1,188 research outputs found
Chronische Graft-versus-Host-Erkrankung am männlichen Genitale: eine unterschätzte Manifestation
No full textnon
Efficacy and safety of guselkumab in two psoriatic patients with hepatitis B and C virus infection
No full textHelicobacter Pylori infection in psoriatic patients during biological therapy
No full textPsoriasis is a relapsing inflammatory disease exacerbated by many triggers. Helicobacter Pylori (H. Pylori) is a Gram-negative bacterium causing the liberation of many cytokines and having a role in systemic inflammation. We assessed over a period of 12 months the presence of H. Pylori in psoriatic patients undergoing biologic therapy and how PASI improved after its eradication
Radiation-induced angiosarcoma of the breast: an uncommon polymorphic disorder
No full textBreast conservative surgery combined with whole-breast radiotherapy has become the gold standard for the treatment of breast cancer, leading to the risk of subsequent occurrence of a secondary breast angiosarcoma in the irradiated area. We describe a case series
Giulia Veronica Varisco
No full textThe headword explains the biography and the contribution of the author Giulia Varisco to the children's literatur
A New Hybrid Therapeutic Approach to Solitary Keratoacanthoma: Complete Recovery in Six Patients
No full textIntroduction: Solitary keratoacanthoma (SKA) is generally considered as a well-differentiated form of squamous cell carcinoma, but it usually runs a benign course and a not aggressive behavior. Diagnostic criteria, prognosis, and treatment of SKA are not fully defined yet. Surgical treatment with fusiform excision represents the gold standard; nonoperative intralesional therapy of KA is uncommon but may provide a valid option in some categories of patients. Case series presentation: We report our experience regarding the treatment of SKA with a hybrid treatment consisting of a minimally invasive technique such as curettage followed by intralesional corticosteroid administration in the same session. Six patients affected with KA were treated ending in a complete resolution, with good esthetic outcome, no relapse after 1 year, and satisfaction of the patients. Discussion and conclusion: The combined treatment allows us on the one hand to avoid radical surgery in selected patients and particular anatomic areas and on the other the side effects that the use of intralesional chemotherapy/immunosuppressive drugs can entail
Treatment of Netherton syndrome with dupilumab
No full textBackground
Netherton syndrome (NS) is a rare autosomal recessive skin disease caused by loss of function mutations in SPINK5 gene (serine protease inhibitor of kazal type 5) encoding LEKTI (lymphoepitelial kazal-type-related inhibitor). Its clinical presentation includes congenital ichthosis, hair shaft abnormalities (bamboo hair or trichorrhexis invaginata) and atopic diathesis. No specific therapy for NS has been identified at the moment.
Objective
To explore the clinical effects that type 2 cytokines blockage with dupilumab has in a patient with NS.
Methods
A 29-year-old woman with NS and severe atopic manifestations was treated with dupilumab. Clinical monitoring was performed over 6 months. We also reviewed the clinical effects reported by other authors while treating NS patients with dupilumab.
Results
In our patient, dupilumab induced a rapid and sustained reduction of pruritus, scaling and erythema. Only ten cases of patients with NS treated with dupilumab are reported in the literature, including ours. In general, dupilumab improved most of patients’ clinical manifestation, especially pruritus. Only two adverse events were reported by other authors, namely a case of conjunctivitis and a case of bacterial infection.
Conclusion
NS is a rare genodermatosis that could cause severe complication and impact patients’ quality of life. In NS patients inhibition of IL-4 and IL-13 signaling was associated with remarkable clinical improvements, especially in controlling pruritus. Our data support the use of dupilumab for controlling skin manifestation and symptoms of NS
Survey of bullous pemphigoid in an Italian University hospital: clinical-epidemiological characteristics and follow-up
No full textThe clinical-epidemiological characteristics and course of bullous pemphigoid in the general population is not clear. Few studies have been performed to date, and only one in the Italian population more than ten years ago. We decided to evaluate the characteristics and outcome of patients admitted for a bullous pemphigoid at our Hospital in the last 4 years
Combining secukinumab with dimethyl fumarate for treatment of a patient with psoriasis and recent diagnosis of multiple sclerosis
No full textResults
We report the case of a 44-year-old male patient referred to our department in 2006 for evaluation and management of psoriasis and psoriatic arthritis not responding to previous topical therapies and to conventional systemic treatments. On initial evaluation, his Psoriasis Area and Severity Index (PASI) was 23 so it was decided to start a biological therapy. Etanercept was firstly introduced with partial control of both cutaneous and articular manifestations and stopped after 2 years due to a loss of efficacy. Then, other different biological drugs were administered but discontinued for loss of efficacy or no clinical response. In 2017, we started a treatment with secukinumab with significant clinical improvement. These results were still maintained after 2 years. In January 2019, due to several episodes of hypoesthesia and paraesthesia, the patient performed a neurological examination and a brain magnetic resonance imaging (MRI) with gadolinium revealing multiple encephalic and spinal hyperintense lesions compatible with focal demyelinated areas. A diagnosis of relapsing-remitting multiple sclerosis was made and therapy with dimethyl fumarate (240 bid) started. Secukinumab therapy was maintained but decreasing the dose to 150 mg/month in order to reduce the immunosuppressive risks. After 12 months of follow-up, the patient tolerates the association of the two therapies and presents good control of both diseases.
To the best of our knowledge, this is the first case of a combination of two immunosuppressive drugs, secukinumab and dimethyl fumarate, for the treatment of a patient with concomitant psoriasis and multiple sclerosis. Among the widely different conventional therapies available to treat these two diseases, only dimethyl fumarate has been approved for both conditions. Moreover, interleukin 17 (IL-17) appears to play a key role in the pathogenesis of both diseases; it is produced by lymphocytes Th17, but also by CD8+ cells, Tγδ lymphocytes and some cells of the central nervous system, such as astrocytes and oligodendrocytes, in the context of active lesions of multiple sclerosis. Currently, the efficacy of anti IL-17 has been described only in few cases of multiple sclerosis. In conclusion, our case emphasizes the potential efficacy and safety of combination therapy of secukinumab and dimethyl fumarate, which may be a therapeutic option for such challenging patients
Dietary habits of psoriatic patients treated with dimethyl fumarate and drug-related side effects: results from an observational study
No full textBackground: Despite its favorable long-term safety profile, side effects during dimethyl fumarate (DMF) treatment for psoriasis are not uncommon and may lead to treatment suspension. The association between side effects, especially gastrointestinal, and dietary habits has not yet been specifically addressed. Methods: This observational, cross-sectional study aimed to assess the dietary habits of patients with moderate-to-severe plaque psoriasis in treatment with DMF who attended three Italian psoriasis clinics. Demographic and clinical data, including any side effects, were collected from the patients' medical records. A self-administered questionnaire recorded and scored: 1) if meals are eaten regularly or not; 2) daily intake at meals of fatty foods, milk and dairy products, alcohol, fruit and vegetables; and 3) in the case of side effects, the time between eating and their onset. Results: We included 53 patients in treatment with DMF at a daily dose of 232.4±194.1 mg for 38±29.8 weeks. Thirty-eight (71.7%) reported side effects, namely flushing (60.5%), diarrhea (44.7%), gastralgia (29%) and nausea (15.8%). Overweight seemed associated with the occurrence of side effects. In 47.4% of subjects, side effects appeared within 2 hours of having a meal. Daily fat intake appeared to protect against side effects, albeit without statistical significance; skipping meals was correlated with their onset in subjects complaining of diarrhea. Conclusions: Finding some correlation between dietary habits and occurrence of side effects during DMF treatment requires further investigation with the aim of developing possible strategies to improve its tolerability and retention rate
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