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1. Long-Term Drug Survival and Effectiveness of Secukinumab in Patients with Moderate to Severe Chronic Plaque Psoriasis: 42-Month Results from the SUPREME 2.0 Study

Author

Russo F, Galluzzo M, Stingeni L, Persechino S, Zichichi L, Conti A, Giofrè C, Dini V, Vispi M, Atzori L, Cattaneo A, Parodi A, Bardazzi F, Stinco G, Dapavo P, Girolomoni G, Musumeci ML, Papini M, Venturini M, Dastoli S, Di Nuzzo S, Fargnoli MC, Pagnanelli G, Bernardini N, Gambini DM, Malagoli P, Mazzatenta C, Peris K, Zalaudek I, Fabbrocini G, Loconsole F, Vassallo C, Pietroleonardo L, Prignano F, Franchi C, Offidani AM, Bonifati C, Di Lernia V, Gigante G, Bartezaghi MS, Franchi M, Ursoleo P, and Aloisi E

Subjects
psoriasis, secukinumab, real-world evidence, drug survival, supreme, Dermatology, RL1-803
Abstract

Filomena Russo,1 Marco Galluzzo,2,3 Luca Stingeni,4 Severino Persechino,5 Leonardo Zichichi,6 Andrea Conti,7 Claudia Giofrè,8 Valentina Dini,9 Martina Vispi,10 Laura Atzori,11 Angelo Cattaneo,12 Aurora Parodi,13 Federico Bardazzi,14 Giuseppe Stinco,15 Paolo Dapavo,16 Giampiero Girolomoni,17 Maria Letizia Musumeci,18 Manuela Papini,19 Marina Venturini,20 Stefano Dastoli,21 Sergio Di Nuzzo,22 Maria Concetta Fargnoli,23 Gianluca Pagnanelli,24 Nicoletta Bernardini,25 Daniele Mario Gambini,26 Piergiorgio Malagoli,27 Carlo Mazzatenta,28 Ketty Peris,29 Iris Zalaudek,30 Gabriella Fabbrocini31 ,† Francesco Loconsole,32 Camilla Vassallo,33 Lucia Pietroleonardo,34 Francesca Prignano,35 Chiara Franchi,36 Anna Maria Offidani,37 Claudio Bonifati,38 Vito Di Lernia,39 Giovanni Gigante,40 Marta Silvia Bartezaghi,40 Matteo Franchi,41,42 Paola Ursoleo,40 Elisabetta Aloisi40 1Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria Alle Scotte Hospital, Siena, Italy; 2Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy; 3Dermatology Unit, Fondazione Policlinico “Tor Vergata”, Rome, Italy; 4Section of Dermatology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy; 5Dermatology Unit, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University of Rome, Sant’Andrea University Hospital, Rome, Italy; 6Unit of Dermatology, San Antonio Abate Hospital, Trapani, Italy; 7Section of Dermatology, Department of Specialized Medicine, University of Modena and Reggio Emilia, Modena, Italy; 8U.O.C. Dermatologia, A.O. Papardo, Messina, Italy; 9Section of Dermatology, Department of Medicine and Oncology, University of Pisa, Pisa, Italy; 10Dermatology Unit, Misericordia Hospital, Grosseto, Italy; 11Dermatology Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; 12Dermatology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy; 13Section of Dermatology, DiSSal University of Genoa, Ospedale-Policlinico San Martino IRCCS, Genova, Italy; 14Dermatology Division, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; 15Section of Dermatology, Department of Medicine, University of Udine, Udine, Italy; 16Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy; 17Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy; 18Section of Dermatology, Department of Medical and Surgical Specialties, University of Catania, Catania, Italy; 19Dermatology Clinic of Terni, University of Perugia, Perugia, Italy; 20Section of Dermatology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; 21Department of Health Sciences, Magna Graecia University, Catanzaro, Italy; 22Department of Medicine and Surgery, University of Parma, Parma, Italy; 23Section of Dermatology, Department of Biotechnological and Applied Clinical Science, University of L’Aquila, L’Aquila, Italy; 24Department of Dermatology, Istituto Dermopatico dell’Immacolata - IRCCS, Roma, Italy; 25Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Dermatology Unit, “Daniele Innocenzi”, Asl Latina, Italy; 26Dermatology Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy; 27Dermatology Unit, Azienda Ospedaliera San Donato Milanese, Milan, Italy; 28Dermatology Unit, Lucca Azienda USL Toscana Nord Ovest, Pisa, Italy; 29Department of Translational Medicine and Surgery, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy; 30Department of Dermatology, University of Trieste, Trieste, Italy; 31Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; 32Department of Dermatology, University of Bari, Bari, Italy; 33Institute of Dermatology, IRCCS Policlinico San Matteo Foundation and University of Pavia, Pavia, Italy; 34Dermatology Unit, Vito Fazzi Hospital, Lecce, Italy; 35Dermatology Clinic, Department of Health Sciences, University of Florence, Florence, Italy; 36Dermatology Unit, IRCCS IO Galeazzi, Milan, Italy; 37Dermatological Clinic, Polytechnic University of the Marche Region, Ancona, Italy; 38Department of Dermatology, Istituto Dermatologico San Gallicano - IRCCS, Roma, Italy; 39Dermatology Unit, Arcispedale S. Maria Nuova IRCCS, Reggio Emilia, Italy; 40Novartis Farma SpA, Origgio, Italy; 41National Centre for Healthcare Research and Pharmacoepidemiology, Milan, Italy; 42Laboratory of Healthcare Research and Pharmacoepidemiology, Department of Statistics and Quantitative Methods, University of Milano Bicocca, Milan, Italy†Gabriella Fabbrocini passed away on 3 March 2023Correspondence: Filomena Russo, Dermatology Section, Department of Medical, Surgical and Neurological Science, University of Siena, S. Maria Alle Scotte Hospital, Siena, Italy, Email file.russo@libero.itPurpose: SUPREME, a phase IIIb study conducted in Italy, demonstrated safety and high efficacy of secukinumab for up to 72 weeks in patients with moderate-to-severe plaque-type psoriasis. SUPREME 2.0 study aimed to provide real-world data on the long-term drug survival and effectiveness of secukinumab beyond 72 weeks.Patients and Methods: SUPREME 2.0 is a retrospective observational chart review study conducted in patients previously enrolled in SUPREME study. After the end of the SUPREME study, eligible patients continued treatment as per clinical practice, and their effectiveness and drug survival data were retrieved from medical charts.Results: Of the 415 patients enrolled in the SUPREME study, 297 were included in SUPREME 2.0; of which, 210 (70.7%) continued secukinumab treatment throughout the 42-month observation period. Patients in the biologic-naïve cohort had higher drug survival than those in the biologic-experienced cohort (74.9% vs 61.7%), while HLA-Cw6–positive and HLA-Cw6–negative patients showed similar drug survival (69.3% and 71.9%). After 42 months, Psoriasis Area and Severity Index (PASI) 90 was achieved by 79.6% of patients overall; with a similar proportion of biologic-naïve and biologic-experienced patients achieving PASI90 (79.8% and 79.1%). The mean absolute PASI score reduced from 21.94 to 1.38 in the overall population, 21.90 to 1.24 in biologic-naïve and 22.03 to 1.77 in biologic-experienced patients after 42 months. The decrease in the absolute PASI score was comparable between HLA-Cw6–positive and HLA–Cw6-negative patients. The baseline Dermatology Life Quality Index scores also decreased in the overall patients (10.5 to 2.32) and across all study sub-groups after 42 months. Safety was consistent with the known profile of secukinumab, with no new findings.Conclusion: In this real-world cohort study, secukinumab showed consistently high long-term drug survival and effectiveness with a favourable safety profile.Keywords: psoriasis, secukinumab, real-world evidence, drug survival, SUPREME

Published
2023

4. Synthesis of the Data on COVID-19 Skin Manifestations: Underlying Mechanisms and Potential Outcomes

Author

Farinazzo E, Dianzani C, Zalaudek I, Conforti C, Grabbe S, and Goldust M

Subjects
covid-19, skin rashes, sars-cov-2, cutaneous manifestations, Dermatology, RL1-803
Abstract

Eleonora Farinazzo,1 Caterina Dianzani,2 Iris Zalaudek,1 Claudio Conforti,1 Stephan Grabbe,3 Mohamad Goldust3 1Dermatology Clinic, Maggiore Hospital, University of Trieste, Trieste, Italy; 2Dermatology Section, Department of Plastic, Reconstructive and Cosmetic Surgery, Campus Biomedico University Hospital, Rome, Italy; 3Department of Dermatology, University Medical Center Mainz, Mainz, GermanyCorrespondence: Mohamad GoldustDepartment of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, GermanyTel +49 1786-97-425Fax +49 6131-17-6629Email mgoldust@uni-mainz.deAbstract: The incidence of coronavirus disease 2019 (COVID-19)-related skin manifestations has progressively grown, in parallel with the global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreading. The available evidence indicates that cutaneous signs are heterogeneous and can be divided as follows: a) erythematous rashes, b) lesions of vascular origin, c) vesicular rashes, d) urticarial rashes, and e) acute generalized exanthematous pustulosis (AGEP), erythema multiforme (EM) and other polymorphic/atypical reactions. Most cutaneous manifestations appear simultaneously or after respiratory and/or systemic symptoms such as fever, even if rarely urticaria has been reported as the first sign of the disease. It has been proposed that erythematous and vesicular rashes, as well as urticaria, are the result of immunological activation against Sars-CoV-2, similarly to other viral exanthems; alternatively, reactivation or co-infection of herpesviruses and drug hypersensitivity represent possible etiologic diagnosis that has to be considered. Regarding lesions of vascular origin, ischemic ones are the result of systemic hypercoagulability established in severe infections, whereas chilblains seem to be linked to the type I-interferon massively produced to halt virus replication. AGEP is triggered by drugs, whereas EM could represent a delayed immune response to the virus or a hypersensitivity reaction to drugs elicited by the inflammatory process built to fight the infection. A further pathogenic hypothesis is that the virus, or its particles detected in the skin (particularly in endothelium and eccrine glands), could be responsible for certain skin reactions, including chilblains and EM. From the available data, it appears that chilblains are correlated with younger age and less severe disease, while ischemic manifestations occur in the elderly with severe infection. In conclusion, larger studies are needed to confirm the suggested pathogenetic mechanisms of COVID-19-related skin reactions and to determine the potential prognostic significance of each one.Keywords: COVID-19, skin rashes, SARS-CoV-2, cutaneous manifestations

Published
2021

5. Prediction of melanoma metastasis using dermatoscopy deep features. An international multicenter cohort study

Author

Lallas, K., primary, Spyridonos, P., additional, Kittler, H., additional, Tschandl, P., additional, Liopyris, K., additional, Argenziano, G., additional, Bakos, R., additional, Braun, R., additional, Cabos, H., additional, Dika, E., additional, Malvehy, J., additional, Marghoob, A., additional, Puig, S., additional, Scope, A., additional, Stolz, W., additional, Tanaka, M., additional, Thomas, L., additional, Apalla, Z., additional, Vakirlis, E., additional, Zalaudek, I., additional, and Lallas, A., additional

Published
2024
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6. Patients Withdrawing Dupilumab Monotherapy for COVID-19-Related Reasons Showed Similar Disease Course Compared With Patients Continuing Dupilumab Therapy

Author

Chiricozzi, A, Di Nardo, L, Talamonti, M, Galluzzo, M, De Simone, C, Fabbrocini, G, Marzano, A, Girolomoni, G, Offidani, A, Rossi, M, Bianchi, L, Cristaudo, A, Fierro, M, Stingeni, L, Pellacani, G, Argenziano, G, Patrizi, A, Pigatto, P, Romanelli, M, Savoia, P, Rubegni, P, Foti, C, Milanesi, N, Belloni Fortina, A, Bongiorno, M, Grieco, T, Di Nuzzo, S, Fargnoli, M, Carugno, A, Motolese, A, Rongioletti, F, Amerio, P, Balestri, R, Potenza, C, Micali, G, Patruno, C, Zalaudek, I, Lombardo, M, Feliciani, C, Antonelli, F, Ferrucci, S, Guarneri, F, Peris, K, Chiricozzi, A., Di Nardo, L., Talamonti, M., Galluzzo, M., De Simone, C., Fabbrocini, G., Marzano, A. V., Girolomoni, G., Offidani, A., Rossi, M. T., Bianchi, L., Cristaudo, A., Fierro, M. T., Stingeni, L., Pellacani, G., Argenziano, G., Patrizi, A., Pigatto, P., Romanelli, M., Savoia, P., Rubegni, P., Foti, C., Milanesi, N., Belloni Fortina, A., Bongiorno, M. R., Grieco, T., Di Nuzzo, S., Fargnoli, M. C., Carugno, A., Motolese, A., Rongioletti, F., Amerio, P., Balestri, R., Potenza, C., Micali, G., Patruno, C., Zalaudek, I., Lombardo, M., Feliciani, C., Antonelli, F., Ferrucci, S. M., Guarneri, F., Peris, K., Chiricozzi, A, Di Nardo, L, Talamonti, M, Galluzzo, M, De Simone, C, Fabbrocini, G, Marzano, A, Girolomoni, G, Offidani, A, Rossi, M, Bianchi, L, Cristaudo, A, Fierro, M, Stingeni, L, Pellacani, G, Argenziano, G, Patrizi, A, Pigatto, P, Romanelli, M, Savoia, P, Rubegni, P, Foti, C, Milanesi, N, Belloni Fortina, A, Bongiorno, M, Grieco, T, Di Nuzzo, S, Fargnoli, M, Carugno, A, Motolese, A, Rongioletti, F, Amerio, P, Balestri, R, Potenza, C, Micali, G, Patruno, C, Zalaudek, I, Lombardo, M, Feliciani, C, Antonelli, F, Ferrucci, S, Guarneri, F, Peris, K, Chiricozzi, A., Di Nardo, L., Talamonti, M., Galluzzo, M., De Simone, C., Fabbrocini, G., Marzano, A. V., Girolomoni, G., Offidani, A., Rossi, M. T., Bianchi, L., Cristaudo, A., Fierro, M. T., Stingeni, L., Pellacani, G., Argenziano, G., Patrizi, A., Pigatto, P., Romanelli, M., Savoia, P., Rubegni, P., Foti, C., Milanesi, N., Belloni Fortina, A., Bongiorno, M. R., Grieco, T., Di Nuzzo, S., Fargnoli, M. C., Carugno, A., Motolese, A., Rongioletti, F., Amerio, P., Balestri, R., Potenza, C., Micali, G., Patruno, C., Zalaudek, I., Lombardo, M., Feliciani, C., Antonelli, F., Ferrucci, S. M., Guarneri, F., and Peris, K.

Published
2022

7. European consensus-based interdisciplinary guideline for diagnosis and treatment of basal cell carcinoma—update 2023

Author

Peris, Ketty, Fargnoli, Maria Concetta, Kaufmann, R., Arenberger, P., Bastholt, L., Seguin, N. B., Bataille, V., Brochez, L., del Marmol, V., Dummer, R., Forsea, A. -M., Gaudy-Marqueste, C., Harwood, C. A., Hauschild, A., Holler, C., Kandolf, L., Kellerners-Smeets, N. W. J., Lallas, A., Leiter, U., Malvehy, J., Marinovic, B., Mijuskovic, Z., Moreno-Ramirez, D., Nagore, E., Nathan, P., Stratigos, A. J., Stockfleth, E., Tagliaferri, Luca, Trakatelli, M., Vieira, R., Zalaudek, Iri, Garbe, C., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), Zalaudek I., Peris, Ketty, Fargnoli, Maria Concetta, Kaufmann, R., Arenberger, P., Bastholt, L., Seguin, N. B., Bataille, V., Brochez, L., del Marmol, V., Dummer, R., Forsea, A. -M., Gaudy-Marqueste, C., Harwood, C. A., Hauschild, A., Holler, C., Kandolf, L., Kellerners-Smeets, N. W. J., Lallas, A., Leiter, U., Malvehy, J., Marinovic, B., Mijuskovic, Z., Moreno-Ramirez, D., Nagore, E., Nathan, P., Stratigos, A. J., Stockfleth, E., Tagliaferri, Luca, Trakatelli, M., Vieira, R., Zalaudek, Iri, Garbe, C., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), and Zalaudek I.

Abstract

Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from European Association of Dermato-Oncology (EADO), European Dermatology Forum, European Society for Radiotherapy and Oncology (ESTRO), Union Européenne des Médecins Spécialistes, and the European Academy of Dermatology and Venereology developed updated recommendations on diagnosis and treatment of BCC. BCCs were categorised into ‘easy-to-treat’ (common) and ‘difficult-to-treat’ according to the new EADO clinical classification. Diagnosis is based on clinico-dermatoscopic features, although histopathological confirmation is mandatory in equivocal lesions. The first-line treatment of BCC is complete surgery. Micrographically controlled surgery shall be offered in high-risk and recurrent BCC, and BCC located on critical anatomical sites. Topical therapies and destructive approaches can be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial and low-risk nodular BCCs. Management of ‘difficult-to-treat’ BCCs should be discussed by a multidisciplinary tumour board. Hedgehog inhibitors (HHIs), vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCC. Immunotherapy with anti-PD1 antibodies (cemiplimab) is a second-line treatment in patients with a progression of disease, contraindication, or intolerance to HHI therapy. Radiotherapy represents a valid alternative in patients who are not candidates for or decline surgery, especially elderly patients. Electrochemotherapy may be offered when surgery or radiotherapy is contraindicated. In Gorlin patients, regular skin examinations are required to diagnose and treat BCCs at an early stage. Long-term follow-up is recommended in patients with high-risk BCC, multiple BCCs, and Gorlin syndrome.

Published
2023

8. Long-Term Drug Survival and Effectiveness of Secukinumab in Patients with Moderate to Severe Chronic Plaque Psoriasis: 42-Month Results from the SUPREME 2.0 Study

Author

Russo, F, Galluzzo, M, Stingeni, L, Persechino, S, Zichichi, L, Conti, A, Giofrè, C, Dini, V, Vispi, M, Atzori, L, Cattaneo, A, Parodi, A, Bardazzi, F, Stinco, G, Dapavo, P, Girolomoni, G, Musumeci, M, Papini, M, Venturini, M, Dastoli, S, Di Nuzzo, S, Fargnoli, M, Pagnanelli, G, Bernardini, N, Gambini, D, Malagoli, P, Mazzatenta, C, Peris, K, Zalaudek, I, Fabbrocini, G, Loconsole, F, Vassallo, C, Pietroleonardo, L, Prignano, F, Franchi, C, Offidani, A, Bonifati, C, Di Lernia, V, Gigante, G, Bartezaghi, M, Franchi, M, Ursoleo, P, Aloisi, E, Russo, Filomena, Galluzzo, Marco, Stingeni, Luca, Persechino, Severino, Zichichi, Leonardo, Conti, Andrea, Giofrè, Claudia, Dini, Valentina, Vispi, Martina, Atzori, Laura, Cattaneo, Angelo, Parodi, Aurora, Bardazzi, Federico, Stinco, Giuseppe, Dapavo, Paolo, Girolomoni, Giampiero, Musumeci, Maria Letizia, Papini, Manuela, Venturini, Marina, Dastoli, Stefano, Di Nuzzo, Sergio, Fargnoli, Maria Concetta, Pagnanelli, Gianluca, Bernardini, Nicoletta, Gambini, Daniele, Malagoli, Piergiorgio, Mazzatenta, Carlo, Peris, Ketty, Zalaudek, Iris, Fabbrocini, Gabriella, Loconsole, Francesco, Vassallo, Camilla, Pietroleonardo, Lucia, Prignano, Francesca, Franchi, Chiara, Offidani, Anna Maria, Bonifati, Claudio, Di Lernia, Vito, Gigante, Giovanni, Bartezaghi, Marta, Franchi, Matteo, Ursoleo, Paola, Aloisi, Elisabetta, Russo, F, Galluzzo, M, Stingeni, L, Persechino, S, Zichichi, L, Conti, A, Giofrè, C, Dini, V, Vispi, M, Atzori, L, Cattaneo, A, Parodi, A, Bardazzi, F, Stinco, G, Dapavo, P, Girolomoni, G, Musumeci, M, Papini, M, Venturini, M, Dastoli, S, Di Nuzzo, S, Fargnoli, M, Pagnanelli, G, Bernardini, N, Gambini, D, Malagoli, P, Mazzatenta, C, Peris, K, Zalaudek, I, Fabbrocini, G, Loconsole, F, Vassallo, C, Pietroleonardo, L, Prignano, F, Franchi, C, Offidani, A, Bonifati, C, Di Lernia, V, Gigante, G, Bartezaghi, M, Franchi, M, Ursoleo, P, Aloisi, E, Russo, Filomena, Galluzzo, Marco, Stingeni, Luca, Persechino, Severino, Zichichi, Leonardo, Conti, Andrea, Giofrè, Claudia, Dini, Valentina, Vispi, Martina, Atzori, Laura, Cattaneo, Angelo, Parodi, Aurora, Bardazzi, Federico, Stinco, Giuseppe, Dapavo, Paolo, Girolomoni, Giampiero, Musumeci, Maria Letizia, Papini, Manuela, Venturini, Marina, Dastoli, Stefano, Di Nuzzo, Sergio, Fargnoli, Maria Concetta, Pagnanelli, Gianluca, Bernardini, Nicoletta, Gambini, Daniele, Malagoli, Piergiorgio, Mazzatenta, Carlo, Peris, Ketty, Zalaudek, Iris, Fabbrocini, Gabriella, Loconsole, Francesco, Vassallo, Camilla, Pietroleonardo, Lucia, Prignano, Francesca, Franchi, Chiara, Offidani, Anna Maria, Bonifati, Claudio, Di Lernia, Vito, Gigante, Giovanni, Bartezaghi, Marta, Franchi, Matteo, Ursoleo, Paola, and Aloisi, Elisabetta

Abstract

Purpose: SUPREME, a phase IIIb study conducted in Italy, demonstrated safety and high efficacy of secukinumab for up to 72 weeks in patients with moderate-to-severe plaque-type psoriasis. SUPREME 2.0 study aimed to provide real-world data on the long-term drug survival and effectiveness of secukinumab beyond 72 weeks. Patients and Methods: SUPREME 2.0 is a retrospective observational chart review study conducted in patients previously enrolled in SUPREME study. After the end of the SUPREME study, eligible patients continued treatment as per clinical practice, and their effectiveness and drug survival data were retrieved from medical charts. Results: Of the 415 patients enrolled in the SUPREME study, 297 were included in SUPREME 2.0; of which, 210 (70.7%) continued secukinumab treatment throughout the 42-month observation period. Patients in the biologic-naïve cohort had higher drug survival than those in the biologic-experienced cohort (74.9% vs 61.7%), while HLA-Cw6–positive and HLA-Cw6–negative patients showed similar drug survival (69.3% and 71.9%). After 42 months, Psoriasis Area and Severity Index (PASI) 90 was achieved by 79.6% of patients overall; with a similar proportion of biologic-naïve and biologic-experienced patients achieving PASI90 (79.8% and 79.1%). The mean absolute PASI score reduced from 21.94 to 1.38 in the overall population, 21.90 to 1.24 in biologic-naïve and 22.03 to 1.77 in biologic-experienced patients after 42 months. The decrease in the absolute PASI score was comparable between HLA-Cw6–positive and HLA–Cw6-negative patients. The baseline Dermatology Life Quality Index scores also decreased in the overall patients (10.5 to 2.32) and across all study sub-groups after 42 months. Safety was consistent with the known profile of secukinumab, with no new findings. Conclusion: In this real-world cohort study, secukinumab showed consistently high long-term drug survival and effectiveness with a favourable safety profile.

Published
2023

9. Benefits and Pitfalls of Using in Vivo Reflectance Confocal Microscopy in Lentigo Maligna Diagnostics: Case Reports

Author

Povilaite I., Argenziano G., Babino G., Conforti C., Moscarella E., Pagliuca F., Ronchi A., Zalaudek I., Agozzino M., Povilaite, I., Argenziano, G., Babino, G., Conforti, C., Moscarella, E., Pagliuca, F., Ronchi, A., Zalaudek, I., and Agozzino, M.

Subjects
Oncology, Genetics, diagnostic accuracy, in vivo reflectance confocal microscopy, Dermatology, lentigo maligna, Molecular Biology, pigmented facial lesion
Published
2022

10. Nationwide multidisciplinary consensus on the clinical management of Merkel cell carcinoma: a Delphi panel

Author

Spada F., Bossi P., Caraco C., Sileni V. C., Dei Tos A. P., Fazio N., Grignani G., Maio M., Quaglino P., Queirolo P., Ascierto P. A., Antonini Cappellini G. C., Antonuzzo L., Badalamenti G., Barberis M., Bassetto F., Berardi R., Berruti A., Bongiovanni A., Bonomo P., Borgognoni L., Borzillo V., Bruder F., Campana D., Consoli F., Cordova A., Depenni R., Di Giacomo A. M., Fabbrocini G., Fargnoli M. C., Ferraresi V., Ferrau F., Fierro M. T., Gatti M., Gelsomino F., Giuffrida D., Graziano P., Gregorelli C., Guida M., Massi D., Mazzarotto R., Milesi L., Minisini A. M., Morgese F., Muto P., Palmieri G., Patuzzo R., Pellacani G., Picciotto F., Pigozzo J., Pimpinelli N., Poletti P., Repetto L., Rinaldi G., Rubegni P., Rubino G., Spagnolo F., Tagliaferri L., Tanda E., Tronconi M. C., Tucci M., Valente M., Vincenzi B., Zalaudek I., Spada F., Bossi P., Caraco C., Sileni V.C., Dei Tos A.P., Fazio N., Grignani G., Maio M., Quaglino P., Queirolo P., Ascierto P.A., Antonini Cappellini G.C., Antonuzzo L., Badalamenti G., Barberis M., Bassetto F., Berardi R., Berruti A., Bongiovanni A., Bonomo P., Borgognoni L., Borzillo V., Bruder F., Campana D., Consoli F., Cordova A., Depenni R., Di Giacomo A.M., Fabbrocini G., Fargnoli M.C., Ferraresi V., Ferrau F., Fierro M.T., Gatti M., Gelsomino F., Giuffrida D., Graziano P., Gregorelli C., Guida M., Massi D., Mazzarotto R., Milesi L., Minisini A.M., Morgese F., Muto P., Palmieri G., Patuzzo R., Pellacani G., Picciotto F., Pigozzo J., Pimpinelli N., Poletti P., Repetto L., Rinaldi G., Rubegni P., Rubino G., Spagnolo F., Tagliaferri L., Tanda E., Tronconi M.C., Tucci M., Valente M., Vincenzi B., and Zalaudek I.

Subjects
Pharmacology, Cancer Research, Skin Neoplasms, Immunology, Carcinoma, Carcinoma, Merkel Cell, Oncology, Italy, Merkel cell polyomavirus, Merkel Cell, Molecular Medicine, Immunology and Allergy, immunotherapy, radiotherapy, skin neoplasms, Humans, Immunotherapy
Abstract

Merkel cell carcinoma (MCC) is a rare and highly aggressive cutaneous neuroendocrine carcinoma. The MCC incidence rate has rapidly grown over the last years, with Italy showing the highest increase among European countries. This malignancy has been the focus of active scientific research over the last years, focusing mainly on pathogenesis, new therapeutic trials and diagnosis. A national expert board developed 28 consensus statements that delineated the evolution of disease management and highlighted the paradigm shift towards the use of immunological strategies, which were then presented to a national MCC specialists panel for review. Sixty-five panelists answered both rounds of the questionnaire. The statements were divided into five areas: a high level of agreement was reached in the area of guidelines and multidisciplinary management, even if in real life the multidisciplinary team was not always represented by all the specialists. In the diagnostic pathway area, imaging played a crucial role in diagnosis and initial staging, planning for surgery or radiation therapy, assessment of treatment response and surveillance of recurrence and metastases. Concerning diagnosis, the usefulness of Merkel cell polyomavirus is recognized, but the agreement and consensus regarding the need for cytokeratin evaluation appears greater. Regarding the areas of clinical management and follow-up, patients with MCC require customized treatment. There was a wide dispersion of results and the suggestion to increase awareness about the adjuvant radiation therapy. The panelists unanimously agreed that the information concerning avelumab provided by the JAVELIN Merkel 200 study is adequate and reliable and that the expanded access program data could have concrete clinical implications. An immunocompromised patient with advanced MCC can be treated with immunotherapy after multidisciplinary risk/benefit assessment, as evidenced by real-world analysis and highlighted in the guidelines. A very high consensus regarding the addition of radiotherapy to treat the ongoing focal progression of immunotherapy was observed. This paper emphasizes the importance of collaboration and communication among the interprofessional team members and encourages managing patients with MCC within dedicated multidisciplinary teams. New insights in the treatment of this challenging cancer needs the contribution of many and different experts.

Published
2022

11. Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: Data from the DA-COVID-19 registry

Author

Chiricozzi, A, Talamonti, M, De Simone, C, Galluzzo, M, Gori, N, Fabbrocini, G, Marzano, A, Girolomoni, G, Offidani, A, Rossi, M, Bianchi, L, Cristaudo, A, Fierro, M, Stingeni, L, Pellacani, G, Argenziano, G, Patrizi, A, Pigatto, P, Romanelli, M, Savoia, P, Rubegni, P, Foti, C, Milanesi, N, Belloni Fortina, A, Bongiorno, M, Grieco, T, Di Nuzzo, S, Fargnoli, M, Carugno, A, Motolese, A, Rongioletti, F, Amerio, P, Balestri, R, Potenza, C, Micali, G, Patruno, C, Zalaudek, I, Lombardo, M, Feliciani, C, Di Nardo, L, Guarneri, F, Peris, K, Caldarola, G, Silvaggio, D, Dattola, A, Napolitano, M, Ferrucci, S, Dal Bello, G, Bianchelli, T, Rovati, C, Pigliacelli, F, Ortoncelli, M, Hansel, K, Calabrese, G, Loi, C, Iannone, M, Veronese, F, Romita, P, Tronconi, G, Caroppo, F, Tilotta, G, Sernicola, A, Esposito, M, Raponi, F, Gualdi, G, Rech, G, Musumeci, M, Nistico, S, Campitiello, A, Bonzano, L, Piras, V, Chiricozzi A., Talamonti M., De Simone C., Galluzzo M., Gori N., Fabbrocini G., Marzano A. V., Girolomoni G., Offidani A., Rossi M. T., Bianchi L., Cristaudo A., Fierro M. T., Stingeni L., Pellacani G., Argenziano G., Patrizi A., Pigatto P., Romanelli M., Savoia P., Rubegni P., Foti C., Milanesi N., Belloni Fortina A., Bongiorno M. R., Grieco T., Di Nuzzo S., Fargnoli M. C., Carugno A., Motolese A., Rongioletti F., Amerio P., Balestri R., Potenza C., Micali G., Patruno C., Zalaudek I., Lombardo M., Feliciani C., Di Nardo L., Guarneri F., Peris K., Caldarola G., Silvaggio D., Dattola A., Napolitano M., Ferrucci S. M., Dal Bello G., Bianchelli T., Rovati C., Pigliacelli F., Ortoncelli M., Hansel K., Calabrese G., Loi C., Iannone M., Veronese F., Romita P., Tronconi G., Caroppo F., Tilotta G., Sernicola A., Esposito M., Raponi F., Gualdi G., Rech G., Musumeci M. L., Nistico S. P., Campitiello A., Bonzano L., Piras V., Chiricozzi, A, Talamonti, M, De Simone, C, Galluzzo, M, Gori, N, Fabbrocini, G, Marzano, A, Girolomoni, G, Offidani, A, Rossi, M, Bianchi, L, Cristaudo, A, Fierro, M, Stingeni, L, Pellacani, G, Argenziano, G, Patrizi, A, Pigatto, P, Romanelli, M, Savoia, P, Rubegni, P, Foti, C, Milanesi, N, Belloni Fortina, A, Bongiorno, M, Grieco, T, Di Nuzzo, S, Fargnoli, M, Carugno, A, Motolese, A, Rongioletti, F, Amerio, P, Balestri, R, Potenza, C, Micali, G, Patruno, C, Zalaudek, I, Lombardo, M, Feliciani, C, Di Nardo, L, Guarneri, F, Peris, K, Caldarola, G, Silvaggio, D, Dattola, A, Napolitano, M, Ferrucci, S, Dal Bello, G, Bianchelli, T, Rovati, C, Pigliacelli, F, Ortoncelli, M, Hansel, K, Calabrese, G, Loi, C, Iannone, M, Veronese, F, Romita, P, Tronconi, G, Caroppo, F, Tilotta, G, Sernicola, A, Esposito, M, Raponi, F, Gualdi, G, Rech, G, Musumeci, M, Nistico, S, Campitiello, A, Bonzano, L, Piras, V, Chiricozzi A., Talamonti M., De Simone C., Galluzzo M., Gori N., Fabbrocini G., Marzano A. V., Girolomoni G., Offidani A., Rossi M. T., Bianchi L., Cristaudo A., Fierro M. T., Stingeni L., Pellacani G., Argenziano G., Patrizi A., Pigatto P., Romanelli M., Savoia P., Rubegni P., Foti C., Milanesi N., Belloni Fortina A., Bongiorno M. R., Grieco T., Di Nuzzo S., Fargnoli M. C., Carugno A., Motolese A., Rongioletti F., Amerio P., Balestri R., Potenza C., Micali G., Patruno C., Zalaudek I., Lombardo M., Feliciani C., Di Nardo L., Guarneri F., Peris K., Caldarola G., Silvaggio D., Dattola A., Napolitano M., Ferrucci S. M., Dal Bello G., Bianchelli T., Rovati C., Pigliacelli F., Ortoncelli M., Hansel K., Calabrese G., Loi C., Iannone M., Veronese F., Romita P., Tronconi G., Caroppo F., Tilotta G., Sernicola A., Esposito M., Raponi F., Gualdi G., Rech G., Musumeci M. L., Nistico S. P., Campitiello A., Bonzano L., and Piras V.

Abstract

Background: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic. Methods: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID-19 pandemic on the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were obtained at different timepoints by teledermatology during COVID-19 pandemic, when regular visits were not allowed due to sanitary restrictions. Disease severity was assessed by both physician- and patient-reported assessment scores evaluating itch intensity, sleep disturbances, and AD severity. Results: A total of 1831 patients were included, with 1580/1831 (86.3%) continuing therapy during pandemic. Most patients were treated with dupilumab (86.1%, 1576/1831) that was interrupted in only 9.9% (156/1576) of cases, while systemic immunosuppressive compounds were more frequently withdrawn. Treatment interruption was due to decision of the patient, general practitioner, or dermatologist in 39.9% (114/286), 5.6% (16/286), and 30.1% (86/286) of cases, respectively. Fear of increased susceptibility to SARS-CoV-2 infection (24.8%, 71/286) was one of the main causes of interruption. Sixteen patients (0.9%) resulted positive to SARS-CoV-2 infection; 3 of them (0.2%) were hospitalized but no cases of COVID-related death occurred. Conclusions: Most AD patients continued systemic treatments during COVID pandemic and lockdown period, without high impact on disease control, particularly dupilumab-treated patients.

Published
2021

12. Characteristic of chronic plaque psoriasis patients treated with biologics in Italy during the COVID-19 Pandemic: Risk analysis from the PSO-BIO-COVID observational study

Author

Talamonti, M, Galluzzo, M, Chiricozzi, A, Quaglino, P, Fabbrocini, G, Gisondi, P, Marzano, A, Potenza, C, Conti, A, Parodi, A, Piaserico, S, Bardazzi, F, Argenziano, G, Rongioletti, F, Stingeni, L, Micali, G, Loconsole, F, Rossi, M, Bongiorno, M, Feliciani, C, Rubegni, P, Amerio, P, Fargnoli, M, Pigatto, P, Savoia, P, Nisticò, S, Giustini, S, Carugno, A, Cannavo’, S, Rech, G, Prignano, F, Offidani, A, Lombardo, M, Zalaudek, I, Bianchi, L, Peris, K, Talamonti, M., Galluzzo, M., Chiricozzi, A., Quaglino, P., Fabbrocini, G., Gisondi, P., Marzano, A. V., Potenza, C., Conti, A., Parodi, A., Piaserico, S., Bardazzi, F., Argenziano, G., Rongioletti, F., Stingeni, L., Micali, G., Loconsole, F., Rossi, M. T., Bongiorno, M. R., Feliciani, C., Rubegni, P., Amerio, P., Fargnoli, M. C., Pigatto, P., Savoia, P., Nisticò, S. P., Giustini, S., Carugno, A., Cannavo’, S. P., Rech, G., Prignano, F., Offidani, A., Lombardo, M., Zalaudek, I., Bianchi, L., Peris, K., Talamonti, M, Galluzzo, M, Chiricozzi, A, Quaglino, P, Fabbrocini, G, Gisondi, P, Marzano, A, Potenza, C, Conti, A, Parodi, A, Piaserico, S, Bardazzi, F, Argenziano, G, Rongioletti, F, Stingeni, L, Micali, G, Loconsole, F, Rossi, M, Bongiorno, M, Feliciani, C, Rubegni, P, Amerio, P, Fargnoli, M, Pigatto, P, Savoia, P, Nisticò, S, Giustini, S, Carugno, A, Cannavo’, S, Rech, G, Prignano, F, Offidani, A, Lombardo, M, Zalaudek, I, Bianchi, L, Peris, K, Talamonti, M., Galluzzo, M., Chiricozzi, A., Quaglino, P., Fabbrocini, G., Gisondi, P., Marzano, A. V., Potenza, C., Conti, A., Parodi, A., Piaserico, S., Bardazzi, F., Argenziano, G., Rongioletti, F., Stingeni, L., Micali, G., Loconsole, F., Rossi, M. T., Bongiorno, M. R., Feliciani, C., Rubegni, P., Amerio, P., Fargnoli, M. C., Pigatto, P., Savoia, P., Nisticò, S. P., Giustini, S., Carugno, A., Cannavo’, S. P., Rech, G., Prignano, F., Offidani, A., Lombardo, M., Zalaudek, I., Bianchi, L., and Peris, K.

Abstract

Background: The susceptibility of patients with chronic plaque psoriasis and the risks or benefits related to the use of biological therapies for COVID-19 are unknown. Few data about prevalence, clinical course and outcomes of COVID-19 among psoriatic patients were reported. The aims of this study were 1) to assess the prevalence and severity of COVID-19 in psoriatic patients treated with biologic agents during the first phase of the emergency (22 February to 22 April 2020) in Italy, and 2) to report the clinical outcomes of patients who have been exposed to individuals with confirmed SARS-CoV-2 infection. Methods: Patients with moderate-to-severe chronic plaque psoriasis, aged ≥18 years and undergoing treatment with biologic agents as of 22 February 2020, were eligible to be included in PSO-BIO-COVID study. Demographic and clinical characteristics of patients using any biologic for psoriasis treatment between 22 February and 22 April 2020 were registered. Results: A total of 12,807 psoriatic patients were included in the PSO-BIO-COVID study. In this cohort 26 patients (0.2%) had a swab confirmation of SARS-CoV-2 infection. Eleven patients required hospitalization and two died. Conclusion: The incidence of COVID-19 observed in our cohort of psoriatic patients (0.2%) is similar to that seen in the general population (0.31%) in Italy. However, the course of the disease was mild in most patients. Biological therapies may likely lessen ‘cytokine storm’ of COVID-19, which sometimes lead to multiple organ failure, ARDS, and death.

Published
2021

13. Position statement on classification of basal cell carcinomas. Part 2: EADO proposal for new operational staging system adapted to basal cell carcinomas

Author

Grob, J. J., Gaudy-Marqueste, C., Guminski, A., Malvehy, J., Basset-seguin, N., Bertrand, B., Fernandez-Penas, P., Kaufmann, R., Zalaudek, I., Fargnoli, M. C., Tagliaferri, L., Fertil, B., Del Marmol, V., Stratigos, A., Garbe, C., Peris, K., Zalaudek I., Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), Peris K. (ORCID:0000-0002-5237-0463), Grob, J. J., Gaudy-Marqueste, C., Guminski, A., Malvehy, J., Basset-seguin, N., Bertrand, B., Fernandez-Penas, P., Kaufmann, R., Zalaudek, I., Fargnoli, M. C., Tagliaferri, L., Fertil, B., Del Marmol, V., Stratigos, A., Garbe, C., Peris, K., Zalaudek I., Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), and Peris K. (ORCID:0000-0002-5237-0463)

Abstract

Background: No simple staging system has emerged for basal cell carcinomas (BCCs), since they do not follow the TNM process, and practitioners failed to agree on simple clinical or pathological criteria as a basis for a classification. Operational classification of BCCs is required for decision-making, trials and guidelines. Unsupervised clustering of real cases of difficult-to-treat BCCs (DTT-BCCs; part 1) has demonstrated that experts could blindly agree on a five groups classification of DTT-BCCs based on five patterns of clinical situations. Objective: Using this five patterns to generate an operational and comprehensive classification of BCCs. Method: Testing practitioner's agreement, when using the five patterns classification to ensure that it is robust enough to be used in the practice. Generating the first version of a staging system of BCCs based on pattern recognition. Results: Sixty-two physicians, including 48 practitioners and the 14 experts who participated in the generation of the five different patterns of DTT-BCCs, agreed on 90% of cases when classifying 199 DTT-BCCs cases using the five patterns classification (part 1) attesting that this classification is understandable and usable in practice. In order to cover the whole field of BCCs, these five groups of DTT-BCCs were added a group representing the huge number of easy-to-treat BCCs, for which sub-classification has little interest, and a group of very rare metastatic cases, resulting in a four-stage and seven-substage staging system of BCCs. Conclusion: A practical classification adapted to the specificities of BCCs is proposed. It is the first tumour classification based on pattern recognition of clinical situations, which proves to be consistent and usable. This EADO staging system version 1 will be improved step by step and tested as a decision tool and a prognostic instrument.

Published
2021

14. Real-life experience on effectiveness and safety of dupilumab in adult patients with moderate-to-severe atopic dermatitis

Author

Fargnoli, M. C., Esposito, M., Ferrucci, S., Girolomoni, G., Offidani, A., Patrizi, A., Peris, K., Costanzo, A., Malara, G., Pellacani, G., Romanelli, M., Amerio, P., Cristaudo, A., Flori, M. L., Motolese, A., Betto, P., Patruno, C., Pigatto, P., Sirna, R., Stinco, G., Zalaudek, I., Bianchi, L., Boccaletti, V., Cannavo, S. P., Cusano, F., Lembo, S., Mozzillo, R., Gallo, R., Potenza, C., Rongioletti, F., Tiberio, R., Grieco, T., Micali, G., Persechino, S., Pettinato, M., Pucci, S., Savi, E., Stingeni, L., Romano, A., Argenziano, G., Hansel, K., Fargnoli, M. C., Esposito, M., Ferrucci, S., Girolomoni, G., Offidani, A., Patrizi, A., Peris, K., Costanzo, A., Malara, G., Pellacani, G., Romanelli, M., Amerio, P., Cristaudo, A., Flori, M. L., Motolese, A., Betto, P., Patruno, C., Pigatto, P., Sirna, R., Stinco, G., Zalaudek, I., Bianchi, L., Boccaletti, V., Cannavo, S. P., Cusano, F., Lembo, S., Mozzillo, R., Gallo, R., Potenza, C., Rongioletti, F., Tiberio, R., Grieco, T., Micali, G., Persechino, S., Pettinato, M., Pucci, S., Savi, E., Stingeni, L., Romano, A., Argenziano, G., Fargnoli, Mc, Esposito, M, Ferrucci, S, Girolomoni, G, Offidani, A, Patrizi, A, Peris, K, Costanzo, A, Malara, G, Pellacani, G, Romanelli, M, Amerio, P, Cristaudo, A, Flori, Ml, Motolese, A, Betto, P, Patruno, C, Pigatto, P, Sirna, R, Stinco, G, Zalaudek, I, Bianchi, L, Boccaletti, V, Cannavò, Sp, Cusano, F, Lembo, S, Mozzillo, R, Gallo, R, Potenza, C, Rongioletti, F, Tiberio, R, Grieco, T, Micali, G, Persechino, S, Pettinato, M, Pucci, S, Savi, E, Stingeni, L, Romano, A, Argenziano, G, and Dupilumab Italian National Access Program (Dup-INAP, group).

Subjects
Male, Dermatitis, Severity of Illness Index, Cohort Studies, 030207 dermatology & venereal diseases, 0302 clinical medicine, Quality of life, Monoclonal, 80 and over, Humanized, Aged, 80 and over, Real-life, Atopic dermatitis, Middle Aged, Atopic dermatiti, Dupilumab, humanities, Treatment Outcome, atopic dermatitis, dupilumab, real-life, Female, Settore MED/35 - MALATTIE CUTANEE E VENEREE, Cohort study, atopic dermatiti, Adult, medicine.medical_specialty, Context (language use), Dermatology, Antibodies, Monoclonal, Humanized, Antibodies, Atopic, Dermatitis, Atopic, 03 medical and health sciences, Young Adult, Internal medicine, Severity of illness, medicine, Humans, Adverse effect, Aged, Retrospective Studies, 030203 arthritis & rheumatology, business.industry, Pruritus, Retrospective cohort study, medicine.disease, Quality of Life, business, Sleep
Abstract

Background: Dupilumab, a fully human monoclonal antibody targeting the alpha subunit of IL-4 was recently approved for the treatment of moderate-to-severe atopic dermatitis (AD) in adult patients. Objective: To assess dupilumab effectiveness and safety in adults with moderate-to-severe AD in a real-life Italian multicentre retrospective cohort. Methods: Adult moderate-to-severe AD patients, referring to 39 Italian centers, received dupilumab in the context of a national patient access program. Disease assessment was performed at baseline, after 4 and 16 weeks of treatment using Eczema-Area-and-Severity-Index (EASI) score, itch and sleep numerical-rating-score (itch-NRS, sleep-NRS) and Dermatology-Life-Quality-Index (DLQI). Results: A total of 109 (71 M/38F) patients was studied. There was a significant reduction in EASI score, itch-NRS, sleep-NRS and DLQI from baseline to week 4 and a further significant decline to week 16. EASI 50, EASI75 and EASI90 were achieved by 59.6%, 28.4% and 9.3% of patients at 4 weeks and by 87.2%, 60.6% and 32.4% of them at 16 weeks, respectively. Adverse events were experienced by 19.2% (21/109) of the patients and they were all mild in intensity, being conjunctivitis the most common side effect. Conclusions: Dupilumab significantly improved disease severity, pruritus, sleep loss and quality of life with an acceptable safety profile.

Published
2021

15. Management of biological therapies for chronic plaque psoriasis during COVID-19 emergency in Italy

Author

Talamonti, M, Galluzzo, M, Chiricozzi, A, Quaglino, P, Fabbrocini, G, Gisondi, P, Marzano, A, Potenza, C, Conti, A, Parodi, A, Belloni Fortina, A, Bardazzi, F, Argenziano, G, Rongioletti, F, Stingeni, L, Micali, G, Loconsole, F, Venturini, M, Bongiorno, M, Feliciani, C, Rubegni, P, Amerio, P, Fargnoli, M, Pigatto, P, Savoia, P, Nistico, S, Giustini, S, Carugno, A, Cannavo, S, Rech, G, Prignano, F, Offidani, A, Lombardo, M, Zalaudek, I, Bianchi, L, Peris, K, Balestri, R, Bernardini, N, Botti, E, Burlando, M, Caldarola, G, Cattaneo, A, Dapavo, P, Dastoli, S, De Simone, C, Di Nuzzo, S, Diotallevi, F, Fierro, M, Fidanza, R, Foti, C, Gambini, D, Gambardella, A, Girolomoni, G, Guarneri, C, Gualdi, G, Hansel, K, Megna, M, Mugheddu, C, Musumeci, M, Patrizi, A, Pellacani, G, Piaserico, S, Richetta, A, Rosi, E, Rossi, M, Sacchelli, L, Tiberio, R, Tilotta, G, Trovato, E, Vezzoni, R, Zangrilli, A, Talamonti M., Galluzzo M., Chiricozzi A., Quaglino P., Fabbrocini G., Gisondi P., Marzano A. V., Potenza C., Conti A., Parodi A., Belloni Fortina A., Bardazzi F., Argenziano G., Rongioletti F., Stingeni L., Micali G., Loconsole F., Venturini M., Bongiorno M. R., Feliciani C., Rubegni P., Amerio P., Fargnoli M. C., Pigatto P., Savoia P., Nistico S. P., Giustini S., Carugno A., Cannavo S. P., Rech G., Prignano F., Offidani A., Lombardo M., Zalaudek I., Bianchi L., Peris K., Balestri R., Bernardini N., Botti E., Burlando M., Caldarola G., Cattaneo A., Dapavo P., Dastoli S., De Simone C., Di Nuzzo S., Diotallevi F., Fierro M. T., Fidanza R., Foti C., Gambini D. M., Gambardella A., Girolomoni G., Guarneri C., Gualdi G., Hansel K., Megna M., Mugheddu C., Musumeci M. L., Patrizi A., Pellacani G., Piaserico S., Richetta A. G., Rosi E., Rossi M. T., Sacchelli L., Tiberio R., Tilotta G., Trovato E., Vezzoni R., Zangrilli A., Talamonti, M, Galluzzo, M, Chiricozzi, A, Quaglino, P, Fabbrocini, G, Gisondi, P, Marzano, A, Potenza, C, Conti, A, Parodi, A, Belloni Fortina, A, Bardazzi, F, Argenziano, G, Rongioletti, F, Stingeni, L, Micali, G, Loconsole, F, Venturini, M, Bongiorno, M, Feliciani, C, Rubegni, P, Amerio, P, Fargnoli, M, Pigatto, P, Savoia, P, Nistico, S, Giustini, S, Carugno, A, Cannavo, S, Rech, G, Prignano, F, Offidani, A, Lombardo, M, Zalaudek, I, Bianchi, L, Peris, K, Balestri, R, Bernardini, N, Botti, E, Burlando, M, Caldarola, G, Cattaneo, A, Dapavo, P, Dastoli, S, De Simone, C, Di Nuzzo, S, Diotallevi, F, Fierro, M, Fidanza, R, Foti, C, Gambini, D, Gambardella, A, Girolomoni, G, Guarneri, C, Gualdi, G, Hansel, K, Megna, M, Mugheddu, C, Musumeci, M, Patrizi, A, Pellacani, G, Piaserico, S, Richetta, A, Rosi, E, Rossi, M, Sacchelli, L, Tiberio, R, Tilotta, G, Trovato, E, Vezzoni, R, Zangrilli, A, Talamonti M., Galluzzo M., Chiricozzi A., Quaglino P., Fabbrocini G., Gisondi P., Marzano A. V., Potenza C., Conti A., Parodi A., Belloni Fortina A., Bardazzi F., Argenziano G., Rongioletti F., Stingeni L., Micali G., Loconsole F., Venturini M., Bongiorno M. R., Feliciani C., Rubegni P., Amerio P., Fargnoli M. C., Pigatto P., Savoia P., Nistico S. P., Giustini S., Carugno A., Cannavo S. P., Rech G., Prignano F., Offidani A., Lombardo M., Zalaudek I., Bianchi L., Peris K., Balestri R., Bernardini N., Botti E., Burlando M., Caldarola G., Cattaneo A., Dapavo P., Dastoli S., De Simone C., Di Nuzzo S., Diotallevi F., Fierro M. T., Fidanza R., Foti C., Gambini D. M., Gambardella A., Girolomoni G., Guarneri C., Gualdi G., Hansel K., Megna M., Mugheddu C., Musumeci M. L., Patrizi A., Pellacani G., Piaserico S., Richetta A. G., Rosi E., Rossi M. T., Sacchelli L., Tiberio R., Tilotta G., Trovato E., Vezzoni R., and Zangrilli A.

Published
2020

16. Likelihood of finding melanoma when removing a melanocytic lesion with peripheral clods

Author

Ribero, S., Argenziano, G., Di Stefani, A., Guidante, M., Moscarella, E., Peris, K., Manganoni, A., Ingordo, V., Zalaudek, I., Senetta, R., Gambardella, A., Venturini, M., Di Meo, N., Quaglino, P., Broganelli, P., Di Stefani A., Peris K. (ORCID:0000-0002-5237-0463), Zalaudek I., Ribero, S., Argenziano, G., Di Stefani, A., Guidante, M., Moscarella, E., Peris, K., Manganoni, A., Ingordo, V., Zalaudek, I., Senetta, R., Gambardella, A., Venturini, M., Di Meo, N., Quaglino, P., Broganelli, P., Di Stefani A., Peris K. (ORCID:0000-0002-5237-0463), and Zalaudek I.

Abstract

na

Published
2020

17. Diagnosis and treatment of Merkel cell carcinoma: European consensus-based interdisciplinary guideline – Update 2022

Author

Gauci, M. -L., Aristei, Cynthia, Becker, J. C., Blom, A., Bataille, V., Dreno, B., Del Marmol, V., Forsea, A. M., Fargnoli, Maria Concetta, Grob, J. -J., Gomes, F., Hauschild, A., Hoeller, C., Harwood, C., Kelleners-Smeets, N., Kaufmann, R., Lallas, A., Malvehy, J., Moreno-Ramirez, D., Peris, Ketty, Pellacani, G., Saiag, P., Stratigos, A. J., Vieira, R., Zalaudek, Iri, van Akkooi, A. C. J., Lorigan, P., Garbe, C., Lebbe, C., Aristei C., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Zalaudek I., Gauci, M. -L., Aristei, Cynthia, Becker, J. C., Blom, A., Bataille, V., Dreno, B., Del Marmol, V., Forsea, A. M., Fargnoli, Maria Concetta, Grob, J. -J., Gomes, F., Hauschild, A., Hoeller, C., Harwood, C., Kelleners-Smeets, N., Kaufmann, R., Lallas, A., Malvehy, J., Moreno-Ramirez, D., Peris, Ketty, Pellacani, G., Saiag, P., Stratigos, A. J., Vieira, R., Zalaudek, Iri, van Akkooi, A. C. J., Lorigan, P., Garbe, C., Lebbe, C., Aristei C., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), and Zalaudek I.

Abstract

Merkel cell carcinoma (MCC) is a rare skin cancer, accounting for less than 1% of all cutaneous malignancies. It is found predominantly in white populations and risk factors include advanced age, ultraviolet exposure, male sex, immunosuppression, such as AIDS/HIV infection, haematological malignancies or solid organ transplantation, and Merkel cell polyomavirus infection. MCC is an aggressive tumour with 26% of cases presenting lymph node involvement at diagnosis and 8% with distant metastases. Five-year overall survival rates range between 48% and 63%. Two subsets of MCC have been characterised with distinct molecular pathogenetic pathways: ultraviolet-induced MCC versus virus-positive MCC, which carries a better prognosis. In both subtypes, there are alterations in the retinoblastoma protein and p53 gene structure and function. MCC typically manifests as a red nodule or plaque with fast growth, most commonly on sun exposed areas. Histopathology (small-cell neuroendocrine appearance) and immunohistochemistry (CK20 positivity and TTF-1 negativity) confirm the diagnosis. The current staging systems are the American Joint Committee on Cancer/Union for international Cancer control 8th edition. Baseline whole body imaging is encouraged to rule out regional and distant metastasis. For localised MCC, first-line treatment is surgical excision with postoperative margin assessment followed by adjuvant radiation therapy (RT). Sentinel lymph node biopsy is recommended in all patients with MCC without clinically detectable lymph nodes or distant metastasis. Adjuvant RT alone, eventually combined with complete lymph nodes dissection is proposed in case of micrometastatic nodal involvement. In case of macroscopic nodal involvement, the standard of care is complete lymph nodes dissection potentially followed by post-operative RT. Immunotherapy with anti-PD-(L)1 antibodies should be offered as first-line systemic treatment in advanced MCC. Chemotherapy can be used when patients fai

Published
2022

18. European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022

Author

Garbe, C., Amaral, T., Peris, Ketty, Hauschild, A., Arenberger, P., Basset-Seguin, N., Bastholt, L., Bataille, V., del Marmol, V., Dreno, B., Fargnoli, Maria Concetta, Forsea, A. -M., Grob, J. -J., Holler, C., Kaufmann, R., Kelleners-Smeets, N., Lallas, A., Lebbe, C., Lytvynenko, B., Malvehy, J., Moreno-Ramirez, D., Nathan, P., Pellacani, G., Saiag, P., Stratigos, A. J., Van Akkooi, A. C. J., Vieira, R., Zalaudek, Iri, Lorigan, P., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Zalaudek I., Garbe, C., Amaral, T., Peris, Ketty, Hauschild, A., Arenberger, P., Basset-Seguin, N., Bastholt, L., Bataille, V., del Marmol, V., Dreno, B., Fargnoli, Maria Concetta, Forsea, A. -M., Grob, J. -J., Holler, C., Kaufmann, R., Kelleners-Smeets, N., Lallas, A., Lebbe, C., Lytvynenko, B., Malvehy, J., Moreno-Ramirez, D., Nathan, P., Pellacani, G., Saiag, P., Stratigos, A. J., Van Akkooi, A. C. J., Vieira, R., Zalaudek, Iri, Lorigan, P., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., and Zalaudek I.

Abstract

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed with dermatoscopy. If a melanoma is suspected, a histopathological examination is always required. Sequential digital dermatoscopy and full body photography can be used in high-risk patients to improve the detection of early melanoma. Where available, confocal reflectance microscopy can also improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the American Joint Committee on Cancer classification. Thin melanomas up to 0.8 mm tumor thickness do not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC onwards whole-body examinations with computed tomography (CT) or positron emission tomography CT (PET-CT) in combination with brain magnetic resonance imaging are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to define the frequency and extent of examinations. A stage-based follow-up scheme is proposed which, according to the experience of the guideline group, covers the optimal requirements, but further studies may be considered. This guideline is valid until the end of 2024.

Published
2022

19. Cutaneous adverse reactions following SARS-CoV-2 vaccine booster dose: a real-life multicentre experience

Author

Avallone, Giulia, Cavallo, F., Astrua, C., Caldarola, Giacomo, Conforti, C., De Simone, Clara, di Meo, N., Di Stefani, Alessandro, Genovese, G., Maronese, C. A., Marzano, A. V., Parente, R., Quaglino, P., Roccuzzo, G., Tassone, F., Zalaudek, Iri, Senetta, R., Ribero, S., Avallone G., Caldarola G. (ORCID:0000-0002-8837-9232), De Simone C. (ORCID:0000-0002-0898-0045), di Stefani A., Zalaudek I., Avallone, Giulia, Cavallo, F., Astrua, C., Caldarola, Giacomo, Conforti, C., De Simone, Clara, di Meo, N., Di Stefani, Alessandro, Genovese, G., Maronese, C. A., Marzano, A. V., Parente, R., Quaglino, P., Roccuzzo, G., Tassone, F., Zalaudek, Iri, Senetta, R., Ribero, S., Avallone G., Caldarola G. (ORCID:0000-0002-8837-9232), De Simone C. (ORCID:0000-0002-0898-0045), di Stefani A., and Zalaudek I.

Abstract

nd

Published
2022

20. European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics: Update 2022

Author

Garbe, C. Amaral, T. Peris, K. Hauschild, A. Arenberger, P. Basset-Seguin, N. Bastholt, L. Bataille, V. del Marmol, V. Dréno, B. Fargnoli, M.C. Forsea, A.-M. Grob, J.-J. Höller, C. Kaufmann, R. Kelleners-Smeets, N. Lallas, A. Lebbé, C. Lytvynenko, B. Malvehy, J. Moreno-Ramirez, D. Nathan, P. Pellacani, G. Saiag, P. Stratigos, A.J. Van Akkooi, A.C.J. Vieira, R. Zalaudek, I. Lorigan, P. European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), the European Organization for Research Treatment of Cancer (EORTC)

Abstract

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multi-disciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed with dermatoscopy. If a melanoma is suspected, a histopathological examination is always required. Sequential digital dermatoscopy and full body photography can be used in high-risk patients to improve the detection of early melanoma. Where available, confocal reflectance microscopy can also improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the American Joint Committee on Cancer classification. Thin melanomas up to 0.8 mm tumor thickness do not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC onwards whole-body examinations with computed tomography (CT) or positron emission tomography CT (PET-CT) in combination with brain magnetic resonance imaging are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to define the frequency and extent of examinations. A stage-based follow-up scheme is proposed which, according to the experience of the guideline group, covers the optimal requirements, but further studies may be considered. This guideline is valid until the end of 2024. © 2022 Elsevier Ltd

Published
2022

21. Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines.

Author

Peris, K, Fargnoli, Mc, Garbe, C, Kaufmann, R, Bastholt, L, Seguin, Nb, Bataille, V, Marmol, Vd, Dummer, R, Harwood, Ca, Hauschild, A, Höller, C, Haedersdal, M, Malvehy, J, Middleton, Mr, Morton, Ca, Nagore, E, Stratigos, Aj, Szeimies, Rm, Tagliaferri, L, Trakatelli, M, Zalaudek, I, Eggermont, A, Grob, Jj, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC)., Peris K (ORCID:0000-0002-5237-0463), Tagliaferri L (ORCID:0000-0003-2308-0982), Zalaudek I, Peris, K, Fargnoli, Mc, Garbe, C, Kaufmann, R, Bastholt, L, Seguin, Nb, Bataille, V, Marmol, Vd, Dummer, R, Harwood, Ca, Hauschild, A, Höller, C, Haedersdal, M, Malvehy, J, Middleton, Mr, Morton, Ca, Nagore, E, Stratigos, Aj, Szeimies, Rm, Tagliaferri, L, Trakatelli, M, Zalaudek, I, Eggermont, A, Grob, Jj, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organization for Research and Treatment of Cancer (EORTC)., Peris K (ORCID:0000-0002-5237-0463), Tagliaferri L (ORCID:0000-0003-2308-0982), and Zalaudek I

Abstract

Basal cell carcinoma (BCC) is the most common malignant tumour in white populations. Multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer collaborated to develop recommendations on diagnosis and treatment of BCC. A new classification into 'easy-to-treat (common) BCC and 'difficult-to-treat' BCC is proposed. Diagnosis is based on clinicodermatoscopic features for 'easy-to-treat' BCCs. Histopathological confirmation is mandatory in ambiguous lesions and in BCCs located in high-risk areas. The first-line treatment of 'easy-to-treat' BCC is complete surgery. Microscopically controlled surgery shall be offered for high-risk BCC, recurrent BCC and BCC in critical anatomical sites. Topical therapies (5% imiquimod, 5% fluorouracil) and destructive approaches (curettage, electrocautery, cryotherapy, laser ablation) should be considered in patients with low-risk superficial BCC. Photodynamic therapy is an effective treatment for superficial BCC and thin nodular BCC. The therapy for a 'difficult-to-treat' BCC should preferentially be discussed by a multidisciplinary tumour board. Hedgehog inhibitors, vismodegib or sonidegib, should be offered to patients with locally advanced and metastatic BCCs. Immunotherapy with anti-programmed cell death 1 (PD-1) antibodies is a promising therapeutic option, currently being investigated in clinical trials. Radiotherapy represents a valid alternative to surgery for BCC on the face, especially in elderly patients. In patients with naevoid basal cell carcinoma syndrome (NBCCS), close surveillance and regular skin examinations are required to diagnose and treat BCCs at early stage. Long-term follow-up is recommended in patients with high-risk BCC subtypes, high-risk sites, multiple BCCs and NBCCS.

Published
2019

22. A multicentre study of naevus-associated melanoma vs. de novo melanoma, tumour thickness and body site differences*

Author

Dessinioti, C. Geller, A.C. Stergiopoulou, A. Dimou, N. Lo, S. Keim, U. Gershenwald, J.E. Haydu, L.E. Dummer, R. Mangana, J. Hauschild, A. Egberts, F. Vieira, R. Brinca, A. Zalaudek, I. Deinlein, T. Evangelou, E. Thompson, J.F. Scolyer, R.A. Peris, K. Garbe, C. Stratigos, A.J.

Abstract

Background: Whether melanoma in histological contiguity with a naevus [naevus-associated melanoma (NAM)] is distinctly different from melanoma arising de novo remains unclear. Objectives: To determine whether the characteristics of de novo melanoma differ from NAM and are not due to naevus obliteration in thicker tumours. Methods: We conducted a multicentre retrospective study of de novo melanoma and NAM in seven referral centres in Europe, Australia and the USA between 2006 and 2015. Results: In a total of 9474 localized melanomas, de novo melanoma was associated with thicker tumours and body site differences compared with NAM. In the subset of T1 melanomas (n = 5307), similar body site differences were found in multivariate analysis by body site. When compared with NAM, de novo melanoma was more likely to affect older individuals (≥ 70 years) when located on the head/neck [odds ratio (OR) 4·65, 95% confidence interval (CI) 2·55–8·46], the trunk (OR 1·82, 95% CI 1·40–2·36) or the upper extremity (OR 1·69, 95% CI 1·14–2·50), was more likely to affect female patients when located on the lower extremities (OR 1·36, 95% CI 1·03–1·80), and was more likely to be of the nodular melanoma subtype (OR 2·23, 95% CI 1·14–4·35) when located on the trunk. De novo melanoma was less likely to have regression present compared with NAM. Conclusions: Clinicopathological and body site differences between de novo melanoma and NAM support the divergent pathway model of development. These differences were also found in thin melanomas, suggesting that de novo melanomas are different from NAM and their differences are not due to the obliteration of naevus remnants in thicker tumours. © 2021 British Association of Dermatologists

Published
2021

23. Position statement on classification of basal cell carcinomas. Part 1: unsupervised clustering of experts as a way to build an operational classification of advanced basal cell carcinoma based on pattern recognition

Author

Grob, J. J. Guminski, A. Malvehy, J. Basset-seguin, N. and Bertrand, B. Fernandez-Penas, P. Kaufmann, R. Zalaudek, I and Gaudy-Marqueste, C. Fargnoli, M. C. Tagliaferri, L. and Fertil, B. Del Marmol, V Stratigos, A. Garbe, C. Peris, K.

Abstract

Background No simple classification system has emerged for `advanced basal cell carcinomas', and more generally for all difficult-to-treat BCCs (DTT-BCCs), due to the heterogeneity of situations, TNM inappropriateness to BCCs, and different approaches of different specialists. Objective To generate an operational classification, using the unconscious ability of experts to simplify the great heterogeneity of the clinical situations into a few relevant groups, which drive their treatment decisions. Method Non-supervised independent and blinded clustering of real clinical cases of DTT-BCCs was used. Fourteen international experts from different specialties independently partitioned 199 patient cases considered `difficult to treat' into as many clusters they want (

Published
2021

24. Position statement on Classification of Basal Cell Carcinomas. Part 2: EADO proposal for new operational staging system adapted to Basal Cell Carcinomas

Author

Grob, J. J. Gaudy-Marqueste, C. Guminski, A. Malvehy, J. and Basset-seguin, N. Bertrand, B. Fernandez-Penas, P. Kaufmann, R. Zalaudek, I. Fargnoli, M. C. Tagliaferri, L. Fertil, B. Del Marmol, V. Stratigos, A. Garbe, C. Peris, K.

Abstract

Background No simple staging system has emerged for basal cell carcinomas (BCCs), since they do not follow the TNM process, and practitioners failed to agree on simple clinical or pathological criteria as a basis for a classification. Operational classification of BCCs is required for decision-making, trials and guidelines. Unsupervised clustering of real cases of difficult-to-treat BCCs (DTT-BCCs; part 1) has demonstrated that experts could blindly agree on a five groups classification of DTT-BCCs based on five patterns of clinical situations. Objective Using this five patterns to generate an operational and comprehensive classification of BCCs. Method Testing practitioner’s agreement, when using the five patterns classification to ensure that it is robust enough to be used in the practice. Generating the first version of a staging system of BCCs based on pattern recognition. Results Sixty-two physicians, including 48 practitioners and the 14 experts who participated in the generation of the five different patterns of DTT-BCCs, agreed on 90% of cases when classifying 199 DTT-BCCs cases using the five patterns classification (part 1) attesting that this classification is understandable and usable in practice. In order to cover the whole field of BCCs, these five groups of DTT-BCCs were added a group representing the huge number of easy-to-treat BCCs, for which sub-classification has little interest, and a group of very rare metastatic cases, resulting in a four-stage and seven-substage staging system of BCCs. Conclusion A practical classification adapted to the specificities of BCCs is proposed. It is the first tumour classification based on pattern recognition of clinical situations, which proves to be consistent and usable. This EADO staging system version 1 will be improved step by step and tested as a decision tool and a prognostic instrument.

Published
2021

25. Dermatoscopy of combined blue nevi: a multicentre study of the International Dermoscopy Society.

Author

UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - SSS/IRSS - Institut de recherche santé et société, Stojkovic-Filipovic, J, Tiodorovic, D, Lallas, A, Akay, B N, Longo, C, Rosendahl, C, Dobrosavljevic, D, Nazzaro, G, Argenziano, G, Zalaudek, I, Tromme, Isabelle, Tschandl, P, Puig, S, Lanssens, S, Kittler, H, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - SSS/IRSS - Institut de recherche santé et société, Stojkovic-Filipovic, J, Tiodorovic, D, Lallas, A, Akay, B N, Longo, C, Rosendahl, C, Dobrosavljevic, D, Nazzaro, G, Argenziano, G, Zalaudek, I, Tromme, Isabelle, Tschandl, P, Puig, S, Lanssens, S, and Kittler, H

Abstract

Combined blue nevi (CBN) may mimic melanoma and are relatively often biopsied for diagnostic reasons. To better characterize CBN and to compare it with melanoma. We collected clinical and dermatoscopic images of 111 histologically confirmed CBN and contrasted their dermatoscopic characteristics with 132 partly blue coloured melanomas. Furthermore, we compared the accuracy of human experts using pattern analysis with a computer algorithm based on deep learning. Combined blue nevi are usually flat or slightly elevated and, in comparison with melanoma, more frequent on the head and neck. Dermatoscopically, they are typified by a blue structureless part in combination with either brown clods (n = 52, 46.8%), lines (n = 28, 25.2%) or skin-coloured or brown structureless areas (n = 31, 27.9%). In contrast with melanoma, the blue part of CBN is more often well defined (18.9% vs. 4.5%, P < 0.001) and more often located in the centre (22.5% vs. 5.3%, P < 0.001). Melanomas are more often chaotic (OR: 28.7, 95% CI: 14.8-55.7, P < 0.001), have at least one melanoma clue (OR: 10.8, 95% CI: 5.2-22.2 P < 0.001) in particular white lines (OR: 37.1, 95% CI: 13.4-102.9, P < 0.001). Using simplified pattern analysis (chaos and clues), two raters reached sensitivities of 93.9% (95% CI: 88.4-97.3%) and 92.4% (95% CI: 86.5-96.3%) at corresponding specificities of 59.5% (95% CI: 49.7-68.7%) and 65.8% (95% CI: 56.2-74.5%). The human accuracy with pattern analysis was on par with a state-of-the-art computer algorithm based on deep learning that achieved an area under the curve of (0.92, 95% CI: 0.87-0.96) and a specificity of 85.3% (95% CI: 76.5-91.7%) at a given sensitivity of 83.6% (95% CI: 72.5-91.5%). CBN usually lack melanoma clues, in particular white lines. The accuracy of pattern analysis for combined nevi is acceptable, and histopathologic confirmation may not be necessary in exemplary cases.

Published
2021

26. Adverse cutaneous and mucous reactions from anti SARS-CoV-2 vaccines: Recommendations from the Italian Society of Dermatology (SIDeMaST)

Author

Stingeni, L., Bianchi, L., Zalaudek, Iri, Pigatto, P. D., Peris, Ketty, Patruno, C., Fabbrocini, G., Micali, G., Napolitano, M., Tramontana, M., Hansel, K., Zalaudek I., Peris K. (ORCID:0000-0002-5237-0463), Stingeni, L., Bianchi, L., Zalaudek, Iri, Pigatto, P. D., Peris, Ketty, Patruno, C., Fabbrocini, G., Micali, G., Napolitano, M., Tramontana, M., Hansel, K., Zalaudek I., and Peris K. (ORCID:0000-0002-5237-0463)

Abstract

na

Published
2021

27. A multicentre study of naevus-associated melanoma vs. de novo melanoma, tumour thickness and body site differences*

Author

Dessinioti, C., Geller, A. C., Stergiopoulou, A., Dimou, N., Lo, S., Keim, U., Gershenwald, J. E., Haydu, L. E., Dummer, R., Mangana, J., Hauschild, A., Egberts, F., Vieira, R., Brinca, A., Zalaudek, Iri, Deinlein, T., Evangelou, E., Thompson, J. F., Scolyer, R. A., Peris, Ketty, Garbe, C., Stratigos, A. J., Zalaudek I., Peris K. (ORCID:0000-0002-5237-0463), Dessinioti, C., Geller, A. C., Stergiopoulou, A., Dimou, N., Lo, S., Keim, U., Gershenwald, J. E., Haydu, L. E., Dummer, R., Mangana, J., Hauschild, A., Egberts, F., Vieira, R., Brinca, A., Zalaudek, Iri, Deinlein, T., Evangelou, E., Thompson, J. F., Scolyer, R. A., Peris, Ketty, Garbe, C., Stratigos, A. J., Zalaudek I., and Peris K. (ORCID:0000-0002-5237-0463)

Abstract

Background: Whether melanoma in histological contiguity with a naevus [naevus-associated melanoma (NAM)] is distinctly different from melanoma arising de novo remains unclear. Objectives: To determine whether the characteristics of de novo melanoma differ from NAM and are not due to naevus obliteration in thicker tumours. Methods: We conducted a multicentre retrospective study of de novo melanoma and NAM in seven referral centres in Europe, Australia and the USA between 2006 and 2015. Results: In a total of 9474 localized melanomas, de novo melanoma was associated with thicker tumours and body site differences compared with NAM. In the subset of T1 melanomas (n = 5307), similar body site differences were found in multivariate analysis by body site. When compared with NAM, de novo melanoma was more likely to affect older individuals (≥ 70 years) when located on the head/neck [odds ratio (OR) 4·65, 95% confidence interval (CI) 2·55–8·46], the trunk (OR 1·82, 95% CI 1·40–2·36) or the upper extremity (OR 1·69, 95% CI 1·14–2·50), was more likely to affect female patients when located on the lower extremities (OR 1·36, 95% CI 1·03–1·80), and was more likely to be of the nodular melanoma subtype (OR 2·23, 95% CI 1·14–4·35) when located on the trunk. De novo melanoma was less likely to have regression present compared with NAM. Conclusions: Clinicopathological and body site differences between de novo melanoma and NAM support the divergent pathway model of development. These differences were also found in thin melanomas, suggesting that de novo melanomas are different from NAM and their differences are not due to the obliteration of naevus remnants in thicker tumours.

Published
2021

28. Position statement on classification of basal cell carcinomas. Part 1: unsupervised clustering of experts as a way to build an operational classification of advanced basal cell carcinoma based on pattern recognition

Author

Grob, J. J., Guminski, A., Malvehy, J., Basset-seguin, N., Bertrand, B., Fernandez-Penas, P., Kaufmann, R., Zalaudek, Iri, Gaudy-Marqueste, C., Fargnoli, Maria Concetta, Tagliaferri, Luca, Fertil, B., Del Marmol, V., Stratigos, A., Garbe, C., Peris, Ketty, Zalaudek I., Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), Peris K. (ORCID:0000-0002-5237-0463), Grob, J. J., Guminski, A., Malvehy, J., Basset-seguin, N., Bertrand, B., Fernandez-Penas, P., Kaufmann, R., Zalaudek, Iri, Gaudy-Marqueste, C., Fargnoli, Maria Concetta, Tagliaferri, Luca, Fertil, B., Del Marmol, V., Stratigos, A., Garbe, C., Peris, Ketty, Zalaudek I., Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), and Peris K. (ORCID:0000-0002-5237-0463)

Abstract

Background: No simple classification system has emerged for ‘advanced basal cell carcinomas’, and more generally for all difficult-to-treat BCCs (DTT-BCCs), due to the heterogeneity of situations, TNM inappropriateness to BCCs, and different approaches of different specialists. Objective: To generate an operational classification, using the unconscious ability of experts to simplify the great heterogeneity of the clinical situations into a few relevant groups, which drive their treatment decisions. Method: Non-supervised independent and blinded clustering of real clinical cases of DTT-BCCs was used. Fourteen international experts from different specialties independently partitioned 199 patient cases considered ‘difficult to treat’ into as many clusters they want (≤10), choosing their own criteria for partitioning. Convergences and divergences between the individual partitions were analyzed using the similarity matrix, K-mean approach, and average silhouette method. Results: There was a rather consensual clustering of cases, regardless of the specialty and nationality of the experts. Mathematical analysis showed that consensus between experts was best represented by a partition of DTT-BCCs into five clusters, easily recognized a posteriori as five clear-cut patterns of clinical situations. The concept of ‘locally advanced’ did not appear consistent between experts. Conclusion: Although convergence between experts was not granted, this experiment shows that clinicians dealing with BCCs all tend to work by a similar pattern recognition based on the overall analysis of the situation. This study thus provides the first consensual classification of DTT-BCCs. This experimental approach using mathematical analysis of independent and blinded clustering of cases by experts can probably be applied to many other situations in dermatology and oncology.

Published
2021

29. Real-life experience on effectiveness and safety of dupilumab in adult patients with moderate-to-severe atopic dermatitis

Author

Fargnoli, Maria Concetta, Esposito, M., Ferrucci, S., Girolomoni, G., Offidani, A., Patrizi, A., Peris, Ketty, Costanzo, Rosa Maria Alba, Malara, G., Pellacani, G., Romanelli, Margherita, Amerio, P., Cristaudo, A., Flori, M. L., Motolese, A., Betto, P., Patruno, C., Pigatto, P., Sirna, R., Stinco, G., Zalaudek, Iri, Bianchi, L., Boccaletti, V., Cannavo, S. P., Cusano, F., Lembo, S., Mozzillo, R., Gallo, Rosanna, Potenza, C., Rongioletti, F., Tiberio, R., Grieco, T., Micali, G., Persechino, S., Pettinato, M., Pucci, S., Savi, E., Stingeni, L., Romano, A., Argenziano, G., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Costanzo A., Romanelli M., Zalaudek I., Gallo R., Fargnoli, Maria Concetta, Esposito, M., Ferrucci, S., Girolomoni, G., Offidani, A., Patrizi, A., Peris, Ketty, Costanzo, Rosa Maria Alba, Malara, G., Pellacani, G., Romanelli, Margherita, Amerio, P., Cristaudo, A., Flori, M. L., Motolese, A., Betto, P., Patruno, C., Pigatto, P., Sirna, R., Stinco, G., Zalaudek, Iri, Bianchi, L., Boccaletti, V., Cannavo, S. P., Cusano, F., Lembo, S., Mozzillo, R., Gallo, Rosanna, Potenza, C., Rongioletti, F., Tiberio, R., Grieco, T., Micali, G., Persechino, S., Pettinato, M., Pucci, S., Savi, E., Stingeni, L., Romano, A., Argenziano, G., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Costanzo A., Romanelli M., Zalaudek I., and Gallo R.

Abstract

Background: Dupilumab, a fully human monoclonal antibody targeting the alpha subunit of IL-4 was recently approved for the treatment of moderate-to-severe atopic dermatitis (AD) in adult patients. Objective: To assess dupilumab effectiveness and safety in adults with moderate-to-severe AD in a real-life Italian multicentre retrospective cohort. Methods: Adult moderate-to-severe AD patients, referring to 39 Italian centers, received dupilumab in the context of a national patient access program. Disease assessment was performed at baseline, after 4 and 16 weeks of treatment using Eczema-Area-and-Severity-Index (EASI) score, itch and sleep numerical-rating-score (itch-NRS, sleep-NRS) and Dermatology-Life-Quality-Index (DLQI). Results: A total of 109 (71 M/38F) patients was studied. There was a significant reduction in EASI score, itch-NRS, sleep-NRS and DLQI from baseline to week 4 and a further significant decline to week 16. EASI 50, EASI75 and EASI90 were achieved by 59.6%, 28.4% and 9.3% of patients at 4 weeks and by 87.2%, 60.6% and 32.4% of them at 16 weeks, respectively. Adverse events were experienced by 19.2% (21/109) of the patients and they were all mild in intensity, being conjunctivitis the most common side effect. Conclusions: Dupilumab significantly improved disease severity, pruritus, sleep loss and quality of life with an acceptable safety profile.

Published
2021

30. Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC)

Author

Lebbe C, Garbe C, Stratigos AJ, Harwood C, Peris K, Marmol VD, Malvehy J, Zalaudek I, Hoeller C, Dummer R, Forsea AM, Kandolf-Sekulovic L, Olah J, Arenberger P, Bylaite-Bucinskiene M, Vieira R, Middleton M, Levy A, Eggermont AM, Battistella M, Spano JP, Grob JJ, Pages C, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation for Research and Treatment of Cancer (EORTC)., Lebbe, C, Garbe, C, Stratigos, Aj, Harwood, C, Peris, K, Marmol, Vd, Malvehy, J, Zalaudek, I, Hoeller, C, Dummer, R, Forsea, Am, Kandolf-Sekulovic, L, Olah, J, Arenberger, P, Bylaite-Bucinskiene, M, Vieira, R, Middleton, M, Levy, A, Eggermont, Am, Battistella, M, Spano, Jp, Grob, Jj, Pages, C, European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation for Research and Treatment of Cancer (EORTC)., University of Zurich, and Lebbe, Celeste

Subjects
0301 basic medicine, Oncology, Male, Cancer Research, medicine.medical_specialty, Electrochemotherapy, Consensus, EADO, medicine.medical_treatment, 610 Medicine & health, Disease, Kaposi, Guideline, 03 medical and health sciences, 0302 clinical medicine, Immune reconstitution inflammatory syndrome, Risk Factors, Internal medicine, medicine, Humans, 1306 Cancer Research, Kaposi's sarcoma, Sarcoma, Kaposi, business.industry, EDF, EORTC, Sarcoma, 10177 Dermatology Clinic, medicine.disease, Radiation therapy, Europe, 030104 developmental biology, Lymphatic system, 030220 oncology & carcinogenesis, 2730 Oncology, Female, business, Settore MED/35 - MALATTIE CUTANEE E VENEREE
Abstract

Kaposi's sarcoma (KS) is a multifocal neoplasm of lymphatic endothelium-derived cells infected with human herpesvirus 8. Four clinical subtypes are distinguished: the classic, the endemic, the epidemic subtype in HIV positive patients and the iatrogenic subtype. The diagnosis is primarily based on clinical features and confirmation by histology with immunohistochemistry. Cutaneous distribution and severity, mucosal, nodal and visceral involvement depend on the type of KS with in general indolent behaviour and chronic evolution in the classic subtype and the more severe forms in iatrogenic or epidemic subtypes. Management should aim at achieving disease control. For localised lesions, several local therapies have been developed without randomised trial comparisons. Radiotherapy, intralesional chemotherapies and electrochemotherapy have high response rates. Topical treatments-imiquimod or topical 9-cis-retinoid acid-can also be used. Systemic treatments are reserved for locally aggressive extensive and disseminated KS: the recommended first-line agents are pegylated liposomal doxorubicin (PLD) and paclitaxel. In CKS, PLD or low-dose interferon-alfa are the recommended first-line agents in younger patients. In AIDS-related KS, combination antiretroviral therapy is the first treatment option; specific systemic treatment is needed only in case of extensive disease and in the prevention and treatment of immune reconstitution inflammatory syndrome. In post-transplant KS, tapering down immunosuppressive therapy and switching to mammalian target of rapamycin (m-TOR) inhibitors are used. Follow-up schedules for patients with KS disease depend on aggressiveness of the disease.

Published
2019

31. Response to: Comment on ‘Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines’

Author

Peris, K. Fargnoli, M.C. Garbe, C. Kaufmann, R. Bastholt, L. Seguin, N.B. Bataille, V. del Marmol, V. Dummer, R. Harwood, C.A. Hauschild, A. Höller, C. Haedersdal, M. Malvehy, J. Middleton, M.R. Morton, C.A. Nagore, E. Stratigos, A.J. Szeimies, R.-M. Tagliaferri, L. Trakatelli, M. Zalaudek, I. Eggermont, A. Grob, J.J. the European Dermatology Forum (EDF) the European Association of Dermato-Oncology (EADO) the European Organization for Research Treatment of Cancer (EORTC)

Published
2020

32. European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 1. epidemiology, diagnostics and prevention

Author

Stratigos, A.J. Garbe, C. Dessinioti, C. Lebbe, C. Bataille, V. Bastholt, L. Dreno, B. Fargnoli, M.C. Forsea, A.M. Frenard, C. Harwood, C.Α. Hauschild, A. Hoeller, C. Kandolf-Sekulovic, L. Kaufmann, R. Kelleners-Smeets, N.W. Malvehy, J. del Marmol, V. Middleton, M.R. Moreno-Ramirez, D. Pellecani, G. Peris, K. Saiag, P. van den Beuken-van Everdingen, M.H.J. Vieira, R. Zalaudek, I. Eggermont, A.M.M. Grob, J.-J. the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) the European Organization for Research Treatment of Cancer (EORTC)

Abstract

Invasive cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in the white populations, accounting for 20% of all cutaneous malignancies. Factors implicated in cSCC etiopathogenesis include ultraviolet radiation exposure and chronic photoaging, age, male sex, immunosuppression, smoking and genetic factors. A collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation of Research and Treatment of Cancer (EORTC) was formed to update recommendations on cSCC classification, diagnosis, risk stratification, staging and prevention, based on current literature, staging systems and expert consensus. Common cSCCs are typically indolent tumors, and most have a good prognosis with 5-year cure rates of greater than 90%, and a low rate of metastases (

Published
2020

33. Inequalities in the patterns of dermoscopy use and training across Europe: conclusions of the Eurodermoscopy pan-European survey

Author

Forsea, A.-M. Tschandl, P. Zalaudek, I. Del Marmol, V. Soyer, H.P. Argenziano, G. Geller, A.C. Arenbergerova, M. Azenha, A. Blum, A. Bowling, J.C. Braun, R.P. Bylaite-Bucinskiene, M. Čabrijan, L. Dobrev, H. Helppikangas, H. Karls, R. Krumkachou, U. Kukutsch, N. McCormack, I. Mekokishvili, L. Nathansohn, N. Nielsen, K. Olah, J. Özdemir, F. Puig, S. Rubegni, P. Rucigaj, T.P. Schopf, T.R. Sergeev, V. Stratigos, A. Thomas, L. Tiodorovic, D. Vahlberg, A. Zafirovik, Z. Eurodermoscopy Working Group

Abstract

Background: Dermoscopy is a widely used technique, recommended in clinical practice guidelines worldwide for the early diagnosis of skin cancers. Intra-European disparities are reported for early detection and prognosis of skin cancers, however, no information exists about regional variation in patterns of dermoscopy use across Europe. Objective: To evaluate the regional differences in patterns of dermoscopy use and training among European dermatologists. Materials & Methods: An online survey of European-registered dermatologists regarding dermoscopy training, practice and attitudes was established. Answers from Eastern (EE) versus Western European (WE) countries were compared and their correlation with their respective countries’ gross domestic product/capita (GDPc) and total and government health expenditure/capita (THEc and GHEc) was analysed. Results: We received 4,049 responses from 14 WE countries and 3,431 from 18 EE countries. A higher proportion of WE respondents reported dermoscopy use (98% vs. 77%, p

Published
2020

34. The evolving field of Dermato-oncology and the role of dermatologists: Position Paper of the EADO, EADV and Task Forces, EDF, IDS, EBDV–UEMS and EORTC Cutaneous Lymphoma Task Force

Author

Garbe, C. Peris, K. Soura, E. Forsea, A.M. Hauschild, A. Arenbergerova, M. Bylaite, M. del Marmol, V. Bataille, V. Samimi, M. Gandini, S. Saiag, P. Eigentler, T.K. Lallas, A. Zalaudek, I. Lebbe, C. Grob, J.-J. Hoeller, C. Robert, C. Dréno, B. Arenberger, P. Kandolf-Sekulovic, L. Kaufmann, R. Malvehy, J. Puig, S. Leiter, U. Ribero, S. Papadavid, E. Quaglino, P. Bagot, M. John, S.M. Richard, M.-A. Trakatelli, M. Salavastru, C. Borradori, L. Marinovic, B. Enk, A. Pincelli, C. Ioannides, D. Paul, C. Stratigos, A.J.

Abstract

Background: The incidence of skin cancers has been increasing steadily over the last decades. Although there have been significant breakthroughs in the management of skin cancers with the introduction of novel diagnostic tools and innovative therapies, skin cancer mortality, morbidity and costs heavily burden the society. Objective: Members of the European Association of Dermato-Oncology, European Academy of Dermatology and Venereology, International Dermoscopy Society, European Dermatology Forum, European Board of Dermatovenereology of the European Union of Medical Specialists and EORTC Cutaneous Lymphoma Task Force have joined this effort to emphasize the fundamental role that the specialist in Dermatology–Venereology has in the diagnosis and management of different types of skin cancer. We review the role of dermatologists in the prevention, diagnosis, treatment and follow-up of patients with melanoma, non-melanoma skin cancers and cutaneous lymphomas, and discuss approaches to optimize their involvement in effectively addressing the current needs and priorities of dermato-oncology. Discussion: Dermatologists play a crucial role in virtually all aspects of skin cancer management including the implementation of primary and secondary prevention, the formation of standardized pathways of care for patients, the establishment of specialized skin cancer treatment centres, the coordination of an efficient multidisciplinary team and the setting up of specific follow-up plans for patients. Conclusion: Skin cancers represent an important health issue for modern societies. The role of dermatologists is central to improving patient care and outcomes. In view of the emerging diagnostic methods and treatments for early and advanced skin cancer, and considering the increasingly diverse skills, knowledge and expertise needed for managing this heterogeneous group of diseases, dermato-oncology should be considered as a specific subspecialty of Dermatology–Venereology. © 2020 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology

Published
2020

35. Comment on ‘Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines’

Author

Peris, K. Fargnoli, M.C. Garbe, C. Kaufmann, R. Bastholt, L. Seguin, N.B. Bataille, V. del Marmol, V. Dummer, R. Harwood, C.A. Hauschild, A. Höller, C. Haedersdal, M. Malvehy, J. Middleton, M.R. Morton, C.A. Nagore, E. Stratigos, A.J. Szeimies, R.-M. Tagliaferri, L. Trakatelli, M. Zalaudek, I. Eggermont, A. Grob, J.J. European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) the European Organization for Research Treatment of Cancer (EORTC)

Published
2020

36. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society

Author

Sgouros, D. Lallas, A. Kittler, H. Zarras, A. Kyrgidis, A. Papageorgiou, C. Puig, S. Scope, A. Argenziano, G. Zalaudek, I. Pizzichetta, M.A. Marghoob, A. Liopyris, K. Malvehy, J. Oikonomou, C. Flórez, A. Braun, R. Cabo, H. Nazzaro, G. Lanssens, S. Menzies, S. Paoli, J. Kaminska – Winciorek, G. Longo, C. Katoulis, A. Apalla, Z. Ioannides, D. Thomas, L. Tromme, I. Ogata, D. Desinioti, C. Geller, A. Stratigos, A.

Abstract

Background: Thin nodular melanoma (NM) often lacks conspicuous melanoma-specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour. Objective: To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours. Methods: Retrospective, morphological case–control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed. Results: Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non-melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4-fold), white shiny streaks (2.9-fold) and irregular blue structureless area (2.4-fold) were predictors for thinner NM compared to non-melanoma nodular tumours. Overall, irregular blue structureless area (3.4-fold), dotted vessels (4.6-fold) and serpentine vessels (1.9-fold) were predictors of all NM compared to non-melanoma nodular lesions. Limitations: Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community. Conclusions: Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non-melanoma nodular tumours. © 2020 European Academy of Dermatology and Venereology

Published
2020

37. European consensus-based interdisciplinary guideline for melanoma. Part 2: Treatment – Update 2019

Author

Garbe, C., Amaral, T., Peris, K. (ORCID:0000-0002-5237-0463), Hauschild, A., Arenberger, P., Bastholt, L., Bataille, V., del Marmol, V., Dreno, B., Fargnoli, M. C., Grob, J. -J., Holler, C., Kaufmann, R., Lallas, A., Lebbe, C., Malvehy, J., Middleton, M., Moreno-Ramirez, D., Pellacani, G., Saiag, P., Stratigos, A. J., Vieira, R., Zalaudek, I., Eggermont, A. M. M., Garbe, C., Amaral, T., Peris, K. (ORCID:0000-0002-5237-0463), Hauschild, A., Arenberger, P., Bastholt, L., Bataille, V., del Marmol, V., Dreno, B., Fargnoli, M. C., Grob, J. -J., Holler, C., Kaufmann, R., Lallas, A., Lebbe, C., Malvehy, J., Middleton, M., Moreno-Ramirez, D., Pellacani, G., Saiag, P., Stratigos, A. J., Vieira, R., Zalaudek, I., and Eggermont, A. M. M.

Abstract

A unique collaboration of multidisciplinary experts from the European Dermatology Forum, the European Association of Dermato-Oncology and the European Organization for Research and Treatment of Cancer (EORTC) was formed to make recommendations on cutaneous melanoma diagnosis and treatment, based on systematic literature reviews and the experts' experience. Cutaneous melanomas are excised with 1- to 2-cm safety margins. Sentinel lymph node dissection shall be performed as a staging procedure in patients with tumour thickness ≥1.0 mm or ≥0.8 mm with additional histological risk factors, although there is as yet no clear survival benefit for this approach. Therapeutic decisions in stage III/IV patients should be primarily made by an interdisciplinary oncology team (“Tumor Board”). Adjuvant therapies in stage III/IV patients are primarily anti–PD-1, independent of mutational status, or dabrafenib plus trametinib for BRAF-mutant patients. In distant metastasis, either resected or not, systemic treatment is indicated. For first-line treatment, particularly in BRAF wild-type patients, immunotherapy with PD-1 antibodies alone or in combination with CTLA-4 antibodies shall be considered. In particular scenarios for patients with stage IV melanoma and a BRAF-V600 E/K mutation, first-line therapy with BRAF/MEK inhibitors can be offered as an alternative to immunotherapy. In patients with primary resistance to immunotherapy and harbouring a BRAF-V600 E/K mutation, this therapy shall be offered in second-line. Systemic therapy in stage III/IV melanoma is a rapidly changing landscape, and it is likely that these recommendations may change in the near future.

Published
2020

38. Dermatoscopic features of thin (≤2 mm Breslow thickness) vs. thick (>2 mm Breslow thickness) nodular melanoma and predictors of nodular melanoma versus nodular non-melanoma tumours: a multicentric collaborative study by the International Dermoscopy Society.

Author

UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service de dermatologie, Sgouros, D, Lallas, A, Kittler, H, Zarras, A, Kyrgidis, A, Papageorgiou, C, Puig, S, Scope, A, Argenziano, G, Zalaudek, I, Pizzichetta, M A, Marghoob, A, Liopyris, K, Malvehy, J, Oikonomou, C, Flórez, A, Braun, R, Cabo, H, Nazzaro, G, Lanssens, S, Menzies, S, Paoli, J, Kaminska-Winciorek, G, Longo, C, Katoulis, A, Apalla, Z, Ioannides, D, Thomas, L, Tromme, Isabelle, Ogata, D, Desinioti, C, Geller, A, Stratigos, A, UCL - SSS/IRSS - Institut de recherche santé et société, UCL - (SLuc) Service de dermatologie, Sgouros, D, Lallas, A, Kittler, H, Zarras, A, Kyrgidis, A, Papageorgiou, C, Puig, S, Scope, A, Argenziano, G, Zalaudek, I, Pizzichetta, M A, Marghoob, A, Liopyris, K, Malvehy, J, Oikonomou, C, Flórez, A, Braun, R, Cabo, H, Nazzaro, G, Lanssens, S, Menzies, S, Paoli, J, Kaminska-Winciorek, G, Longo, C, Katoulis, A, Apalla, Z, Ioannides, D, Thomas, L, Tromme, Isabelle, Ogata, D, Desinioti, C, Geller, A, and Stratigos, A

Abstract

BACKGROUND: Thin nodular melanoma (NM) often lacks conspicuous melanoma-specific dermatoscopic criteria and escapes clinical detection until it progresses to a thicker and more advanced tumour. OBJECTIVE: To investigate the dermatoscopic morphology of thin (≤2 mm Breslow thickness) vs. thick (>2 mm) NM and to identify dermatoscopic predictors of its differential diagnosis from other nodular tumours. METHODS: Retrospective, morphological case-control study, conducted on behalf of the International Dermoscopy Society. Dermatoscopic images of NM and other nodular tumours from 19 skin cancer centres worldwide were collected and analysed. RESULTS: Overall, 254 tumours were collected (69 NM of Breslow thickness ≤2 mm, 96 NM >2 mm and 89 non-melanoma nodular lesions). Light brown coloration (50.7%) and irregular brown dots/globules (42.0%) were most frequently observed in ≤2 mm NMs. Multivariate analysis revealed that dotted vessels (3.4-fold), white shiny streaks (2.9-fold) and irregular blue structureless area (2.4-fold) were predictors for thinner NM compared to non-melanoma nodular tumours. Overall, irregular blue structureless area (3.4-fold), dotted vessels (4.6-fold) and serpentine vessels (1.9-fold) were predictors of all NM compared to non-melanoma nodular lesions. LIMITATIONS: Absence of a centralized, consensus pathology review and cases selected form tertiary centres maybe not reflecting the broader community. CONCLUSIONS: Our study sheds light into the dermatoscopic morphology of thin NM in comparison to thicker NM and could provide useful clues for its differential diagnosis from other non-melanoma nodular tumours.

Published
2020

39. Management of biological therapies for chronic plaque psoriasis during COVID-19 emergency in Italy

Author

Talamonti, M., Galluzzo, M., Chiricozzi, Andrea, Quaglino, P., Fabbrocini, G., Gisondi, P., Marzano, A. V., Potenza, C., Conti, A., Parodi, A., Belloni Fortina, A., Bardazzi, F., Argenziano, G., Rongioletti, F., Stingeni, L., Micali, G., Loconsole, F., Venturini, M., Bongiorno, M. R., Feliciani, C., Rubegni, P., Amerio, P., Fargnoli, M. C., Pigatto, P., Savoia, P., Nistico, S. P., Giustini, S., Carugno, A., Cannavo, S. P., Rech, G., Prignano, F., Offidani, A., Lombardo, M., Zalaudek, I., Bianchi, L., Peris, Ketty, Balestri, R., Bernardini, N., Botti, E., Burlando, M., Caldarola, Giacomo, Cattaneo, A., Dapavo, P., Dastoli, S., De Simone, Clara, Di Nuzzo, S., Diotallevi, F., Fierro, M. T., Fidanza, R., Foti, C., Gambini, D. M., Gambardella, A., Girolomoni, G., Guarneri, C., Gualdi, G., Hansel, C., Megna, M., Mugheddu, C., Musumeci, M. L., Patrizi, A., Pellacani, G., Piaserico, S., Richetta, A. G., Rosi, E., Rossi, M. T., Sacchelli, L., Tiberio, R., Tilotta, G., Trovato, E., Vezzoni, R., Zangrilli, A., Chiricozzi A. (ORCID:0000-0002-6739-0387), Peris K. (ORCID:0000-0002-5237-0463), Caldarola G. (ORCID:0000-0002-8837-9232), De Simone C. (ORCID:0000-0002-0898-0045), Talamonti, M., Galluzzo, M., Chiricozzi, Andrea, Quaglino, P., Fabbrocini, G., Gisondi, P., Marzano, A. V., Potenza, C., Conti, A., Parodi, A., Belloni Fortina, A., Bardazzi, F., Argenziano, G., Rongioletti, F., Stingeni, L., Micali, G., Loconsole, F., Venturini, M., Bongiorno, M. R., Feliciani, C., Rubegni, P., Amerio, P., Fargnoli, M. C., Pigatto, P., Savoia, P., Nistico, S. P., Giustini, S., Carugno, A., Cannavo, S. P., Rech, G., Prignano, F., Offidani, A., Lombardo, M., Zalaudek, I., Bianchi, L., Peris, Ketty, Balestri, R., Bernardini, N., Botti, E., Burlando, M., Caldarola, Giacomo, Cattaneo, A., Dapavo, P., Dastoli, S., De Simone, Clara, Di Nuzzo, S., Diotallevi, F., Fierro, M. T., Fidanza, R., Foti, C., Gambini, D. M., Gambardella, A., Girolomoni, G., Guarneri, C., Gualdi, G., Hansel, C., Megna, M., Mugheddu, C., Musumeci, M. L., Patrizi, A., Pellacani, G., Piaserico, S., Richetta, A. G., Rosi, E., Rossi, M. T., Sacchelli, L., Tiberio, R., Tilotta, G., Trovato, E., Vezzoni, R., Zangrilli, A., Chiricozzi A. (ORCID:0000-0002-6739-0387), Peris K. (ORCID:0000-0002-5237-0463), Caldarola G. (ORCID:0000-0002-8837-9232), and De Simone C. (ORCID:0000-0002-0898-0045)

Abstract

N/A

Published
2020

40. Comment on ‘Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines’

Author

Peris, Ketty, Fargnoli, Maria Concetta, Garbe, C., Kaufmann, R., Bastholt, L., Seguin, N. B., Bataille, V., del Marmol, V., Dummer, R., Harwood, C. A., Hauschild, A., Holler, C., Haedersdal, M., Malvehy, J., Middleton, M. R., Morton, C. A., Nagore, E., Stratigos, A. J., Szeimies, R. -M., Tagliaferri, Luca, Trakatelli, M., Zalaudek, Iri, Eggermont, A., Grob, J. J., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), Zalaudek I., Peris, Ketty, Fargnoli, Maria Concetta, Garbe, C., Kaufmann, R., Bastholt, L., Seguin, N. B., Bataille, V., del Marmol, V., Dummer, R., Harwood, C. A., Hauschild, A., Holler, C., Haedersdal, M., Malvehy, J., Middleton, M. R., Morton, C. A., Nagore, E., Stratigos, A. J., Szeimies, R. -M., Tagliaferri, Luca, Trakatelli, M., Zalaudek, Iri, Eggermont, A., Grob, J. J., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), and Zalaudek I.

Abstract

na

Published
2020

41. The evolving field of Dermato-oncology and the role of dermatologists: Position Paper of the EADO, EADV and Task Forces, EDF, IDS, EBDV–UEMS and EORTC Cutaneous Lymphoma Task Force

Author

Garbe, C., Peris, Ketty, Soura, E., Forsea, A. M., Hauschild, A., Arenbergerova, M., Bylaite, M., del Marmol, V., Bataille, V., Samimi, M., Gandini, S., Saiag, P., Eigentler, T. K., Lallas, A., Zalaudek, Iri, Lebbe, C., Grob, J. -J., Hoeller, C., Robert, C., Dreno, B., Arenberger, P., Kandolf-Sekulovic, L., Kaufmann, R., Malvehy, J., Puig, S., Leiter, U., Ribero, S., Papadavid, E., Quaglino, P., Bagot, M., John, S. M., Richard, M. -A., Trakatelli, M., Salavastru, C., Borradori, L., Marinovic, B., Enk, A., Pincelli, C., Ioannides, D., Paul, C., Stratigos, A. J., Peris K. (ORCID:0000-0002-5237-0463), Zalaudek I., Garbe, C., Peris, Ketty, Soura, E., Forsea, A. M., Hauschild, A., Arenbergerova, M., Bylaite, M., del Marmol, V., Bataille, V., Samimi, M., Gandini, S., Saiag, P., Eigentler, T. K., Lallas, A., Zalaudek, Iri, Lebbe, C., Grob, J. -J., Hoeller, C., Robert, C., Dreno, B., Arenberger, P., Kandolf-Sekulovic, L., Kaufmann, R., Malvehy, J., Puig, S., Leiter, U., Ribero, S., Papadavid, E., Quaglino, P., Bagot, M., John, S. M., Richard, M. -A., Trakatelli, M., Salavastru, C., Borradori, L., Marinovic, B., Enk, A., Pincelli, C., Ioannides, D., Paul, C., Stratigos, A. J., Peris K. (ORCID:0000-0002-5237-0463), and Zalaudek I.

Abstract

Background: The incidence of skin cancers has been increasing steadily over the last decades. Although there have been significant breakthroughs in the management of skin cancers with the introduction of novel diagnostic tools and innovative therapies, skin cancer mortality, morbidity and costs heavily burden the society. Objective: Members of the European Association of Dermato-Oncology, European Academy of Dermatology and Venereology, International Dermoscopy Society, European Dermatology Forum, European Board of Dermatovenereology of the European Union of Medical Specialists and EORTC Cutaneous Lymphoma Task Force have joined this effort to emphasize the fundamental role that the specialist in Dermatology–Venereology has in the diagnosis and management of different types of skin cancer. We review the role of dermatologists in the prevention, diagnosis, treatment and follow-up of patients with melanoma, non-melanoma skin cancers and cutaneous lymphomas, and discuss approaches to optimize their involvement in effectively addressing the current needs and priorities of dermato-oncology. Discussion: Dermatologists play a crucial role in virtually all aspects of skin cancer management including the implementation of primary and secondary prevention, the formation of standardized pathways of care for patients, the establishment of specialized skin cancer treatment centres, the coordination of an efficient multidisciplinary team and the setting up of specific follow-up plans for patients. Conclusion: Skin cancers represent an important health issue for modern societies. The role of dermatologists is central to improving patient care and outcomes. In view of the emerging diagnostic methods and treatments for early and advanced skin cancer, and considering the increasingly diverse skills, knowledge and expertise needed for managing this heterogeneous group of diseases, dermato-oncology should be considered as a specific subspecialty of Dermatology–Venereology.

Published
2020

42. European consensus-based interdisciplinary guideline for melanoma. Part 1: Diagnostics – Update 2019

Author

Garbe, C., Amaral, T., Peris, Ketty, Hauschild, A., Arenberger, P., Bastholt, L., Bataille, V., del Marmol, V., Dreno, B., Fargnoli, Maria Concetta, Grob, J. -J., Holler, C., Kaufmann, R., Lallas, A., Lebbe, C., Malvehy, J., Middleton, M., Moreno-Ramirez, D., Pellacani, G., Saiag, P., Stratigos, A. J., Vieira, R., Zalaudek, Iri, Eggermont, A. M. M., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Zalaudek I., Garbe, C., Amaral, T., Peris, Ketty, Hauschild, A., Arenberger, P., Bastholt, L., Bataille, V., del Marmol, V., Dreno, B., Fargnoli, Maria Concetta, Grob, J. -J., Holler, C., Kaufmann, R., Lallas, A., Lebbe, C., Malvehy, J., Middleton, M., Moreno-Ramirez, D., Pellacani, G., Saiag, P., Stratigos, A. J., Vieira, R., Zalaudek, Iri, Eggermont, A. M. M., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., and Zalaudek I.

Abstract

Cutaneous melanoma (CM) is potentially the most dangerous form of skin tumor and causes 90% of skin cancer mortality. A unique collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization of Research and Treatment of Cancer (EORTC) was formed to make recommendations on CM diagnosis and treatment, based on systematic literature reviews and the experts' experience. The diagnosis of melanoma can be made clinically and shall always be confirmed through dermatoscopy. If a melanoma is suspected, a histopathological examination is required. Sequential digital dermatoscopy and full-body photography can be used in risk persons to detect the development of melanomas at an earlier stage. Where available, confocal reflectance microscopy can improve clinical diagnosis in special cases. Melanoma shall be classified according to the 8th version of the AJCC classification. Thin melanomas up to 0.8 mm tumor thickness does not require further imaging diagnostics. From stage IB onwards, examinations with lymph node sonography are recommended, but no further imaging examinations. From stage IIC whole-body examinations with CT or PET-CT in combination with brain MRI are recommended. From stage III and higher, mutation testing is recommended, particularly for BRAF V600 mutation. It is important to provide a structured follow-up to detect relapses and secondary primary melanomas as early as possible. There is no evidence to support the frequency and extent of examinations. A stage-based follow-up scheme is proposed, which, according to the experience of the guideline group, covers the minimum requirements; further studies may be considered. This guideline is valid until the end of 2021.

Published
2020

43. The presence of eccentric hyperpigmentation should raise the suspicion of melanoma

Author

Borsari, S., Peccerillo, F., Pampena, R., Lai, M., Spadafora, M., Moscarella, E., Lallas, A., Pizzichetta, M. A., Zalaudek, Iri, Del Regno, L., Peris, Ketty, Pellacani, G., Longo, C., Zalaudek I., Peris K. (ORCID:0000-0002-5237-0463), Borsari, S., Peccerillo, F., Pampena, R., Lai, M., Spadafora, M., Moscarella, E., Lallas, A., Pizzichetta, M. A., Zalaudek, Iri, Del Regno, L., Peris, Ketty, Pellacani, G., Longo, C., Zalaudek I., and Peris K. (ORCID:0000-0002-5237-0463)

Abstract

Background: Melanocytic lesions with eccentric hyperpigmentation (EH), even though without other dermatoscopic features of melanoma, are often excised. Objective: Aiming to understand whether the EH in a pigmented lesion is an accurate criterion of malignancy, we evaluated the capability of two evaluators, with different expertise, to correctly diagnose a melanoma when analysing a given lesion in toto versus a partial analysis, with only the EH or the non-hyperpigmented portion (non-EH) visible. Methods: Dermatoscopic images of 240 lesions (107 melanomas and 133 nevi) typified by EH were selected. Facial, acral, mucosal lesions and lesions showing clear-cut features of melanoma (except for atypical network) were excluded. Clinical and dermoscopic features (main pattern and numbers of colours) were described for all cases. Each image was split in two through a software so that only the EH or the non-EH was visible. Two blinded evaluators examined three sets of images, two with customized images and one with the non-modified ones: they were asked to give a dichotomous diagnosis (melanoma or nevus) for each image. Results: Melanomas were significantly more frequently typified by colour variegation (3 colours in 44.8% and 4 colours in 41.1% of cases) and atypical network (88.1% in the EH). No significant differences in diagnostic accuracy emerged between the two evaluators. Sensitivity improved in the evaluation of the whole lesions (mean sensitivity 89.7%) in comparison with the evaluation of EH or non-EH alone (72.7–62.6%). Specificity increased when evaluating the EH (54.1%). Positive predictive value (PPV) and likelihood ratio (LR+) of EH resulted 52.3% and 1.4, meaning that in one case out of two with EH is a melanoma. Conclusions: Lesions with EH are challenging, regardless of dermoscopic experience. The EH is a robust criterion for malignancy, since the evaluation of the whole lesion, through an intralesional comparative approach, increases sensitivity.

Published
2020

44. Management of cutaneous melanoma: Comparison of the leading international guidelines updated to the 8th American Joint Committee on Cancer staging system and workup proposal by the Italian Society of Dermatology

Author

Argenziano, G., Brancaccio, G., Moscarella, E., Dika, E., Fargnoli, Maria Concetta, Ferrara, Giovanna, Longo, C., Pellacani, G., Peris, Ketty, Pimpinelli, N., Quaglino, P., Rongioletti, F., Simonacci, Matteo, Zalaudek, Iri, Calzavarapinton, P., Fargnoli M. C., Ferrara G., Peris K. (ORCID:0000-0002-5237-0463), Simonacci M., Zalaudek I., Argenziano, G., Brancaccio, G., Moscarella, E., Dika, E., Fargnoli, Maria Concetta, Ferrara, Giovanna, Longo, C., Pellacani, G., Peris, Ketty, Pimpinelli, N., Quaglino, P., Rongioletti, F., Simonacci, Matteo, Zalaudek, Iri, Calzavarapinton, P., Fargnoli M. C., Ferrara G., Peris K. (ORCID:0000-0002-5237-0463), Simonacci M., and Zalaudek I.

Abstract

The melanoma care landscape is changing fast in the last years. As a result of new insights in melanoma biology, prognosis and therapeutic options, both the American Joint Committee on Cancer (AJCC) and the World Health OrgaÂnization (WHO) Classification of Skin Tumors underwent substantial changes in 2018. Consequently, all the leading guidelines on melanoma management have been updated. Most of the recommendations derive from systematic reÂviews, while others are based on expert opinion, due to the lack of high-level evidence in some aspects of melanoma management. We provide a revision of all the available guidelines that have been updated to the 8th version of the AJCC classification system. Comparison is not provided for topics on which there is agreement on the standard of care.

Published
2020

45. Response to: Comment on ‘Diagnosis and treatment of basal cell carcinoma: European consensus-based interdisciplinary guidelines’

Author

Peris, Ketty, Fargnoli, Maria Concetta, Garbe, C., Kaufmann, R., Bastholt, L., Seguin, N. B., Bataille, V., del Marmol, V., Dummer, R., Harwood, C. A., Hauschild, A., Holler, C., Haedersdal, M., Malvehy, J., Middleton, M. R., Morton, C. A., Nagore, E., Stratigos, A. J., Szeimies, R. -M., Tagliaferri, Luca, Trakatelli, M., Zalaudek, Iri, Eggermont, A., Grob, J. J., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), Zalaudek I., Peris, Ketty, Fargnoli, Maria Concetta, Garbe, C., Kaufmann, R., Bastholt, L., Seguin, N. B., Bataille, V., del Marmol, V., Dummer, R., Harwood, C. A., Hauschild, A., Holler, C., Haedersdal, M., Malvehy, J., Middleton, M. R., Morton, C. A., Nagore, E., Stratigos, A. J., Szeimies, R. -M., Tagliaferri, Luca, Trakatelli, M., Zalaudek, Iri, Eggermont, A., Grob, J. J., Peris K. (ORCID:0000-0002-5237-0463), Fargnoli M. C., Tagliaferri L. (ORCID:0000-0003-2308-0982), and Zalaudek I.

Abstract

na

Published
2020

46. Italian expert consensus paper on the management of patients with actinic keratoses

Author

Moscarella, E., Di Brizzi, E. V., Casari, A., De Giorgi, V., Di Meo, N., Fargnoli, Maria Concetta, Lacarrubba, F., Micali, G., Pellacani, G., Peris, Ketty, Piaserico, S., Calzavara-Pinton, P., Quaglino, P., Sollena, P., Zalaudek, Iri, Zane, C., Argenziano, G., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Zalaudek I., Moscarella, E., Di Brizzi, E. V., Casari, A., De Giorgi, V., Di Meo, N., Fargnoli, Maria Concetta, Lacarrubba, F., Micali, G., Pellacani, G., Peris, Ketty, Piaserico, S., Calzavara-Pinton, P., Quaglino, P., Sollena, P., Zalaudek, Iri, Zane, C., Argenziano, G., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), and Zalaudek I.

Abstract

Two round tables involving experts were organized in order to reach a consensus on the management of patients with actinic keratosis (AK). In the first, seven clinical questions were selected and analyzed by a systematic literature review, using a Population, Intervention, Control, and Outcomes framework; in the second, the experts discussed relevant evidences and a consensus statement for each question was developed. Consensus was reached among experts on how to best treat AK patients with respect to different clinical scenarios and special populations. Lesion-directed treatments are preferred in patients with few AKs. Patients with multiple AKs are challenging, with more than one treatment usually needed to achieve complete lesion clearance or a high lesion response rate, therapy should be personalized, based on previous treatments, patient, and lesion characteristics. Methyl aminolevulinate-PDT, DL (day light) PDT, and imiquimod cream were demonstrated to have the lowest percentage of new AKs after post treatment follow-up. For IMQ 5% and 3.75%, a higher intensity of skin reactions is associated with higher efficacy. Photodynamic therapy (PDT) is the most studied treatment for AKs on the arms. Regular sunscreen use helps preventing new AKs. Oral nicotinamide 500 mg twice daily, systemic retinoids and regular sunscreen use were demonstrated to reduce the number of new squamous cell carcinomas in patients with AKs. Limited evidence is available for the treatment of AKs in organ transplant recipients. There is no evidence in favor or against the use of any of the available treatments in patients suffering from hematological cancer.

Published
2020

47. European interdisciplinary guideline on invasive squamous cell carcinoma of the skin: Part 1. epidemiology, diagnostics and prevention

Author

Stratigos, A. J., Garbe, C., Dessinioti, C., Lebbe, C., Bataille, V., Bastholt, L., Dreno, B., Fargnoli, Maria Concetta, Forsea, A. M., Frenard, C., Harwood, C. Alpha., Hauschild, A., Hoeller, C., Kandolf-Sekulovic, L., Kaufmann, R., Kelleners-Smeets, N. W., Malvehy, J., del Marmol, V., Middleton, M. R., Moreno-Ramirez, D., Pellecani, G., Peris, Ketty, Saiag, P., van den Beuken-van Everdingen, M. H. J., Vieira, R., Zalaudek, Iri, Eggermont, A. M. M., Grob, J. -J., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Zalaudek I., Stratigos, A. J., Garbe, C., Dessinioti, C., Lebbe, C., Bataille, V., Bastholt, L., Dreno, B., Fargnoli, Maria Concetta, Forsea, A. M., Frenard, C., Harwood, C. Alpha., Hauschild, A., Hoeller, C., Kandolf-Sekulovic, L., Kaufmann, R., Kelleners-Smeets, N. W., Malvehy, J., del Marmol, V., Middleton, M. R., Moreno-Ramirez, D., Pellecani, G., Peris, Ketty, Saiag, P., van den Beuken-van Everdingen, M. H. J., Vieira, R., Zalaudek, Iri, Eggermont, A. M. M., Grob, J. -J., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), and Zalaudek I.

Abstract

Invasive cutaneous squamous cell carcinoma (cSCC) is one of the most common cancers in the white populations, accounting for 20% of all cutaneous malignancies. Factors implicated in cSCC etiopathogenesis include ultraviolet radiation exposure and chronic photoaging, age, male sex, immunosuppression, smoking and genetic factors. A collaboration of multidisciplinary experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO) and the European Organisation of Research and Treatment of Cancer (EORTC) was formed to update recommendations on cSCC classification, diagnosis, risk stratification, staging and prevention, based on current literature, staging systems and expert consensus. Common cSCCs are typically indolent tumors, and most have a good prognosis with 5-year cure rates of greater than 90%, and a low rate of metastases (<4%). Further risk stratification into low-risk or high-risk common primary cSCC is recommended based on proposed high-risk factors. Advanced cSCC is classified as locally advanced (lacSCC), and metastatic (mcSCC) including locoregional metastatic or distant metastatic cSCC. Current systems used for staging include the American Joint Committee on Cancer (AJCC) 8th edition, the Union for International Cancer Control (UICC) 8th edition, and Brigham and Women's Hospital (BWH) system. Physical examination for all cSCCs should include total body skin examination and clinical palpation of lymph nodes, especially of the draining basins. Radiologic imaging such as ultrasound of the regional lymph nodes, magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography–computed tomography (PET-CT) scans are recommended for staging of high-risk cSCC. Sentinel lymph node biopsy is currently not recommended. Nicotinamide, oral retinoids, and topical 5-FU have been used for the chemoprevention of subsequent cSCCs in high-risk patients but are not routinely recommended. Education about sun prot

Published
2020

48. A 48-week update of a multicentre real-life experience of dupilumab in adult patients with moderate-to-severe atopic dermatitis

Author

Fargnoli, Maria Concetta, Esposito, M., Ferrucci, S., Girolomoni, G., Offidani, A., Patrizi, A., Peris, Ketty, Costanzo, Rosa Maria Alba, Malara, G., Pellacani, G., Romanelli, Margherita, Amerio, P., Cristaudo, A., Flori, M. L., Motolese, A., Betto, P., Patruno, C., Pigatto, P., Peccianti, C., Stinco, G., Zalaudek, Iri, Bianchi, L., Boccaletti, V., Cannavo, S. P., Cusano, F., Lembo, S., Mozzillo, R., Gallo, Rosanna, Potenza, C., Rongioletti, F., Tiberio, R., Grieco, T., Micali, G., Persechino, S., Pettinato, M., Pucci, S., Stingeni, L., Caruso, C., Argenziano, G., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Costanzo A., Romanelli M., Zalaudek I., Gallo R., Fargnoli, Maria Concetta, Esposito, M., Ferrucci, S., Girolomoni, G., Offidani, A., Patrizi, A., Peris, Ketty, Costanzo, Rosa Maria Alba, Malara, G., Pellacani, G., Romanelli, Margherita, Amerio, P., Cristaudo, A., Flori, M. L., Motolese, A., Betto, P., Patruno, C., Pigatto, P., Peccianti, C., Stinco, G., Zalaudek, Iri, Bianchi, L., Boccaletti, V., Cannavo, S. P., Cusano, F., Lembo, S., Mozzillo, R., Gallo, Rosanna, Potenza, C., Rongioletti, F., Tiberio, R., Grieco, T., Micali, G., Persechino, S., Pettinato, M., Pucci, S., Stingeni, L., Caruso, C., Argenziano, G., Fargnoli M. C., Peris K. (ORCID:0000-0002-5237-0463), Costanzo A., Romanelli M., Zalaudek I., and Gallo R.

Abstract

na

Published
2020

49. Eruptive epidermoidzysten nach imiquimod-therapie eines rezidivierenden basalzellkarzinoms

Author

Woltsche, N, El-Shabrawi-Caelen, L, Deinlein, T, Kupsa, R, Gschwandtner, M, Hofmann-Wellenhof, R, and Zalaudek, I

Abstract

Eruptive Epidermoidzysten stellen eine seltene Nebenwirkung von Imiquimod zur Behandlung von Basalzellkarzinomen dar. Bis dato wurden 8 Fälle in der Literatur beschrieben. Wir präsentieren den Fall einer 75-jährigen kaukasischen Patientin mit einem 8‑mal rezidivierten Basalzellkarzinom der Nase. Nach mehrfachen Exzisionen und Therapie mit Vismodegib erhielt die Patientin schließlich Imiquimod 5 % Creme in der Standarddosierung 5‑mal wöchentlich für die Dauer von 6 Wochen. Zwei Monate nach dem Absetzen von Imiquimod zeigten sich eruptive Epidermoidzysten. Eruptive epidermoid cysts are a rare adverse event of imiquimod treatment for basal cell carcinoma. Up to date, 8 cases have been described in the literature. We present the case of a 75-year-old Caucasian woman with recurrent basal cell carcinoma on the nose. After multiple excisions and treatment with vismodegib, imiquimod 5% cream was administered 5 times per week over 6 weeks. Two months after the end of treatment, the patient presented with eruptive epidermoid cysts.

Published
2019

50. Diagnosis and treatment of Kaposi's sarcoma: European consensus-based interdisciplinary guideline (EDF/EADO/EORTC)

Author

Lebbe, C. Garbe, C. Stratigos, A.J. Harwood, C. Peris, K. Marmol, V.D. Malvehy, J. Zalaudek, I. Hoeller, C. Dummer, R. Forsea, A.M. Kandolf-Sekulovic, L. Olah, J. Arenberger, P. Bylaite-Bucinskiene, M. Vieira, R. Middleton, M. Levy, A. Eggermont, A.M. Battistella, M. Spano, J.P. Grob, J.J. Pages, C. the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO)and the European Organisation for Research Treatment of Cancer (EORTC)

Abstract

Kaposi's sarcoma (KS)is a multifocal neoplasm of lymphatic endothelium-derived cells infected with human herpesvirus 8. Four clinical subtypes are distinguished: the classic, the endemic, the epidemic subtype in HIV positive patients and the iatrogenic subtype. The diagnosis is primarily based on clinical features and confirmation by histology with immunohistochemistry. Cutaneous distribution and severity, mucosal, nodal and visceral involvement depend on the type of KS with in general indolent behaviour and chronic evolution in the classic subtype and the more severe forms in iatrogenic or epidemic subtypes. Management should aim at achieving disease control. For localised lesions, several local therapies have been developed without randomised trial comparisons. Radiotherapy, intralesional chemotherapies and electrochemotherapy have high response rates. Topical treatments—imiquimod or topical 9-cis-retinoid acid—can also be used. Systemic treatments are reserved for locally aggressive extensive and disseminated KS: the recommended first-line agents are pegylated liposomal doxorubicin (PLD)and paclitaxel. In CKS, PLD or low-dose interferon-alfa are the recommended first-line agents in younger patients. In AIDS-related KS, combination antiretroviral therapy is the first treatment option; specific systemic treatment is needed only in case of extensive disease and in the prevention and treatment of immune reconstitution inflammatory syndrome. In post-transplant KS, tapering down immunosuppressive therapy and switching to mammalian target of rapamycin (m-TOR)inhibitors are used. Follow-up schedules for patients with KS disease depend on aggressiveness of the disease. © 2019 Elsevier Ltd

Published
2019

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