventional therapies are topical steroids, salicylic acid, methotrexate, and the sun. More studies concerning the appropriate management of people with psoriasis in low income countries, including standardization of indigenous therapies and a reduction of costs of conventional drugs, could help the care of people with psoriasis.
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http://dx.doi.org/10.1111/dth.14718DOI Listing
December 2020

Pseudo-dense Hair Transplantation: Strategy of "Less Inside, More Outside" and Central Bulking with Curled Chest Hairs as Treatment for Scalp Scars.

J Cutan Aesthet Surg 2020 Jul-Sep;13(3):226-228

Department of Physiology/Pathology, San Juan Bautista School of Medicine, Caguas, Puerto Rico, USA.

Hair transplantation in areas of scalp scars is a clinical challenge. However, by creating the visual illusion of central bulking with the use of peripherally transplanted curled chest hairs, cicatricial alopecia can perhaps be cosmetically improved. In a case of a 34-year-old affected man, this strategic procedure was implemented with positive results, as the transplantation was successful, the scar was far less noticeable, and the patient was satisfied with the results. The "pseudo-dense hair transplantation" method can be applied to similar patients, noting that a more succinct procedure will need to be elucidated for the varying etiologies of cicatricial alopecia.
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http://dx.doi.org/10.4103/JCAS.JCAS_104_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7646433PMC
November 2020

Treatment considerations for Behçet disease in the era of COVID-19: A narrative review.

Dermatol Ther 2021 Jan 9;34(1):e14507. Epub 2020 Nov 9.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

COVID-19 is a multisystem disease caused by severe acute respiratory syndrome coronavirus 2. It has been declared a pandemic by the World Health Organization in March 2020 and the outbreak still keeps its impacts worldwide. Behçet disease (BD) is a multi-systemic vasculitis involving the skin, mucosa, eyes, joints, nervous system, cardiovascular system, and gastrointestinal system. The precise etiopathogenesis of the disorder is unknown but autoimmunity is believed to play a key role. A considerable part of patients with BD are susceptible to immunosuppression and are more predisposed to infections than healthy individuals. Hence, the protection and control measures for patients with BD against the COVID-19 are of the utmost significance. Given the requirement to balance proper treatment of BD with the smallest risk of COVID-19 associated mortality and morbidity, we aimed to review the management of BD in the era of the pandemic with a special focus on treatment considerations. According to current expert recommendations, there is no reason to discontinue topical treatments, colchicine, and nonsteroidal antiinflammatory drugs. Systemic steroids can be used at the lowest possible dose if needed. Ongoing treatments can be continued unchanged in patients with no suspected or confirmed COVID-19. In cases with COVID-19 symptoms, immunosuppressive and biological agents can be temporarily stopped but the decision should be made on a case by case basis. Considering their potential beneficial effects on the course of COVID-19, colchicine, pentoxifylline, and dapsone can be considered as safe treatment options in BD.
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http://dx.doi.org/10.1111/dth.14507DOI Listing
January 2021

Management and prevention of laser complications in aesthetic medicine: An analysis of the etiological factors.

Dermatol Ther 2021 Jan 19;34(1):e14373. Epub 2020 Oct 19.

University of Guglielmo Marconi, Rome, Italy.

Growing popularity of laser treatment has understandably resulted in increased incidence of potential complications. The analysis of complications, taking into account the causes of their occurrence, is of particular interest. The identification of etiological factors and the development of a step-by-step prophylactic algorithm with their consideration is the way to reduce the number of possible complications in future practice. In this article, we present a classification of the causes of complications associated with various types of laser procedures. This classification was developed on the basis of a review of last 20 years' literature and our own experience in a network of clinics "Linline" in Russia. We identified six groups of the etiological classification of laser complications: errors of patient selection, errors of treatment tactics, wrong choice of device and technology, neglect of treatment protocol, inadequate post-procedural care, individual response of the patient. The causes of all specified groups of complication, except the last one, are preventable causes.
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http://dx.doi.org/10.1111/dth.14373DOI Listing
January 2021

Complication of Soft Tissue Fillers: Prevention and Management Review.

J Drugs Dermatol 2020 Sep;19(9):829-832

The use of dermal fillers has increased manifold over the past decade, which has been attributed to the ever-increasing need of the population for being young. Fillers have become quite popular both among patients and treating physicians due to their quick and quite predictable results. Filler injection is a safe procedure in the hands of an experienced provider using appropriate technique. Nevertheless, various adverse effects to fillers have been reported that range from mild injection site complications, such as pain and bruising, to severe complications, like tissue necrosis, retinal artery occlusion, and infections. The esthetic provider should be aware of and be able to quickly recognize such complications, and be confident in managing them. In this article we highlight the various adverse effects noted with the use of fillers and discuss prevention and management. J Drugs Dermatol. 2020;19(9):829-832. doi:10.36849/JDD.2020.5084.
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http://dx.doi.org/10.36849/JDD.2020.10.36849/JDD.2020.5084DOI Listing
September 2020

Uncommon presentation of morphea related to interferon beta in a patient with concomitant multiple sclerosis and chronic hepatitis C: A case report.

Clin Case Rep 2020 Sep 26;8(9):1647-1650. Epub 2020 May 26.

Mazandaran University of Medical Sciences Sari Iran.

Recombinant interferon beta-1b is one of the treatment options of multiple sclerosis (MS). Insertional biologics that are used in the treatment of MS may lead to skin adverse effects, for example, morphea.
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http://dx.doi.org/10.1002/ccr3.2971DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7495805PMC
September 2020

Congress report Second National Congress of the Bulgarian Society for dermatologic surgery, Sofia, 13th March and 13th June 2020.

Dermatol Ther 2020 11 18;33(6):e14289. Epub 2020 Sep 18.

Clinic "ONKODERMA", Sofia, Bulgaria.

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http://dx.doi.org/10.1111/dth.14289DOI Listing
November 2020

Pemphigus and COVID-19: Critical overview of management with a focus on treatment choice.

Dermatol Ther 2020 11 14;33(6):e14265. Epub 2020 Sep 14.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

COVID-19 is a serious multisystem disease caused by severe acute respiratory syndrome coronavirus 2. Due to the COVID-19 crisis, that still keeps its impacts worldwide, numerous scheduled medical activities have been postponed and this interruption has a potential to modify the management of many cutaneous conditions including pemphigus. This narrative review aims to discuss the management of pemphigus in the era of COVID-19, considering the necessity to balance suitable pemphigus treatment with minimal risk of COVID-19-related mortality and morbidity. The data on the effect of treatments used for pemphigus on COVID-19 are limited. However, the evidence to manage patients properly is evolving and our knowledge is updated. Current expert recommendations include that patients with pemphigus should be informed clearly to avoid mismanagement and they should be monitored regularly for symptoms of COVID-19. Patients with mild disease can be managed with topical or intralesional corticosteroids, dapsone, or doxycycline. Systemic corticosteroids should be tapered to the lowest effective dose during the pandemic. Prednis(ol)one ≤10 mg/d can be continued in patients with COVID-19 while prednis(ol)one >10 mg/d may be reduced considering the activity of the disease. Conventional immunosuppressive therapies should only be discontinued in confirmed cases of COVID-19. Postponing rituximab treatment should be considered on a case by case basis. Intravenous immunoglobulin is not likely to increase the risk of infection and may be considered a safe option in patients with COVID-19. Given the psychological burden brought by COVID 19, online or face-to-face psychological support programs should be considered.
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http://dx.doi.org/10.1111/dth.14265DOI Listing
November 2020

COVID-19 and alcohol use.

Drug Alcohol Rev 2021 05 2;40(4):683-684. Epub 2020 Sep 2.

Department of Dermatology, University of Studies Guglielmo Marconi, Rome, Italy.

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http://dx.doi.org/10.1111/dar.13163DOI Listing
May 2021

Severe hypertrichosis in infants due to transdermic exposure to 5% and 7% topical minoxidil.

Dermatol Ther 2020 11 21;33(6):e14230. Epub 2020 Sep 21.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

We report three cases of severe hypertrichosis in healthy infants, who did not present any type of endocrinological pathology and whose parents used topical minoxidil for the treatment of their baldness. Any type of direct application or administration of the product was ruled out. Hypertrichosis is considered to have occurred through skin-to-skin contact with the parent, and even through fomites. Given the widespread use of topical minoxidil, it is likely that this etiology of childhood hypertrichosis is underdiagnosed and that it sometimes leads to minimal forms that go unnoticed.
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http://dx.doi.org/10.1111/dth.14230DOI Listing
November 2020

Can monocyte to HDL cholesterol ratio and monocyte to lymphocyte ratio be markers for inflammation and oxidative stress in patients with vitiligo? A preliminary study.

Arch Dermatol Res 2020 Aug 20. Epub 2020 Aug 20.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

Both systemic inflammation and oxidative stress play crucial roles in the pathogenesis of vitiligo. In recent studies, monocyte to high-density lipoprotein cholesterol ratio (MHR), monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV) and plateletcrit (PCT) have been shown to reflect inflammation and oxidative stress in chronic inflammatory and autoimmune diseases. In this study, we aimed to investigate the hematological and inflammatory parameters in patients with vitiligo and to evaluate their possible relationship with disease severity. The parameters including MHR, MLR, NLR, PLR, MPV, and PCT were retrospectively investigated in patients with vitiligo and healthy controls. Disease severity was evaluated using the vitiligo extent tensity index (VETI) score. A total of 180 patients with vitiligo, and age-gender-matched 180 healthy controls were enrolled in the study. MHR, MLR, PLR, PCT values were found to be significantly higher in patients with vitiligo (p < 0.05). MPV and NLR values showed no statistically significant difference between the two groups. A positive correlation was also detected between MHR and MLR values, disease duration, and VETI score (p < 0.05). We suggest that MHR and MLR can be used as markers of inflammation and oxidative stress in patients with vitiligo. Both markers may also reflect disease severity.
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http://dx.doi.org/10.1007/s00403-020-02129-3DOI Listing
August 2020

COVID-19 and immunosuppressive therapy in dermatology.

Dermatol Ther 2020 11 3;33(6):e14140. Epub 2020 Sep 3.

University of Studies Guglielmo Marconi, Rome, Italy.

Coronavirus 2019 (COVID 19) was first detected in December 2019 in China. It has become a pandemic. With concern about therapies that may decrease immunity and enhance the severity of an individual's COVID-19 infection, leading to a possibly fatal outcome, use of immunosuppressants has become an important concern. This work focuses on management of various skin diseases individuals lacking immunity to COVID-19 but requiring a systemic immunosuppressant, keeping in view the challenge of the COVID 19 pandemic and that our knowledge of this virus and its effects on the immune system are incomplete including knowledge as to an individual's immunity after COVID-19 infection.
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http://dx.doi.org/10.1111/dth.14140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7435553PMC
November 2020

Melanoma and COVID-19: A narrative review focused on treatment.

Dermatol Ther 2020 11 25;33(6):e14101. Epub 2020 Aug 25.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

Melanoma is the most severe form of skin cancer and its incidence has increased over the past few decades. COVID-19 pandemic affected the diagnosis and management of many diseases including melanoma. In this study, we aimed to provide a review focused on the diagnosis and management of melanoma in the era of COVID-19. A comprehensive search was conducted on PubMed, Web of Science, and Google Scholar databases using the keywords "melanoma," "coronavirus," "COVID 19," and "SARS-CoV-2." The relevant guidelines published by the European Society for Medical Oncology and the National Comprehensive Cancer Network were also included. The current guidelines recommend that surgical interventions for new diagnosis of invasive primary melanoma, patients with postoperative complications, wide resection and sentinel lymph node biopsy for newly diagnosed T3-T4 melanoma, and planned surgical procedures for patients in neo-adjuvant trials should be prioritized. Surgical treatment of T3/T4 melanomas should be prioritized over T1/T2 melanomas except for any melanoma in which large clinical residual lesion is visible. Adjuvant therapies can be postponed for up to 12 weeks depending on the local center circumstances. PD-1 inhibitor monotherapy is recommended for patients starting immunologic therapy. Combination immunotherapy is still considered suitable for patients with higher-risk disease. Encorafenib and binimetinib should be prioritized for patients requiring BRAF-targeted therapy due to the lower chance of symptoms mimicking COVID-19 infection.
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http://dx.doi.org/10.1111/dth.14101DOI Listing
November 2020

Melanoma: A silver lining in the black cloud of COVID-19.

Dermatol Ther 2020 11 6;33(6):e14070. Epub 2020 Sep 6.

Department of Dermatology, University of Rome G. Marconi, Rome, Italy.

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http://dx.doi.org/10.1111/dth.14070DOI Listing
November 2020

Female pattern hair loss: A comprehensive review.

Dermatol Ther 2020 11 31;33(6):e14055. Epub 2020 Aug 31.

Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Female pattern hair loss is a common form of hair loss in women that increases in incidence with age. The etiology is unknown with numerous factors identified that influence its onset. Female pattern hair loss may be viewed as a marker for an increased risk of cardiovascular and metabolic disease. New treatments include microneedling, low-level laser therapy, and autologous fat transfer. This article focuses on the pathophysiology, diagnosis, systemic associations, and current treatments for female pattern hair loss, which is the most common cause of alopecia in women.
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http://dx.doi.org/10.1111/dth.14055DOI Listing
November 2020

Psoriasis and COVID-19: A narrative review with treatment considerations.

Dermatol Ther 2020 11 9;33(6):e13858. Epub 2020 Jul 9.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

Coronavirus disease (COVID-19) is a highly contagious respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 outbreak has been declared a pandemic by the World Health Organization on March 2020. The pandemic has affected the management of psoriasis not only for those who are under treatment but also for those who are about to begin a new therapy to control their disease. An increasing number of studies in the current literature have focused on the relationship between psoriasis and COVID-19 from different perspectives. This narrative review includes searching the PubMed and Web of Science databases using the keywords "psoriasis," "psoriatic arthritis," "coronavirus," "COVID-19," and "SARS-CoV-2." The search was supplemented by manual searching of reference lists of included articles. A total of 11 relevant original investigations and 6 case studies was identified. The search was updated in May 2019. Due to the absence of randomized controlled trials, it is not likely to have a robust evidence-based approach to psoriasis management in the era of COVID-19. However, the current literature may provide some clues for safety considerations. Conventional immunosuppressive therapies such as methotrexate and cyclosporine, and anti-tumor necrosis factor agents should not be preferred due to increased risk of infection, especially in high-risk areas. The use of cyclosporine may pose additional risk due to the side effect of hypertension, which has been reported to be associated with susceptibility to severe COVID-19. Considering that the current literature has provided no conclusive evidence that biologics increase the risk of COVID-19, withdrawal of these agents should be reserved for patients with COVID-19 symptoms. The treatment approach should be personalized, considering the advantages and disadvantages for each case separately.
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http://dx.doi.org/10.1111/dth.13858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323009PMC
November 2020

A case of erythema multiforme major in a patient with COVID 19: The role of corticosteroid treatment.

Dermatol Ther 2020 11 13;33(6):e13899. Epub 2020 Jul 13.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

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http://dx.doi.org/10.1111/dth.13899DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361159PMC
November 2020