Publications (22)59.9 Total impact
-
Article: Development of a preliminary US power Doppler composite score for monitoring treatment in PsA.
[show abstract] [hide abstract]
ABSTRACT: To develop a preliminary power Doppler (PD) US composite score for global assessment of PsA patients. Sixteen PsA patients receiving anti-TNF-α therapy were enrolled. All patients were involved in multiple psoriatic targets, including joints, tendon, enthesis, skin and nail. The target with the highest PD signal, one for each target area, was selected to be scanned at baseline and at follow-up visit 8 weeks after. For each target, PD was graded according to semi-quantitative scoring systems. Inter- and intra-observer reliability and feasibility was also investigated. The new PD composite score for PsA was called Five Targets PD for Psoriatic Disease (5TPD). Sixty targets (16 joints, 9 tendons, 11 enthesis, 16 psoriatic plaques and 8 psoriatic onychopathies) were assessed. A significant improvement of the clinical scores was found at follow-up with respect to the baseline: HAQ modified for SpA (HAQ-S) (P = 0.0001); Psoriasis Area and Severity Index (P = 0.0001) and Nail Psoriasis Severity Index (P = 0.35). The 5TPD showed a significant change between baseline and follow-up (P = 0.0001). There was no significant correlation between HAQ-S and 5TPD findings. The inter- and intra-observer κ-values varied from good to excellent at baseline and follow-up. The time spent on baseline US examinations was mean (s.d.) 10.5 (2.0) min and no more than 7 min for follow-up assessment. The present study provides a new working hypothesis that the sonographic core set may be useful to construct a PDUS composite score for the assessment of PsA. The 5TPD formula provides a feasible and reliable approach for multi-target monitoring of psoriatic disease.Rheumatology (Oxford, England) 02/2012; 51(7):1261-8. · 4.24 Impact Factor -
Article: Hemosiderotic clear-cell acanthoma: a pigmented mimicker.
[show abstract] [hide abstract]
ABSTRACT: The authors report on a case of a 65-year-old man with pigmented clear-cell acanthoma located on the right thigh. Dermoscopy disclosed a peculiar picture consisting of diffuse black pigmentation with a superficial greyish veil in the central portion, dotted-to-globular dark red-black structures mainly located at the periphery with a homogenous regular reticular arrangement; peripheral translucid desquamation. Dermoscopic features are correlated with the histology, where hemosiderin deposits present in a sheet-like arrangement in the perivascular papillary dermis and in a band-like disposition in the reticular dermis at the base of the lesion can account for the pigmented picture. The lesion arose on a trauma-prone skin site; thus the authors believe that traumatic irritation may be responsible for the clinical and dermoscopic pictures, giving rise to a reaction similar in a way to the Auspitz's sign provocated by trauma for psoriasis. Red blood cells extravasation from extremely superficialized capillaries may have led to hemosiderin deposition in the papillary and the reticular dermis.Indian Journal of Dermatology 07/2011; 56(4):426-7. -
Article: Subclinical entheseal involvement in patients with psoriasis: an ultrasound study.
[show abstract] [hide abstract]
ABSTRACT: The main aim of the present study was to determine the prevalence of subclinical entheseal involvement at lower limbs by ultrasound (US) in patients with psoriasis. The secondary aim was to determine the interobserver reliability of the Glasgow Ultrasound Enthesitis Scoring System (GUESS) and power Doppler (PD) technique in the assessment of enthesopathy. The study was conducted on 45 patients with psoriasis and 45 healthy sex- and age-matched controls. All patients with no clinical evidence of arthritis or enthesitis underwent an US examination. All US findings were identified according to GUESS. The interobserver reliability was calculated in 15 patients with psoriasis. A total of 450 entheses in 45 patients with psoriasis were evaluated by US. In 148 of 450 (32.9%) entheses, grayscale US found signs indicative of enthesopathy. In 4/450 (0.9%) entheses PD signal was detected. In the healthy population, US found signs of enthesopathy in 38 of 450 (8.4%) entheses and no PD signal was detected. The GUESS score was significantly higher in patients with psoriasis than in healthy controls (P < 0.0001). Both concordance correlation coefficient and unweighted κ values for US findings showed an excellent agreement (0.906 and 0.890, respectively). Our results indicate that both grayscale US and PD findings indicative of enthesopathy were more frequent in patients with psoriasis. The US ability to detect signs of subclinical enthesopathy should be the object of longitudinal investigations to define its value in predicting the clinical onset of psoriatic arthritis.Seminars in arthritis and rheumatism 04/2011; 40(5):407-12. · 4.72 Impact Factor -
Article: Clinical images: multi-modality imaging monitoring of anti-tumor necrosis factor α treatment at the joint and skin level in psoriatic arthritis.
Arthritis & Rheumatism 12/2010; 62(12):3829. · 7.87 Impact Factor -
Article: Treating psoriasis with etanercept in italian clinical practice: prescribing practices and duration of remission following discontinuation.
[show abstract] [hide abstract]
ABSTRACT: conventional antipsoriatic therapies are often administered until remission, with treatment resumed in the case of relapse, in order to reduce the likelihood of cumulative, dose-dependent toxicities. Biological agents have been safely used in continuous therapy. to assess the use of etanercept for psoriasis in clinical practice in Italy. this was an observational study carried out in 13 dermatological centres across Italy in patients with plaque psoriasis (with a Psoriasis Area and Severity Index [PASI] score >or=10) treated with etanercept. The study comprised a treatment and subsequent discontinuation period. Patients were eligible if they had plaque psoriasis and had begun treatment with etanercept between 1 September 2007 and 1 April 2008. Patients were evaluable for the duration of discontinuation analysis if they achieved a PASI reduction >or=50% (PASI50) and a PASI score <10 at the end of treatment. Etanercept treatment was restarted if the PASI score reached >or=10 or the patient had a clinical relapse. Data were collected retrospectively up to June 2008 and prospectively between July 2008 and January 2009. Patients received etanercept during the treatment period, followed by no etanercept treatment (other psoriasis treatment permitted) during the discontinuation period, and etanercept again during re-treatment. The main outcome measures were: PASI scores (type A responders: PASI reduction >or=75% [PASI75]; type B responders: PASI50 and PASI final score <10), Dermatology Life Quality Index (DLQI) scores and body surface area (BSA) involvement. Time from discontinuation to re-treatment was evaluated. Use of other antipsoriatic medications was recorded throughout. eighty-five patients were evaluable for the treatment period. Overall, 55 (64.7%) of these patients were prescribed etanercept 50 mg twice weekly. The mean treatment duration was approximately 25 weeks. In total, 79 patients (92.9%) were considered type B responders and 77 of these patients were evaluable for the duration of discontinuation analysis. Overall, 68/85 (80%) were type A responders. During the treatment period, 7/85 (8.2%) patients received other antipsoriatic therapies. Improvements in mean DLQI score (-71.5%) and mean BSA involvement (-79.2%) were also observed. Etanercept was well tolerated. During the discontinuation period, 40/77 (51.9%) patients used other antipsoriatic medications (group 1) and 37/77 (48.1%) did not (group 2). The mean duration of discontinuation was significantly longer in group 1 (174 days) than in group 2 (117 days, log-rank test: p = 0.0013). in clinical practice, the duration of discontinuation from etanercept was in accordance with previously reported data, and was longer in patients who received other antipsoriatic drugs during discontinuation of etanercept than in those who did not. High rates of PASI50 and PASI75 response were obtained with etanercept, and these rates were higher than those observed in controlled clinical studies. Etanercept treatment was flexible, effective and well tolerated, and was associated with improved quality of life.Clinical Drug Investigation 01/2010; 30(8):507-16. · 1.82 Impact Factor -
Article: High-frequency sonography in the evaluation of psoriasis: nail and skin involvement.
[show abstract] [hide abstract]
ABSTRACT: The purpose of this study was to show the potential of the latest sonographic equipment using high-frequency probes and a very sensitive power Doppler (PD) technique in depicting both skin and nail changes in patients affected by psoriasis. The study was conducted in 30 patients with a diagnosis of psoriasis clinically performed by an experienced dermatologist and 15 healthy participants, using a currently available sonography system equipped with a variable-frequency transducer ranging from 6 to 18 MHz and a Doppler frequency ranging from 7 to 14 MHz. The images illustrated in this presentation are representative examples of the ability of sonography to show and characterize even minimal morphostructural and blood flow changes in patients with both psoriatic plaques and onychopathy. This report provides pictorial evidence that high-resolution gray scale sonography with a PD technique is a real-time and noninvasive imaging technique that can be used as an adjunct to the clinical evaluation in assessing psoriatic disease.Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 11/2009; 28(11):1569-74. · 1.25 Impact Factor -
Article: A sonographic spectrum of psoriatic arthritis: "the five targets".
[show abstract] [hide abstract]
ABSTRACT: Ultrasound is a rapidly evolving technique that is gaining an increasing success in the assessment of psoriatic arthritis. Most of the studies have been aimed at investigating its ability in the assessment of joints, tendons, and entheses in psoriatic arthritis patients. Less attention has been paid to demonstrate the potential of ultrasound in the evaluation of skin and nail. The aim of this pictorial essay was to show the main high-frequency grayscale and power Doppler ultrasound findings in patients with psoriatic arthritis at joint, tendon, enthesis, skin, and nail level.Clinical Rheumatology 10/2009; 29(2):133-42. · 2.00 Impact Factor -
Article: Acute generalized exanthematous pustulosis induced by hydroxychloroquine: three cases and a review of the literature.
[show abstract] [hide abstract]
ABSTRACT: Acute generalized exanthematous pustulosis (AGEP) is a clinical reaction pattern that is principally drug induced and is characterized by acute, extensive formation of nonfollicular sterile pustules on an erythematous and edematous substrate. Hydroxychloroquine (HHCQ), an antimalarial drug widely used to treat rheumatic and dermatologic diseases, has been described as an uncommon cause of AGEP. This article reports 3 cases of HCQ-induced AGEP and reviews similar cases in the published literature. The first case involved a 36-year-old woman with a 10-year history of rheumatoid arthritis and Sjögren's syndrome who had begun a 25-day course of HCQ 100 mg BID due to lack of response to a corticosteroid, with a skin reaction developing 21 days into the new treatment. In the second case, a 70-year-old man with poorly controlled rheumatoid arthritis had begun a course of oral HCQ 100 mg BID 20 days before development of AGEP. The final case involved a 79-year-old woman with polymyalgia rheumatica who had been receiving HCQ 100 mg BID as a steroid-sparing agent for 22 days, with rash developing 20 days after the initiation of HCQ. Sixteen cases of HCQ-induced AGEP were identified in the literature, including some that may have been reported under a different name but were consistent with a clinical diagnosis of AGEP. The US Food and Drug Administration has mandated a change to the labeling for HCQ to include AGEP among potential adverse dermatologic reactions to the drug. This article reports 3 cases of AGEP related to administration of HCQ. HCQ-induced AGEP is a rare but severe, extensive, and acute reaction. No specific therapy is available, and correct diagnosis generally leads to spontaneous resolution once the causative drug has been withdrawn.Clinical Therapeutics 06/2008; 30(5):930-40. · 2.32 Impact Factor -
Article: Pegylated liposomal doxorubicin in the treatment of primary cutaneous T-cell lymphomas.
[show abstract] [hide abstract]
ABSTRACT: Pegylated liposomal doxorubicin (Peg-Doxo) is a promising drug for advanced/recalcitrant primary cutaneous T-cell lymphomas (CTCLs). This prospective phase II trial enrolled 19 patients. We observed overall and complete response rates of 84.2% and 42.1% (with no significant differences between stage I-IIA and IIB-IV patients), and 11% grade III/IV toxicity. After a maximum 46 month-follow-up, median overall (OS), event-free (EFS) and progression-free (PFS) survival were 34, 18 and 19 months. OS, EFS and PFS rates at 46 months were 44%, 30% and 37% respectively. Peg-Doxo seems to be an active and safe principle that should be used in plurirelapsed, early stage-MF and in combination with other chemotherapeutic agents in advanced and aggressive CTCLs.Haematologica 06/2007; 92(5):686-9. · 6.42 Impact Factor -
Article: Acquired reactive perforating collagenosis following diclofenac therapy in a patient with parapsoriasis
[show abstract] [hide abstract]
ABSTRACT: A case of acquired reactive perforating collagenosis in a 70-year old man with a long standing digitate parapsoriasis is reported. Multiple asymptomatic cutaneous hyperpigmented papules with a central adherent keratotic plug developed simultaneously with widespread purpuric eruption following a single i.m. diclofenac injection. Histologic examination of a keratotic lesion revealed an epidermal crater with centrally degenerated collagen and elastic fibre extrusion. This case is interesting for the lack of pruritus, the transepithelial elimination of both collagen and elastic fibres and the association with parapsoriasis. The etiologic role of diclofenac is discussed. The term acquired perforating dermatosis may be more suitable for this case.Journal of the European Academy of Dermatology and Venereology 07/2006; 6(1):65 - 70. · 2.98 Impact Factor -
Article: Lichen planus with plasma cell infiltrate
Journal of the European Academy of Dermatology and Venereology 07/2006; 8(1):75 - 77. · 2.98 Impact Factor -
Article: Long-term experience with low-dose interferon-alpha and PUVA in the management of early mycosis fungoides.
[show abstract] [hide abstract]
ABSTRACT: Combined high-dose Interferon-alpha and psoralen plus ultraviolet A irradiation (PUVA) have been reported to be effective in the treatment of early mycosis fungoides (MF); however, our study is the first controlled prospective study in the literature exploring the activity and tolerability of the combination with low dosages and evaluating further clinical outcome of early-MF patients. We carried out a multicentric prospective Phase II clinical study on 89 patients with early-stage IA to IIA MF treated for 14 months with low-dose IFN-alpha2b (6-18 MU/wk) and PUVA. Treatment success was analysed in terms of freedom from treatment failure. Complete remission (CR) was achieved in 84% and an overall response rate in 98% of cases: six-month CR was associated with a non-confluent skin infiltrate at histology (P = 0.044) and 14-month CR with high epidermal CD1a+ dendritic-cell density (P = 0.030). The combination protocol was successfully tolerated and the most common reason of 'failure' was related to relapse and not to toxicity. Sustained remissions were achieved in 20% of patients. High CD8+ lymphoid T-cell density was associated with a lower relapse rate (P = 0.002). We think that our combination therapy can be considered an alternative approach compared with other modalities. Good immunological host surveillance in the skin lesions seems to be an optimal basis for the therapeutic success.European Journal Of Haematology 09/2005; 75(2):136-45. · 2.61 Impact Factor -
Article: Long‐term experience with low‐dose interferon‐α and PUVA in the management of early mycosis fungoides
[show abstract] [hide abstract]
ABSTRACT: Objectives: Combined high-dose Interferon-α and psoralen plus ultraviolet A irradiation (PUVA) have been reported to be effective in the treatment of early mycosis fungoides (MF); however, our study is the first controlled prospective study in the literature exploring the activity and tolerability of the combination with low dosages and evaluating further clinical outcome of early-MF patients. Methods: We carried out a multicentric prospective Phase II clinical study on 89 patients with early-stage IA to IIA MF treated for 14 months with low-dose IFN-α2b (6–18 MU/wk) and PUVA. Treatment success was analysed in terms of freedom from treatment failure. Results and conclusions: Complete remission (CR) was achieved in 84% and an overall response rate in 98% of cases: six-month CR was associated with a non-confluent skin infiltrate at histology (P = 0.044) and 14-month CR with high epidermal CD1a+ dendritic-cell density (P = 0.030). The combination protocol was successfully tolerated and the most common reason of ‘failure’ was related to relapse and not to toxicity. Sustained remissions were achieved in 20% of patients. High CD8+ lymphoid T-cell density was associated with a lower relapse rate (P = 0.002). We think that our combination therapy can be considered an alternative approach compared with other modalities. Good immunological host surveillance in the skin lesions seems to be an optimal basis for the therapeutic success.European Journal Of Haematology 07/2005; 75(2):136 - 145. · 2.61 Impact Factor -
Article: Early videocapillaroscopic changes of the psoriatic skin after anti-tumour necrosis factor alpha treatment.
Dermatology 02/2005; 210(3):241-3. · 2.05 Impact Factor -
Article: Raynaud's phenomenon after combined adjuvant chemotherapy for breast cancer.
Chemotherapy 10/2003; 49(5):267-8. · 1.82 Impact Factor -
Article: Psoriasis-like dermoscopic pattern of clear cell acanthoma.
[show abstract] [hide abstract]
ABSTRACT: Dermoscopy provides additional criteria for the diagnosis of skin lesions. To investigate the dermoscopic aspect of clear cell acanthoma (CCA). Six consecutive cases of CCAs were observed under conventional dermoscopy (Case 1-4) or videodermoscopy (Case 5-6). Common dermoscopic findings were: (i) squamous surface with translucid collarette; (ii) dilated capillary loops, mainly perpendicularly orientated to the skin surface, as dotted, pinpoint-like structures, regularly distributed in a reticular array over the surface. The vascular psoriasis-like dermoscopic findings seem to be a clue for CCA and provide evidence of an inflammatory process for CCA formation.Journal of the European Academy of Dermatology and Venereology 08/2003; 17(4):452-5. · 2.98 Impact Factor -
Article: Hereditary benign telangiectasia: videocapillaroscopic findings.
[show abstract] [hide abstract]
ABSTRACT: In this article, we provide a detailed depiction of capillary changes at the nailfold and labial mucosa in a patient with hereditary benign telangiectasia. To the best of our knowledge, no such extensive capillaroscopic documentation of this entity has been made previously.Dermatology 02/2003; 206(3):260-2. · 2.05 Impact Factor -
Article: Atrophie blanche associated with interferon-alfa adjuvant therapy for melanoma: a cutaneous side effect related to the procoagulant activity of interferon?
Dermatology 02/2002; 204(2):154. · 2.05 Impact Factor -
Article: Videocapillaroscopic findings in the microcirculation of the psoriatic plaque.
[show abstract] [hide abstract]
ABSTRACT: Videocapillaroscopy (VCP) is a method to study the morphology and dynamics of microcirculation, but information about capillaroscopic features of the psoriatic plaque is limited. To investigate the distribution, morphology and density of capillaries in lesional and perilesional skin of the psoriatic plaque. VCP of a well-delimited plaque of the trunk, arms or legs in 15 consecutive patients with untreated, chronic plaque psoriasis was performed. In the lesional skin, capillaries were tortuous and dilated, homogeneously appearing as 'bushy'. In the perilesional skin, capillary loops seemed to be on a parallel course with respect to the skin surface, with their apex directed towards the marginal zone. The number of capillary loops per area unit was statistically increased in perilesional compared to lesional skin. According to the morphology, distribution and density of capillary loops, two different angiogenetic patterns were found in lesional and perilesional skin.Dermatology 02/2002; 204(3):236-9. · 2.05 Impact Factor -
Article: Cutaneous carcinomas and preinvasive neoplastic lesions. Role of MMP‐2 and MMP‐9 metalloproteinases in neoplastic invasion and their relationship with proliferative activity and p53 expression
[show abstract] [hide abstract]
ABSTRACT: Background: Metalloproteinases (MMPs) are thought to be involved in the process of destruction of basement membranes and stromal invasion by neoplastic epithelial cells.Aims: In order to investigate the role of MMPs in cutaneous oncogenesis we studied the expression of MMP-2 and MMP-9 in 34 cases of epidermal preinvasive neoplastic lesions and invasive carcinomas. We also studied their relationship with the expression of tissue inhibitors of MMPs and with proliferative activity and p53 expression in neoplastic epithelial cells.Results: MMP-9 was found to be focally expressed by neoplastic epithelial cells at the infiltrative edges in microinvasive carcinomas and in dyskeratotic foci in Bowen’s disease and widely invasive carcinomas. Gradation of Mib-1 positivity and p53 expression was found with increasing abnormality in the spectrum of malignancy.Conclusions: Our results seem to suggest the involvement of MMPs in microinvasive carcinomas, which show also low proliferative activity and p53 expression, whether other factors seem to be more important in widely invasive carcinomas.Journal of Cutaneous Pathology 12/2001; 28(3):120 - 126. · 1.56 Impact Factor
Top co-authors
Top Journals
Institutions
-
2009–2012
-
Università Politecnica delle Marche
- Chair of Rheumatology
Ancona, The Marches, Italy
-
