Stefano Piaserico

University of Padova, Padua, Veneto, Italy

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Publications (81)259.09 Total impact

  • Acta Dermato-Venereologica 11/2015; DOI:10.2340/00015555-2293 · 3.03 Impact Factor
  • Stefano Piaserico · Anna Michelotto · Anna C Frigo · Mauro Alaibac ·
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    ABSTRACT: Aim: The Toll-like receptor 7 (TLR7) agonist, imiquimod, offers a topical and noninvasive therapeutic method for the clinical treatment of superficial basal cell carcinoma (BCC). In this study we explored the relationship between the functional X-linked TLR7 rs179008/Gln11Leu polymorphism and the response to imiquimod in patients with BCC. Patients & methods: Thirty-four BCC patients treated with imiquimod were included in the study. SNP genotyping of the TLR7 promoter polymorphism was performed by TaqMan allelic discrimination assay. Results: In the group of female nonresponders to imiquimod a higher frequency of the altered genotype compared with responders was observed. Similarly, in the group of male nonresponders to imiquimod both patients with the mutated genotype were nonresponders. Conclusion: The results of this study show that patients carrying at least one T allele of the TLR7 promoter polymorphism are associated with an increased probability to be resistant to imiquimod therapy.
    Pharmacogenomics 11/2015; DOI:10.2217/pgs.15.132 · 3.22 Impact Factor
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    ABSTRACT: is missing (Short communication).
    Acta Dermato-Venereologica 08/2015; DOI:10.2340/00015555-2209 · 3.03 Impact Factor
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    ABSTRACT: Actinic keratoses (AKs) are a common premalignant skin condition. Many treatments are available for AKs. Photodynamic therapy (PDT) is one of the most effective treatments. However, major concerns exist on the possibility of PDT-induced DNA-mutagenesis/immunosuppression, leading to AKs recurrence/treatment failure. An extract (PLE) from the fern polypodium leucotomos reduces UV-induced immunosuppression and mutagenesis. To assess the ability of PLE to enhance the efficacy of PDT treatment, reducing AKs recurrence on the scalp. Thirty-four bald patients presenting at least two AKs on the scalp were alternatively assigned to two groups. Both groups underwent two PDT-sessions one-week apart. The first group began oral PLE supplementation one week after the last PDT session. Evaluation of the effect of PLE supplementation was performed by direct inspection of the bald areas, lesions count, and photodynamic diagnosis assessment at 2 and 6 months. Both groups were homogeneous in terms of skin phototype and previous UV exposure. Mean age was 75.7 ± 7.8 years and 76.5 ± 5.5 years, respectively. Both treatment modalities were successful in reducing AKs number (p < .001). However, PLE supplementation increased clearance rate compared with PDT alone (p = .040). Polypodium leucotomos improves PDT clearance and decreases AK recurrence rate at 6 months, suggesting its use as a complementary agent in the treatment of field cancerization.
    Dermatologic Surgery 08/2015; 41(8):898-902. DOI:10.1097/DSS.0000000000000425 · 2.11 Impact Factor
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    ABSTRACT: Actinic cheilitis (AC) is a common premalignant condition that requires an effective treatment to reduce the risk of malignant transformation. Photodynamic therapy (PDT) has been recently added to the armamentarium available for AC treatment. Daylight PDT (D-PDT) is a novel PDT modality in which the activation of the topical photosensitizer is induced by the exposure to natural daylight instead of artificial light sources without preliminary occlusion. This simplified procedure was found to be more tolerated as compared to conventional PDT. We report our preliminary experience on the use of D-PDT using methyl-aminolevulinate cream in 10 patients with refractory AC of the lower lip. Patients received two consecutive D-PDT sessions with an interval of 7-14 days. At 3 months after therapy, a complete response was observed in seven patients, with sustained results in five patients over an observational period of 6-12 months. Treatment was well tolerated. © 2015 Wiley Periodicals, Inc.
    Dermatologic Therapy 07/2015; DOI:10.1111/dth.12258 · 1.60 Impact Factor
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    ABSTRACT: Topical photodynamic therapy (PDT) is a widely approved therapy for actinic keratoses, squamous cell carcinoma in-situ, superficial and certain thin basal cell carcinomas. Recurrence rates are typically equivalent to existing therapies, although inferior to surgery for nodular basal cell carcinoma. PDT can be used both as a lesional or as a field therapy and has the potential to delay/reduce the development of new lesions. PDT has also been studied for its place in the treatment of, as well as its potential to prevent, superficial skin cancers in immune-suppressed patients, although sustained clearance rates are lower than for immunocompetent individuals. Many additional indications have been evaluated, including photo-rejuvenation and inflammatory and infective dermatoses. This S2 guideline considers all current and emerging indications for the use of topical photodynamic therapy in Dermatology, prepared by the PDT subgroup of the European Dermatology Forum guidelines committee. It presents consensual expert recommendations reflecting current published evidence. An unabridged version of this guideline is available online at:
    06/2015; 25(4). DOI:10.1684/ejd.2015.2570
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    ABSTRACT: CT--P13, a biosimilar of infliximab, was the first biosimilar monoclonal antibody to be approved in both the European Union and Korea. As a monoclonal antibody, CT--P13 is a large molecule with a high molecular weight and as such it differs from other biosimilars currently in the market. The comparability exercise for CT--P13 therefore requires special consideration as it was the first demonstration of biosimilarity between a biosimilar monoclonal antibody and its originator. This paper summarizes current regulations on the approval of biosimilars, describes the evidence leading to the approval of CT--P13 and discusses the potential role of this molecule in the Italian scenario on the basis of the view of a Group of Experts.
    Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia 03/2015; 150(4). · 0.86 Impact Factor
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    ABSTRACT: This was a prospective, multicentre study conducted in 14 Italian psoriasis referral centers (January-June 2014) with the objective of identifying factors associated with different levels of patient awareness on psoriasis. Overall, 298 patients (119 females, mean age 49.4 years, range 20-88) with a diagnosis of psoriasis (median of 14.1 years) were enrolled. Patients were more knowledgeable about the pathogenic nature of their condition compared with the other parameters (diagnosis, clinical course, prognosis, effect on QoL). Variables associated with significantly higher awareness, included years of education (the higher the educational levels the greater awareness), internet usage, other family member with the disease, diet rich in fruit/vegetables, cigarette smoking and bone and joint involvement. Older age, diabetes, and alcohol abuse were inversely associated. Having established factors that affect awareness in our patients we can now go on to devise educational interventions to address these needs.
    Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia 03/2015; · 0.86 Impact Factor
  • E Zattra · L Guarda Nardini · R Salmaso · S Piaserico ·

    Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia 02/2015; 150(1):131-133. · 0.86 Impact Factor
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    ABSTRACT: IntroductionDaylight-mediated photodynamic therapy has been shown to be an effective therapy for actinic keratoses (AKs) and a simple and tolerable treatment procedure in three randomized Scandinavian studies and two recent Phase III randomized controlled studies in Australia and Europe.Objectives To establish consensus recommendations for the use of daylight photodynamic therapy (DL-PDT) using topical methyl aminolaevulinate (MAL) in European patients with AKs.Methods The DL-PDT consensus recommendations were developed on behalf of the European Society for Photodynamic Therapy in Dermatology and comprised of 10 dermatologists from different European countries with experience in how to treat AK patients with PDT. Consensus was developed based on literature review and experience of the experts in the treatment of AK using DL-PDT.ResultsThe recommendations arising from this panel of experts provide general guidance on the use of DL-PDT as a dermatological procedure with specific guidance regarding patient selection, therapeutic indications, when to treat, pre-treatment skin preparation, MAL application and daylight exposure for patients with AK in different countries of Europe.Conclusions This consensus recommendation provides a framework for physicians to perform DL-PDT with MAL cream while ensuring efficiency and safety in the treatment of patients with AK in different European countries.
    Journal of the European Academy of Dermatology and Venereology 01/2015; 29(9). DOI:10.1111/jdv.12974 · 2.83 Impact Factor

  • Journal of Dermatological Science 01/2015; 78(2). DOI:10.1016/j.jdermsci.2015.01.005 · 3.42 Impact Factor
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    ABSTRACT: Postmarketing Phase IV Tumor necrosis factor alpha (TNF-α) is a cytokine that plays a critical role in inflammatory and immune processes and in the control of infections and sepsis. Data on the perioperative management of patients treated with biologic drugs are limited and mainly in patients with rheumatoid arthritis (RA) and inflammatory bowel disease (IBD). This retrospective study assesses variations in the incidence of side effects between psoriatic patients who temporarily discontinue or continue biological therapy before surgical treatment. Despite the immunosuppressive risk, our results suggest that postoperative complications are not influenced by the suspension of biologic therapies. As TNF-α plays a role in promoting collagen synthesis and wound healing, we suggest that anti-TNFs should be discontinued before major surgery, whereas for minor surgery, the lower rates of infections favor anti-TNF-α continuation, particularly since suspending anti-TNF therapy is known to induce psoriasis relapse.
    Drug Development Research 11/2014; 75 Suppl 1(S1):S24-6. DOI:10.1002/ddr.21189 · 0.77 Impact Factor
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    ABSTRACT: Background There is increasing awareness of the clinical relevance of psoriasis comorbidities and of the importance of timely and effective screening for such comorbidities in the management of psoriatic patients. Previous works have focused on assessing evidence for prevalence of comorbidities and on the best available evidence for sensitivity in diagnosing suspected comorbidities. No algorithms are available, which have been tested on large numbers of physicians concerning the acceptance of such algorithms both by practicing clinical dermatologists and by their consulting specialists from other fields.Objective To propose a multidimensional assessment algorithm for psoriasis comorbidities which may prove at the same time enough sensitive and practically sustainable in daily clinical practice.Methods After an exhaustive literature search, we performed a Delphi procedure involving 50 dedicated dermatological centres to obtain a standardized assessment algorithm, which would meet requirements of sustainability and acceptability both from the point of view of Evidence-Based Medicine as well as from the point of view of practical and clinical feasibility: to meet both requirements, results from the Delphi procedure were elaborated and modified by a restricted panel of experts.ResultsThe procedure has yielded PSOCUBE, a three-dimensional table comprising 14 clinical examination and history taking items, 32 screening laboratory and instrumental exams and 11 clinimetric scores.ConclusionPSOCUBE, a simple algorithm, may be employed by practising dermatologists to perform standardized assessment procedures on psoriatic patients raising the chances of early recognition of patients at risk for comorbidities, thus fostering more effective prevention; PSOCUBE may therefore contribute to reduce the overall impact of this chronic, widespread disease.
    Journal of the European Academy of Dermatology and Venereology 11/2014; 29(7). DOI:10.1111/jdv.12809 · 2.83 Impact Factor
  • Stefano Piaserico · Elena Sandini · Alda Saldan · Davide Abate ·
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    ABSTRACT: Postmarketing Phase IV Psoriasis was previously considered to be mostly a Th1 cell-related disorder, but Th17 cell has recently emerged as an important player in the pathogenesis of psoriasis. The Th17 immune pathway is increased in psoriatic patients, both in peripheral circulation and in skin lesions, and positively correlates with the Psoriasis Area and Severity Index. Anti-tumor necrosis factor alpha (TNF-α) agents, in addition to potent inhibition of TNF-α activity, are able to decrease IL-17 levels and Th17 cells in the skin and plasma of patients with moderate-to-severe psoriasis. We found a decrease in the median Th17 cell count in peripheral blood after 4 months' therapy with anti-TNF-α compared with baseline values, but the difference did not reach statistical significance, probably due to the small cohort size. Our data suggest that anti-TNF-α treatment for psoriasis is able to achieve a substantial Th17 cell count reduction in the peripheral blood of patients and that this decrease is significantly associated with an adequate response to biologic therapy, as previous studies in rheumatoid arthritis have shown.
    Drug Development Research 11/2014; 75 Suppl 1(S1):S73-6. DOI:10.1002/ddr.21202 · 0.77 Impact Factor
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    ABSTRACT: OBJECTIVE: Psoriasis can have a profound impact on quality of life (QoL) and an awareness of the processes of the disease and its treatment is important in coping with symptoms. Patients do not always understand the potential consequences of their disease and the wide range of effective treatment strategies now available. We designed and validated a questionnaire to investigate patient awareness and understanding of psoriasis including pathogenesis, diagnosis, prognosis and treatment. PATIENTS AND METHODS: This was a multicentre, cross-sectional investigation involving 14 psoriasis referral centres in Italy. The focus group technique was used by a panel of experts in psoriasis, to draw-up a list of questions exploring pathogenesis, diagnosis, prognosis, factors influencing clinical course of psoriasis as well as QoL issues and sources of information on their condition. Psychometric properties of the questionnaire were tested on a sample of 240 adult patients with psoriasis (including treatment-naïve and -experienced patients). RESULTS: The mean age of patients was 50.3±14.9 years and 34.2% were female. The median time from diagnosis was 13.7 years (IQR 7.3-23.2). The Cronbach alpha was 0.77 and all items showed higher correlations within their own dimensions than to other dimensions. Each domain of awareness was well represented by a single dimension. Mean overall awareness was 59.7±13.1 on a 100-point scale. CONCLUSIONS: Our questionnaire was valid in assessing patient awareness in five relevant areas of psoriasis, and can be useful in both the clinical setting and research studies to evaluate patients' knowledge of psoriasis better, with the final aim of reducing the burden of this chronic condition.
    European review for medical and pharmacological sciences 11/2014; 18(22):3435-52. · 1.21 Impact Factor
  • I Russo · S Piaserico · A Belloni-Fortina · M Alaibac ·
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    ABSTRACT: Solid organ transplant patients are at greatly increased risk of developing a wide variety of skin cancers, particularly epithelial skin cancers. On the other hand, it is well known that an intact immune system limits the development of benign melanocytic lesions. The eruptive nevi phenomenon, which we can observe in solid organ transplant recipients, is indicative of the relationship between melanocyte proliferation and immune system. Regression of melanocytic nevi after restoration of complete immune responsiveness is a further clinical example the role of immunosurveillance on melanocyte proliferation. However, melanoma incidence in organ transplant recipients appears only 2-3 folds higher than in general population. To this regard, organ transplant recipients who develop de novo melanomas thicker than 2mm seem to have a significantly worse outcome with a greatly increased risk of dying of metastatic melanoma, whereas those who develop a ≤2 mm thickness melanoma seem to have a prognosis similar to that of the general population. Furthermore, there is no evidence supporting an increased risk of melanoma recurrences after transplant in patients with a history of low-risk melanoma. Melanoma is also one of the most frequent and lethal donor-derived malignancies suggesting that a history of invasive melanoma should be considered an absolute contraindication to donation. The aim of this review is to investigate the relationship between immunosuppression and melanoma and to discuss its clinical implications for the management of transplant-associated melanoma.
    Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia 08/2014; 149(4):389-94. · 0.86 Impact Factor
  • S Piaserico · E Sandini · A Peserico · M Alaibac ·
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    ABSTRACT: Cutaneous infections might occur in up to 80% of organ transplant recipients (OTR) and viral infections are the most common them. The risk of different skin infection is among related to the intensity of immunosuppression. During the first post-transplant period, herpes viruses are most common. After some months following transplantation, human papilloma viruses represent the most significant infections among OTR. Reactivation of herpes simplex virus in OTR can become more invasive, takes longer to heal, and shows greater potential for dissemination to visceral organs compared to the general population. Specific immunosuppressive drugs (namely muromonab and mycophenolate mofetil) have been associated with an increased risk of herpes virus reactivation after transplantation. On the other hand, there is evidence that the mTOR inhibitors, such as everolimus, may be associated with a decreased incidence of herpesvirus infections in transplant recipients. The incidence of herpes zoster in OTR is 10 to 100 fold higher than the general population, ranging from 1% to 12%. The chronic immunosuppression performed in OTR may lead to persistent replication of herpesviruses, dissemination of the virus with multivisceral involvement (hepatitis, pneumonitis, myocarditis, encephalitis and disseminated intravascular coagulation) and eventually, the emergence of antiviral-drug resistance. Viral warts are the most common cutaneous infection occurring in OTR. The number of warts increases with the duration of immunosuppressive therapy. Since warts in organ recipients are frequently multiple and only rarely undergo spontaneous regression, the therapeutic management of warts in patients treated with immunosuppressive drugs might be challenging. Imiquimod, 1% cidofovir ointment, acitretin proved to be useful off-labelstrategies for recalcitrant cutaneous viral warts in OTR. Extensive and atypical presentation of molluscum contagiosum has been also reported in OTR, with a prevalence between 3% to 6.9%. Giant molluscum contagiosum is a clinical variant in which large nodule greater than 0.5-1 cm in diameter are observed.
    Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia 08/2014; 149(4):409-15. · 0.86 Impact Factor
  • E Zattra · I Coati · M Alaibac · S Piaserico ·
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    ABSTRACT: Kaposi sarcoma and Merkel cell carcinoma represent potentially lethal cutaneous complications in organ transplanted patients. These neoplasms can severely complicate the clinical outcome of transplanted patient. Moreover, as the diagnosis is mainly clinical, a knowledge of these clinical entities may be fundamental in the daily management of this group of patients. In this review we will discuss these neoplasms in relation to the role of immunosuppression in their onset and progression.
    Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia 06/2014; 149(4). · 0.86 Impact Factor
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    ABSTRACT: Abstract is missing (Short).
    Acta Dermato-Venereologica 03/2014; 94(6). DOI:10.2340/00015555-1789 · 3.03 Impact Factor

  • 03/2014; 24(1). DOI:10.1684/ejd.2014.2269