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Linked Article: Calabrese et al. Br J Dermatol 2022; 186:925–941. The interleukin‐1 (IL‐1) family are a group of chemicals called cytokines that form part of our immune system. Unfortunately, the body may start to use these cytokines inappropriately (dysregulation), and they may stimulate certain white blood cells (neutrophils) to increase in number causing inflammation without an infectious trigger. In this paper, the authors from Italy and Germany review the role of the different members of the IL‐1 family in inflammatory skin disorders and the progress being made to develop antibody treatments aiming to reverse their effects. Interleukin‐1 antagonists such as anakinra and canakinumab have already proved useful in the treatment of disorders directly related to neutrophil proliferation, but there is evidence that this group of drugs may also be beneficial in commoner disorders such as psoriasis and atopic eczema. Sometimes a drug that blocks a single cytokine molecule may have limited effect. Laboratory studies suggest that agents that block receptors on the cell surface membrane may be more effective at reducing skin inflammation caused by several IL‐1 subsets. One promising target is IL‐1 receptor accessory protein (IL‐1R3). The authors stress the need for drugs that target the harmful effects of the IL‐1 family at several levels. Linked Article: Calabrese et al. Br J Dermatol 2022; 186:925–941. [ABSTRACT FROM AUTHOR]

The article presents information on the first international society of tropical dermatology held in Naples, Italy during the week commencing June 8, 1964 in the Palazzo dei Congressi, Mostra d'Ottremare. Two halls were used simultaneously during the Congress, a main hall with very comfortable seating accommodation for one thousand persons and equipment for simultaneous translation into five languages, and a small halt with less comfortable seating and no translators. There were 520 participants from over 50 countries, and altogether about 130 papers were presented. The translators were at times sorely tried by speakers who attempted to read a 30-minute paper in the 10 minutes allowed, and one cannot help but conclude that brevity is foreign to the natures of many of those who speak at international medical congresses.

COVID-19-related dermatosis in November 2019: could this case be Italy's patient zero? We analysed skin biopsies of patients from Milan with dermatoses and positive polymerase chain reaction (PCR) swabs for SARS-CoV-2 at different stages of infection.1,2 The results were compared with skin biopsies of 20 patients with dermatoses who had not been diagnosed with COVID-19, but were at high risk of infection. We were not able to detect viral RNA with RT-PCR technology because the viral load was probably too low or degraded by RNA enzymes released after exogenous or cellular destruction.3 By April 2020, the patient had recovered from the dermatosis. [Extracted from the article]

Background Systematic studies of delusional infestation (DI), also known as delusional parasitosis, are scarce. They lack either dermatological or psychiatric detail. Little is known about the specimens that patients provide to prove their infestation. There is no study on the current presentation of DI in Europe. Objectives To determine the number of true infestations, to assess with which pathogens patients believe themselves to be infested, and to gather details about the frequency and nature of the specimens and the containers used to store them, based on European study centres. Methods Retrospective study of consecutive cases with suspected DI from six centres (Dermatology, Psychiatry, Tropical Medicine) in four European countries (U.K., Germany, Italy, France). Results In total, 148 consecutive cases of suspected DI were included, i.e. the largest cohort reported. None of the patients had evidence of a genuine infestation, as shown by examinations by dermatologists and/or infectious disease specialists. Only 35% believed themselves to be infested by parasites; the majority reported a large number of other living or inanimate (17%) pathogens. Seventy-one patients (48%) presented with what they believed was proof of their infestation. These specimens were mostly skin particles or hair, and rarely insects (only very few of which were human pathogenic or anthropophilic, and none of these could be correlated with the clinical presentation), and only 4% were stored in matchboxes (three of 71). Conclusions This first multicentre study of DI in Europe confirms that the term 'delusional infestation' better reflects current and future variations of this entity than 'delusional parasitosis'. The presentation of proofs of infestation, commonly referred to as 'the matchbox sign', is typical but not obligatory in DI and might better be called 'the specimen sign'. [ABSTRACT FROM AUTHOR]

Biologic agents are an important new class of drugs, offering targeted treatment for chronic skin diseases such as psoriasis. The biologic therapy efalizumab is an anti-CD11a monoclonal antibody, which was approved by the European regulatory agency in 2004 for the treatment of moderate-to-severe plaque psoriasis. Here we describe our 2-year experience in treating over 100 patients with moderate-to-severe psoriasis with efalizumab at two dermatology centres in Italy. Overall, we found efalizumab is efficacious for a large subset of patients, regardless of previous therapies received, and has an easily manageable safety profile. We believe one important quality of efalizumab is the stability and maintenance of clinical response over time. We found that most patients who respond to treatment experience a long-term clearing of psoriasis with only mild recurrence events. Our experience with individual cases provides specific insights into efalizumab re-treatment, the use of efalizumab in patients with a history of heart failure, and the management of patients who become pregnant or conceive while receiving efalizumab therapy. In summary, our off-trial experience in over 100 patients confirms the efficacy and safety of efalizumab in the treatment of moderate-to-severe plaque psoriasis. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is a chronic or chronically relapsing inflammatory skin condition that can have a considerable impact on those affected. There are a number of instruments available to measure outcome in dermatological conditions but none have been developed specifically for AD. In addition, most measure symptoms and/or daily functioning, which are potential influences on quality of life (QoL) rather than assessments of the construct itself. The aim of the current study was to develop a new instrument specifically designed to measure QoL in adults with AD—the Quality of Life Index for Atopic Dermatitis (QoLIAD). The instrument was developed based on the needs-based model of QoL and was produced in several different countries simultaneously. Its content was derived from 65 in-depth interviews with relevant patients in the U.K., Italy and the Netherlands. The initial version of the measure was produced in U.K. English and translations were produced for the Netherlands, Italy, Germany, France and the U.S.A. using a dual translation panel methodology. A Spanish version was developed using the same adaptation process after the instrument was finalized. Field-test interviews were conducted with approximately 20 patients in each country to assess face and content validity. The instrument [in addition to the Dermatology Life Quality Index (DLQI) and the Psychological General Well-Being Schedule (PGWB)] was then administered to up to 300 AD patients in each country at two time points to finalize the instrument and test its psychometric properties. The initial version of the QoLIAD had 56 items that reflected the areas of need fulfilment identified in the qualitative interviews as having been affected by AD: mental and emotional stimulation, physical and emotional stability, security, sharing and belonging, self-esteem, personal development and fulfilment. Comments from patients in field-test interviews resulted in the removal of 14 items, to leave a 42-item instrument that was considered relevant and acceptable. The number of patients participating in the survey were 286 in the U.K., 46 in the Netherlands, 213 in France, 187 in Germany, 178 in the U.S.A. and 83 in Spain. Application of the Rasch model to these data identified the final 25-item QoLIAD. Unidimensionality was confirmed, with deviation of the total scale from the Rasch model evident at a single time point in one country only (the U.K.). All language versions, with the exception of the Dutch measure, had test–retest reliability coefficients in excess of 0·85. The test–retest in the Netherlands was 0·80. However, this country had the smallest sample size and the corresponding reliability for the DLQI was only 0·40. The QoLIAD had adequate internal consistency and the initial indications of construct validity were good. The levels of association with the DLQI indicated that the two instruments measure related but distinct constructs. The QoLIAD is a practical, reliable, valid and culturally applicable instrument for measuring the impact of AD and its treatment on QoL in clinical trials or in routine clinical practice. [ABSTRACT FROM AUTHOR]

The article presents news and notices related to the medical field. It is reported that the 3rd International Symposium on Irritant Contact Dermatitis is to be held in Rome Italy during October 2-4, 1997. This Symposium will focus on recent clinical and experimental advances in the field of skin irritation. It is informed that Dermatopathology Self-assessment Workshop will take place on October 4, 1997 at the Cleveland Clinic Foundation.

The article presents information about various events and proceeding related to Dermatology and Venereology. The 85th annual meeting of the British Association of Dermatologists is to be held in Glasgow, Scotland. The Society for Pediatric Dermatology announces an annual award for a dermatologist who has made significant contribution to the care of pediatric skin disease in his or her developing country. It is informed that the 13th Congress of the European Academy of Dermatology and Venereology will be held in Florence, Italy, during 17-21 November 2004.

The article presents news and notices in the field of dermatology. The 6th Annual Meeting of the B.A.D. will be held in London from July 3 to July 5 1985, at Kensington Town Hall and St George's Hospital, under the Presidency of K.V. Sanderson. The Third Immunodermatology Symposium will be held in Milan, Italy on 2 1-23 September 1986. For further information contact: Professor R. Caputo, Clinica Dermatologica Prima, Universita di Milano, Milano, Italia. The Second International Symposium on 'New Trends in Allergy' will be held in Munich on 26-28 July 1985.