Publications by authors named "Santo Mercuri"

: Janus kinase inhibitors (JAKi) have significantly advanced the treatment of various dermatological conditions by modulating the JAK-STAT signalling pathway. While these inhibitors have proven effective, they also pose challenges due to associated increase in serum lipid levels and relative potential cardiovascular risks. This perspective work aims to discuss the implications of these lipid alterations proposing management strategies for patients with dermatological disorders under JAKi treatments.

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Baricitinib, a JAK 1/2 inhibitor, is approved for treating severe alopecia areata (AA). This study aimed to evaluate the long-term effectiveness and safety of baricitinib in a real-world setting over 52 weeks. This multicenter retrospective study included 96 adult patients diagnosed with severe AA from 11 Italian Dermatology Units.

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Introduction: Psoriasis and hidradenitis suppurativa (HS) are chronic inflammatory diseases with significant overlap in their immunologic pathways, which involve cytokines such as tumor necrosis factor-alfa, interleukin (IL)-17, and IL-23. Current treatment options for HS are limited, as only adalimumab and secukinumab are approved for severe cases. Given the overlapping pathogenetic features between HS and psoriasis, anti-IL-17 and anti-IL-23 drugs could represent valuable treatments for the management of HS.

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Melanoma is currently the most prevalent malignant neoplasm among adults and represents the second most common cancer in both sexes among individuals aged 0 to 39 years. This retrospective multicenter study delves into the distinctive clinical, anamnestic, histopathologic, and prognostic attributes of melanoma in Adolescent and Young Adults (AYA), defined as patients diagnosed at ≤40 years, across four Italian centers. Through a computer-based review of clinical records from 1 January 2010 to 30 September 2023, AYA melanomas were contrasted with non-AYA melanomas (>40 years) among 1452 patients.

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(1) Background/Objectives: Nail psoriasis (NP) is a chronic and difficult-to-treat disease, which causes significant social stigma and impairs the patients' quality of life. Moreover, nail psoriasis is a true therapeutic challenge for clinicians. The presence of nail psoriasis can be part of a severe form of psoriasis and can have predictive value for the development of psoriatic arthritis.

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Anorectal melanoma (ARM) is a rare malignancy often associated with a poor prognosis due to its late diagnosis and aggressive biological behavior. This review aims to comprehensively investigate ARM's diagnosis, management, and treatment, emphasizing its clinical characteristics, laboratory findings, and implications for patient prognosis. A systematic literature search was conducted in PubMed, Embase, and Cochrane CENTRAL databases from inception to 1 July 2024.

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Psoriasis is a chronic, immune-mediated, inflammatory skin disease, associated with multiple comorbidities and psychological and psychiatric disorders. The quality of life of patients with this disease is severely compromised, especially in moderate-to-severe plaque psoriasis. Secukinumab, a fully humanized monoclonal antibody, was the first anti-interleukin (IL)-17 biologic approved for treating psoriasis.

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: Amelanotic/hypomelanotic melanomas (AHMs) account for 2-8% of all cutaneous melanomas. Due to their clinical appearance and the lack of specific dermoscopic indicators, AHMs are challenging to diagnose, particularly in thinner cutaneous lesions. The aim of our study was to evaluate the clinicopathological and dermoscopic features of thin AHMs.

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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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The autoantigens LL37 and ADAMTSL5 contribute to induce pathogenetic T-cells responses in a subset of psoriatic patients. Whether the presence of LL37-and/or ADAMTS5-reactive T-cells influences the clinical response to treatment is still unknown. The aim of the study is to evaluate the clinical responses to the anti-IL-23 risankizumab in LL37 and/or ADAMTSL5-reactive patients in comparison with non-reactive ones and to assess whether genetics (HLA-Cw06.

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Background: Genital involvement in atopic dermatitis(AD) can have a significant impact on the patient's quality of life. However, inspection of genital areas is not usually conducted during routine examination and patients may be reluctant to inform the clinician or show this area.

Objective: to evaluate the efficacy of tralokinumab in AD patients with genital involvement.

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Purpose: Tildrakizumab is a selective inhibitor of IL-23 approved for the treatment of moderate-to-severe plaque psoriasis in two dosages. We conducted a 16-week multicenter retrospective study to compare the effectiveness and safety of tildrakizumab 200 mg versus tildrakizumab 100 mg in patients with a high disease burden or high body weight.

Materials And Methods: Our retrospective study included 134 patients treated with tildrakizumab 200 mg and 364 patients treated with tildrakizumab 100 mg from 28 Italian Dermatology Units affected by moderate-to-severe plaque psoriasis.

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  • During the COVID-19 pandemic, dermatologists faced challenges in assessing nail psoriasis via teledermatology, particularly when patients also had other nail issues like onychotillomania and onychophagy.
  • The study evaluated patients with nail psoriasis over 9 months, comparing the Nijmegen-Nail psoriasis Activity Index (N-NAIL) with a new tool, Galeazzi-Nail psoriasis Activity Index (GN-NAIL), to improve severity rating and treatment monitoring.
  • The findings indicated that GN-NAIL effectively scored nail psoriasis severity even in complicated cases, showing solid consistency and correlation in assessments across different clinical settings.
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Background: Tirbanibulin 1% ointment is approved for the field treatment of Olsen grade I actinic keratoses (AKs) of the face and scalp.

Methods: We performed a multicenter retrospective study involving 15 dermatologic units in Italy to investigate the efficacy and tolerability of tirbanibulin in a real-life setting. 250 patients were enrolled.

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Introduction: Multicentric Castleman's disease (MCD) with cutaneous involvement has rarely been discussed in dermatologic literature, with few reports. Cutaneous lesions in MCD may induce deep scars, causing a significant impact in the daily life of the patients. The treatment of Castleman's disease (CD) is usually a challenge, especially in case of cutaneous involvement.

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  • Melasma is a common skin condition that's hard to treat, and assessing the depth and distribution of pigmentation is crucial for effective treatment.
  • Non-invasive imaging techniques like reflectance confocal microscopy (RCM) are helping to evaluate melasma by providing detailed insights into pigment location within the skin layers.
  • The study highlights two main types of melasma (epidermal and mixed) and emphasizes RCM's role in monitoring treatment effectiveness and identifying factors that influence treatment outcomes.
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  • Genital psoriasis affects about 60% of psoriasis patients, presenting challenges in treatment, but IL-17 inhibitors like bimekizumab have shown promise for this difficult condition.
  • A 16-week study on 65 participants revealed that 98.4% achieved clear improvement in genital psoriasis, demonstrating both effective symptom relief and enhanced quality of life.
  • The results indicate bimekizumab could be a beneficial treatment for genital psoriasis, but further research with larger and longer studies is needed to confirm these findings.
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  • A study investigated the effects of dupilumab exposure during pregnancy in women with atopic dermatitis, focusing on safety and outcomes for both mothers and infants.
  • Researchers analyzed data from 19 hospitals in Italy, identifying 29 pregnant patients who used dupilumab, with the majority reporting unplanned pregnancies and stopping the medication when they learned of their pregnancy.
  • The findings indicated no significant risks associated with dupilumab for adverse pregnancy or neonatal outcomes, suggesting safety for its use in early pregnancy, but further monitoring is recommended for continued use throughout pregnancy.
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Introduction: The development of several effective biological drugs for moderate-to-severe plaque psoriasis has dramatically changed the lives of patients. Despite the wide use of interleukin (IL) inhibitors, limited data are available to date regarding long-term treatment persistence.

Method: This multicenter retrospective real-world study evaluated 5932 treatment courses across 5300 patients, all treated with interleukin inhibitors.

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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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: Cutaneous lupus erythematosus (CLE) presents clinically heterogeneous manifestations, partially explained by the different expression of Toll-like receptors (TLRs) type 8 and 9, located to endosomal compartments where they are poised to recognize microbial nucleic acids. This disease is empirically treated with hydroxychloroquine (HCQ), which is hallmarked with a safe and effective profile, but induces a slow and sometimes clinically insufficient therapeutic response. Currently, no biomarkers predictive of response are validated or even proposed in the scientific literature.

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