Publications by authors named "Pileri A"

This case report describes an 83-year-old patient with a history of non-melanoma skin cancer who presented with a violaceous, painless nodule on the neck. Dermoscopic examination and subsequent biopsy revealed a Small/Medium CD4 T-cell lymphoproliferative disorder (SMPLPD) of the skin. Although excision was initially recommended, the patient opted for treatment with CO laser ablation.

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A 57-year-old male with a three-year history of folliculotropic mycosis fungoides (FMF), previously treated systemically, received CO2 laser-assisted photodynamic therapy (PDT) following the recurrence of FMF on the face. The procedure involved a CO2 laser (SmartXide DOT Deka) and the photosensitizing agent methyl aminolevulinate (MAL) (METVIX 160 mg/g Cream, Galderma Medical), in conjunction with a red light-emitting diode lamp (Aktilite CL128, Galderma, wavelength 630 nm). The primary endpoint was the clinical remission of the lesions; the secondary one the evaluation of treatment tolerance, measured using the 11-point (0-10) Numeric Rating Scale (NRS) for burning/pain, heat, and swelling.

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Topical chlormethine (CL) gel formulation was approved by the EMA in 2017 for the treatment of adult patients with mycosis fungoides (MF). To expand the knowledge on the management of MF, this paper provides an overview of clinical practice evidence about the MF diagnostic phase and a collection of clinical experiences to better characterize the use of CL gel in daily practice. Collected cases underline the importance of the concomitant biopsy and clinical evaluation in the diagnostic phase, with the contribution of a multidisciplinary team, and support the use of CL gel as a first-line or adjuvant treatment in selected patients.

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Article Synopsis
  • Skin infections can be linked to underlying diseases, with lymphomas being a potential primary cause.
  • There are two types of lymphomas related to the skin: primary cutaneous lymphoma and secondary cutaneous lymphoma (SCL), the latter being associated with systemic lymphoma.
  • The review aims to explore current knowledge about SCL, focusing on clinical aspects, histological characteristics, and survival rates.
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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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Article Synopsis
  • - CCR4 receptor plays a key role in cutaneous T-cell lymphoma (CTCL) therapy by weakening immune responses against cancerous T-cells, making it a critical target for treatment.
  • - Monoclonal antibodies like mogamulizumab help decrease tumor size and improve patient outcomes by blocking CCR4’s interaction with ligands, preventing harmful T-cell movement and survival; further combinations with other treatments are being researched.
  • - Challenges such as drug resistance and off-target effects remain, leading to the need for improved patient selection and ongoing trials; despite advances, more real-world data is essential to set realistic expectations for these new therapies.
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Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorders (PCSM-LPDs), represent a rare group of haematological diseases primarily affecting the skin. In this retrospective single-centre case series study, we aimed to investigate the demographic, clinical, therapeutic and prognostic aspects of PCSM-LPD. We collected data from cases diagnosed between 2010 and the present, employing histopathological and immunohistochemical methods following the World Health Organization criteria.

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Background: Psoriasis (P) and atopic dermatitis (AD) share some common characteristics. The resulting clinical picture with shared manifestations is a new entity called psoriasis dermatitis (PD), atopic psoriasis or psorema. The purpose of this study was to identify the clinical manifestations of this new dermatological condition, focusing on the adult population.

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Cutaneous T cell lymphomas (CTCLs), encompassing mycosis fungoides (MF) and Sézary syndrome (SS), present a complex landscape influenced by cytokines and cellular responses. In this work, the intricate relationship between these inflammatory proteins and disease pathogenesis is examined, focusing on what is known at the clinical and therapeutic levels regarding the most well-known inflammatory mediators. An in-depth look is given to their possible alterations caused by novel immunomodulatory drugs and how they may alter disease progression.

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Article Synopsis
  • Lymphomatoid papulosis (LyP) can present in various ways and may be misdiagnosed as aggressive skin lymphomas, especially those involving γδ T-cells.
  • A study analyzed 26 cases of LyP with γδ T-cell expression, noting that most patients were treated with topical steroids or had no treatment.
  • The findings highlighted significant differences in how LyP presents, underlining the importance of recognizing specific clinical features and markers to avoid misdiagnosis.
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Introduction: Cutaneous adverse events can occur in patients treated with antineoplastic treatments, albeit their incidence has not been defined yet. The clinical presentation of CAEs related to anticancer treatments can vary. The purpose of our study is to characterize skin toxicities during oncological treatments, manage such adverse events to improve patients' quality of life, and ensure therapeutic adherence.

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Mogamulizumab is a first-in-class IgG1k monoclonal antibody that selectively targets the chemokine receptor type 4. The drug has received Food and Drug administration authorisation for mycosis fungoides and Sézary syndrome following failure of at least one previous course of systemic therapy and now is available in Europe. One of the most common treatment-related side effects observed has been the mogamulizumab-associated rash (MAR), which affects up to a quarter of patients and is the most frequent adverse event leading to drug discontinuation.

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Background: Topical chlormethine (CL) is recommended as a first-line treatment for early-stage mycosis fungoides (MF) and in 2017, the European Medicines Agency approved the CL gel formulation to treat adult patients. More recently, to increase patient compliance and adherence, clinicians have developed flexible protocols that allow the concomitant use of CL gel with topical corticosteroids in daily practice regimens. Therefore, sharing real-life data on CL gel use and side effects management may help improve the use of this agent.

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