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Atopic dermatitis (AD) has substantial negative impact on patients' quality of life. Although considerable advances have been made in understanding the pathogenesis and its treatment, there is still limited transfer of this knowledge into daily management. Aiming to identify unmet needs in clinical management of patients with AD, we used a Delphi consensus process. A set of statements regarding diagnosis, management, prognosis, and treatment was identified by five experts (Steering Committee). Then, the Steering Committee and a second group of four clinicians were involved in a Delphi process. Lastly, agreement was assessed in a larger panel of Italian clinicians. Overall, 37 clinicians participated to the process. 17 statements reached strong agreement and 2 reached weak agreement. In general, the statements reflected the need for accurate and effective diagnostic criteria to support clinical experience, especially in the atypical forms of AD. Moreover, prognostic criteria are needed to predict the duration of adult-onset AD. The identification of biomarkers was considered to be useful for clinical management of AD at all stages of disease. Lastly, greater emphasis should be placed on patient education and development of effective tools that can aid informing patients about their disease and its treatment. [ABSTRACT FROM AUTHOR]

Lichen sclerosus (LS) is a chronic relapsing disease with a predilection for the anogenital areas of patients of both sexes and at all ages. In males, LS is usually a late diagnosis, increasing the odds for serious complications up to the worse clinical scenario. LS is known to affect the quality of patients' social and interpersonal life. Here, we designed a study to monitor the possible beneficial effects of fractional photo-thermolysis with CO2 laser for treating penile LS during a non-active phase of the disease. Ten patients were enrolled in this study. They all underwent three ablation laser sessions, followed by a follow-up visit 6 months after the last treatment. In four out of five visits conducted, questionnaires were filled in by both clinician and patients to evaluate outcomes on quality of life (DLQI test), symptoms of LS (MenLas Observer Scale and MenLas Patient Scale), and sexual function (MSHQ questionnaire). Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life. Our study shows that treatment with fractioned laser CO2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life. [ABSTRACT FROM AUTHOR]

Thanks to their specificity of action, biologic drugs often lead to complete clearance of psoriatic lesions. In order to maintain its effectiveness, biological therapies cannot be discontinued. The aim of the study was to investigate the effect of widening the administration window of four biologic drugs, thus improving the quality of life of psoriatic patients and satisfying their desire to feel free from the disease, without loss of effectiveness. We performed a multicentric cohort study considering patients with moderate-severe plaque psoriasis and/or arthropathic psoriasis treated with infliximab, adalimumab, etanercept or ustekinumab. The study group included patients with stabilized psoriasis in which the administration regimen of the biologic drug was deferred. The control group included psoriatic patients treated according the product monograph. The percentage of relapses in case of deferred administration intervals was comparable to that of standard administration intervals. The delayed administration modality got a good psychological consensus from the patients themselves, that reported a greater 'perceived satisfaction'. A consistent economic advantage was reported in case of prolonged administration intervals. The administration of biologic drugs with prolonged intervals maintains the same effectiveness as standard administration and produces a 'perceived satisfaction' in psoriatic patients. [ABSTRACT FROM AUTHOR]

Rituximab, a chimeric monoclonal antibody that targets the CD-20 molecule on B-cells' surface, has led to significant advances in the treatment of autoimmune pemphigus in recent decades. The aim of the study was to assess the clinical efficacy as well as safety data for biosimilar rituximab with emphasis on the treatment of pemphigus vulgaris. A total of 12 individuals with pemphigus vulgaris treated with biosimilar rituximab were followed for at least 1 year. We assessed patient characteristics, disease history, pemphigus disease area index (PDAI) score, anti-desmoglein (Dsg)1 and anti-Dsg3 antibody level, clinical response, and any adverse events during each clinical follow-up visit. We also recorded time to achieve complete remission, duration of complete remission and time to relapse. A consistent decrease in the PDAI score was observed (p<.0001), as well as a significant decrease of anti-Dsg3 values. In addition, the clinical response of this population confirmed that the equivalent is not inferior to Rituximab (p=.521). The introduction or the switch to Rixathon, a rituximab biosimilar, appears to be safe and may provide an opportunity to reduce health system costs because of its similarity to the reference drug in terms of safety and efficacy. [ABSTRACT FROM AUTHOR]

Introduction: This mono-center randomized, controlled, double-blind study evaluates the safety and efficacy of MD2011001 cream versus placebo, in mild-to-moderate atopic dermatitis (AD). MD2011001 is a nonsteroidal topical cream containing vitamin E, epigallocatechin gallate and grape seed procyanidins. Methods: Patients with AD (corresponding to an IGA score of 2 or 3), involving the face, the perioral/periocular area and/or the neck, were enrolled. Patients were randomized 1:1 ratio to receive MD2011001 or placebo before the start of the study (D0), then evaluated after 7 days, and after 28 days. The study was approved by the Local Independent Ethics Committee and conducted according to the Declaration of Helsinki and local regulations. The statistical tests used were the Wilcoxon test and the Mann–Whitney U-test. Results: Forty-four patients (29F and 15M) were enrolled. The IGA values showed a statistically significant reduction during the treatment period obtaining a favorable safety profile and local tolerance for both the products. The reduction in the surface area affected by AD was significantly faster with MD2011001. Discussion: This study focuses on very sensitive areas known to be particularly susceptible to local complications. Conclusions: These results suggest the usefulness of an emollient treatment for mild/moderate AD. [ABSTRACT FROM PUBLISHER]

Introduction: The management of surgical wounds of the donor areas for split-thickness skin grafts might be difficult in terms of pain, risk of infection, and delayed healing. Materials and methods: In the period from September 2011 to June 2012, 12 patients affected by large ulcerated basal cell carcinoma (BCC) of the lower legs, 2 patients affected by squamous cell carcinoma (SCC), and 1 patient presenting malignant melanoma located on the scalp, with split-thickness skin grafts were treated. In the 12 BCC patients, the donor site areas were situated on the anterior or lateral site of the contralateral thigh and in 3 other patients on the forearms. Immediately after dermatome skin removal of 0.3 mm layer of epidermis, the donor sites were treated by applying an advanced epithelialization dressing consisting of pure cellulose film in all patients. The wound surfaces were covered by the cellulose dressing with 1 cm of excess. Bleeding was controlled with slight compression with sterile gauzes before the medication was applied. Multiple small cuts of the cellulose dressing, with a No. 11 surgical blade were made, in order to avoid hematoma formation or fluid accumulation. A mild compression bandage was used in all patients. The patients were visited after 7, 14, and 21 days. The bandage was removed after 1 week and the medical device was left at the site for other 7 days. Results: After 2 weeks, the medical device was partially detached on the underlying areas showing almost completely reepithelialization. Almost no pain was referred by the patients. In the authors' experience, this medical device markedly reduces the level of pain especially at the time of dressing application, after the surgical procedure, and during the healing process. No infections were observed. The healing process was fast and produced good aesthetic results. Conclusions: The use of Cuticell® Epigraft BSN medical device simplifies the management and healing of the donor areas for split-thickness skin grafts. [ABSTRACT FROM AUTHOR]

From March 9, 2020, our outpatient service was temporarily suspended and replaced by phone call to patients, asking if they had discontinued therapy and/or had suffered from any COVID-19 related symptoms since February. On the contrary, the prompt discontinuation of immunomodulant/immunosuppressant therapies and rituximab is mandatory in cases of moderate-severe respiratory symptoms or contact history with COVID-19 patients, until swab-confirmed negativity for COVID-19 and complete remission of respiratory symptoms. Dear Editor, There are different opinions about the management of ongoing immunosuppressant/immunomodulant therapies during the COVID-19 outbreak ([[1], [3]]). [Extracted from the article]

A letter to the editor is presented which discusses the effectiveness of 5-methylaminolevulinic acid (MAL)-associated photodynamic therapy in treating multiple warts in the face.

Introduction: Lichen sclerosus (LS) is a chronic relapsing disease with a predilection for the anogenital areas of patients of both sexes and at all ages. In males, LS is usually a late diagnosis, increasing the odds for serious complications up to the worse clinical scenario. LS is known to affect the quality of patients' social and interpersonal life. Here, we designed a study to monitor the possible beneficial effects of fractional photo-thermolysis with CO2 laser for treating penile LS during a non-active phase of the disease., Methods: Ten patients were enrolled in this study. They all underwent three ablation laser sessions, followed by a follow-up visit 6 months after the last treatment. In four out of five visits conducted, questionnaires were filled in by both clinician and patients to evaluate outcomes on quality of life (DLQI test), symptoms of LS (MenLas Observer Scale and MenLas Patient Scale), and sexual function (MSHQ questionnaire)., Results: Our study shows that treatment with fractioned laser CO 2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life., Conclusions: Our study shows that treatment with fractioned laser CO 2 therapy, by promoting fast clinical recovery, has a positive impact on patients' sexual function and ultimately their social life.