Publications by authors named "Naldi Luigi"

Eosinophilic fasciitis (EF) poses a diagnostic challenge owing to its uncommon occurrence and aetiology that remains poorly understood. We report a case of a 79-year-old woman with a prolonged history of breast cancer exhibiting EF with concomitant pelvic metastases. This case underscores EF's potential as an indicator signaling a potential resurgence of cancer, highlighting its significance as a red flag of disease recurrence.

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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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Importance: Prurigo nodularis (PN) is a chronic and debilitating skin condition, characterized by intense itch with multiple nodular lesions. Nemolizumab demonstrated significant improvements in itch and skin nodules in adults with moderate to severe PN in a previous 16-week phase 3 study (OLYMPIA 2).

Objective: To assess the efficacy and occurrence of adverse events in adults with moderate to severe PN treated with nemolizumab vs those receiving placebo.

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Article Synopsis
  • Oral antifungals are the main treatment for onychomycosis, with topical treatments for mild cases, and CO laser therapy has been introduced to improve topical effectiveness.
  • This study compared the effectiveness of two CO laser treatments (fractional and fully ablative) in patients with a specific type of toenail fungal infection.
  • Results showed that fully ablative CO laser treatment had a higher success rate and lower relapse rate compared to fractional treatment, indicating it may be a better option for cases resistant to topical therapies.
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Background: Atopic dermatitis (AD) is a heterogeneous disease, associated with comorbidities, and high healthcare consumptions and costs. This study assessed the burden before and after treatment with dupilumab in adults with severe AD from 2018 to 2020, from the perspective of the Italian National Health Service (SSN).

Methods: From Fondazione Ricerca e Salute's administrative healthcare database (~5 million inhabitants/year), adults treated with dupilumab from 09/01/2018 to 31/12/2020 (index date) and a five-year lookback were identified.

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Article Synopsis
  • * Treatment methods for HS include a mix of medical therapies (like antibiotics and biologics) and surgical options, though many patients still experience high rates of recurrence and progression despite these treatments.
  • * A recent meeting of Italian HS experts focused on improving treatment strategies, emphasizing the importance of integrating biologic therapy with surgical options, and identifying ten key areas that need further exploration to optimize patient care.
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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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Introduction: Onychomycosis is the most common nail infection, predominantly caused by spp., and is divided into four main types. Confirmatory testing is crucial, but obtaining an adequate sample may be challenging.

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Background: Alopecia areata (AA) is an organ-specific autoimmune disease that affects the hair follicles of the scalp and the rest of the body causing hair loss. Due to the unpredictable course of AA and the different degrees of severity of hair loss, only a few well-designed clinical studies with a low number of patients are available. Also, there is no specific cure, but topical and systemic anti-inflammatory and immune system suppressant drugs are used for treatment.

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Article Synopsis
  • A new guideline for atopic eczema was published in two parts in August and September 2022, based on the EuroGuiDerm standards, following extensive consensus conferences with experts from twelve European countries.
  • The guideline incorporates recent evidence on new systemic medications, with an update released in October 2022.
  • Italian dermatological societies adapted the original EuroGuiDerm guideline for the Italian healthcare context, adding specific notes to highlight regulations and recommendations from the Italian Ministry of Health and regional authorities.
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SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and affordable tool to Italian physicians who take care of patients affected by atopic dermatitis. The evidence- and consensus-based guideline on atopic eczema was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual.

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Article Synopsis
  • - SIDeMaST developed guidelines for treating chronic plaque psoriasis and adapted them for the Italian healthcare system, aiming to provide a dependable resource for doctors treating atopic dermatitis patients in Italy.
  • - The guideline follows the EuroGuiDerm Manual and was created with the input of 29 experts from 12 European countries, involving four consensus conferences held between December 2020 and July 2021.
  • - It includes comprehensive information on systemic therapies, discussing conventional immunosuppressants, biologics, and Janus kinase inhibitors, while the second part will focus on factors like diet, immunotherapy, and considerations for special patient groups.
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Retroareolar cysts (RCs) are a benign self-resolving condition primarily affecting pubertal individuals. However, their presentation as asymptomatic bluish areolar lumps remains underreported in the literature, with only six cases previously documented. This lack of awareness may lead to the oversight of RCs during diagnosis.

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Background: Nail psoriasis poses challenges for effective treatment, and topical drug delivery through the nail plate is limited. A novel approach to address this challenge involves the use of ablative fractional laser as a pretreatment strategy to enhance topical drug delivery for nail psoriasis.

Summary: This systematic review, conducted in accordance with PRISMA guidelines, involved an extensive literature search across PubMed/MEDLINE, EMBASE, and the Cochrane Library up to July 2023.

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Psoriasis, a chronic inflammatory skin disease, goes beyond visible symptoms and affects the general well-being of patients. The aim of this study is to understand how patients with psoriasis perceive their skin characteristics and reactivity to allergens. The study population includes 11,283 participants within the European Dermato-Epidemiology Network (EDEN) Fragrance study, covering several European regions.

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A 14-year-old boy presented with a history of non-tender, subcutaneous coalescing nodules located on the ventral-lateral aspects of the penis shaft for one year. Laboratory investigations for blood count and autoimmunity were within normal limits. Complete excision was performed, and on histology, the dermis showed necrobiotic material composed of altered collagen bundles, surrounded by a palisade of histiocytes and scattered lymphocytes, thus allowing a diagnosis of subcutaneous granuloma annulare.

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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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Limited real-world data are available on upadacitinib drug survival in patients with atopic dermatitis (AD). To investigate upadacitinib drug survival, and the reasons and predictors of drug discontinuation in AD patients. All consecutive patients aged 18-75 years, affected by moderate-to-severe AD, and treated with upadacitinib for more than 1 month at dermatological clinics were included during November 2020-August 2023.

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