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Fabrizio Martora, Massimiliano Scalvenzi, Teresa Battista, Luigi Fornaro, Luca Potestio, Angelo Ruggiero, Matteo Megna Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, ItalyCorrespondence: Fabrizio Martora, Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Napoli, 80131, Italy, Tel +39-081-7462457, Fax +39-081-7462442, Email fabriziomartora92@libero.itAbstract: The treatment of hidradenitis suppurativa (HS) has always been a real challenge for dermatologists; to date, the only biologic drugs approved for HS are adalimumab, an anti-tumor necrosis factor (TNF)-α drug, authorized in 2015, and secukinumab, recently licensed. The management of this condition is challenging as the available treatments show variable results, and the course of the condition is often chronic-recurrent; therefore, it will be necessary for the future to identify new therapeutic targets for HS. In recent years, studies have focused on the development towards new therapeutic targets. The purpose of our review was to perform a comprehensive literature review of real-life data on anti-IL23 (guselkumab, tildrakizumab, and risankizumab) in HS to summarize the existing evidence on the efficacy and safety of these drugs. We selected 64 articles, among which 32 had the characteristics that we were looking for in our review. To date, the positive data expressed in real-life experiences contrast with the three existing Phase 2 studies conducted so far, where it seems that these drugs may be useful only for a subgroup of patients with HS whose features need to be elucidated. Data from Phase 3 studies and other real-life experiences, perhaps more detailed and with higher numbers, will certainly be needed to fully understand the efficacy and safety of this class of drugs.Keywords: hidradenitis suppurativa, anti-IL23, guselkumab, tildrakizumab, risankizumab, real life evidence

Luca Potestio,1 Elisa Camela,2 Sara Cacciapuoti,1 Luigi Fornaro,1 Angelo Ruggiero,1 Fabrizio Martora,1 Teresa Battista,1 Matteo Megna1 1Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; 2Dermatology Unit, Istituto Dermopatico dell’Immacolata - IRCCS, Rome, ItalyCorrespondence: Luca Potestio, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy, Tel +39 - 081 - 7462457, Fax +39 - 081 - 7462442, Email potestioluca@gmail.comAbstract: Erythrodermic psoriasis (EP) is a severe and rare variant of psoriasis (less than 3% of cases), characterized by generalized scaling and erythema affecting more than 90% of body surface area. Several systemic symptoms can be present in patients with EP such as lymphadenopathy, arthralgia, fever, fatigue, dehydration, serum electrolyte disturbances, and tachycardia making this condition a possible life-threatening disease, particularly if appropriate treatments are not performed. In this scenario, effective and safe therapies are required. Unfortunately, the rarity of EP makes head-to-head Phase III trials challenging, leading to the lack of established guidelines for its management. Globally, conventional systemic drugs such as cyclosporine, methotrexate, and retinoids often have contraindications linked to patients’ comorbidities and have not shown a high profile of efficacy and safety. Recently, the development of biologic drugs including anti-tumor necrosis factor-α and anti-interleukin 12– 23, 23, and 17 has revealed favorable results for the management of plaque psoriasis, making them also a possible therapeutic option for EP disease. However, their use in EP is still off-label. The aim of our study was to review current literature on the use of biologic drugs for the treatment of EPs in order to offer a wide perspective on their possible application in EP management.Keywords: erythrodermic psoriasis, treatment, biologic drugs

Angelo Ruggiero,1 Fabrizio Martora,1 Gabriella Fabbrocini,1 Alessia Villani,1 Claudio Marasca,1 Matteo Megna,1 Luigi Fornaro,1 Rosita Comune,2 Luca Potestio1 1Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy; 2Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, ItalyCorrespondence: Angelo Ruggiero, Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini, 5, Naples, 80131, Italy, Tel +39 - 081 - 7462457, Fax +39 - 081 - 7462442, Email Angeloruggiero1993@libero.itAbstract: Teledermatology represented one of the most important and useful tools during the COVID-19 pandemic era. Indeed, due to the severe restriction, and to reduce the spread of the infection, different measures were applied among different countries and hospitals to ensure a continuity of care for patients. In this scenario, teledermatology played a central role, especially in the management of patients suffering from chronic inflammatory skin diseases. The aim of this narrative review is to describe the role of teledermatology during the COVID-19 pandemic to analyze main strengths and limitations of this tool, as well as to provide future perspectives in clinical applications.Keywords: teledermatology, telemedicine, COVID-19, psoriasis, atopic dermatitis, hidradenitis suppurativa

Matteo Megna, Luigi Fornaro, Luca Potestio, Maria Antonietta Luciano, Mariateresa Nocerino, Mario Delfino, Maria Guarino, Gabriella Fabbrocini, Elisa Camela Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, NA, ItalyCorrespondence: Elisa Camela, Section of Dermatology - Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Pansini 5, Naples, NA, 80131, Italy, Tel +39 - 081 – 7462457, Fax +39 - 081 – 7462442, Email elisacamela@gmail.comPurpose: To determine the efficacy and safety of adalimumab (ADA) and etanercept (ETA) biosimilars in elderly and children with psoriasis.Methods: A real-life retrospective observational study was conducted on pediatric (< 18 years) and geriatric (≥ 65 years) psoriasis patients treated with anti-TNF biosimilar agents referring to the Psoriasis Unit of the University of Naples Federico II, Italy, from January 2018 to January 2022. At baseline, demographic characteristics (age and sex), data on psoriasis duration and severity (measured by Psoriasis Area Severity Index [PASI] and body surface area [BSA]), presence of psoriatic arthritis if applicable, comorbidities, and previous psoriasis treatments were recorded. Patients were monitored by regular follow-ups (week 12, 24, 48 and 72) through clinical and haematological assessments and adverse events (AEs) were registered.Results: A total of 11 children and 23 elderly psoriasis patients were enrolled. Concerning children, 6 (54.5%) were under ADA biosimilar and 5 (45.5%) under ETA biosimilar. ETA and ADA biosimilars were equally effective and safe for up to 72 weeks (mean PASI and BSA < 3). No significant AEs were reported, and none discontinued treatment. In the elderly, 15 (65.2%) were treated with ADA biosimilar and 8 (34.8%) with ETA biosimilar. ETA and ADA biosimilars were equally effective up to 72 weeks (mean PASI < 4 and mean BSA < 5%). AEs (mainly mild) were registered in 9 subjects (39.1%). Also, 4 (17.4%) patients discontinued biologicals for secondary lack of efficacy (3, 75%) or AEs (1, 25%).Conclusion: Our study found that ADA and ETA biosimilars are effective and safe for the treatment of moderate-to-severe psoriasis in children and the elderly. No statistically significant efficacy and safety differences were found between ADA and ETA biosimilars in both children and the elderly. Geriatric patients displayed a higher discontinuation rate and side effects than the pediatric counterpart even if without approaching statistical significance.Keywords: psoriasis, etanercept, adalimumab, biosimilar, treatment

Andrea Casadei-Gardini,1 Francesco Montagnani,2 Chiara Casadei,1 Francesca Arcadipane,3 Kalliopi Andrikou,4 Deborah Aloi,5 Alessandra Anna Prete,6,7 Maria Giulia Zampino,8 Antonella Argentiero,9 Giuseppe Pugliese,4 Stefania Martini,10 Giuseppe Carlo Iorio,10 Mario Scartozzi,11 Massimiliano Mistrangelo,12 Lorenzo Fornaro,13 Paola Cassoni,14 Giorgia Marisi,15 Veronica Dell’Acqua,16 Paola Simona Ravenda,8 Sara Lonardi,6 Nicola Silvestris,7 Berardino De Bari,5 Umberto Ricardi,3 Stefano Cascinu,4 Pierfrancesco Franco91Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy; 2Oncology Department, SOC Oncology, ASL (Health Local Authority), Biella, Italy; 3Department of Oncology, Radiation Oncology, AOU Città della Salute e della Scienza, Turin, Italy; 4Department of Hematology and Oncology, University of Modena and Reggio Emilia, Modena, Italy; 5Radiation Oncology Department, Centre Hospitalier Régional Universitaire “Jean Minjoz”, Besançon Cedex, France; 6Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto, IRCCS, Padua, Italy; 7Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I University Hospital, Rome, Italy; 8Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, European Institute of Oncology, IRCCS, Milan, Italy; 9Medical Oncology Unit, Cancer Institute Giovanni Paolo II, Bari, Italy; 10Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy; 11Department of Medical Oncology, University of Cagliari, Cagliari, Italy; 12Department of Surgical Sciences, University of Turin, Turin, Italy; 13Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana University, Pisa, Italy; 14Department of Medical Sciences, Pathology Unit, University of Turin, Turin, Italy; 15Biosciences Laboratory, Istituto Scientifico Romagnolo per Lo Studio e La Cura Dei Tumori (IRST) IRCCS, Meldola, Italy; 16Department of Radiotherapy, IRCCS, European Institute of Oncology, Milan, ItalyBackground: In anal cancer, there are no markers nor other laboratory indexes that can predict prognosis and guide clinical practice for patients treated with concurrent chemoradiation. In this study, we retrospectively investigated the influence of immune inflammation indicators on treatment outcome of anal cancer patients undergoing concurrent chemoradiotherapy.Methods: All patients had a histologically proven diagnosis of squamous cell carcinoma of the anal canal/margin treated with chemoradiotherapy according to the Nigro’s regimen. Impact on prognosis of pre-treatment systemic index of inflammation (SII) (platelet x neutrophil/lymphocyte), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were analyzed.Results: A total of 161 consecutive patients were available for the analysis. Response to treatment was the single most important factor for progression-free survival (PFS) and overall survival (OS). At univariate analysis, higher SII level was significantly correlated to lower PFS (p

Mercuric iodide films were grown by the physical vapor deposition method on palladium-coated glass substrates 2' x 2' in size. The growth was performed in a system especially designed and constructed for getting a fine control of the growth parameters. The best growth conditions were a source temperature of 120 [degrees]C, a growth temperature of 60 [degrees]C and a growth time of 24 h, with an initial pressure of 6 x [10.sup.-3] Pa. Film thicknesses and grain sizes gave values ranging between 100 and 260 [micro]m (10%), and between (10 [+ or -] 5) and (30 [+ or -] 10) [micro]m, respectively. Films grew oriented with the (0 0 l) crystalline planes parallel to the substrate, with a texture of 0.94, measured by X-ray powder diffraction. The dark current density of the films is lower than 0.3 pA/[mm.sup.2] for electric fields below 0.4 V/[micro]m, and their resistivity is 1.5 x [10.sup.14] [ohm].cm. Mobility-lifetime values of 5.2 x [10.sup.-6] [cm.sup.2]/V and 6.2 x [10.sup.-6] cm2/V can be estimated for electrons and holes, respectively. Films give a sensitivity to X-rays of 37 nC/R.[cm.sup.2]. A signal to dark relation of 1120 was measured at 750 mR/s and 32 KVp, with an electric field of 0.4 V/[micro]m applied to the film. The low dark current, as far as the high signal to noise results obtained, indicate these films as very suitable for direct and digital imaging. Index Terms--Digital radiography, mercuric iodide, oriented films.

Films of HgBrI (eutectic composition) were grown by the physical vapor deposition method on palladium-coated glass substrates 2' x 2' in size. The growth was performed in a system especially designed and constructed for getting a fine control of the growth parameters. The best growth conditions were a source temperature of 116 [degrees]C, a growth temperature of 40[degrees]C and a growth time of 3 h, with an initial pressure of 6 x [10.sup-3] Pa. Film thicknesses and grain sizes gave values ranging between 100 and 350/[micro]m (10%), and between (10 [+ or -] 5) and (50 [+ or -] 20) [micro]m, respectively. The dark current density of the films is higher than 10 pA/[mm.sup.2] (maximum value required for the application) for electric fields above 0.03 V/[micro]m, and the resistivity is 3.8 x [10.sup.11] [ohm].cm. Electron and hole mobility-lifetimes of 7.1 x [10.sup-6] [cm.sup.2]/V y 1.0 x [10.sup.-5] [cm.sup.2]/V were estimated. HgBrI films give a sensitivity to X-rays of 65 nC/R. [cm.sup.2] for an X-ray beam of 70 KVp, with an electric field of 0.25 V/[micro]m applied to the film. Taking into account that this is the first attempt on growing films with this material, these results indicate HgBrI as a new compound semiconductor candidate for the application. Index Terms--Digital radiology, HgBrI, X-ray detectors.

CdTe crystals doped with several heavy metals (Hg, TI, Pb, and Bi) in the concentration range of [10.sup.17]-[10.sup.18] at/[cm.sup.3] have been grown by the vertical Bridgman method. The structural quality and uniformity of the crystals was verified by chemical determination of etch pits density and by X-ray rocking curves. Inductively coupled plasma-mass spectroscopy (ICP-MS) was employed for evaluating the dopant concentration and foreign impurities. Low-temperature photoluminescence (PL) measurements were performed on the crystals in the 1.2-1.6 eV energy range. The crystals electrical properties were studied by Hall and I-V measurements. (D-X) and (DAP) lines dominate the PL spectra for CdTe crystals, suggesting n-type conductivity and the presence of a compensation mechanism due to the heavy metal dopant incorporation. Investigating the 1.4 eV band, we obtained the Huang-Rhys parameter, the principal energy of zero phonon line and the energy of longitudinal optical phonon for each dopant. A particular PL line at 1.473 eV, correlated to [M.sub.Te] (M=heavy metal) defect centers, was found. It was found that the heavy metal-doped CdTe crystals have resistivity values in the range [10.sup.8]-[10.sup.10] [OMEGA] X cm, with maximum values for Bi- and Hg-doped materials. Also, these materials show a higher dark current stability than the ones doped with the other heavy metals. Only detectors made from Hg-doped crystals gave response to X and [gamma] radiation.

Bismuth tri-iodide polycrystalline films were grown by the physical vapor deposition method. Glass 1' x 1' in size was used as the substrate. Palladium was deposited previously onto the substrates as the rear contact. For growth, bismuth tri-iodide 99.999% was heated at 130-170[degrees]C under high vacuum atmosphere (5 x [10.sup.-5] mmHg) or under Ar pressure for 20 hours. Film thickness was measured by the transmission of 59.5 keV 242 Am emission, giving values ranging from 90 to 130 [micro]m (5%). Film grain size was measured by scanning electron microscopy, and it gave an average of (50 [+ or -] 20) [micro]m. Detectors were made with the films by depositing palladium as the front contact (contact area 4 [mm.sup.2]) and then performing acrylic encapsulation. Resistivities of 6 x 1022 [ohm].cm and current densities of 240 pA/[cm.sup.2] at 20 V were obtained for these detectors. The electron mobility and lifetime and the electron mobility-lifetime product were measured by the transient charge technique, which gave values of 4.4 [cm.sup.2]/V.s, 3.3 x [10.sup.-7]s and 1.4 x [10.sup.-6] [cm.sup.2]/V respectively. X-ray film response was checked by irradiating the films with a [sup.241] Am source and with an X-ray beam, for different beam energies and intensities and for several bias voltages applied to the detector. A linear response with exposure rate was obtained. Finally, the results were compared with previous ones for monocrystals of bismuth tri-iodide and polycrystalline films of alternative materials like lead iodide and mercuric iodide. Index Terms--Bismuth tri-iodide, compound semiconductor films, X-ray imaging.

Lead iodide purified by repeated evaporation was used for growing films by the physical vapor deposition method. Purity and stoichiometry of the starting material were determined by ICP and wet techniques. Films were grown onto 2 in x 2 in glass substrates with palladium as rear electrode. Lead-iodide films were grown by evaporating the starting material at 460 [degrees]C in high-purity Ar atmosphere (600 mmHg) for 1 to 4 days, depending on the film thickness. The substrate temperature was prefixed from 200 to 250[degrees]C. Film thickness was measured by transmission of the 59.5 keV radiation from [sup.241]Am giving values from 35 to 50 [micro]m (5%). Optical microscopy was performed on the films for determining crystallinity and grain size. Films were characterized by X-ray diffraction and texture was calculated as [[SIGMA]I(O O l)]/[[SIGMA]I(h k l)]. Correlations between grain size, crystallinity, and growth-preferred orientation along the c-axis perpendicular to the substrate with substrate temperature were confirmed. The texture of the films strongly increases with substrate temperature, and films with texture of about 90% were obtained. Correlation between starting material purity and stoichiometry with epitaxial growth were also found. For measuring electrical and X-ray response properties detectors were assembled by front palladium thermal deposition, palladium wire attachment, and acrylic encapsulation. Resistivity values of 5 x [10.sup.14] [ohm].cm and current density values of 5 pA/[cm.sup.2] at 30 V were obtained. X-ray film response was checked by irradiating with an X-ray beam, giving linear response with exposure rate and sensitivities of about 0.35 [micro]C/R.[cm.sup.2]. Again, a correlation between electrical properties with the substrate temperature and epitaxial growth was confirmed. Finally, results were compared with previous ones for the same and alternative materials. Index Terms--Compound semiconductor films, lead iodide, X-ray imaging.

This paper describes recent results obtained with mercuric iodide (Hg[I.sub.2]) polycrystalline films that we have produced. The ultimate goal of this effort is to develop a new detector technology for digital X-ray imaging based on Hg[I.sub.2] polycrystalline films coupled to large-area flat-panel amorphous silicon, thin-film transistor-addressed readout arrays. We have employed two approaches for producing the polycrystalline films: 1) thermal evaporation (sublimation) and 2) deposition of films from various solutions. The 50- to 150-[micro]m-thick films were characterized with respect to their electrical properties and in response to ionizing radiation. The leakage current was about 40 pA/[cm.sup.2] at an operating bias voltage of ~50 V. Signals from the Hg[I.sub.2] polycrystalline detectors, in response to ionizing radiation, compare favorably to the best published results for all high Z polycrystalline films grown elsewhere, including TIBr, Pb[I.sub.2], and Hg[I.sub.2]. Index Terms--Detectors, digital, Hg[I.sub.2] polycrystalline films, X-ray imagers.