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This report presents the case of a 22-year-old male with recurrent genital ulcers, oral aphthae, and gastrointestinal ulcerations initially diagnosed as Crohn’s disease by gastroenterologists. Despite overlapping clinical and histological features between Crohn’s disease and intestinal Behçet’s disease, a dermatological consultation raised suspicion for Behçet’s, leading to a revised diagnosis. This case highlights the helpful role of dermatologists in avoiding misdiagnosis and ensuring appropriate treatments for complex inflammatory conditions.

Introduction: Pustular psoriasis (PP) is a rare life-threatening skin disease with negatively impact on quality of life (QoL). Clinically, it may be systemic (generalized pustular psoriasis [GPP]) or localized on palms and soles (palmoplantar pustulosis [PPP]). It is not rare to observe plaque psoriasis associated with GPP. Objective: We explored the therapies used for PP and their correlation with patient QoL scores, through a cross-sectional study using retrospective data from a monocentric database in the period 2017-2021. Method: Patient characteristics were summarized using descriptive statistics and treatment predictors of QoL were identified by multiple regression analysis. Among 108 patients with PP, 57.4% had GPP + PSO whereas 42.6% had PPP. The therapeutic management is based on systemic conventional treatments and biological therapies in both GPP and PPP. Results: GPP + PSO patients with an impaired QoL (DLQI≥10) were associated with biological therapy including certolizumab (OR=2.38), etanercept (OR=2.25), secukinumab (OR=2.03) or ustekinumab (OR=2.79) whereas, PPP patients were positively associated with secukinumab (OR=2.85) or apremilast (OR 4.28, 95%-CI 0.56-9.62). Conclusion: Currently, systemic conventional therapy remains the therapeutic fulcrum of PP management. A great effect on QoL, especially for GPP+PSO, was assessed regardless the ongoing treatment and only newer biologic options were able to somehow positively impact.

Introduction: Managing rubbing injuries in atopic dermatitis is challenging and has a significant impact on patients' quality of life. Polyhexamethylene biguanide (PHMB) and Rigenase® (a patented Triticum vulgare extract) show promise in tissue repair and antimicrobial activity. Objective: The aim of this study was to compare the effectiveness of two topical treatments, Fitostimoline® Plus spray and a hydrating formulation with hyaluronic acid, in rubbing injuries secondary to atopic dermatitis. Materials and Methods: This comparative study enrolled 68 patients with atopic dermatitis and rubbing injuries, randomly assigned to Group A (N=38) receiving Fitostimoline® Plus spray (0.1% PHMB and Rigenase®) or Group B (N=30) receiving a hyaluronic acid spray. The primary endpoint was the clinical lesion response at 10 days post-treatment. Secondary endpoints included pain reduction (Visual Analogue Scale, VAS) and patient satisfaction (Dermatology Life Quality Index,DLQI). Results: Group A had a significantly higher complete response rate (81.3% vs. 64.3%, P

Introduction: The diagnosis of fully amelanotic skin tumors is difficult on clinical and dermoscopic examination. Objective: We sought to identify an accurate and user-friendly dermoscopic algorithm to differentiate between benign and malignant pink lesions. Methods: The database of 1 referral center was retrospectively reviewed for images of non-inflammatory fully amelanotic skin lesions. Two dermatologists jointly assessed a validation set of images for dermoscopic criteria and constructed a diagnostic algorithm, the 2-step 7-pink rule (2S-7PR). Two external clinicians, with different skills in dermoscopy and blinded to the final diagnosis, separately evaluated images from the validation test sets using the prevalent criterion method and the new 2S-7PR algorithm. Results: A total of 763 lesions from 652 patients were included in the validation set database, of which 68.3% were malignant and 31.7% were benign. Three suspicious dermoscopic criteria were included in the first step of the 2S-7PR: polymorphous or sharply focused vessels, scales or crusts, and erosions or ulcerations; and 4 non-suspicious criteria were included in the second: white collarette, white scar-like area, vascular lacunae, and necklace pinpoint vessels. High levels of specificity and sensitivity were calculated in the validation and test phases for both the expert and non-expert evaluators, the former achieving higher levels of both sensitivity and specificity by employing the 2S-7PR compared to the prevalent method, and the latter only improved specificity. Conclusions: The present study showed that an algorithm focused on a few reproducible and easily recognizable criteria could improve diagnostic accuracy in the management of amelanotic lesions.

Background Drug delivery strategies using chitosan nanobubbles (CS-NBs) could be used to reduce drug side effects and improve outcomes in hepatocellular carcinoma (HCC) treatment. To enhance their action, a targeting agent, such as the humanized anti-GPC3 antibody GC33 (condrituzumab), could be attached to their surface. Here, we investigated the use of idarubicin-loaded CS-NBs for HCC treatment and a GC33-derived minibody (that we named 4A1) to enhance CS-NB delivery. Methods Various CS-NB formulations were prepared with or without 4A1 conjugation and idarubicin loading. Results CS-NBs had a positive charge and a diameter of about 360 nm. In in-vitro experiments using the HCC-like HUH7 cell line, CS-NBs showed a cytotoxic effect once loaded with idarubicin. In-vivo biodistribution in HUH7 tumor-bearing xenograft mice demonstrated that CS-NBs can accumulate in the tumor mass. This effect was enhanced by 4A1 conjugation (p = 0.0317). In HUH7 tumor-bearing xenograft mice, CS-NBs loaded with idarubicin and conjugated or not conjugated with 4A1 were both able to slow tumor growth, to increase mouse survival time compared to free idarubicin (p = 0.00044 and 0.0018, respectively) as well as to reduce drug side effects. Conclusions CS-NBs loaded with idarubicin can be a useful drug delivery strategy for HCC treatment. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aims to evaluate whether the presence of isolated tumor cells (ITCs) correlates with specific stages of cutaneous melanoma, potentially shedding light on their prognostic significance and the paradoxical survival outcomes in stage IIIA. Methods: This study analyzed cases of sentinel lymph node biopsies for cutaneous melanoma between 2021 and 2023. It included patients with CM diagnoses, available histological slides, and clinical information about the neoplasia stage. The correlation between the primary tumor stage and the presence of isolated tumor cells was statistically analyzed. Results: This study analyzed 462 sentinel lymph node biopsies, revealing 77.1% negative cases and 22.9% positive cases. Isolated tumor cells were observed in 24 cases (5.2%), most commonly in the early stages (e.g., pT1b and pT2a). Statistical analysis confirmed a significant correlation between ITC presence and early-stage neoplasms (p = 0.014). Conclusions: Although ITCs prompt upstaging, their prognostic impact appears limited, especially in thin melanomas, where survival aligns more closely with stage IB than stage IIIA. This aligns with findings from breast cancer studies where ITCs are not equated to metastases in staging due to their minimal impact on prognosis. Current melanoma staging practices could benefit from differentiating ITCs from larger metastatic deposits to better reflect the actual metastatic burden and guide treatment decisions. [ABSTRACT FROM AUTHOR]

The global healthcare sector faced immense challenges due to the COVID‐19 pandemic. Oncologists noted reduced cancer screening, which impacted melanoma diagnosis and treatment, leading to concerns about delayed care and poorer outcomes. This review analyzes how the pandemic influenced melanoma ulceration risk and Breslow thickness index through a meta‐analysis of published studies. Following PRISMA guidelines, we conducted a systematic review of literature from January 2021 to December 2022 on cutaneous melanoma before and during the COVID‐19 pandemic. Upon screening 1854 manuscripts, the review led to 13 studies meeting inclusion standards. The quality assessment followed MINORS and Newcastle‐Ottawa Scale criteria. Regarding ulceration, post‐COVID ulceration surpassed pre‐COVID levels significantly, with a risk ratio of 1.31 and an estimated odds ratio of 1.41, indicating a 44% rise post‐COVID. As for Breslow thickness, studies show a rising trend in the Breslow index post‐COVID, but less significantly, with an effect size of 0.08 regarding the meta‐analysis model (P = 0.02) with a pre‐COVID mean Breslow of 1.56 mm and post‐COVID of 1.84 mm. This meta‐analysis concluded that post‐COVID ulceration rates significantly surpassed pre‐COVID levels. Considering that ulcerated melanomas usually undergo sentinel lymph node biopsy and are more likely to benefit from adjuvant therapies, this indicates important implications, as many patients might have missed the opportunity to start therapy appropriately, regardless of their Breslow thickness status. [ABSTRACT FROM AUTHOR]

Background Recently, we developed AT101, an IgM-class mouse monoclonal antibody directed against glypican-1 (GPC1), a proteoglycan that can be considered as useful target for glioblastoma multiforme (GBM) treatment being specifically and highly expressed on GBM cell surface. Here, we proposed the use of AT101 as targeting agent in a drug delivery nanoplatfom to effectively deliver chitosan nanobubbles (NBs) for GBM treatment. Methods Chitosan NBs were prepared and conjugated with AT101 or left unconjugated as control. Results The ability of AT101 to bind the GPC1 protein was demonstrated by flow cytometry and immunofluorescence analysis in the "GBM-like" GPC1-expressing cell lines U-87 MG and T98G. AT101 was shown to bind GPC1-expressing GBM tumor samples by immunofluorescence. In-vivo experiments in the U-87 MG xenograft model showed that AT101 was able to bind GPC1 on cell surface and accumulate in U-87 MG tumor masses (p = 0.0002 respect to control). Moreover, in-vivo experiments showed that AT101 is able to target GPC1 when conjugated to chitosan NBs, thus increasing their specific deliver to GPC1-expressing cells of U-87 MG tumor, as compared to chitosan NBs not conjugated to AT101 (p = 0.02). Conclusions AT101 is an useful targeting agent for the development of drug delivery nanoplatforms for GBM treatment. [ABSTRACT FROM AUTHOR]