Nickel is the major cause of allergic contact dermatitis. It is a widely spread metal, being therefore very difficult to avoid. Nickel cutaneous allergy can occur in occupational and non-occupational contexts and can result from direct... more
Nickel is the major cause of allergic contact dermatitis. It is a widely spread metal, being therefore very difficult to avoid. Nickel cutaneous allergy can occur in occupational and non-occupational contexts and can result from direct cutaneous contact, systemic as well as airborne exposure. Such allergy can manifest with typical lesions of allergic contact dermatitis or with peculiar features such as follicular erythemato-micropapularvescicular lesions. Diagnosis of allergic contact dermatitis to nickel is based on patch testing, employing nickel sulfate 5% in petroleum jelly. Reactions to patch test have to be assessed at 48-72 hours, and up to 6 days. Nickel contact dermatitis can be managed with the traditional therapeutic approach used in allergic contact dermatitis. As of today, hyposensitization therapy with oral nickel represents to be the only treatment acting on the pathogenetic mechanisms of nickel allergy.
Research Interests: Endocrinology, Immunology, Endocrine Surgery, Clinical immunology, Endocrine disrupter chemicals (hormones), and 6 moreTB vaccines and immunology; clinical trials, Microbiology and Immunology, Environmental Endocrine Disrupting Compounds, Stem Cell Research, Clinical Microbiology, Clinical Immunology, Endocrine System Mediators, and Clinical Allergy and Immunology
Rapidly growing mycobacteria (RGM) are among the most common nontuberculous mycobacteria (NTM) associated with cutaneous infections in industrialized countries [1–8].
Research Interests:
Research Interests:
The bovine tubercle bacillus must firstly be placed in context among the other agents of tuberculosis [1–5]. In the early decades of the twentieth century, bacteriologists recognized four varieties of tubercle bacilli (human, bovine,... more
The bovine tubercle bacillus must firstly be placed in context among the other agents of tuberculosis [1–5]. In the early decades of the twentieth century, bacteriologists recognized four varieties of tubercle bacilli (human, bovine, avian and cold-blooded), depending on the life forms from which they were isolated. By the middle of the century, only two varieties were still recognized as agents of human and bovine tuberculosis (TB), namely Mycobacterium tuberculosis and M. bovis [6], respectively.
Mycobacterium scrofulaceum is a member of the Runyon class II scotochromogen acid-fast bacilli [1–3]. It is widely present in nature, but is now an infrequent human pathogen. It was first described in the 1950s [4–6] and the name likely... more
Mycobacterium scrofulaceum is a member of the Runyon class II scotochromogen acid-fast bacilli [1–3]. It is widely present in nature, but is now an infrequent human pathogen. It was first described in the 1950s [4–6] and the name likely derives from its isolation from cervical lymph nodes.
Melanoma is reported as the 19th most common cancer worldwide, with estimated age-standardized incidence rates of 2.8–3.1 per 100,000. Although the origin is most frequently cutaneous, mucosal melanoma has been described several times in... more
Melanoma is reported as the 19th most common cancer worldwide, with estimated age-standardized incidence rates of 2.8–3.1 per 100,000. Although the origin is most frequently cutaneous, mucosal melanoma has been described several times in literature, and despite its rarity (only 1% of all melanomas), increasing attention is being paid to this disease form. Within this subgroup, melanomas of the uropoetic apparatus are a rarity among rarities. Indeed, less than 50 cases of primary melanoma originating from the urinary bladder have been described, and even less originating from the kidney, renal pelvis and urethra. In this work, we present a detailed review of the literature related to this subclass of mucosal melanoma, delve into the biological landscape of this neoplasm and discuss current approaches, future perspectives and potential therapeutic approaches.
Research Interests:
We present a case of symmetrical thermal intermediate-deep burns treated in a case-control fashion with the stromal vascular fraction (SVF) obtained with the MyStem™ device and a scaffold of hyaluronic acid. After enzymatic debridement... more
We present a case of symmetrical thermal intermediate-deep burns treated in a case-control fashion with the stromal vascular fraction (SVF) obtained with the MyStem™ device and a scaffold of hyaluronic acid. After enzymatic debridement and SVF harvesting and application, we observed quicker healing (as assessed by wound area histogram planimetry) in the case area as opposed to the control one, which eventually underwent skin grafting. At the 3 months follow-up, the Vancouver Scar Scale was 9 for the case side and 10 for the control side, with a tendency to hypertrophic scarring in both areas, while patient satisfaction Visual Analogue Scale was 7 for the case side and 2 for the control side. CD31 expression, a marker of neoangiogenesis, was significantly higher in the case area as compared to the control one. SVF could potentially represent a valid alternative to the current standard of care, with a decreased need of invasive surgery and consequent improved patients' quality of life.
Research Interests:
Research Interests:
It is also possible that your web browser is not configured or not able to display style sheets. In this case, although the visual presentation will be degraded, the site should continue to be functional. We recommend using the ...
Research Interests:
Mycobacterium marinum lives in aquatic environments, where it causes disease in many poikilodermic fish species living in fresh or saltwater; the organism has a wide geographic distribution in the water world [1]. The first report of a... more
Mycobacterium marinum lives in aquatic environments, where it causes disease in many poikilodermic fish species living in fresh or saltwater; the organism has a wide geographic distribution in the water world [1]. The first report of a mycobacterium isolated in fish (very likely M. marinum) is attributed to Bataillon and Coll., who isolated acid-fast bacilli, named M. piscium, in 1897, from a tuberculous lesion of a common carp (Cyprinus carpio) [2, 3]. Then in 1926 it was isolated and identified by Aronson from tubercles in various organs of marine fish found dead in the Philadelphia Aquarium [4]. Initially M. marinum was thought to infect fishes only and was named accordingly, but it is now known to be a ubiquitous species. The original freshwater isolate of M. piscium was quite possibly a variant of M. marinum. Other marine Mycobacterium species have been described in the literature, such as M. platypoecilus, M. anabanti, and M. balnei; however, comparative cultural, morphologica...
Airborne dermatoses are complaints linked to external environmental, chemical, and biotic agents carried through the air. In general, airborne dermatoses that are most common in the work environment, tend to cause diagnostic problems that... more
Airborne dermatoses are complaints linked to external environmental, chemical, and biotic agents carried through the air. In general, airborne dermatoses that are most common in the work environment, tend to cause diagnostic problems that are challenging for both the patient and the doctor. It should also be borne in mind that since the external culprit agents are present in the environment, they do not only come in contact with the skin and mucosa, but can also be inhaled or ingested, thus also causing respiratory and systemic symptoms. Among the various clinical forms, airborne contact dermatitis interests the parts of the body exposed to the air: face, neck, upper aspect of the chest, hands, wrists. These cases must be differentiated from photocontact dermatitis; in the latter case, however, shadowed anatomic areas, such as the upper eyelids, behind the ears, the submandibular region, and under the hair, are not affected.
Research Interests:
The etiopathogenesis of the nummular eczema is not fully known. Various causative factors have been proposed, and among these only a few studies investigate the relevance of contact allergy. Here, we present a case of nummular contact... more
The etiopathogenesis of the nummular eczema is not fully known. Various causative factors have been proposed, and among these only a few studies investigate the relevance of contact allergy. Here, we present a case of nummular contact eczema in an 8-year-old allergic to perfumes. Since atopic dermatitis may also present with different clinical phenotypes, among which nummular eczema is quite frequent, the possible significant differences between non-atopic and atopic nummular diseases are considered. Based on the high incidence of contact sensitization in all cases of nummular eczema, it is recommended to perform patch tests for diagnostic-preventive purposes.
Research Interests:
Atopic dermatitis (AD) prevalence is rising worldwide. Literature data suggest the incidence of AD in developing countries is gradually getting close to that of developed ones, in which AD affects 20% of the paediatric population. Such an... more
Atopic dermatitis (AD) prevalence is rising worldwide. Literature data suggest the incidence of AD in developing countries is gradually getting close to that of developed ones, in which AD affects 20% of the paediatric population. Such an increment, associated with significant variations in prevalence among the various countries, underlines the importance of environmental factors in the disease onset. Among these, great importance is given to hygiene, intestinal microbiota, exposure to bacterial endotoxins, outdoor living with contact to animals, atmospheric pollution, weather, and diet. Genetic (alteration of the skin barrier function) as well as immunologic factors concur with the environmental ones. Only the systematical study of all these elements can best elucidate AD epidemiology.
Research Interests:
Etanercept is licensed for the treatment of moderate-to-severe plaque psoriasis in children. The aim of this analysis was to investigate effectiveness, tolerability, and reasons for discontinuation of etanercept in a real-life cohort of... more
Etanercept is licensed for the treatment of moderate-to-severe plaque psoriasis in children. The aim of this analysis was to investigate effectiveness, tolerability, and reasons for discontinuation of etanercept in a real-life cohort of children and adolescents with moderate to severe plaque psoriasis. Data collected from a number of centers belonging to the 'Pediatric Dermatology Group' of the Italian Society of Dermatology (SIDeMaST) were examined in patients (age ≤17 years) who started treatment with etanercept from 2011 to 2015. A group of 23 patients were identified. Efficacy assessment was defined as the proportion of patients with a ≥50% and ≥75% improvement in Psoriasis Area Severity Index (PASI) at weeks 12, 24, and 52. Safety was evaluated on adverse event reporting. Reasons for discontinuation were classified as ineffectiveness, adverse events, remission, or other reasons. At week 12, 56.5% of patients achieved PASI 75, 86.9% achieved PASI 50. Efficacy was sustain...
Research Interests:
Acute generalized exanthematous pustulosis (AGEP) is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake.... more
Acute generalized exanthematous pustulosis (AGEP) is an uncommon and self-limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever, pustulosis, and neutrophilia from 4 to 10 days after the drug intake. We describe a case of AGEP in a 61-year-old woman that was hospitalized for the acute onset of fever, erythroderma, and pustulosis. Clinical history revealed that she had been treating a bacterial inguinal intertrigo for 4 days with ciprofloxacin 500 mg tablets twice daily and desloratadine 5 mg tablet once daily. To the best of our knowledge, this is the third reported case of AGEP caused by ciprofloxacin, supporting two other previous reports.
Research Interests:
Research Interests:
Research Interests: Christianity, Medicine, Italy, Humans, Female, and 4 moreRecurrence, Clinical Sciences, Adult, and Malingering
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis. Retrospective analysis of a group of children and adolescents... more
Acitretin is licensed for and is most commonly used to treat psoriasis. Little information exists about its efficacy and safety in childhood and adolescent psoriasis. Retrospective analysis of a group of children and adolescents (<17 years of age) with moderate to severe plaque psoriasis treated with acitretin between 2010 and 2014 at Italian dermatology clinics. Patients were identified through databases or registries. The study population consisted of 18 patients with a median age of 9.5 years at the start of therapy. The median maintenance dosage per day was 0.41 mg/kg. Eight patients (44.4%) achieved complete clearance or good improvement of their psoriasis, defined as improvement from baseline of 75% or more on the Psoriasis Area and Severity Index at week 16. Three had three or more courses of treatment with short disease-free intervals. In three patients, acitretin treatment was ongoing at the time of data collection. The mean total duration of treatment in responders was 22.7 months. One patient discontinued treatment because of arthralgia. The remaining nine patients (50%) discontinued treatment because it was ineffective. Mucocutaneous adverse effects occurred in all patients, but did not affect therapy maintenance. In this retrospective case series, acitretin was a moderately effective, well-tolerated treatment in children with moderate to severe plaque psoriasis. Given the small number of patients, statements about long-term safety are not possible.
Research Interests: Patient Safety, Treatment Outcome, Risk assessment, Adolescent, Humans, and 14 moreChild, Female, Male, Follow-up studies, Psoriasis, Retrospective Studies, Age Factors, Risk Assessment, Pediatric dermatology, Acitretin, Cohort Studies, Severity of Illness Index, Child preschool, and Paediatrics and reproductive medicine
We describe the case of a 42-years-old non-atopic man who developed a severe eczematous reaction in the genital area some hours after the use of a condom (Settebello-Hatù Durex) containing a retarding cream. Patch test revealed a strong... more
We describe the case of a 42-years-old non-atopic man who developed a severe eczematous reaction in the genital area some hours after the use of a condom (Settebello-Hatù Durex) containing a retarding cream. Patch test revealed a strong allergic reaction to the retarding cream and to benzocaine and paraben mix contained in the cream itself. Condoms with retarding cream should be avoided in man sensitized to local anestethetics.
Research Interests:
Research Interests:
Unsatisfactory response rates are not rarely observed in the management of acne and seem largely related to poor adherence to treatment. As more specifically regards management of the disease in female patients, available literature... more
Unsatisfactory response rates are not rarely observed in the management of acne and seem largely related to poor adherence to treatment. As more specifically regards management of the disease in female patients, available literature provides contradictory indications regarding permissibility of using cosmetics. In this study we aimed to narrow our investigation on the habits of non-academic dermatologists specifically with regards to allowing/not-allowing their female patients to use camouflage cosmetics. A Web-based survey was carried out by sending an e-mail containing a brief, aim- oriented questionnaire to a random, nationwide sample of 1,508 Italian colleagues. Basic demographic data (sex, age and seniority of specialization), and 'tick box' and 'open' responses to the questionnaire underwent statistical analyses, as appropriate. The response rate was 32,9% (N=334), this meaning 7,6% of the entire (N=4,390) Italy- based dermatologist population. The outcome betw...
Research Interests: Italy, Humans, Female, Male, Acne Vulgaris, and 6 moreCosmetics, Middle Aged, Adult, Internet, dermatologists, and Health Care Surveys
Chemical leukoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, is an acquired form of cutaneous pigment loss caused by exposure to a variety of chemicals that act through selective... more
Chemical leukoderma, often clinically mimicking idiopathic vitiligo and other congenital and acquired hypopigmentation, is an acquired form of cutaneous pigment loss caused by exposure to a variety of chemicals that act through selective melanocytotoxicity. Most of these chemicals are phenols and aromatic or aliphatic catechols derivatives. These chemicals, however, are harmful for melanocytes in individuals with an individual susceptibility. Nowadays, chemical leukoderma is fairly common, caused by common domestic products. The presence of numerous acquired confetti- or pea-sized macules is clinically characteristic of chemical leukoderma, albeit not diagnostic. Other relevant diagnostic elements are a history of repeated exposure to a known or suspected depigmenting agent at the sites of onset and a macules distribution corresponding to sites of chemical exposure. Spontaneous repigmentation has been reported when the causative agent is avoided; the repigmentation process is perifollicular and gradual, taking place for a variable period of weeks to months.
Research Interests:
Research Interests:
Tobacco and tobacco smoke are strongly associated with various skin conditions, among which contact dermatitis is of prime importance. The aetiological and clinical aspects vary according to the different tobacco production and processing... more
Tobacco and tobacco smoke are strongly associated with various skin conditions, among which contact dermatitis is of prime importance. The aetiological and clinical aspects vary according to the different tobacco production and processing steps. Contact dermatitis is frequent in tobacco harvesters, curers and cigar makers, whereas it rarely affects smokers and, only exceptionally, cigarette packaging workers. The skin sites involved also vary, according to whether the exposure is occupational or non-occupational. Tobacco contact irritation is far more frequent than contact allergy. The sensitizing compound in tobacco is unknown; nicotine, while highly toxic, does not seem to cause sensitization, except in rare cases. Besides natural substances, several compounds are added to tobacco during processing and manufacturing. For this reason, identifying the aetiological factors is exceedingly difficult. Another important aspect to take into account is the co-causative role of tobacco in e...
Research Interests:
Most of systemic therapies have not been systematically investigated in moderate to severe childhood plaque psoriasis. Treatment preferences for moderate to severe psoriasis in childhood are unknown. the objectives of this study were to... more
Most of systemic therapies have not been systematically investigated in moderate to severe childhood plaque psoriasis. Treatment preferences for moderate to severe psoriasis in childhood are unknown. the objectives of this study were to investigate the systemic treatment patterns of moderate to severe psoriasis in children and adolescents aged ≤ 18 years in Italy. Additional secondary outcomes were duration of treatment and reasons for discontinuation. to define differences in treatment patterns, we performed a chart review of all consecutive patients treated with systemic drugs during an index period of five years. Consecutive sampling of all patients with psoriasis, aged ≤ 18 years, who had been treated with at least one systemic drug over a 5-year period, was made. the records of 58 consecutive patients, 27 males, 31 females. with moderate to severe psoriasis treated with at least one systemic therapy were reviewed. The median age (standard deviation) at the start of the first sy...
Research Interests:
Research Interests:
Research Interests:
Photoallergic contact dermatitis (PCD) is a delayed-type hypersensitivity cutaneous reaction in response to a photoantigen applied to the skin in subjects previously sensitized to the same substance. For the development of PCD,... more
Photoallergic contact dermatitis (PCD) is a delayed-type hypersensitivity cutaneous reaction in response to a photoantigen applied to the skin in subjects previously sensitized to the same substance. For the development of PCD, irradiation with ultraviolet (UV) radiations, usually UVA, is required to create a complete antigen, and the culprit substance needs to be within the skin at the time of UVA exposure. The incidence of PCD in the general population is unknown and is considered uncommon. Epidemiological data have been obtained from studies performed using photo-patch tests in patients with suspected photodermatoses in tertiary care outpatient units. Prevalence of PCD over time has been also dependent on prescription and/or usage patterns of potential photosensitizers, and was particularly high in the past, causing mini-epidemics in some countries because of the widespread use of halogenated salicylanilides and other photosensitizing compounds. Many topical substances with photosensitizing properties are currently available, with the most important ones being sunscreen agents and nonsteroidal antiinflammatory drugs. The diagnosis of PCD, in patients with a history of photosensitivity and especially with an eczematous form of photodermatosis, should be confirmed by photo-patch testing.
Research Interests:
Acne vulgaris is a chronic dermatological disorder that affects the majority of teenagers in the Western world. Topical therapy is widely used to treat mild-moderate acne and is known as well-tolerated thanks to its low systemic toxicity,... more
Acne vulgaris is a chronic dermatological disorder that affects the majority of teenagers in the Western world. Topical therapy is widely used to treat mild-moderate acne and is known as well-tolerated thanks to its low systemic toxicity, although associated to skin adverse effects. Acne seems to be associated also to an intrinsic alteration of the epidermal barrier, regarding both the upper and the follicular stratum corneum that promotes the onset of such local side effects. The commonest one is irritant contact dermatitis, an event of frequent observation occurring with erythema, burning, dryness, scaling, and itching, usually characterized by low severity and limited duration. Among topical acne drugs, retinoids are the most irritating ones. Another side effect is allergic contact dermatitis: it is rare and mainly associated to benzoyl peroxide.
Research Interests:
Alkyl glucosides and alkyl poly-glucosides are widely used as wetting agents, surfactants and emulsifiers in several industrial and cosmetic products. They are known as well-tolerated and are usually added to the primary surfactants in... more
Alkyl glucosides and alkyl poly-glucosides are widely used as wetting agents, surfactants and emulsifiers in several industrial and cosmetic products. They are known as well-tolerated and are usually added to the primary surfactants in order to reduce the irritating potential of the main foaming agents. Recently, some authors suggested that allergic contact dermatitis to alkyl glucosides might be more frequent than suspected. On the other hand, the chemical structures of glucosides do not show potentially allergenic chemical groups or strongly polarized structures. The aim of our study is to investigate alkyl glucosides carrying out a detailed chemical analysis on samples of raw materials to identify potentially allergenic impurities or by-products contained in commercial samples of alkyl glucosides. We chemically analyzed samples of cocoyl glucoside, decyl glucoside and lauryl glucoside by three different analytical methods, in order to identify any undesired or polluting substance...
Research Interests:
Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D... more
Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD.
Research Interests:
BackgroundA non-steroidal, anti-inflammatory moisturizing cream containing rhamnosoft, ceramides, and L-isoleucine (ILE) (pro-AMP cream) has been recently developed for the specific treatment of atopic eczema (AE) of the face. In this... more
BackgroundA non-steroidal, anti-inflammatory moisturizing cream containing rhamnosoft, ceramides, and L-isoleucine (ILE) (pro-AMP cream) has been recently developed for the specific treatment of atopic eczema (AE) of the face. In this trial, we evaluated the clinical efficacy and tolerability of pro-AMP cream in the treatment of facial AE in children in comparison with an emollient cream. Methods In a randomized, prospective, assessor-blinded, parallel groups (2:1) controlled trial, 107 children (72 allocated to pro-AMP cream and 35 allocated to control group) with mild-to-moderate chronic AE of the face were enrolled. Treatments were applied twice daily for a 6-week period. Facial Eczema Severity Score (ESS) was evaluated at baseline, week 3, and week 6, by an assessor unaware of treatment allocation. Investigator's Global Assessment (IGA) score was assessed at week 3 and at week 6. Tolerability was evaluated at week 3 and at week 6 using a 4-point score (from 0: low tolerabili...