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Simple Summary: Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) are the commonest types of non-melanoma skin cancer. Surgical excision is the mainstay of treatment for both tumors. However, tumor features and patients' comorbidities may limit the use of these techniques, making the treatment challenging. The introduction of oral therapies targeting a pathogenetic pathway in BCC has revolutionized the therapeutic scenario. However, there are still patients unresponsive or intolerant to these drugs. In this context, cemiplimab has been approved as second-line treatment. As regards SCC, cemiplimab was the first systemic therapy approved. The objective of this manuscript was to investigate the efficacy and safety of cemiplimab for the management of BCC and cSCC. Cemiplimab has a durable and significant effect for the management of BCC and CSCC, with a favorable safety profile. Non-melanoma skin cancer includes several types of cutaneous tumors, with basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) as the commonest. Among the available therapeutic options, surgical excision is the mainstay of treatment for both tumors. However, tumor features and patients' comorbidities may limit the use of these techniques, making the treatment challenging. As regards BCC, even if hedgehog inhibitors revolutionized the therapeutic scenario, there are still patients unresponsive or intolerant to these drugs. In this context, cemiplimab has been approved as second-line treatment. As regards SCC, cemiplimab was the first systemic therapy approved. The objective of this manuscript was to investigate the efficacy and safety of cemiplimab for the management of BCC and cSCC. Cemiplimab has a durable and significant effect for the management of BCC and CSCC, with a favorable safety profile. Different specialists including oncologists, radiologists, dermatologists, and surgeons are required to guarantee an integrated approach, leading to the best management of patients. Moreover, the collaboration among specialists will allow them to best manage the TEAEs, reducing the risk of treatment suspension or discontinuation. Certainly, ongoing studies and more and more emerging real-world evidence, will allow us to better characterize the role of cemiplimab for the management of advanced non-melanoma skin cancer. [ABSTRACT FROM AUTHOR]

The treatment of hidradenitis suppurativa (HS) has always been a real challenge for dermatologists; to date, the only biologic drugs approved for HS are adalimumab, an anti-tumor necrosis factor (TNF)-α drug, authorized in 2015, and secukinumab, recently licensed. The management of this condition is challenging as the available treatments show variable results, and the course of the condition is often chronic-recurrent; therefore, it will be necessary for the future to identify new therapeutic targets for HS. In recent years, studies have focused on the development towards new therapeutic targets. The purpose of our review was to perform a comprehensive literature review of real-life data on anti-IL23 (guselkumab, tildrakizumab, and risankizumab) in HS to summarize the existing evidence on the efficacy and safety of these drugs. We selected 64 articles, among which 32 had the characteristics that we were looking for in our review. To date, the positive data expressed in real-life experiences contrast with the three existing Phase 2 studies conducted so far, where it seems that these drugs may be useful only for a subgroup of patients with HS whose features need to be elucidated. Data from Phase 3 studies and other real-life experiences, perhaps more detailed and with higher numbers, will certainly be needed to fully understand the efficacy and safety of this class of drugs. [ABSTRACT FROM AUTHOR]

Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis (less than 3% of cases), characterized by generalized scaling and erythema affecting more than 90% of body surface area. Several systemic symptoms can be present in patients with EP such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia making this condition a possible life-threatening disease, particularly if appropriate treatments are not performed. In this scenario, effective and safe therapies are required. Unfortunately, the rarity of EP makes head-to-head Phase III trials challenging, leading to the lack of established guidelines for its management. Globally, conventional systemic drugs such as cyclosporine, methotrexate, and retinoids often have contraindications linked to patients' comorbidities and have not shown a high profile of efficacy and safety. Recently, the development of biologic drugs including anti-tumor necrosis factor-α and anti-interleukin 12– 23, 23, and 17 has revealed favorable results for the management of plaque psoriasis, making them also a possible therapeutic option for EP disease. However, their use in EP is still off-label. The aim of our study was to review current literature on the use of biologic drugs for the treatment of EPs in order to offer a wide perspective on their possible application in EP management. [ABSTRACT FROM AUTHOR]

COVID-19 vaccination was the main measure to overcome the pandemic. As with other drugs and vaccines, mild to moderate adverse events have been reported following vaccination. In addition, several cutaneous reactions have been described. In particular, there are several reports investigating de novo psoriasis or the exacerbation of psoriasis following COVID-19 vaccination. However, data on the possible pathogenetic mechanisms as well as comprehensive manuscripts on the topic are scant. Thus, the aim of our manuscript was to perform a review of the current literature on post-COVID-19 vaccination exacerbations and new-onset psoriasis in order to offer a wide perspective on this area and to point out possible pathogenetic mechanisms. Research on the current literature was performed following PRISMA guidelines. In total, 49 studies involving 134 patients developing new-onset psoriasis (n = 27, 20.1%) or psoriasis exacerbation (n = 107, 79.9%) were collected. Although cases of de novo psoriasis or a worsening of psoriasis have been reported following vaccination, all of the cases have been successfully treated while overall benefit–risk profile of COVID-19 vaccination does not justify vaccine hesitancy due to the risk of psoriasis being developed or worsening. Certainly, further studies are needed to identify possible pathogenetic mechanisms in order to identify "at-risk" patients. Finally, vaccination should not be discouraged. [ABSTRACT FROM AUTHOR]

The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a critical role in orchestrating immune and inflammatory responses, and it is essential for a wide range of cellular processes, including differentiation, cell growth, and apoptosis. Over the years, this pathway has been heavily investigated due to its key role in the pathogeneses of several chronic inflammatory conditions, e.g., psoriasis, atopic dermatitis (AD), and inflammatory bowel diseases (IBDs). Nevertheless, the impact of this pathway on the pathogenesis of inflammatory conditions remains unclear. This review describes the role of the JAK/STAT signaling pathway in the pathogenesis of inflammatory diseases such as psoriasis (Pso), psoriatic arthritis (PsA), AD, and IBD with a focus on ulcerative colitis (UC) and briefly resumes the use of JAK inhibitors in their clinical management. [ABSTRACT FROM AUTHOR]

We conducted a one-year prospective study involving the enrollment of 58 patients with Hidradenitis Suppurativa. Through a retrospective analysis of data on the same patients, with reference to the year prior to the initiation of the anti-TNFα drug adalimumab, we aimed to show how the advent of this biologic therapy changes the number of days of antibiotic therapy, the number of flare-ups per year, and their duration in days, as well as the quality of life and perceived pain of patients. [ABSTRACT FROM AUTHOR]

Recent epidemiological studies highlighted a possible link between PsO and demyelinating disorders such as MS.[2] Herein, we reported the case of a 40-year-old female who suffered from PsO and MS successfully treated with a combination therapy of secukinumab and fingolimod. Keywords: fingolimod; multiple sclerosis; psoriasis; real-life experience; secukinumab EN fingolimod multiple sclerosis psoriasis real-life experience secukinumab e100 e102 3 02/17/23 20230201 NES 230201 Dear Editor, Psoriasis (PsO) is a chronic inflammatory disease characterized by erythemato-desquamative plaques with systemic involvement (psoriatic arthritis, metabolic syndrome, cardiovascular disorders, Crohn's disease, and depression).[1] Multiple sclerosis (MS) is an auto-immune neurological disease characterized by inflammation, demyelination, gliosis, and neuronal loss. [Extracted from the article]

Purpose: To determine the efficacy and safety of adalimumab (ADA) and etanercept (ETA) biosimilars in elderly and children with psoriasis. Methods: A real-life retrospective observational study was conducted on pediatric (< 18 years) and geriatric (≥ 65 years) psoriasis patients treated with anti-TNF biosimilar agents referring to the Psoriasis Unit of the University of Naples Federico II, Italy, from January 2018 to January 2022. At baseline, demographic characteristics (age and sex), data on psoriasis duration and severity (measured by Psoriasis Area Severity Index [PASI] and body surface area [BSA]), presence of psoriatic arthritis if applicable, comorbidities, and previous psoriasis treatments were recorded. Patients were monitored by regular follow-ups (week 12, 24, 48 and 72) through clinical and haematological assessments and adverse events (AEs) were registered. Results: A total of 11 children and 23 elderly psoriasis patients were enrolled. Concerning children, 6 (54.5%) were under ADA biosimilar and 5 (45.5%) under ETA biosimilar. ETA and ADA biosimilars were equally effective and safe for up to 72 weeks (mean PASI and BSA < 3). No significant AEs were reported, and none discontinued treatment. In the elderly, 15 (65.2%) were treated with ADA biosimilar and 8 (34.8%) with ETA biosimilar. ETA and ADA biosimilars were equally effective up to 72 weeks (mean PASI < 4 and mean BSA < 5%). AEs (mainly mild) were registered in 9 subjects (39.1%). Also, 4 (17.4%) patients discontinued biologicals for secondary lack of efficacy (3, 75%) or AEs (1, 25%). Conclusion: Our study found that ADA and ETA biosimilars are effective and safe for the treatment of moderate-to-severe psoriasis in children and the elderly. No statistically significant efficacy and safety differences were found between ADA and ETA biosimilars in both children and the elderly. Geriatric patients displayed a higher discontinuation rate and side effects than the pediatric counterpart even if without approaching statistical significance. [ABSTRACT FROM AUTHOR]

Background: The most frequent inflammatory skin diseases are psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne. Their management is challenging for dermatologists since their relapsing chronic clinical course is associated with a great impact on quality of life. Nevertheless, the recent introduction of novel therapies, such as biological drugs and small molecules has been changing the history of these diseases. Methods: A systematic review of the scientific literature of case reports, case series, epidemiological studies, reviews, and systematic reviews regarding teledermatology and inflammatory skin disease. Studies were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. Results: A total of 69 cases articles were included in the review. Conclusions: As we have shown in the review, several experiences of teledermatology for patients affected by inflammatory skin diseases have been demonstrated to increase due to clinical access to hospital and specialized health care services, allowing better access to specialized dermatology care for people living in remote areas, and saving costs and money with health care. [ABSTRACT FROM AUTHOR]

Keywords: alopecia areata; COVID-19; herpes zoster; vaccine EN alopecia areata COVID-19 herpes zoster vaccine 36 38 3 01/23/23 20230101 NES 230101 The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic spread over the world in 2019. Herpes zoster and alopecia areata following mRNA BNT162b2 COVID-19 vaccine: Controversial immune effects 2022; 35 (5): e15411. doi: 10.1111/dth.15411 7 May Lee M, Bertolani M, Pierobon E, Lotti T, Feliciani C, Satolli F. Alopecia areata following COVID-19 vaccination: vaccine-induced autoimmunity?. [Extracted from the article]

The author wrote some comments on our recently published article entitled 'Could wide tattoo delay the early diagnosis of cutaneous melanoma? '.[1] The patient described in our paper, skin photo-type III according to Fitzpatrick, had a negative anamnesis for melanoma and a negative family history as well. We agree with the author when he states that the upper back is an area of difficult self-control regardless of the tattoo particularly in unmarried patients,[2] but in our case, the patient's marital status could not affect it since the patient is married. [Extracted from the article]

MM prognosis is related to Breslow index (a measure of deepness of melanoma) and sentinel lymph node. Dear Editor, Herein, we report a case of a 32-year-old woman, Caucasian, phototype IV, with an insurgence of a single pigmented lesion developed on a wide tattoo in the back. [Extracted from the article]

Introduction: Vitiligo is an acquired skin disorder clinically characterized by hypopigmentated macules and patches. Psoriasis is a chronic‐inflammatory‐skin‐condition characterized by erythematous‐plaques covered with scales particularly over the extensor‐surfaces, scalp, and lumbosacral region. Recent major‐researches‐advancements have significantly expanded our understanding of psoriasis‐pathophysiology, resulting in the development of highly effective targeted‐therapies, such as anti TNFα, IL‐12/23‐inhibitors, IL‐17‐inhibitors, or IL‐23‐inhibitors. Particularly, ixekizumab, a humanized‐monoclonal immunoglobulin‐G 4 antibody, specifically binding IL‐17A, demonstrated strong efficacy in threating recalcitrant psoriasis. Nevertheless, paradoxical reactions due to IL‐17 inhibitors have been described. Case report: Herein, we report the case of a 53‐year‐old Caucasian man who obtained complete skin clearance of psoriasis plaques after 16 weeks of ixekizumab treatment together with the appearance of vitiligo patches localized on the facial area. He had never suffered of vitiligo and his family history excluded vitiligo diagnosis. We also could exclude post inflammatory psoriasis hypopigmentation because of absence of facial involvement at baseline. Our experience suggests that vitiligo might be considered a rare adverse effects of anti‐IL‐17 therapy. [ABSTRACT FROM AUTHOR]

We retrospectively investigated all the surgical excisions with a histopathological diagnosis of melanoma performed in our department from January 2018 to December 2021 in order to analyse how COVID-19 pandemic impacted on melanoma diagnosis during these years. 2022; 36: e762 - 4. https://doi.org/10.1111/jdv.18337 5 Villani A, Fabbrocini G, Scalvenzi M. The reduction in the detection of melanoma during the coronavirus disease 2019 (COVID-19) pandemic in a melanoma center of South Italy. Melanoma is the main cause of death from skin cancer.[1]Its stage at the moment of the diagnosis, particularly primary tumour thickness, is the main prognostic factor, leading to the need for an early diagnosis and treatment.[1] Restrictive measures adopted during COVID-19 pandemic in order to avoid infection spreading led to a reduction in the number of accesses in dermatologic clinics.[[2]] We read with great interest the article recently written by Balakirski et al.[4] evaluating the long-term effect of COVID-19 pandemic on the detection and dermatosurgical treatment of melanoma, and we also want to report the experience of our third-level centre for 'Melanoma Diagnosis and Prevention. [Extracted from the article]

In a recent meta-analysis, the average estimated recurrences were 5.0% for wide excisions and 26.0% for partial excisions,[3] although radical surgery is associated with a longer recovery time that can influence the therapeutic choice depending on the patients' needing. Surgical procedures are mentioned in almost all international guidelines, nevertheless, patients' compliance could be not always high due to the fear of wide excisions and reconstructive surgeries. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease affecting ~1% of the population, with a female prevalence.[1] Management of HS may be challenging since the lack of effective treatments. [Extracted from the article]

Reply to "A case of symmetrical drug-related intertriginous and flexural exanthema-like eruption associated with Pfizer COVID-19 vaccination" by Manaa et al Dear Editor, We have read with great interest the article recently published by Manaa et al. who reported a case of symmetrical drug-related intertriginous and flexural exanthema (SDRIFE) - like eruption associated with COVID-19 vaccination.[1] We herein describe an analogous case that was referred at the Dermatology Unit of the University Hospital of Naples Federico II, in May 2022. 2021; 35 (10): e634 - e635. doi: 10.1111/jdv.17454 7 Lim PN, Wylie G. Symmetrical drug-related intertriginous and flexural exanthema like eruption associated with COVID-19 vaccination. [Extracted from the article]

Atopic dermatitis (AD) and chronic rhinosinusitis with nasal polyps (CRSwNP) are type-2 inflammatory diseases sharing interleukin (IL)-4 and IL-13 as key mediators.1 However, AD globally affects 15%-20% of children and 5%-10% of adolescents in European countries,2 while CRSwNP is rare with an estimated incidence of 0.21% in patients aged 10-19 years.3 Dupilumab is a monoclonal antibody blocking the -subunit of the IL-4 receptor, shared by IL-4 and IL-13.4,5 It has been shown to be effective and safe in type-2 inflammatory diseases.4,5 Dupilumab is approved in Italy for the treatment of patients with moderate-to-severe AD (>=6 years), severe asthma (>=12 years), or severe CRSwNP (>=18 years).6 A 12-year-old female suffering from AD since the first months of life was first referred to us for the recent worsening of the disease. Since the patient was affected by severe AD, dupilumab 400 mg loading dose and then 200 mg subcutaneously every other week (patient weight: 52 kg) was prescribed. PATIENT CONSENT The authors have obtained the consent of the patient for clinical images. [Extracted from the article]

Moreover, teledermatology remains a useful tool to monitor and guide patients in their disease treatment, and other dermatological conditions, such as skin cancer, may also benefit from teledermatology [[8]]. In our opinion, patients undergoing biological treatment for chronic inflammatory skin diseases, such as psoriasis, atopic dermatitis and hidradenitis suppurativa, or with a controlled disease may benefit the most from teledermatology [[7]]. However, according to Borgia et al., teledermatology cannot replace face-to-face visits since the physician-patient relationship is at the basis of therapeutic management. [Extracted from the article]

Pityriasis rosea Gibert type rash in an asymptomatic patient that tested positive for COVID-19. Dear Editor, We read with great interest the article by Veraldi et al. on the relationship between pityriasis rosea (PR) and COVID-19 infection.1 In response to the above-mentioned article we would like to share our experience on a case of PR diagnosed after COVID-19 infection with atypical clinical presentation, and low responsiveness to conventional treatments. Can COVID-19 cause atypical forms of pityriasis rosea refractory to conventional therapies?. [Extracted from the article]

Our experience in addition to that described by the authors seems to confirm that vitiligo is a rare adverse event due to anti-IL-17[[2], [4]]; nevertheless, the occurrence of de novo vitiligo is not a contraindication to treatment. Demographic and clinical characteristics of patients with both psoriasis and vitiligo in a cohort of vitiligo patients: a cross-sectional study. [Extracted from the article]

Particularly, conventional systemic treatments are approved only after 18 years of age while phototherapy is time-consuming showing logistic concerns.3 Biologics represent the only officially approved systemic drugs for moderate-to-severe pediatric psoriasis. We observed a complete skin clearance after only 4 weeks of treatment together with a huge improvement in quality of life and skin symptoms (PASI; 0, BSA 0%, Figure 1C,D); these results were maintained up to the last follow up at 24 weeks of treatment. His failed treatment history was wide: topical agents (0.05% clobetasol propionate), 16 weeks of oral cyclosporine (2.5 mg/kg/day) at the age of 9 years and 24 weeks of nb-UVB therapy when he was 10 years. [Extracted from the article]

Introduction: Generalized pustular psoriasis (GPP) is a rare form of psoriasis (less of 1% of cases). Currently, GPP is recognized as a clinical entity, distinguished from plaque psoriasis. However, there are not guidelines for GPP management and treatments are often derived from plaque psoriasis. Therefore, conventional systemic drugs are usually used as first-line treatment options, and biologics are still used off label. Recently, spesolimab, an anti-IL36 receptor humanized IgG1 monoclonal antibody, has been specifically approved for GPP disease, revolutionizing treatment scenario., Areas Covered: The aim of this review is to investigate current literature on the use of spesolimab for GPP management to underline its potential role in GPP and offer a current clinical perspective. Literature research using the Google Scholar, Pubmed, Embase, Cochrane Skin, and clinicaltrials.gov databases was performed, selecting the most relevant manuscripts., Expert Opinion: Spesolimab is efficacious and has a consistent and favorable safety profile in patients presenting with a GPP flare. However, despite excellent results in terms of safety and efficacy have been reported by both clinical trials and very limited real-life experiences, long-term data, especially in flare-up prevention, are scant. Thus, while the available data are encouraging, further research is warranted to understand the efficacy, safety, and long-term outcomes associated with spesolimab treatment in GPP.

Introduction: Surgery is the standard management for most of basal cell carcinomas (BBCs). In some cases, also radiotherapy may be a valuable weapon as well as ablative and topical treatments. However, all these approaches may be limited by some tumor features. In this scenario, locally advanced BCCs (laBCC) and metastatic BCC, also defined as 'difficult-to-treat' BCC, remain the real treatment challenge. New knowledge on BCC pathogenesis, particularly the Hedgehog (HH) pathway, led to the development of new selective therapies such as vismodegib and sonidegib. In particular, sonidegib is an orally administered small molecules, which inhibits the HH signaling pathway through the binding to SMO receptor, recently approved for the management of adult patients with laBCC who are not amenable to curative surgery or radiation therapy., Areas Covered: The purpose of this review is to analyze and discuss the efficacy and safety of sonidegib for the management of BCC, to provide a broad perspective on the currently available data., Expert Opinion: Sonidegib is a valuable weapon for the management of difficult-to-treat BCC. Current data showed promising results in terms of effectiveness and safety. However, more studies are needed to underline its role in BCC management, also considering the presence of vismodegib, and to investigate its use in a long-term period.

Introduction: Since Anti-IL-17s availability, concerns about their safety have been raised due to the inhibition of physiological activities that IL-17A plays in the immune response against infections. Ixekizumab is a humanized monoclonal antibody specifically targeting IL-17A approved for the treatment of moderate-to-severe psoriasis., Areas Covered: The aim of this review is to evaluate the safety profile of ixekizumab in moderate-to-severe psoriasis patients. A compressive literature review has included articles since March 2022., Expert Opinion: In our analysis, most of the reported AEs were mild or moderate and rarely required treatment discontinuation. Among the class-specific AEs to consider during ixekizumab treatment, there are the risk of Candida infections and the risk of IBD, both of which were reported more frequently than placebo or other biologics (etanercept, ustekinumab, and guselkumab). However, the reported candidiasis resulted in mild-to-moderate and easily managed. The risk of IBD (both exacerbation and de novo diagnosis) represents a class effect of IL-17 inhibitors, which should be well evaluated before considering starting ixekizumab treatment. The most common AEs were represented by nasopharyngitis, upper respiratory tract infection, and injection-site reactions. The analyzed studies confirmed the favorable safety profile of ixekizumab even in more recently published studies.

Atopic dermatitis (AD) is an inflammatory chronic-relapsing skin disease affecting approximately 15% to 20% of children and 10% of adults in industrialized countries. Both loss of epidermal barrier permeability and immune dysregulation seem to be the most important actors in AD pathogenesis. Several studies have demonstrated the role of Janus kinase (JAK) enzymes in AD pathogenesis suggesting oral and topical JAK inhibitors as new emerging therapies for AD. Among the JAK inhibitors, abrocitinib is an oral JAK1-selective inhibitor. The aim of this study is reviewing current literature about the efficacy and safety of abrocitinib in AD. The literature search was carried out considering the main search engines relating to medical literature and clinical trials. The efficacy and safety of abrocitinib have been confirmed in several studies suggesting this drug as a valuable treatment for moderate to severe AD., (Copyright 2022 Clarivate.)