Publications by authors named "Anna Belloni Fortina"

While atypical, the development of psoriatic plaques over vascular malformations in children is plausible and should not necessarily prompt clinicians to perform costly or invasive procedures.

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Introduction: Chronic hand eczema (CHE) is an inflammatory skin condition characterized by different pathomechanisms, clinical presentations, and prognoses. Treatment is often challenging because of limited approved drugs, and severe CHE is associated with reduced quality of life (QoL) and poor overall health measures in terms of psychological, functional, and occupational challenges. This study aims to describe the real-life management practices of Italian dermatologists who frequently treat patients with CHE, compare these practices with existing guidelines, and propose practical clinical recommendations for the management of these patients.

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This study, employing an interim analysis, investigates the effects of the Dermamecum protocol, a structured educational and tailored approach that stratifies ostomy patients into risk paths (green, yellow, red) based on pre-operative and post-operative characteristics. The green path indicates a low risk of peristomal skin complications (PSCs), focusing on sustaining healthy behaviours and basic stoma care. The yellow path represents a moderate risk, emphasizing the need for patients to self-monitor and recognize early signs of complications.

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  • * The systematic literature review analyzed six relevant studies from a total of 64, examining the effectiveness of these treatments on nine patients, highlighting benefits like long-term tissue remodeling and improved skin aesthetics.
  • * The findings suggest that the combination of laser therapy and fillers could enhance treatment for LS patients, indicating a need for more research to develop a solid clinical approach and improve patient quality of life.
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  • Atopic dermatitis (AD) affects about 14.8% of adolescents and can negatively impact their sleep, academic performance, mood, self-esteem, and social interactions.
  • Upadacitinib was recently approved for treating moderate-to-severe AD in adolescents 12 years and older, and this real-world study aimed to assess its effectiveness and safety.
  • The study found significant improvements in the severity of AD among patients treated with upadacitinib over 52 weeks, with most achieving substantial reductions in symptoms and good overall safety outcomes.
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This comprehensive review offers a detailed look at atopic dermatitis (AD) treatment in Italy, focusing primarily on the use of biologics and small molecules. In response to advancing knowledge of AD's causes and treatments, there's a global need for updated guidelines to provide physicians with a more comprehensive clinical perspective, facilitating personalized treatment strategies. Dupilumab, a groundbreaking biologic, gained approval as a significant milestone.

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Atopic dermatitis (AD) is still a demanding challenge in clinical practice. Type 2 inflammation is the most common inflammatory pathway in children and adolescents with AD. Anti-inflammatory drugs, mainly corticosteroids (CS) and immunomodulant agents are the primary therapeutic approach to dampening type 2 inflammation.

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Background: The efficacy and safety of dupilumab in atopic dermatitis (AD) have been defined in clinical trials but limited real-world evidence on long-term treatment outcomes is currently available to inform clinical decisions.

Objectives: To describe the long-term effectiveness and safety of dupilumab up to 48 months in patients with moderate-to-severe AD.

Methods: A multicentre, retrospective, dynamic cohort study was conducted to assess long-term effectiveness and safety of dupilumab in patients with moderate-to-severe AD in a real-world setting.

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  • Acral amelanotic melanomas (AAMs) are rare skin cancers found on areas like palms and soles, often misdiagnosed due to their lack of pigmentation and benign appearance, which leads to treatment delays and worse outcomes.
  • A systematic review analyzed 26 cases of AAMs misdiagnosed as other conditions, revealing a balanced gender distribution, an age range of 38-91 years, and highlighting that the foot was the most common site of these lesions.
  • The study emphasizes the need for more biopsy evaluations in lower extremity lesions to improve diagnosis rates, as only 7.1% of foot lesions underwent histological assessment, compared to 50% for upper extremity cases.
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  • Hypersensitivity reactions (HR) are common in mastocytosis, a condition analyzed using data from the European Competence Network on Mastocytosis (ECNM), involving 2485 adults.
  • About 38.1% of patients reported HR, with Hymenoptera venoms being the primary trigger for cutaneous mastocytosis and indolent systemic mastocytosis, while drug reactions were more common in advanced systemic mastocytosis.
  • Key risk factors for HR include lower tryptase levels, minimal mast cell infiltration in bone marrow, and a diagnosis of indolent systemic mastocytosis, with new reactions occurring in 4.8% of patients over four years.
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Allergic contact dermatitis (ACD) is a common inflammatory skin disease caused by delayed hypersensitivity to chemical and biotic contact allergens. ACD significantly affects the patients' quality of life negatively impacting both occupational and non-occupational settings. Patch testing is the gold standard diagnostic in vivo test to precise the ACD etiology and to correctly perform prevention.

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Certain laboratory abnormalities correlate with subvariants of systemic mastocytosis (SM) and are often prognostically relevant. To assess the diagnostic and prognostic value of individual serum chemistry parameters in SM, 2607 patients enrolled within the European Competence Network on Mastocytosis and 575 patients enrolled within the German Registry on Eosinophils and Mast Cells were analyzed. For screening and diagnosis of SM, tryptase was identified as the most specific serum parameter.

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  • Kaposi's sarcoma (KS) is a rare tumor with four clinical forms, diagnosed through histopathological and immunohistochemical analyses, and treated using a mix of local and systemic methods.
  • A retrospective study analyzed 86 KS patients treated over 29 years, showing that most were male and had the classical variant, with surgery and chemotherapy being the common treatments.
  • The study found a persistent treatment response in about 65% of patients, a 22% relapse rate, and an overall survival rate of 90% to 70% over 2 to 10 years, emphasizing the need for a multidisciplinary approach to manage the disease effectively.
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Preferentially Expressed Antigen in Melanoma (PRAME), a member of the cancer/testis antigen family, is central to the field of skin cancer diagnostics and therapeutics. As a nuclear receptor and transcriptional regulator, PRAME plays a critical role in inhibiting retinoic acid signalling, which is essential for cell differentiation and proliferation. Its aberrant overexpression in various malignancies, particularly cutaneous melanoma, is associated with more aggressive tumour phenotypes, positioning PRAME as both a diagnostic and prognostic marker.

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Background: Approved systemic treatment options are limited for pediatric patients with moderate to severe plaque psoriasis.

Objective: To assess the efficacy and safety of apremilast over 16 weeks in pediatric patients with plaque psoriasis.

Methods: SPROUT (NCT03701763) was a phase 3, multicenter, randomized, double-blind, placebo-controlled study of apremilast in patients aged 6-17 years with moderate-to-severe psoriasis (Psoriasis Area and Severity Index [PASI] ≥12, body surface area ≥10%, static Physician Global Assessment [sPGA] ≥3) inadequately controlled by/inappropriate for topical therapy.

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Background: Pancreatic cancer is notorious for its aggressive nature and low survival rate, with less than 10% of patients surviving beyond five years. Early detection is difficult, but skin metastases can be a rare but significant indicator. This systematic review focuses on the epidemiology, clinical features, and histology of skin metastases from pancreatic cancer to determine their importance in early diagnosis and overall management of the disease.

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  • * A study involving 118 adults with moderate-to-severe AD found that over half experienced sleep issues, severe itching, and frequent flare-ups, affecting their daily functioning.
  • * Many patients reported significant disease impact on their lives, with around 37.3% indicating severe effects from AD, while one in four felt their current treatment was insufficient.
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Background: Ethylenediamine dihydrochloride is a versatile aliphatic amine found in numerous medications and industrial compounds and is a known sensitiser. The sensitization prevalence is affected by geographical and socio-cultural factors.

Objectives: The objectives are to analyse the temporal trend of sensitization to ethylenediamine dihydrochloride in northeastern Italy and to investigate associations with occupations.

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  • Psoriasis is a common skin condition that typically appears in areas of friction, but when it affects the lips, it's rare and often misdiagnosed.
  • Despite various anti-psoriatic treatments available, most evidence comes from limited case studies with incomplete results.
  • A 14-year-old boy with lip psoriasis was treated successfully with adalimumab, leading to complete remission after 6 months.
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