Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa. Several clinical s... more Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa. Several clinical subtypes of OLP have been reported, including the reticular and erosive one. On the one hand, reticular OLP is usually asymptomatic and is characterized by white streaks surrounded by well-defined erythematous borders. On the other hand, erosive OLP shows ulcerations and erosions surrounded by erythematous mucosa. While reticular OLP is relatively easy to control, erosive OLP is extremely painful and refractory to therapies, limiting the quality of life of the patients. In addition, treating erosive OLP is extremely tricky, and a gold standard treatment has not yet been established. However, several therapeutic approaches have been reported as effective, including systemic corticosteroids, systemic retinoids, and anti-interleukin (IL)-17/anti-IL-23 drugs. Indeed, our group and other several authors reported the effectiveness of anti-IL17, anti-IL12/23, and anti-IL23 agents in refractory O...
Paraneoplastische Hautmanifestationen bei Malignomen sind polymorph. Kliniker sollten mit paraneo... more Paraneoplastische Hautmanifestationen bei Malignomen sind polymorph. Kliniker sollten mit paraneoplastischen Dermatosen vertraut gemacht werden, um eine Frühdiagnose des begleitenden Malignoms durchführen zu können. Mangelnde Vertrautheit mit kutanen Hinweisen auf bösartige innere Erkrankungen kann ihre Diagnose und Behandlung verzögern. In dieser Übersicht haben wir mehrere paraneoplastische autoimmune Dermatosen beschrieben, darunter das paraneoplastische autoimmune Multiorgansyndrom (PAMS), das paraneoplastische bullöse Pemphigoid und die paraneoplastische Dermatomyositis.
Concidence of cotrimoxazole induced toxic epidermal necrolysis and chronic Q Fever in an Afghan shepherd
Journal of the European Academy of Dermatology and Venereology
Anorectal melanoma (AM) is a rare malignancy, characterized by aggressive behavior and a poor pro... more Anorectal melanoma (AM) is a rare malignancy, characterized by aggressive behavior and a poor prognosis. AM is more frequent in female patients aged over 50 years. AM accounts for 0.4-1.6% of all melanomas, 23.8% of all mucosal melanomas, and 1% of all anorectal malignant tumors. There are many theories regarding AM pathogenesis. Some consider that AM may be related to oxidative stress in the region and/or to immunosuppression. Others propose that AM may derive from Schwannian neuroblastic cells or cells of the amine-precursor uptake and decarboxylation system of the gut. Assessment of pigmented lesions located on hidden areas is difficult. Together with late and nonspecific signs and symptoms which usually occur only in conjunction with large masses, diagnosis of these mucosal melanomas is often delayed. Most frequently, the signs and symptoms are obstruction, rectal bleeding, pain, or rectal tenesmus. There are various histological variants of AM: epithelioid, spindle cell, lymphoma-like, and pleomorphic. Surgery (abdominoperineal resection or local excision) is the most Anorectal Melanoma 84 effective treatment for AM; however, this is not associated with improved overall survival. Recurrence is more frequent in cases of anorectal and rectal involvement when compared with anal-only involvement. There is currently no consensus about the most appropriate systemic treatment. The efficacy of some protocols previously used in patients with cutaneous melanomas is currently being studied in mucosal melanoma.
Italian journal of dermatology and venereology, 2021
Lentigo maligna (LM) is usually diagnosed in sun-damaged skin of elderly patients and a correct e... more Lentigo maligna (LM) is usually diagnosed in sun-damaged skin of elderly patients and a correct excision of the lesion determines a complete healing from the disease. LM is very rare in young patients and, for this reason, it can be commonly misdiagnosed. We describe the case of a locally recurrent LM in a 19-year-old male patient, which initially arose at the age of 17 years. In order to avoid diagnostic pitfalls, clinicians have to put more emphasis on diseases which previously were prerogative only of elderly patients and that now could begin to engage a younger age, according to climate and behavior changes.
Mucosal nasopharyngeal melanoma is a rare head and neck melanoma. Prognosis is poor (5-year overa... more Mucosal nasopharyngeal melanoma is a rare head and neck melanoma. Prognosis is poor (5-year overall survival rate of 10-30%) with high rates of metastases and local recurrence. Head and neck mucosal melanoma represents 0.8-3.7% of all melanomas and 0.03% of all neoplasms; the most commonly involved sites are the nose, paranasal sinuses, oral cavity, pharynx, and larynx. A slight female predominance has been described and the median age of presentation is 64.3. Irritants and carcinogenic substances, such as tobacco smoke and formaldehyde, seem to be related to its development. A lack of specific clinical features often leads to a late diagnosis. At an early stage, clinical features can include epistaxis, obstruction, difficulty breathing, serous otitis media, and nasal discharge; subsequently, pain, facial distortion, proptosis, and diplopia predominate the clinical pictures. Masses are mostly polyploid, friable, and bloody. They can be amelanotic or surrounded by black-or brown-pigmented dots. Nasopharyngeal melanoma resembles other common polypoid lesions; therefore, Nasopharyngeal Melanoma 50 histology plays a pivotal role in confirming the diagnosis. Computed tomography, facial and total body scan, as well as magnetic resonance imaging are mandatory for a correct staging. Surgical treatment remains the gold standard. External or intranasal incision depends on tumor site and size. Sentinel lymph node biopsy is not usually performed. Neck dissection is indicated in cases of clinical and/or radiological positivity. Radiotherapy is mostly palliative, as radiotherapy lacks efficacy for mucosal melanomas. The effectiveness of target therapy and/or immunotherapy is undergoing evaluation.
Journal of the European Academy of Dermatology and Venereology, 2020
In 2009, snakebites were included in the list of the World Health Organization (WHO) neglected di... more In 2009, snakebites were included in the list of the World Health Organization (WHO) neglected diseases. Dermatological literature lacks current and up‐to‐date articles about snakebites and their management, despite the fact that dermatologists, especially from rural hospitals, can be called into the emergency room to consult the management of suspected snakebites. In this systematic review, we highlighted the main clinical and laboratory aspects of snakebites from Vipera spp. in Europe, by reviewing 3574 studies initially retrieved from PubMed, Embase and Cochrane CENTRAL databases. Of these, 78 were finally included in the systematic review. We found that the most involved taxon was V. berus in 63.3% and the most involved anatomic site of the bite was the upper limbs 53.1% with fang marks reported in 90.5%. The mean age of the patients was 32.9 years, and bites were slightly more common among males (58.2%). A wound washing was performed in 86.9% of cases before the hospitalization...
This article has been accepted for publication and undergone full peer review but has not been th... more This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as
Mastocytosis can be associated with other clonal or non-clonal hematologic diseases as well as a ... more Mastocytosis can be associated with other clonal or non-clonal hematologic diseases as well as a variety of non-hematologic malignancies. A 75-year-old Caucasian male patient was referred to us with a 5-month history of neutrophilic leukocytosis and mild splenomegaly. He had developed a cutaneous melanoma sixteen years ago. According to the clinical and pathological features, a final diagnosis of systemic mastocytosis was established. The patient started treatment with interferon-α at a dose of 3 MIU/day, combined with low doses of prednisone. We observed a rapid disappearance of symptoms. Unfortunately, after 3 months a diagnosis of pancreatic adenocarcinoma was established. A review of the literature suggests that mastocytes could have a pivotal role in several malignancies. Different chemokines, mitogenic factors, chemical mediators of inflammation, and specific gene mutations could explain the association between mastocytosis and other hematologic and non-hematologic disorders.
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