Publications by authors named "Tognetti L"

Aims: ultrasound (US) diagnosis of enthesitis is burdened of low specificity, especially when it is performed in patients with psoriasis (PsO) but without clinical psoriatic arthritis (PsA), because of mechanical, dysmetabolic and age-related concurrent enthesopatic changes. We propose a novel US score to quantify the cortical-entheseal bone remodeling burden of several peripheral entheses, aiming to improve the specificity of US for PsA-related enthesitis, and to evaluate its diagnostic value in PsO patients with subsequent diagnosis of psoriatic arthritis (PsO/PsA).

Methods: clinical and US data of 119 consecutive patients with moderate/severe PsO and nonspecific musculoskeletal symptoms, were included in this retrospective study.

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Background/objectives: Hidrocystomas, eccrine and apocrine, are rare cystic lesions that form benign tumors of the sweat glands. This study aimed to describe the clinical features of hidrocystomas and evaluate the role of non-invasive imaging techniques, including dermoscopy, Line-field Confocal Optical Coherence Tomography (LC-OCT), Reflectance Confocal Microscopy (RCM), and Ultra-High-Frequency Ultrasound (UHFUS), in their diagnosis.

Methods: In total, seven cases of hidrocystomas were collected from the Dermatologic Clinic of the University of Siena, Italy.

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Article Synopsis
  • Lentigo maligna (LM) and LM melanoma (LMM) are challenging to surgically remove due to unclear boundaries, especially on the face where minimizing tissue excision is important.
  • This study evaluated the long-term effectiveness of using Reflectance Confocal Microscopy (RCM) alongside the "spaghetti" surgical technique for excising LM/LMM in 70 patients.
  • Findings showed a 5.7% recurrence rate over an average of 6.3 years, with the RCM method achieving effective margin clearance (2.7 mm) while reducing tissue removal compared to traditional methods (6.7 mm).
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Introduction: Line-field confocal optical coherence tomography (LC-OCT) represents one of the newest non-invasive in vivo skin imaging techniques. Previous studies described morphologic criteria of basal cell carcinoma (BCC) under LC-OCT examination. Preliminary data on LC-OCT diagnostic performance for BCC have recently been published but showed only a modest improvement compared to dermoscopy, possibly due to study limitations.

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  • Facial pigmented skin lesions are common, especially in South-European countries, and can be either malignant or benign; diagnosing them can be challenging, even for specialists like dermatologists.* -
  • A study was conducted to assess the impact of a one-day dermoscopy training course on ophthalmologists, focusing on their ability to evaluate periorbital pigmented lesions through clinical and dermoscopic analysis.* -
  • Results showed that before the training, ophthalmologists had an accuracy of 63.7%, but after the course, their sensitivity improved, indicating a positive effect of the training on their diagnostic skills.*
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Primary cutaneous lymphomas (PCL) are a heterogeneous group of non-Hodgkin lymphomas arising from malignant T (CTCL) or B (CBCL) cells, often mimicking other skin conditions. Recently, non-invasive diagnostic imaging modalities, including dermoscopy, Reflectance Confocal Microscopy (RCM), and Line-field Optical Coherence Tomography (LC-OCT), have become increasingly important, supporting clinicians in clinical practice. Hence, our study aimed to describe dermoscopic, RCM, and LC-OCT features of PCL and to explore their role in PCL management.

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Introduction: UVA-UVB increases skin matrix metalloproteinases and breaks down extracellular proteins and fibrillar type 1 collagen, leading to photodamage. Topical application of nicotinamide prevents UV-induced immunosuppression. Several studies have demonstrated the importance of protection against UV.

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Given progressive population ageing and the increase in the number of patients with comorbidities, the management of chronic and/or hard-to-heal wounds (HHWs) nowadays represents a common problem in many clinical settings. In these cases, standard strategies may not be sufficient. Autologous grafting represent the gold standard for permanent wound closure, but is almost never realized when the skin loss is extensive/the patient is young.

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  • Diagnosing atypical pigmented facial lesions (aPFLs) is difficult for dermatologists and crucial for patient care, as incorrect diagnoses can lead to mismanagement and delays in treatment.
  • The study compared machine learning and deep learning models to improve diagnostic accuracy of aPFLs using 1197 dermoscopic images classified into seven categories, focusing on the potential role of AI in supporting clinicians.
  • Results showed that while dermatologists were 71.2% accurate in identifying malignant versus benign lesions, their accuracy dropped to 42.9% when distinguishing among specific lesions, highlighting the complexity of aPFL evaluations.
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  • Antibiotic resistance is a growing global issue, affecting both systemic and topical treatments for infections, highlighting the need for alternatives like antiseptics.
  • Polyhexanide (PHMB) is noted for its effectiveness in controlling infections without promoting resistance, making it a viable option for treating various dermatological conditions.
  • The text suggests updated clinical practices for managing wounds and skin infections, advocating for the use of innovative treatments like PHMB and Rigenase® instead of traditional topical antibiotics.
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(1) Background: Ocular emergencies account for 1.5-3% of emergency department (ED) visits and require urgent diagnosis to prevent serious complications. Ultrasonography is a crucial, non-invasive diagnostic tool for these conditions but traditionally lacks portability and integration with modern electronic smart devices.

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Background: Line-field confocal optical coherence tomography is a novel technology able to reproduce a "virtual biopsy" of the skin. The aim of this review is to explore the application of line-field confocal optical coherence tomography (LC-OCT) in various skin diseases, covering skin cancers, inflammatory and infectious skin diseases, genetic diseases, cosmetic procedures, and less common disorders.

Methods: Study selection was conducted based on LC-OCT and using pertinent MeSh terms, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines from inception to March 2024; to evaluate the quality and risk of bias of studies, Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) was used.

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Article Synopsis
  • Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are key melanoma subtypes with an incidence of 1.37 per 100,000 in the U.S., often misdiagnosed, especially among the elderly, leading to treatment delays.
  • A study evaluated the diagnostic abilities of ophthalmologists in identifying pigmented skin lesions in the periorbital region by reviewing 79 cases, comparing their results with dermatologists.
  • Results showed that ophthalmologists had a diagnostic accuracy of 63.5% and lower sensitivity compared to dermatologists (33.3% vs. 46.9%), with a significantly higher percentage of ophthalmologists rating cases as "difficult" and suggesting fewer biopsies
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There has been growing scientific interest in the research field of deep learning techniques applied to skin cancer diagnosis in the last decade. Though encouraging data have been globally reported, several discrepancies have been observed in terms of study methodology, result presentations and validation in clinical settings. The present review aimed to screen the scientific literature on the application of DL techniques to dermoscopic melanoma/nevi differential diagnosis and extrapolate those original studies adequately by reporting on a DL model, comparing them among clinicians and/or another DL architecture.

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Article Synopsis
  • * The systematic review analyzed 21 eligible studies and found that people with skin diseases like psoriasis, chronic urticaria, and acne suffer more frequently from FM symptoms.
  • * While this review suggests a connection between FM and skin conditions, the exact causes remain unclear, highlighting the need for more research in this field.
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Introduction: Soon after birth, the clinical differential diagnosis between sebaceous of Jadassohn (NSJ), congenital triangular alopecia (CTA) and aplasia cutis congenita (ACC) may be challenging. A certain overlap of standard dermoscopic features can occur, especially in atypical cases, depending on scalp skin morphology and maturation age. The recently developed line-field confocal optical coherence tomography (LC-OCT) can provide morphological skin details with cellular resolution trough a rapid non-invasive examination.

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  • Extramammary Paget disease (EMPD) is a rare skin cancer that often gets misdiagnosed due to its misleading appearance, complicating effective treatment and diagnosis.
  • Traditional methods like biopsies are invasive and can be uncomfortable for patients, and non-invasive techniques have limited effectiveness.
  • Line-field confocal optical coherence tomography (LC-OCT) is a promising new imaging technology that provides better diagnostic accuracy for EMPD and its recurrence, with a study showing much higher accuracy rates after proper training in its use.
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  • Porokeratosis variants are uncommon skin conditions that can often be misdiagnosed, mimicking more common skin issues.
  • A new technology called line-field confocal optical coherence tomography (LC-OCT) allows for non-invasive imaging of the skin, providing detailed views up to 500µm deep.
  • In a study with 54 patients, LC-OCT showed high reliability in diagnosing porokeratosis variants and identified unique features not visible in traditional histology, suggesting it could help avoid unnecessary biopsies.
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  • * Researchers collected a dataset of 471 lesions from 10 European centers and evaluated them through a blinded analysis involving 156 dermatologists of varying experience, using a specialized online platform.
  • * The findings revealed that certain areas, like the heel and fingers, had higher rates of early-stage melanomas compared to atypical nevi, and demonstrated that diagnosing lesions in the plantar arch was particularly challenging for dermatologists.
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