Search

Interferon alpha (IFNalpha) is the most used adjuvant treatment in clinical practice for melanoma (MEL) high-medium risk patients; however, the use of IFNalpha has yielded conflicting data on Overall Survival (OS) and disease free survival (DFS) rates. Starting from these considerations, we carried out an analysis on our MEL patients who received adjuvant IFNalpha therapy, in order to identify possible predictors for their outcome. A total of 140 patients were included in our analysis. Patients with Breslow thickness#8804;2.00 mm presented a significantly longer mean DFS than patients with Breslow#8805;2.01 mm (p = 0.01). Using non- parametric Spearman’s Coefficient test we found association between DFS and Breslow thickness (p0.001) and between DFS and ulceration (p = 0.03). Performing Multiple Regression test, Breslow thickness (p0.001) remained the only statistically significant predictor. From the OS analysis we found that patients with lower Breslow values#8804; 2.00 mm (p0.0001), and absence of ulceration (p0.004) showed a significantly better long-term survival. From the current analysis we found that the use of low dose IFNalpha is justified only for cutaneous melanoma#8804; 4.01 mm that was not ulcerated; patients with Breslow#8805; 4.01 mm, in our opinion, should not carry out adjuvant treatment with low dose IFNalpha, because its side effects could be higher than the its benefits.

T helper 17 (Th17) cells are characterized by the secretion of IL-17, a proinflammatory cytokine. They represent a newly described T helper subpopulation that is distinct from Th1 and Th2 lineages. Because of their pleiotropic activity on fibroblasts, keratinocytes, endothelial cells, neutrophils and memory T cells, Th17 cells are thought to be crucial in mediating tissue inflammation and autoimmunity. Autoimmune diseases were classically considered as Th1-mediated disorders such as rheumatoid arthritis or mixed Th1/Th2 diseases such as inflammatory bowel diseases, systemic lupus erythematosus, bullous diseases, but new evidence suggests the deep involvement of Th17 cells in their pathogenesis that, potentially, may address a selective therapeutic approach targeting the IL23/Th17 pathway. This review summarizes the current knowledge of the pathogenic contribution of Th17 cells in select cutaneous autoimmune disorders, including lupus erythematosus, scleroderma, dermatomyositis, bullous pemphigoid and pemphigus vulgaris.

Psoriasis is a chronic inflammatory skin disorder showing multifactorial inheritance. Linkage studies have mapped disease susceptibility loci to several genomic regions, including the chromosome 16 interval that contains the CARD15/NOD2 gene. CARD15 has been involved in Crohn's Disease (CD) susceptibility and it has been hypothesised that it may also contribute to the pathogenesis of psoriasis. To test this hypothesis we studied the distribution of 3 CARD15 SNPs in an Italian case-control data set. We failed to observe any significant difference between patients and controls, thereby excluding the presence of a strong genetic association between CARD15 gene polymorphisms and psoriasis, in the Italian population.

Skin cancer is the most common malignancy in humans and accounts for one-third of newly diagnosed cancers. Basal cell carcinoma (BCC) is one of the most prevalent and persistent types, and appears in two main histological forms, superficial and nodular. Typical treatments include surgery; however, this may leave scarring, which is undesirable, especially in facial lesions. We report the results of seven individual patients with one or more BCCs (both nodular and superficial) treated with imiquimod 5% cream. Eleven of 13 lesions cleared following daily topical treatment for 10-18 weeks. Any local skin reactions resolved at the end of treatment.

BACKGROUND Dupilumab has been demonstrated to be an effective treatment for patients with moderate-to-severe atopic dermatitis (AD) in clinical trials. However, evidence of real-world experience with dupilumab in a broader population is limited to date. METHODS Adult patients with moderate-to-severe AD, defined as an Eczema Area Severity Index (EASI) score of 24 or higher, treated with dupilumab at ten Italian academic centers, were included in the study. Physician-reported outcome measures (EASI), patient-reported outcome measures (pruritus and sleep score, Dermatology Life Quality Index, DLQI) and serological markers [immunoglobulin (Ig) E and eosinophil count] after 16 weeks were analyzed. RESULTS We enrolled 543 patients with moderate-to-severe AD. Two patients (0.4%) discontinued treatment. The median ± interquartile percentage change from baseline to 16 weeks of treatment in the EASI score was -87.5±22.0 (p

Major advances in psoriasis pathogenesis have resulted in the development of effective new drugs for its treatment. In particular, biologics have revolutionized disease management.1 Tumour necrosis factor (TNF)‐α inhibitors were the first in 2000.1 Thus, adverse cutaneous reactions to their use have been extensively investigated.2 However, the anti‐interleukin (IL)‐17 agents secukinumab, ixekizumab and brodalumab have been introduced more recently for moderate‐to‐severe psoriasis.1 As a consequence, possible skin adverse events as a result of their use are not so fully elucidated. Eczematous eruption (EE) has been previously reported in 5–20% of patients with various inflammatory diseases treated with anti‐TNF‐α.3 Conversely, only anecdotal cases of EE induced by anti‐IL‐12/23 or anti‐IL‐17 in patients with psoriasis have been described.