Publications by authors named "Fortina A"

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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Article Synopsis
  • 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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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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  • 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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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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  • * 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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  • 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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We present the case of a child developing widespread vesicle-bullous lesions during an acute and symptomatic Epstein-Barr Virus infection. Antibody serology, biopsy, and direct immunofluorescence allowed the diagnosis of a paraviral bullous eruption. To our knowledge, this is the first report of bullous eruption following Epstein-Barr virus infection in childhood.

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Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive measures. This cross-sectional study involved data regarding 232 Italian patients with a stoma.

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  • - A newborn was diagnosed with trichothiodystrophy-3 (TTD3) due to a new homozygous variant in the GTF2H5 gene.
  • - The patient's severe symptoms included congenital ichthyosis, serious brain anomalies, life-threatening infections, bilateral cryptorchidism, and a rare complex heart defect.
  • - This case highlights the unusual severity and complexity of TTD3 symptoms, particularly the associated cardiac malformation not seen in previous TTD3 patients.
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Background: Organomegaly, including splenomegaly, hepatomegaly, and/or lymphadenopathy, are important diagnostic and prognostic features in patients with cutaneous mastocytosis (CM) or systemic mastocytosis (SM).

Objectives: To investigate the prevalence and prognostic impact of 1 or more organomegalies on clinical course and survival in patients with CM/SM.

Methods: Therefore, 3155 patients with CM (n = 1002 [32%]) or SM (n = 2153 [68%]) enrolled within the registry of the European Competence Network on Mastocytosis were analyzed.

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Mast cell leukemia (MCL) is a rare subtype of systemic mastocytosis defined by ≥20% mast cells (MC) on a bone marrow aspirate. We evaluated 92 patients with MCL from the European Competence Network on Mastocytosis registry. Thirty-one (34%) patients had a diagnosis of MCL with an associated hematologic neoplasm (MCL-AHN).

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Introduction: Psoriasis affects children with a considerable burden in early life. Treating pediatric psoriasis is challenging also because of the lack of updated specific guidelines. With the recent approval of several biologics for pediatric psoriasis and the ongoing COVID-19 pandemic, the management of young psoriatic patients is facing major changes.

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Currently, there are a few detailed guidelines on the overall management of children and adolescents with moderate-severe atopic dermatitis. AD ​​is a complex disease presenting with different clinical phenotypes, which require an individualized and multidisciplinary approach. Therefore, appropriate interaction between primary care pediatricians, pediatric allergists, and pediatric dermatologists is crucial to finding the best management strategy.

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Background: Contact allergy and atopic dermatitis (AD) are both common inflammatory T cell-mediated diseases and many factors may influence the prevalence of contact allergy in AD patients. In children, their possible correlation was debated with conflicting results.

Objectives: The present study aimed to assess the prevalence of contact sensitivity in children and to investigate the association with AD.

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  • Biological therapies are effective for treating severe psoriasis in children under 12, but this age group is often not included in clinical trials.
  • The 'BiPe Jr' study analyzed data from 82 children in France and Italy who received biological treatments, showcasing significant improvement in psoriasis severity and treatment duration for drugs like adalimumab and ustekinumab.
  • Although 52 children stopped their treatments mostly due to ineffectiveness and remission, the study pointed out safety concerns with reports of serious adverse events, including severe infections.
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Background: Contact dermatitis in construction workers (CWs) is frequent due to the widespread exposure to sensitizing substances and irritating agents and the wet and cold working conditions.

Objective: Our objectives were to evaluate contact dermatitis characteristics among CWs who underwent patch test in northeastern Italy and to identify related allergens.

Methods: Seven hundred ninety-five CWs were studied and their data were compared to 2.

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  • Bacterial impetigo is a prevalent skin infection in children, but there is a lack of clarity on how to effectively manage it, prompting the need for expert suggestions.* -
  • A team of Italian physicians reviewed current literature and identified 10 key controversial issues regarding the treatment of pediatric impetigo, discussing them from various medical perspectives to reach a consensus.* -
  • The article provides practical management recommendations for pediatric impetigo, aimed at reducing uncertainty in both hospital and outpatient care settings.*
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In systemic mastocytosis (SM), the clinical features and survival vary greatly. Patient-related factors determining the outcome in SM are largely unknown. We examined the impact of sex on the clinical features, progression-free survival (PFS), and overall survival (OS) in 3403 patients with mastocytosis collected in the registry of the European Competence Network on Mastocytosis (ECNM).

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Background: Mastocytosis in adults often presents with skin lesions. A bone marrow biopsy is necessary to confirm or exclude the presence of systemic mastocytosis (SM) in these cases. When a bone marrow biopsy is not performed, the provisional diagnosis is mastocytosis in the skin (MIS).

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