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The article discusses a rare cutaneous disease called nodular colloid degeneration (NCD) that manifests as asymptomatic, violaceous to yellow nodules or plaque-like lesions on sun-exposed areas of the face. The case study presented involves a 51-year-old White woman with multiple nodular lesions on her cheeks and forehead, which were unsuccessfully treated with antibiotics and corticosteroids. The histological examination revealed characteristic dermal colloid deposits, and various diagnostic tools such as dermoscopy and line-field confocal optical coherence tomography (LC-OCT) were used to aid in diagnosis due to the rarity of the condition. [Extracted from the article]

This article discusses the use of a new antibody called spesolimab in treating patients with flare-ups of generalized pustular psoriasis (GPP), a rare and potentially life-threatening inflammatory disease. The study focuses on a group of 11 patients with GPP flare-ups who were treated with intravenous spesolimab. The results showed that spesolimab was effective in reducing the severity of GPP symptoms and improving the patients' quality of life. The study suggests that spesolimab could be a viable treatment option for GPP flare-ups that do not respond to other conventional and biological systemic treatments. The article also provides information about the authors and their affiliations, references to related studies and publications, and discloses potential conflicts of interest. The data from the study are available upon request, and the patients involved have given consent for the publication of their case details. [Extracted from the article]

Introduction: Bullous pemphigoid is the most common autoimmune bullous dermatosis. In recent years several studies have tried to identify the main factors of the disease related with an increased risk of death. The aim of this multicenter Italian study was to assess the risk score of death considering epidemiologic, clinical, immunological, and therapeutic factors in a cohort of patients affected by bullous pemphigoid and try to identify the cumulative survival up to 120 months. Methods: We retrospectively reviewed the medical records of patients with bullous pemphigoid who were diagnosed between 2005 and 2020 in the 12 Italian centers. Data collected included sex, age at the time of diagnosis, laboratory findings, severity of disease, time at death/censoring, treatment, and multimorbidity. Results: A total of 572 patients were included in the study. The crude mortality rate was 20.6%, with an incidence mortality rate of 5.9 × 100 person/year. The mortality rate at 1, 3, 5, and 10 years was 3.2%, 18.2%, 27.4% and 51.9%, respectively. Multivariate model results showed that the risk of death was significantly higher in patients older than 78 years, in presence of multimorbidity, anti‐BP180 autoantibodies >72 U/mL, or anti‐BP230 > 3 U/mL at diagnosis. The variables jointly included provided an accuracy (Harrel's Index) of 77% for predicting mortality. Conclusion: This study represents the first nationwide Italian study to have retrospectively investigated the mortality rates and prognostic factors in patients with bullous pemphigoid. A novel finding emerged in our study is that a risk prediction rule based on simple risk factors (age, multimorbidity, steroid‐sparing drugs, prednisone use, and disease severity) jointly considered with two biomarkers routinely measured in clinical practice (anti‐BP230 and anti‐BP180 autoantibodies) provided about 80% accuracy for predicting mortality in large series of patients with this disease. [ABSTRACT FROM AUTHOR]

Cutaneous adverse reactions following SARS-CoV-2 vaccine booster dose: a real-life multicentre experience All patients denied any adverse reaction after the first two doses of vaccination and, at the time of the rash, no patient presented with symptoms of COVID-19 nor tested positive for Sars-Cov-2 nor had been in contact with a symptomatic subject. As for vaccine type, eight patients received BNT162b2 homologous booster, four patients received BNT/1273 heterologous booster and one patient underwent ChAd/1273. [Extracted from the article]

Background: Certolizumab, a pegylated tumour necrosis factor‐α inhibitor, reduced disease activity in randomized trials of patients with psoriasis and psoriatic arthritis. Real‐life data are missing. Objective: To confirm the effectiveness and safety of certolizumab in patients with psoriasis and psoriatic arthritis in routine clinical practice. Methods: In this retrospective study involving 11 Italian sites, patients with psoriasis and psoriatic arthritis received subcutaneous certolizumab (400 mg loading dose at 0, 2 and 4 weeks, followed by 200 mg every 2 weeks) for up to 52 weeks. Primary outcomes included mean change from baseline in Psoriasis Area and Severity Index (PASI) and modified Nail Psoriasis Severity Index (mNAPSI) scores, and the proportion of patients achieving a 75%, 90% or 100% reduction in PASI score. Other endpoints included Disease Activity Score computed on 44 joints correlated with the erythrocyte sedimentation rate during the first hour (DAS44‐ESR), Tender Joint Count (TJC), Swollen Joint Count (SJC), pain [visual analogue scale (VAS) score], inflammatory markers and quality of life (QOL). Results: In the study were enrolled 153 patients (mean age: 55 years). Certolizumab reduced the mean PASI score from baseline by 4.45, 6.30 and 7.58 at weeks 12, 24 and 52, respectively (P < 0.001 for all). At weeks 24 and 52, 69.6% and 83.3% of patients had a PASI score ≤3. DAS44‐ESR, TJC, SJC and mNAPSI scores, and pain VAS were also all significantly improved from baseline at each time point. C‐reactive protein levels decreased during treatment, being significant at week 24. On multivariate analysis, psoriasis duration, baseline PASI, mNAPSI and pain VAS scores were found to be predictive of the improvement in PASI score at week 12. Conclusion: Certolizumab displayed also in the real‐life encouraging results in both psoriasis and psoriatic arthritis patients. [ABSTRACT FROM AUTHOR]

Background: Anti‐tumour necrosis factor (TNF) and anti‐interleukin (IL)‐12/23 biologics revolutionized plaque psoriasis treatment by enabling ≥75% improvement in the Psoriasis Area and Severity Index (PASI 75) in clinical trials. Modern biologics are now reported to achieve PASI 100 (complete skin clearance) in clinical trials. However, real‐world evidence of skin clearance rates with biologics is limited. PSO‐BIO‐REAL was conducted to understand the real‐world burden of plaque psoriasis. Objective: The primary objective of this observational study was to estimate the proportion of patients who achieved complete skin clearance at 6 months. Secondary objectives included maintenance of response and evaluation of complete skin clearance at 12 months. Methods: PSO‐BIO‐REAL was a multinational, prospective, real‐world, non‐interventional study of skin clearance and patient‐reported outcomes (PROs) with biologics. A total of 846 patients from the United States (32%), France (28%), Italy (22%), the United Kingdom (11%) and Germany (8%) were enrolled and followed for one year. Eligible patients were aged ≥18 years with moderate‐to‐severe plaque psoriasis who had initiated a biologic for plaque psoriasis. Patients could be biologic‐naïve or switching biologics (biologic‐experienced). Assessments were made at baseline and at months 6 and 12. Results: At 6 and 12 months, 23% and 26% of patients achieved complete skin clearance, respectively. Prior to study entry, 60% were biologic‐naïve. The proportion of patients achieving complete skin clearance was lower among biologic‐experienced patients (20% at both months 6 and 12) compared with biologic‐naïve patients (25% at month 6, 30% at month 12). The rate of complete skin clearance decreased as the number of prior biologics and baseline comorbidities increased. Conclusion: Only one in four patients achieved complete skin clearance after 6 months of treatment with biologics. The study indicates there still is an unmet need for more efficacious biologics for patients with psoriasis. [ABSTRACT FROM AUTHOR]

New onset of remitting seronegative symmetrical synovitis with pitting oedema and palmoplantar psoriasis flare-up after Sars-Cov-2 vaccination The scenario indicated a flare-up of palmar psoriasis associated with the onset of psoriatic arthritis with remitting seronegative symmetrical synovitis with pitting oedema (RS3PE). (b) Tenosynovitis of the digital extensor tendon. gl New onset or exacerbation of psoriatic disease following vaccinations, though rare, is reported in literature. [Extracted from the article]

Background: Anti‐nuclear antibodies (ANA), anti‐extractable nuclear antigens (ENA) and anti‐dsDNA antibodies are often associated with cutaneous lupus erythematosus (CLE), with variable frequency depending on skin subtype. However, specific data based on large case‐series on the pathogenetic, diagnostic and prognostic meaning of such autoantibodies are still lacking. Objective: To characterize the correlations between CLE subtypes as well as LE‐non‐specific skin lesions and their autoantibody pattern. Methods: Epidemiological, clinical and immunopathological data of 619 Italian patients with CLE and LE‐non‐specific skin lesions were analysed. Differences in age, sex, clinical features and autoantibody profile were evaluated in each LE subgroup. Results: Anti‐nuclear antibodies (P < 0.0001), anti‐dsDNA (P < 0.0001), ENA (P = 0.001), anti‐Sm (P = 0.001), anti‐RNP (P = 0.004) and anti‐histone (P = 0.005) antibodies were associated with SLE. A strong association between ANA (P < 0.0001) and anti‐dsDNA (P < 0.0001) and female gender was also found: positive ANA and positive anti‐dsDNA had a higher prevalence among females. Chronic CLE resulted to be negatively associated with ENA (OR = 0.51, P < 0.0001), anti‐Ro/SSA (OR = 0.49, P < 0.0001) and anti‐dsDNA (OR = 0.37, P < 0.0001). Intermittent CLE resulted to be negatively associated with ENA (OR = 0.50, P = 0.007) and ANA (OR = 0.61, P = 0.025). Subacute CLE resulted to be associated with ENA (OR = 5.19, P < 0.0001), anti‐Ro/SSA (OR = 3.83, P < 0.0001), anti‐Smith (OR = 2.95, P = 0.004) and anti‐RNP (OR = 3.18, P = 0.007). Acute CLE resulted to be strongly associated with anti‐dsDNA (OR = 6.0, P < 0.0001) and ANA (OR = 18.1, P < 0.0001). LE‐non‐specific skin lesions resulted to be significantly associated with systemic involvement. Livedo reticularis was significantly associated with ENA (P = 0.007) and anti‐Ro/SSA (P = 0.036). Palpable purpura and periungual telangiectasia were significantly associated with ANA. Conclusion: According to our findings, some well‐known associations between CLE subtypes and autoantibody profile were confirmed; moreover, specific association between autoantibodies and LE‐non‐specific skin lesions was highlighted. A strict association between anti‐ENA and anti‐Ro/SSA antibodies and livedo reticularis, ANA and palpable purpura, and ANA and periungual telangiectasia was evidenced. [ABSTRACT FROM AUTHOR]

Abstract: Background: Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with psoriasis (PsO). Early diagnosis and prompt therapeutic intervention are crucial for limiting PsA progression and prevention of disability. Dermatologists are in a privileged position to detect early PsA. The management of patients with PsA in the dermatology setting is widely variable. Objective: To provide practical recommendations for the management of patients with PsA in the dermatology setting including early diagnosis and treatment. Methods: A consensus document was written by an expert panel composed by dermatologists (n = 12) and rheumatologists (n = 6). Eleven highly relevant questions were selected and elaborated with answers/statements based on a narrative literature review. The resulting document was discussed in a face‐to‐face meeting adopting a nominal group technique to reach consensus (i.e. 100% agreement) using the Delphi method. Results: A consensus was achieved in defining the following: the clinical characteristics differentiating inflammatory and non‐inflammatory signs and symptoms of joint disease; the most important differential diagnoses of PsA in clinical practice; the most useful screening questionnaires, serum laboratory tests and imaging techniques for the detection of early PsA; the criteria for dermatologist to refer patients with PsO to rheumatologist; the criteria for the diagnosis of PsA; the selection of the indices that the dermatologist could use for measuring the activity and severity of PsA in clinical practice; when systemic steroids and/or intra‐articular steroid injections are indicated in the treatment of PsA. Finally, systemic treatments including synthetic and biologic disease‐modifying antirheumatic drugs to be considered for the treatment of PsA have been reported. Conclusions: The implementations of these practical recommendations could be very helpful for the management of patients with PsA in the dermatology setting including early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Psoriasis is a common disease, which has a considerable impact on the healthcare system. Therefore, appropriate use of therapeutic resources is very important. Management of psoriasis in daily clinical practice is highly variable because many issues are still debated and not definitely addressed by the evidence-based medicine. Moreover, the different availability and reimbursability of drugs in each country justifies national guidelines. Expert consensus can provide helpful guidelines for optimizing patient care. A total of 20 dermatologists from different areas of Italy and with large experience in the treatment of psoriasis agreed to participate in the guidelines expert panel who aimed to reach consensus on the factors influencing psoriasis severity, the indications for systemic treatments, the parameters to be considered in the choice of treatment, and the factors to be considered in the choice of biological treatment. The recommendations for the use, screening and monitoring of systemic therapies were based on the 2015 S3 European Dermatology Forum/European Academy of Dermatology and Venereology psoriasis guidelines. Recommendations on the treatment of psoriasis in special patient populations were also agreed. The final document was discussed in a meeting moderated by a facilitator with participation of the entire group and adopting a nominal group technique to reach consensus. A statement was regarded as consented when agreement was achieved by at least 75% of the voting experts according to the Delphi procedure. [ABSTRACT FROM AUTHOR]

Chronic lymphocytic leukaemia (CLL) is the most common adult-onset lymphoproliferative disorder, characterized by the accumulation of monoclonal neoplastic B lymphocytes.[1] We report one case of palmo-plantar fissures related to ibrutinib therapy in a patient with CLL. Our patient, who is under ibrutinib treatment for CLL, presented painful fissures on the palms, soles and nail folds, which have never been previously described nor reported. [Extracted from the article]

I Editor i , Immune checkpoint inhibitors (ICI) are monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), programmed cell death protein 1 (PD-1) and programmed death ligand 1 (PD-L1).1 The spectrum of immunotherapy-induced adverse reactions is unique and referred to as immune-related adverse events (irAEs). The risk of scleroderma should be considered prior to initiating immunotherapy; future research is needed to unveil the role of ICI in the pathogenesis of scleroderma. We sincerely thank the patients and their families who have given written informed consent to the publication of their case details. [Extracted from the article]

Mass quarantine measures in the time of COVID-19 pandemic: psychosocial implications for chronic skin conditions and a call for qualitative studies During the ongoing COVID-19 pandemic, almost all European countries are adopting mass quarantine or isolation measures as a public health strategy to limit the spread of the contagion. We support an "holistic" management of skin diseases, and we encourage a comprehensive study of the complex implications of this pandemic for such patients. [Extracted from the article]

Sweet' syndrome (SS) is a rare neutrophilic dermatitis characterized by high fever, neutrophilia and painful papulonodular lesions with a neutrophilic dermal infiltrate. Cases may be idiopathic or associated with neoplasms, inflammatory bowel diseases (IBDs), infections or drug intake. Autoinflammatory skin disorders in inflammatory bowel diseases, pyoderma gangrenosum and Sweet's syndrome: a comprehensive review and disease classification criteria. [Extracted from the article]

The patient claimed that the lesions appeared at the site of a previous herpes zoster virus (HZV) infection, which had been treated with intravenous acyclovir 3 months earlier. Although granulomatous dermatitis (i.e. granuloma annulare, interstitial granuloma and sarcoidosis) have been reported after HZV infection, the case described herein is the first of AEGCG occurring after HZV infection at the same anatomical site and suggests that AEGCG should be considered as potential secondary disease after HZV infection. [Extracted from the article]