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Zeno Fratton,1 Vincenzo Maione,2 Stefano Bighetti,2 Luca Bettolini,2 Mariachiara Arisi,2 Giuseppe Stinco,1 Enzo Errichetti1 1Department of Medicine, Institute of Dermatology, University of Udine, Udine, Italy; 2Dermatology Department, University of Brescia, ASST Spedali Civili di Brescia, Brescia, ItalyCorrespondence: Enzo Errichetti, Institute of Dermatology, Department of Medicine, University of Udine, Piazzale Santa Maria della Misericordia, 15, Udine, 33100, Italy, Tel +39 0432559822, Email enzo.errichetti@uniud.it

Alen Zabotti,1 Nicola Cabas,1 Ivan Giovannini,1 Silvia Guella,1 Lorenzo Cereser,2 Chiara Zuiani,2 Giuseppe Stinco,3 Luca Quartuccio,1 Enzo Errichetti3 1Department of Medical and Biological Sciences, Rheumatology Institute, Azienda sanitaria universitaria Friuli Centrale, Udine, Italy; 2Department of Medicine, Institute of Radiology, Azienda sanitaria universitaria Friuli Centrale, Udine, Italy; 3Department of Medical and Biological Sciences, Dermatology Institute, Azienda Sanitaria Universitaria Friuli Centrale, Udine, ItalyCorrespondence: Enzo Errichetti, Institute of Dermatology, Department of Medical Area, University of Udine, Piazzale Santa Maria della Misericordia, 15, Udine, 33100, Italy, Tel +39 0432559822, Email enzoerri@yahoo.it

Laura Manuela Pulgarin,1 Alessandro De Pellegrin,2 Giuseppe Stinco,3 Enzo Errichetti3 1Department of Dermatology, Universidad del Valle, Cali, Colombia; 2Department of Pathology, Udine “S. Maria della Misericordia” University Hospital, Udine, Italy; 3Institute of Dermatology, Department of Medicine, University of Udine, Udine, ItalyCorrespondence: Enzo Errichetti, Institute of Dermatology, Department of Medical Area, University of Udine, Piazzale Santa Maria della Misericordia, 15, Udine, 33100, Italy, Tel +39 0432559822, Email enzoerri@yahoo.it

Background: Facial (FP) and genital psoriasis (GP) significantly affect patients' quality of life. Despite the advances in treatments, limited data on efficacy and safety are available on these difficult-to-treat areas. Guselkumab is an interleukin (IL)-23 inhibitor which has been proven effective in treating patients with moderate-to-severe plaque psoriasis., Objectives: The aim of this interim analysis was to report the efficacy and safety of guselkumab in the treatment of patients with FP and/or GP., Materials and Methods: GULLIVER is a 52-week Italian observational study to evaluate the effectiveness and safety of guselkumab in a real-life setting in patients with FP and/or GP. Adult patients with facial and/or genital moderate-to-severe psoriasis (sPGA score ≥ 3) were included. The primary endpoint of this analysis was the percentage of patients achieving a facial or genital sPGA score of 0 (clear) or 1 (almost clear), at Week 12. The change in the score of the facial or genital sPGA components in patients with a score ≥3 for each sPGA component was assessed. PASI score in patients with a baseline PASI above or below 10 was evaluated., Results: Overall, 351 patients were included in the study; 83.3% of FP and 76.5% of GP patients achieved the primary endpoint. Similar response rates were observed for the facial or genital sPGA components in patients with a baseline facial or genital sPGA score ≥3 in each component. Among patients with a baseline PASI score >10, mean PASI score improved from 19.0 (SD 8.3) to 2.2 (SD 4.8). Forty-four AEs were observed in 32 patients; two mild and transient AEs (fatigue and nausea) were considered treatment related. No SAEs were observed., Conclusions: Guselkumab, showing to be effective and safe in treating FP and GP, may be a valid therapeutic option for patients with psoriasis localized in these difficult-to-treat areas., (© 2024 European Academy of Dermatology and Venereology.)

Background: Dermatophytosis is a prevalent superficial infection caused by filamentous fungi, primarily affecting the skin and/or its appendages. In recent years, there has been a notable increase in mycotic strains resistant to standard antifungal therapies, including Trichophyton indotineae , a dermatophyte of the Trichophyton mentagrophytes complex. This review aims to provide a comprehensive overview of the treatment options for T. indotineae , elucidating their effectiveness in managing this challenging mycotic infection. Methods: For this review, a search was conducted in the PubMed, Scopus, Web of Science, Embase, and Google Scholar databases, encompassing all published data until March 2024. English-language articles detailing therapy outcomes for patients confirmed to be affected by T. indotineae , identified through molecular analysis, were included. Results: Itraconazole was shown to be a good therapeutic choice, particularly when administered at a dosage of 200 mg/day for 1-12 weeks. Voriconazole was also demonstrated to be effective, while terbinafine exhibited a reduced response rate. Griseofulvin and fluconazole, on the other hand, were found to be ineffective. Although topical treatments were mostly ineffective when used alone, they showed promising results when used in combination with systemic therapy. Mutational status was associated with different profiles of treatment response, suggesting the need for a more tailored approach. Conclusions: When managing T. indotineae infections, it is necessary to optimize therapy to mitigate resistances and relapse. Combining in vitro antifungal susceptibility testing with mutational analysis could be a promising strategy in refining treatment selection.

Background: Preliminary data support the possible use of ultraviolet-induced fluorescence (UVF) dermoscopy in general dermatology, yet no accuracy analysis has been performed so far., Objective: To evaluate diagnostic accuracy of UVF dermoscopy in clinically similar non-neoplastic conditions as compared to polarized light-based dermoscopy., Methods: Patients with dermatoses potentially showing UV-induced findings were considered; cases were grouped according to clinical patterns and controls were also included. Standardized evaluation of dermoscopic pictures of the target lesion along with comparative and accuracy analysis were performed for polarized and UVF dermoscopic findings., Results: A total of 208 patients were included [31 foot intertrigo (7 due to Pseudomonas, 13 due to Corynebacterium and 11 due to dermatophytes); 57 intertrigo of major creases (18 inverse psoriasis, 13 erythrasma, 15 tinea infections and 11 candidiasis); 16 acne (papulopustular) and 13 Malassezia folliculitis; 46 papulosquamous dermatoses (14 guttate psoriasis, 11 lichen planus, 12 pityriasis rosea and 9 pityriasis lichenoide chronica); and 45 hypopigmented macular dermatoses of the trunk (9 progressive macular hypomelanosis, 9 idiopatic guttate hypomelanosis, 13 vitiligo and 14 achromic pityriasis versicolor)]. Significant (p < 0.01) UVF was seen in several conditions: green in Pseudomonas foot intertrigo; red in Corynebacterium foot intertrigo, inverse and guttate psoriasis (arranged around dermal papillae in the former), progressive macular hypomelanosis (folliculocentric distribution) and erythrasma (showing polygonal or structureless appearance); blue fluorescent concretions along hair shaft in erythrasma; light green in achromic pityriasis versicolor and tinea of major creases; and blue follicular in Malassezia folliculitis. Additionally, both acne and achromic pityriasis versicolor were also associated with interruption of uniform follicular red fluorescence. Notably, polarized and UVF dermoscopy were related to the most accurate feature in nine and eight analysed dermatoses, respectively., Conclusion: UVF dermoscopy improves recognition of non-neoplastic dermatoses, yet it should be considered complimentary to polarized light-based dermoscopy to increase diagnostic performance., (© 2024 European Academy of Dermatology and Venereology.)

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease that negatively impacts the quality of life and work productivity of patients., Objectives: We sought to evaluate the real-world burden of AD patients in Italy., Methods: This sub-analysis of the MEASURE-AD multicountry study conducted between December 2019-2020 included patients diagnosed with moderate-to-severe AD eligible for or receiving systemic therapy in the previous 6 months. During a single visit, physician and patient-reported questionnaires were used., Results: A total of 118 adult patients were enrolled and 57.6% (N = 68) of patients had moderate-to-severe AD at the time of enrolment according to the Eczema Area and Severity Index. Sleep disorders interfered with daily function in the previous week in 58.5% (N = 69) of patients, pruritus was severe in 50% (N = 59) and 42.4% (N = 50) reported a flare lasting >7 days in the previous 6 months. According to the Dermatology Quality of Life Index, 37.3% (N = 44) of patients reported a severe impact of AD and approximately 10% had clinical depression/anxiety. Current drug therapy was considered inadequate in controlling AD in 26.3% (N=31) of patients. Work activity impairment was 38.6±31.7% and monthly AD-related expenses were 148.6±134.6 Euros per patient., Conclusions: This real-life study documents a high burden of disease in patients with moderate-severe AD in Italy.