Francesca Giusti

Publications (10)29.15 Total impact

• Article: Variegated dermoscopy of in situ melanoma.

  Stefania Seidenari, Sara Bassoli, Stefania Borsari, Chiara Ferrari, Francesca Giusti, Giovanni Ponti, Carlo Tomasini, Cristina Magnoni
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  ABSTRACT: Melanomas in situ (MIS) are difficult to diagnose, lacking well-established dermoscopic descriptors. The aim of this study was to improve the identification of early melanomas describing the variegated dermoscopic features of MIS and their correlation with demographic and clinical aspects. Dermoscopic images of 114 histologically proven MIS were evaluated by 3 expert dermoscopists and classified into their main dermoscopic patterns. Dermoscopic features were also considered for their correlation with clinical parameters. Eight different dermoscopic subtypes of MIS were identified: reticular grey-blue (27.2%), reticular (21.1%), multicomponent (20.2%), island (10.5%), spitzoid (7%), inverse network (6.1%), 'net-blue globules' (5.3%) and globular (2.6%). Clinical characteristics of lesions and patients varied according to the different dermoscopic groups. We hypothesize that the different dermoscopic subgroups of MIS correspond to lesions with a different origin and, possibly, various patterns of growth and a different biological behaviour.
  Dermatology 05/2012; 224(3):262-70. · 2.05 Impact Factor
• Article: The dermoscopic variability of pigment network in melanoma in situ.

  Stefania Seidenari, Chiara Ferrari, Stefania Borsari, Sara Bassoli, Anna Maria Cesinaro, Francesca Giusti, Giovanni Pellacani, Giovanni Ponti, Iris Zalaudek, Giuseppe Argenziano
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  ABSTRACT: To define the dermoscopic aspects of the network in melanoma in situ (MIS), using both standard and newly introduced network descriptors. Fifty-four histologically confirmed MIS with a reticular pattern, 108 atypical reticular naevi and 108 typical reticular naevi were evaluated for the presence of 11 network descriptors. The ABCD-score and the seven-point score were calculated, and the diameter of the lesions was measured by means of a dedicated software. Clinical data including age, sex and skin site were also considered. The prevalence of different dermoscopic features was calculated to allow (i) the identification of lesions to be excised and (ii) the distinction between MIS and dermoscopically atypical naevi. In dermoscopically atypical lesions (MIS and atypical naevi), the frequency of all descriptors significantly differed from those of typical naevi. With respect to atypical naevi, MIS more frequently showed larger size, an atypical network involving more than half of the lesion, the contemporary presence of more than one type of network and more extended reticular grey-blue regression areas located both in the centre and at the periphery of the lesion. The list of network descriptors proposed by us can be used for the identification of lesions that should be subjected to surgery. For the distinction between MIS and atypical naevi, the extension of an atypical network, the presence of more than one type of network, the distribution of reticular grey-blue areas and the lesion diameter must be considered.
  Melanoma research 04/2012; 22(2):151-7. · 2.06 Impact Factor
• Article: Novel PTCH1 Mutations in Patients with Keratocystic Odontogenic Tumors Screened for Nevoid Basal Cell Carcinoma (NBCC) Syndrome.

  Lorenza Pastorino, Annamaria Pollio, Giovanni Pellacani, Carmelo Guarneri, Paola Ghiorzo, Caterina Longo, William Bruno, Francesca Giusti, Sara Bassoli, Giovanna Bianchi-Scarrà, Cristel Ruini, Stefania Seidenari, Aldo Tomasi, Giovanni Ponti
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  ABSTRACT: Keratocystic odontogenic tumors (KCOTs) are cystic tumors that arise sporadically or associated with nevoid basal cell carcinoma syndrome (NBCCS). NBCCS is a rare autosomal dominantly inherited disease mainly characterized by multiple basal cell carcinomas, KCOTs of the jaws and a variety of other tumors. PTCH1 mutation can be found both in sporadic or NBCCS associated KCOTs. The aim of the current study was to assess whether a combined clinical and bio-molecular approach could be suitable for the detection of NBCCS among patients with a diagnosis of keratocystic odontogenic tumors (KCOTs). The authors collected keratocystic odontogenic tumors recorded in the database of the Pathology Department of the University of Modena and Reggio Emilia during the period 1991-2011. Through interviews and examinations, family pedigrees were drawn for all patients affected by these odontogenic lesions. We found out that 18 of the 70 patients with KCOTs and/or multiple basal cell carcinomas actually met the clinical criteria for the diagnosis of NBCCS. A wide inter- and intra-familial phenotypic variability was evident in the families. Ameloblastomas (AMLs) were reported in two probands that are also carriers of the PCTH1 germline mutations. Nine germline mutations in the PTCH1 gene, 5 of them novel, were evident in 14 tested probands. The clinical evaluation of the keratocystic odontogenic tumors can be used as screening for the detection of families at risk of NBCCS. Keratocystic odontogenic lesions are uncommon, and their discovery deserves the search for associated cutaneous basal cell carcinomas and other benign and malignant tumors related to NBCCS.
  PLoS ONE 01/2012; 7(8):e43827. · 4.09 Impact Factor
• Article: Dermoscopic island: a new descriptor for thin melanoma.

  Stefania Borsari, Caterina Longo, Chiara Ferrari, Elisa Benati, Sara Bassoli, Simona Schianchi, Francesca Giusti, Anna Maria Cesinaro, Giovanni Pellacani, Stefania Seidenari
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  ABSTRACT: To determine the frequency and the features of the dermoscopic island (DI) in melanocytic lesions and to assess its specificity for the diagnosis of melanoma. Dermoscopy improves the diagnostic accuracy of melanoma, but only a few dermoscopic descriptors specific for thin melanomas have been identified. We defined a new descriptor, the dermoscopic island, a well-circumscribed area showing a uniform dermoscopic pattern that differs from the rest of the pigmented lesion. Dermoscopic images of 96 in situ melanomas, 266 invasive melanomas, and 612 dermoscopic atypical nevi were evaluated to establish the presence and the main pattern of the DI. Also, clinical and histologic characteristics were analyzed. Dermoscopic images were collected from lesions excised between 2003 and 2008 at the Department of Dermatology, University of Modena and Reggio Emilia. Specificity and odds ratio for melanoma; dermoscopic and histologic characteristics of lesions with a DI. The DI was present in 10.4% of in situ melanomas, 4.1% of invasive melanomas, and 3.1% of dermoscopic atypical nevi. The odds ratio for melanoma was 1.922, and specificity was 96.9%. Invasive melanomas with a DI were thinner than those lacking this descriptor. In addition, more than half of the melanomas with a DI arose on a nevus. The DI appeared mainly reticular on a reticular background. The DI is characteristic of thin melanoma arising in a nevus; thus, it can be considered a potential early sign of transformation of a nevus into a melanoma.
  Archives of dermatology 11/2010; 146(11):1257-62. · 4.76 Impact Factor
• Article: Reproducibility of atopy patch tests with Dermatophagoides: a study on 85 patients with atopic dermatitis.

  Francesca Giusti, Stefania Seidenari
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  ABSTRACT: Atopy patch tests (APTs) are considered a useful addition to standard testing procedures for the identification of allergens triggering the appearance of eczema in patients with atopic dermatitis (AD). The aim of the study was to evaluate the reproducibility of APTs with house dust mites by simultaneously patch testing AD patients. 85 subjects affected by AD, 36 males and 48 females, aged from 1 to 52 years, were patch tested with Dermatophagoides mix (D. pteron/D. farinae) 20% pet. In our patients, the percentage of agreement between the frequency of positive and negative responses to Dermatophagoides mix was 96.7%. Reproducibility was highly satisfactory, as evaluated by k-value (0.953). As regards the agreement in the intensity of APT responses to Dermatophagoides mix between the right and left sides, we found that reproducibility was also highly satisfactory (k = 0.851). In conclusion, for Dermatophagoides APTs, the agreement rate was similar to that of standard patch tests, and therefore APTs may be considered sufficiently reproducible to be employed as a diagnostic testing procedure.
  Contact Dermatitis 02/2004; 50(1):18-21. · 3.51 Impact Factor
• Article: Textile dyes sensitization: a study of 49 patients allergic to disperse dye alone.

  Francesca Giusti, Stefania Seidenari
  Contact Dermatitis 02/2003; 48(1):54-5. · 3.51 Impact Factor
• Article: Hand dermatitis as an unsuspected presentation of textile dye contact sensitivity.

  Francesca Giusti, Lucia Mantovani, Alessandro Martella, Stefania Seidenari
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  ABSTRACT: The aim of this study was to evaluate disperse dye sensitization in patients with hand dermatitis. From January 1996 to December 2000, we identified 130 patients with hand dermatitis reacting to one of the 7 dyes included in our standard series. In 82 subjects the dermatitis was localized to the hands alone, whereas 48 patients had lesions both on the hands and on other skin sites. Disperse Blue dyes, and Disperse Orange 3 were the most common sensitizers. Among the 13 subjects allergic to disperse dyes alone, we found 3 cases of occupational allergic contact dermatitis, 1 child with atopic dermatitis worsening after the use of synthetic fibre garments, 4 subjects affected by clothing dermatitis, and 5 individuals occupationally exposed to irritants with a dermatitis involving the hands alone. In the latter, the hands may represent a 'locus minoris resistentiae', and both induction and elicitation of contact sensitization could be caused by impaired barrier function at a skin site repeatedly exposed to sensitizing garments.
  Contact Dermatitis 09/2002; 47(2):91-5. · 3.51 Impact Factor
• Article: Sensitization to propolis in 1255 children undergoing patch testing.

  Francesca Giusti, Roberta Miglietta, Patrizia Pepe, Stefania Seidenari
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  ABSTRACT: To investigate the frequency and the features of contact sensitization to propolis in children, we patch tested 1255 consecutive children suspected of allergic contact dermatitis with propolis 20% petrolatum over an 8-year period (1995-2002). Positive responses were observed in 5.9% of patch-tested subjects, with a significantly higher frequency in boys than in girls. The dermatitis was localized mainly on the face, hands and limbs. A significant linear increase in the annual frequency of propolis allergy was noted. Confirming literature data, a significant association with balsam of Peru sensitivity was present in children reacting to propolis, linked to the presence of common constituents in the 2 substances. In conclusion, based on our data, we suggest that propolis should not be used in topical products for children because of its high sensitization rate at the paediatric age.
  Contact Dermatitis 51(5-6):255-8. · 3.51 Impact Factor
• Article: Patch testing with egg represents a useful integration to diagnosis of egg allergy in children with atopic dermatitis.

  Francesca Giusti, Stefania Seidenari
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  ABSTRACT: Our aim was to investigate atopy patch and skin prick test reactions to egg in 85 children with atopic dermatitis, and to evaluate their relevance by performing repeated open challenges with egg. Thirty-one percent of our patients showed an eczematous response to the challenge. Positive reactions to atopy patch and skin prick tests were recorded in 37% and 19%, respectively. Atopy patch test sensitivity proved significantly higher than that of skin prick test (79.6% vs. 46.2%), whereas specificity was lower (81.4% vs. 93.2%). Our data suggest that combined skin prick and patch testing improves screening for egg allergy in affected children, identifying 92% of those who were challenge positive among our patients.
  Pediatric Dermatology 22(2):109-11. · 1.07 Impact Factor
• Article: Contact sensitization in 1094 children undergoing patch testing over a 7-year period.

  Stefania Seidenari, Francesca Giusti, Patrizia Pepe, Lucia Mantovani
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  ABSTRACT: Contact sensitization in children is frequent. However, because exposure to sensitizing agents varies rapidly, it is of utmost importance to perform a periodic evaluation of patch test results. Our purpose was to compare our data on contact sensitization in children during the past 7 years to our previous 1988-1994 findings, in order to identify emerging allergens and update our pediatric series. From 1995 to 2001, 1094 consecutive children were examined. Of these, 997 patients were patch tested with our pediatric series, which includes 30 allergens, whereas 97 underwent patch testing with 46 allergens. A total of 570 children proved allergic (52.1%). The highest sensitization rate was observed in children under 3 years of age. No differences between atopic dermatitis patients and nonatopic ones were observed in the sensitization rate. Neomycin, nickel, wool alcohols, thimerosal, and ammoniated mercury gave most of the positive responses. With respect to 1988-1995 data, allergy to substances such as neomycin, nickel, wool alcohols, thimerosal, ammoniated mercury, propolis, potassium dichromate, and thiuram mix proved more frequent. In conclusion, as sensitization rates to different allergens show great variations over time, periodic evaluations of patch test results in children is necessary in order to update the test trays.
  Pediatric Dermatology 22(1):1-5. · 1.07 Impact Factor