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The starting point of this study described in this paper is the desire to create a model that will be useful in various fields related to mathematical modeling and that will contain a new perspective of what we call and know about feedback. This feedback has appeared in cyber studies. The modeling of this computer system involves the transfer of information from the data of a problem written in a practical language to the language specific to the feedback contained in cellular automata and algebraic fractals. Both cellular automata and algebraic fractals are fundamental in the development of technical solutions used in the fields related to quantum mechanics. The bases of these researches are from the articles conceived by Prof. Dr. Colceag, in which he mentions information fields, structural fractals, but also about modeling and the models that emerge from this modeling. All this complex modeling structure will describe more complex objects with characteristics such as: feedback cycles, projective relationships in the projective space and specific transformations that describe how this model was obtained, these being common features for everything that means description and modeling the phenomena of physics, chemistry, biology, economy etc. At the beginning, such a model focuses on feedback cycles, and will also develop commutative diagrams based on automorphisms. After this first phase, the model is organized on progressive levels where its structure is divided into new and stable structures that self-determine, this leading to a fractalized modeling in which a feedback structure is inserted in the form of a loop.

Despite the presence of this erythema and although the lesions did not respond to treatment, all patients continued with their dupilumab treatment with spontaneous remission of erythema within two to three months. 1 and Table 1) with severe AD treated with dupilumab and with paradoxical head and neck erythema that appeared 8-20 weeks after the start of biological treatment while eczema on other body parts had greatly improved. Dear Editor, Atopic dermatitis (AD) is a chronic inflammatory dermatological disease with multifactorial etiology. [Extracted from the article]

The clinical presentation associated with RCM and histological examination confirmed the diagnosis of Morbihan syndrome rosacea associated. Morbihan syndrome is a rare dermatological condition characterized by chronic persistent erythema and firm edema of the face accompanied by telangiectasia, papules, or pustules.1-3 It is considered a complication of acne or rosacea. 5 Kutlay S, Ozdemir EC, Pala Z, Ozen S, Sanli H. Complete decongestive therapy is an option for the treatment of rosacea lymphedema (Morbihan Disease): two cases. [Extracted from the article]

Atopic dermatitis (AD) is a complex disease and can often be a clinical challenge for dermatologists. When standard immunosuppressive therapies fail, extracorporeal phototherapy (ECP) can be considered as a therapeutic option. In recent years, better understanding of the pathogenesis of AD allowed to improve treatment strategies with many emerging therapeutic options. Currently, Dupilumab, a monoclonal antibody that selectively inhibits IL‐4 and IL‐13, is the only biological drug authorized for the treatment of severe adult atopic dermatitis, refractory to traditional firstline and secondline therapies. ECP, compared to biological therapy, is associated with some disadvantages: it is costly and time‐consuming for patients and personnel to administer. Moreover, it should be noted that the completion of the entire procedure takes about 3 hr and must be done in a hospital, while the administration of Dupilumab can be carried out by patients themselves at home. For these reasons and on the basis of our experience, it would be necessary to evaluate whether all patients with refractory atopic dermatitis in treatment with ECP with unsatisfactory clinical response should be switched to recent available target therapies. [ABSTRACT FROM AUTHOR]

The article aims to provide a perspective on economic growth by relying on the influence and use of the stock market as an economic lever. Two methods will be used: a quantitative one, determined by a multiple linear regression model, and a qualitative one that encumbers a sustainable vector model for generating economic growth. The data panel covers 36 states, for a period of 21 years. The paper manages to identify the main control functions that the stock exchange has over the macroeconomic context, through the quantitative and qualitative method, and to highlight the most important positive and negative attributes of using qualitative methods, in contrast to quantitative ones. The results show a predominant probabilistic characteristic of quantitative methods, in contrast to the flexibility and complexity of the qualitative method, which has been used. Additionally, the quantitative method offers a strictly cartesian perspective for determining future scenarios, while the sustainable vector model, based on a fractalized vision of reality, manages to capture a plurality of perspectives, as well as the interrelationships between the determining parameters, thus being a complex system of simple equations, as opposed to the quantitative method which is defined as a simple system of complex equations. [ABSTRACT FROM AUTHOR]

Background: Kaposi’s sarcoma (KS) is a lymphangioproliferative tumour. Therapy of KS depends on the characteristics of the disease, especially area and growth rate of lesions, and patient condition. Currently symptomatic resectable lesions are excised, whereas more advanced disease and unresectable lesions are treated with radiotherapy. If a large area or internal organs are affected or other treatments fail, chemotherapy is used. Recently some authors have reported their encouraging experience in the use of thalidomide in patients with AIDS-related KS. Objective: To evaluate the efficacy of thalidomide in 3 patients with non-AIDS-related KS. Methods: Two patients with classic widespread cutaneous and 1 with iatrogenic cutaneous and visceral KS were treated with thalidomide (100 mg/day) for 12 months. Results: In all 3 patients partial remission was evident after 4 months of thalidomide therapy; in 2 out of 3 complete remission was achieved after 12 months of treatment. Conclusions: Our results seem to confirm the utility of thalidomide in the treatment of non-AIDS-related KS. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The histopathological pattern of psoriasis is characterized by dermal inflammatory reaction and hyperproliferation of the epidermis. The mechanism of the epidermal hyperproliferation is not completely understood, but it is probably modulated by the basal lamina (BL), the alterations of which have not been described. We performed the present study to evaluate the expression of the α1, α2, β1 and γ1 laminin chains and collagen IV in the BL of active psoriasis vulgaris before and after cyclosporin treatment administered until the psoriasis was in remission. The results showed that the α2 chain is weak and irregular in the lesions, while the α1, β1 and γ1 chains and collagen IV are normal, with intense and continuous reaction. In the same subjects, this alteration was absent in skin that was clinically unaffected. After treatment with cyclosporin, the altered expression of the α2 chain returned to normal in the healing lesions. [ABSTRACT FROM AUTHOR]

Background: Palmoplantar psoriasis is difficult to treat and often recalcitrant to conventional therapies. Clinical trials have demonstrated the efficacy and safety of secukinumab for this debilitating psoriasis form, but real-life evidence is currently limited. Therefore, here we described the outcomes of patients treated with secukinumab in clinical practice., Research Design and Methods: This was a real-life, retrospective, observational study involving patients with palmoplantar psoriasis treated with secukinumab (300 mg, subcutaneously) at seven dermatologic clinics in Italy. Treatment effectiveness was evaluated based on the changes of the Psoriasis Area and Severity Index (PASI) and palmoplantar (pp) PASI during treatment and by recording safety and tolerability issues over 104 weeks., Results: Forty-three patients initiated treatment with secukinumab. Previous treatments included topical and systemic therapies; half of patients had already tried one or more biologics. Secukinumab improved mean PASI rapidly and substantially with a 78.2% decrease at 16 weeks. Mean ppPASI also improved substantially, but more gradually, with reductions of 55.0% and 79.3% at 16 and 104 weeks, respectively. Approximately half of patients achieved complete skin clearance at 40 weeks. Secukinumab was well tolerated and no relevant treatment-related adverse events were reported., Conclusions: Secukinumab appears to be effective for the treatment of palmoplantar psoriasis also in the real-life setting.

Background: Sleep disturbances are common in patients with atopic dermatitis (AD). Considering their relevant burden on health, routine screening of sleep disturbances seems to be very useful in AD adults' management. However, few studies have evaluated the association between sleep disturbances and AD in adults, and real-life data are lacking. The aim of this study was to assess the effect of treatment with dupilumab on sleep disturbances in adult patients with severe atopic dermatitis., Methods: This is a retrospective, multicenter study including patients (age ≥18 y) with severe atopic dermatitis treated with dupilumab for at least 8 months from January 2019 to January 2020. Patients were evaluated three times: at treatment initiation (T0), at 4 (T4) and 8 months (T8) from the start of treatment. At each visit disease activity was assessed by severity score (Eczema Area and Severity Index [EASI]), patient-reported outcomes (Pruritus Numerical Rating Scale [NRS], Dermatology Life Quality Index [DLQI], and Pittsburgh Sleep Quality Index [PSQI]). Kolmogorov-Smirnov Test was performed to evaluate the normality distribution, Bartlett's Test for homoscedasticity. Since the assumptions were met, ANOVA for repeated measures was performed to evaluate the mean difference of PSQI, EASI, DLQI and pruritus NRS between baseline, the 4 th month and the 8 th month. In addition, χ 2 for Trend Test was performed to evaluate the increasing/decreasing prevalence of poor sleepers., Results: A total of 36 patients (15 females and 21 males) with a mean age of 42.5±14.3 (range 20-67) were included in the study. The mean score for PSQI at TO was 9.0±3.6. At week 16 (T4) the mean score for PSQI was 4.92±2.99 and at week 32 (T8), the mean score for PSQI was 4.3±3.0. EASI, NRS pruritus and DLQI significantly improved during follow-up (P<0.001) whereas PSQI improved significantly at 16 weeks (T4); however, no significant further improvement was observed at 32 weeks. Of the 31 patients (86%) with baseline PSQI≥5, 17 (54%) experienced sleep quality improvement during treatment. Overall, we observed a total of 22 patients (61.1%) having a PSQI<5 at 32 weeks., Conclusions: Our data show effectiveness of dupilumab in improving sleep disturbances in adult patients with severe AD. However, further studies are required to understand if PSQI could serve as useful evaluating tool.

Born in 1995, teledermatology (TD) turns 25 years old today. Since then, TD evolved according to patients and physicians needs. The present review aimed to summarize all the efforts and experiences carried out in the field of TD and its subspecialties, the evolution and the future perspectives. A literature search was conducted in PubMed and Google Scholar. The state of the art of the "tele-dermo research" included TD and clinical trials, TD/TDS web platforms, TDS and artificial intelligence studies. Finally, the future perspective of TD/TDS in the era of social distancing was discussed. Using TD in specific situations adds several benefits including time-effectiveness of intervention and reduction in the waiting time for the first visit, reduced travel-costs, reduced sanitary costs, equalization of access from patient to specialistic consult. The communication technologies devices currently available can adequately support the growing needs of tele-assistance. A main limit is the current lack of a common clear European regulation for practicing TD, encompassing privacy issues and data management. The pandemic lockdown of 2020 has highlighted the importance of performing TD for all those patient, elderly and/or fragile, where the alternative would be no care at all. Many efforts are needed to develop efficient workflows and TD programs to facilitate the interplay among the different TD actors, along with practice guidelines or position statements.

Atopic dermatitis (AD) is an inflammatory disease with a chronic-relapsing course that is intensely itchy. A correct diagnosis of AD in adults and consequently appropriate clinical therapeutic management is a critical issue for extreme clinical expression heterogeneity and various grades of disease severity. In order to ensure high levels of care and standardization of clinical therapeutic management of Adult AD, the decision was taken to create an AD Tuscan Consensus Group (the Group), to work on and validate a consensus based regional clinical-therapeutic management model. The aims of the Group were to find agreement on the criteria for diagnosis, scoring of severity, multidisciplinary approach and treatment of adult atopic dermatitis and to create an easier way for patients to access specialized dermatology outpatient services and importantly to reduce waiting lists and costs related to the management of AD. The Tuscan Consensus Group adopted a simplified Delphi method, in three principal steps: 1) literature metanalysis and critical review of patient's clinical experience to identify the main areas considered questionable or uncertain; 2) discussion of those areas requiring consensus and statement definition through four different sub-committees (diagnosis, severity evaluation, scoring and comorbidities); 3) a consensus based simplified process with final approval of each statement by plenary vote with approval >80% of the participants. The Group here presents and discusses the consensus based recommendation statements on adult atopic dermatitis.

Cyclosporine (CsA) is an effective and safe therapeutic option in various dermatoses in both adults and children. Over the last 25 years, Italian dermatologists have gained relevant experience about the use of CsA in the treatment of psoriasis and atopic dermatitis, and an Italian Consensus Conference has recently provided recommendations in adult patients. A comparison between these real-world indications and current European guidelines is hereby provided.

The relationship between skin color and illness severity in the newborn remains untested. We have evaluated the predictive value of skin color readings for illness severity in a population of high-risk newborn infants. A prospective study was conducted on 107 white newborns in the intensive care unit, which were categorized as either high or low severity of illness, defined by the presence of severe neonatal morbidity. Illness severity was also determined using a Score for Neonatal Acute Physiology (SNAP). Color readings were obtained at 10 different body sites using a portable tristimulus colorimeter during the first 24 h, and color was expressed using the standard CIE L*a*b* system. Skin CIE b* values were significantly lower in the high severity group (p < 0.0001), and a significant inverse correlation with SNAP was observed (r(s) range, -0.37 to -0.71, p < 0.0001). In particular a low b* value for the abdomen was found to be a significant predictor of illness severity (92.6% sensitivity; 96.6% specificity; 96% positive predictive value; 93.7% negative predictive value; adjusted odds ratio, 14.7; 95% confidence interval, 6.4 to 33.8). Our findings indicate that skin color reflects clinical severity in the newborn and that skin colorimetry can accurately identify higher risk infants.