Paolo Amerio

• MD, PhD Dermatologic Oncology
• Professor (Full) at University of Chieti-Pescara

The new coronavirus pandemic poses question and challenges for dermatologists. One of question is if psoriasis patients treated with immunomodulating and immunosuppressive drugs have to discontinue their treatment in the midts of fears for the infection and its consequences. One of the challenges is how can we support our patients in this critical...

Background: Giant basal cell carcinoma (GBCC) is a basal cell carcinoma (BCC) enlarged in a diameter more than 5 cm. Since GBCCs are a highly infrequent entity and the occurrence rate is approximately 0.5-1% out of all BCC types, only anecdotal cases are reported, and causes and characteristics inducing development of this tumor are not defined....

Introduction: The relationship between psoriasis, immunomodulatory therapies, and the risk of malignancies is complex and still debated. The scarcity of evidence in this field makes clinicians hesitate to prescribe biological therapies for 'difficult-to-treat' patients. Areas covered: Based on a comprehensive MEDLINE/PUBMED search of articles pu...

Objective. Psoriatic arthritis (PsA) can be treated with biological drugs targeting IL-17A, such as secukinumab, with good responses and long-term positive outcomes in clinical studies. Methods. An observational study was conducted on adult subjects with PsA and comorbidities, treated with secukinumab after prior therapy with conventional disease-m...

Background: the present multicenter retrospective study aimed to evaluate the efficacy and safety of intra-class switching between interleukin-17A (IL-17A) inhibitors, specifically from ixekizumab to secukinumab, in patients with plaque psoriasis. Methods: this study included 11 patients (6 male, 5 female) who had previously received ixekizumab and...

Introduction: Atopic dermatitis (AD) is a common chronic inflammatory skin disease. Moderate-to-severe AD severely affects patients' quality of life. New drugs selectively targeting molecular pathways involved in the pathogenesis of the disease led to a new era for the treatment of AD. However, the current available options are limited and do not...

Psoriasis is a chronic, immune-mediated, inflammatory skin disease, associated with multiple comorbidities and psychological and psychiatric disorders. The quality of life of patients with this disease is severely compromised, especially in moderate-to-severe plaque psoriasis. Secukinumab, a fully humanized monoclonal antibody, was the first anti-i...

Atopic dermatitis (AD) is a highly heterogeneous chronic inflammatory skin disorder that is frequently associated with a plethora of comorbidities. AD is, therefore, considered a systemic disease impacted by a considerable burden and leading to poor quality of life, especially in patients with moderate-to-severe disease. Since atopic and non-atopic...

SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and...

The evidence- and consensus-based guideline on atopic eczema, published in JEADV on 18 August 2022 (part 1) and 3 September 2022 (part 2) was developed in accordance with the EuroGuiDerm Guideline and Consensus Statement Development Manual. Four consensus conferences were held between December 2020 and July 2021. Twenty-nine experts (including clin...

SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and...

Venous leg ulcers are one of the most common nonhealing conditions and represent an important clinical problem. The application of pulsed radiofrequency electromagnetic fields (PRF-EMFs), already applied for pain, inflammation, and new tissue formation, can represent a promising approach for venous leg ulcer amelioration. This study aims to evaluat...

This article presents a case study featuring a novel modification of the A-T flap, termed the "Sorting Hat" flap, employed in dermatologic surgery for facial reconstruction. In the treatment of an 89-year-old male's squamous cell carcinoma lesion on the forehead, the "Sorting Hat" flap, introduced as an innovative alternative, eliminates the need f...

Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease that negatively impacts the quality of life and work productivity of patients. Objectives: We sought to evaluate the real-world burden of AD patients in Italy. Methods: This sub-analysis of the MEASURE-AD multicountry study between December 2019-2020 included patients...

Background: Dermatological surgery has a primary role in dermatologists' daily practice and is usually performed under local anesthesia. This approach required particular attention in patient management before, after, and especially during the surgical procedures. Many people experience anxiety and negative emotions when approaching surgery, and ho...

Hidradenitis suppurativa (HS) is considered a post-pubertal disease; however, earlier onset is not infrequent. The burden of HS on the female population is very relevant, and early identification might reduce the quality of life impairment and improve the therapeutic approach. In this study, we investigated clinical biomarkers of HS that could impa...

Background Brodalumab, a fully human anti‐interleukin (IL)‐17 monoclonal antibody that blocks IL‐17RA, is approved in Europe for the treatment of adult patients with moderate‐to‐severe plaque psoriasis who are candidates for systemic treatment. Objectives This study evaluated the achievement and maintenance of therapeutic response for 1 year in ps...

Immunodeficiency with thymoma was described by R.A. Good in 1954 and is also named after him. The syndrome is characterized by hypogammaglobulinemia associated with thymoma and recurrent infections, bacterial but also viral, fungal and parasitic. Autoimmune diseases, mainly pure red cell aplasia, other hematological disorders and erosive lichen pla...

Background After decades of use, methotrexate displays an established safety and efficacy profile in both in-hospital and outpatient settings. Despite its widespread use, there is surprisingly little clinical evidence to guide daily practice with methotrexate in dermatology.Objectives To provide guidance for clinicians in daily practice for areas i...

Introduction: Dermatologists had to face several challenges during the COVID-19 pandemic. In this scenario, a large amount of data has been produced and published. Objectives: We present a literature analysis of publications on COVID-19 in the dermatology field in the first year of the pandemic. Methods: The research was carried out by searching th...

Background: Prevention campaigns for skin cancers have focused primarily on melanoma, and over time there has been increasing awareness of the need to select the population to be screened to maximize program effectiveness. Objectives: To report the results of a free dermatological initiative, as part of an awareness campaign dedicated to keratin...

After the outbreak of the pandemic due to COVID-19 infection, several vaccines were developed on short timelines to counteract the public health crisis. To allow the administration of mRNA vaccines through a faster-paced approval process, the Emergency Use Authorization (EUA) was applied. The Ba.5 (omicron) variant of SARS-CoV-2 is the predominant...

Purpose Psoriasis, a common systemic inflammatory disorder, presents with gender-related differences in the quality of life (QoL) and treatment outcomes. This post hoc analysis from the Phase 3b SUPREME study explored gender-related differences in patient characteristics and efficacy of secukinumab 300 mg on Psoriasis Area and Severity Index (PASI)...

Rituximab is a monoclonal antibody approved for treatment of adults with severe and refractory pemphigus vulgaris. Concerns about side effects and high costs of conventional doses have rised the hypothesis that low-dose rituximab regimen may be cost-effective with a better safety profile. Here we report our experience of seven patients with extensi...

Hailey Hailey disease is a rare autosomal dominant chronic recalcitrant blistering genodermatosis involving the intertriginous areas. Therapeutic options are various, depending on the type and size of the lesion, and include topical and systemic corticosteroids, topical and systemic retinoids and DMARDs, but the the only true curative approach is r...

Atopic dermatitis is a common chronic-relapsing, inflammatory and itchy eczematous skin disorder which occurs in both children and adults. AD pathogenesis is complex and several factors are implicated. Pruritus plays a pivotal role in disease’s burden, significantly worsening atopic patient quality of life by limiting productivity and daily activit...

Merkel cell carcinoma (MCC) is a rare neuroendocrine skin cancer that usually occurs in elderly people on sun-exposed areas, with a predisposition to local recurrence. Evidence suggests a growing incidence over the past decade; however, robust epidemiologic data are still lacking. We describe the MCC population in clinical practice in a retrospecti...

Atopic dermatitis (AD) is a common inflammatory skin disease often associated with a significant impairment in the quality of life of affected patients. The Italian Society of Dermatology and Venereology (SIDeMaST) planned a national information campaign, providing direct access to 27 dermatologic centers dedicated to the management of AD. The aim...

Among the forms of idiopathic hyperhidrosis, those involving the forehead have the greatest impact on patients’ quality of life, as symptoms are not very controllable and are difficult to mask for patients. Although the local injection therapy with Incobotulinum toxin type A (IncoBTX-A therapy) can be considered a rational treatment, data from the...

Background: Epidermal barrier defects have been described in psoriatic lesions. Transepidermal water loss (TEWL) is the measure of steady-state water vapor flux crossing the skin to the external environment, and it has been used extensively to characterize skin barrier function. We evaluated how biological treatments impact TEWL in with psocratic...

SIDeMaST (Società Italiana di Dermatologia Medica, Chirurgica, Estetica e delle Malattie Sessualmente Trasmesse) contributed to the development of the present guideline on the systemic treatment of chronic plaque psoriasis. With the permission of EuroGuiDerm, SIDeMaST adapted the guideline to the Italian healthcare context to supply a reliable and...

Post-SARS-CoV-2 telogen effluvium has been described in case reports of COVID-19 patients. We evaluated the prevalence of post-SARS-CoV-2 telogen effluvium in patients from a single medical center, exploring any causal links with the infection. Our hospital-based, cross-sectional study was conducted with patient participants discharged with a diagn...

Recent reports have confirmed higher levels of growth hormone (GH) receptor (GHR) transcripts in malignant melanomas (MM), yet the role of GH in the pathogenesis of MM remains controversial. Although melanocytes appear to be hormonally responsive, the effects of GH on MM cells are less clear. A direct correlation between GH administration and the d...

Atopic dermatitis (AD) is a common chronic-relapsing inflammatory skin disease, burdened by various comorbidities. AD most commonly occurs in children but may persist or present in adulthood becoming a lifelong condition. Therefore, AD requires an effective long-term treatment improving disease signs and symptoms but also of patients' quality of li...

Purpose For patients with psoriasis, treatment adherence and persistence are fundamental if therapeutic goals are to be met. Patient Support Programs (PSPs) may be used as a support tool to assist patients and health care professionals optimize treatment and improve disease management. Patients and Methods In Italy, the PSP PSOLife CARE, which beg...

The present study aimed at assessing the consequences of prolonged exposure to COVID-19 distress on mental health in non-frontline health care workers. For this purpose, we have conducted a survey on 425 Italian dermatologists, in the period February–March 2021. The psychopathological symptoms, depression, anxiety, post-traumatic symptoms (PTDS), a...

Introduction In daily practice management of psoriasis, evaluation of risk factors for infections is having a growing influence. Indeed, in psoriatic patients, risk of infections may be due to psoriasis itself, immunomodulatory therapy and comorbidities that may increase this risk and patient hospitalization. Areas covered Given the greater unders...

Background: Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent, debilitating skin disease of the hair follicle that usually occurs after puberty with painful, deep-seated, inflamed nodules and sinus tracts in the apocrine gland-bearing areas of the body, most commonly the axillae and inguinal and anogenital regions, with a relevan...

The present study aims to assess the relationship between chronic disease and the difficulties created by the perception of the own body. We focused on the investigation of the negative feelings, as body uneasiness, as well as on the investigation of the emotional mechanisms. We evaluate two categories of emotion regulation: reappraisal (R) and sup...

The present study aimed at assessing the consequences of prolonged exposure to COVID-19 distress on the mental health of Italian dermatologists. For this purpose, we conducted an online survey (between February-March 2021), after one year of COVID-19 pandemic and lockdown, to evaluate psychopathological symptoms (depression, anxiety, post-traumatic...

Wound healing is a complex, staged process. It involves extensive communication between the different cellular constituents of various compartments of the skin and its extracellular matrix (ECM). Different signaling pathways are determined by a mutual influence on each other, resulting in a dynamic and complex crosstalk. It consists of various dyna...

The COVID-19 pandemic has led to lockdowns for much of the world. In Italy, all health procedures not directly related to COVID-19 were reduced/suspended, thus limiting patient access to hospitals. Any delay in cancer treatment presents the additional risk of tumors progressing from being curable to becoming incurable. Specifically, melanoma surviv...

Secukinumab, a fully human monoclonal antibody, neutralizes interleukin-17A, a cornerstone cytokine driving the multiple manifestations of psoriasis. This post-hoc analysis of the SUPREME study was performed to determine the sustainability of response to secukinumab in terms of Psoriasis Area and Severity Index (PASI) 90 in patients with moderate-t...

Raynaud’s phenomenon (RP) is a microvessels’ disorder resulting in transient ischemia. It can be either primary or secondary to connective tissue diseases, such as systemic sclerosis. The differentiation between primary and secondary to systemic sclerosis is of paramount importance to set the proper therapeutic strategy. Thus far, thermal infrared...

Background Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID‐19) pandemic. Methods A national registry, named DA‐COVID‐19 and involving 35 Italian dermatology units, was established in order to evaluate the impa...

Guselkumab, a subcutaneously administered fully human IgG1λ monoclonal antibody that selectively inhibits the p19 subunit of interleukin 23, is approved in both the USA and the EU for the treatment of adult patients with moderate-to-severe plaque psoriasis. The efficacy and safety of guselkumab were demonstrated in four randomized, double-blind, Ph...

Background: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic. Methods: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the imp...

Introduction & Objectives Phototherapy is a mainstay for the treatment of MF. However, there is scarce evidence for its use, mostly due to the lack of a unified schedule. The primary aim of this study was to establish the first structured, expert‐based consensus regarding the indications and technical schedules of NB‐UVB and PUVA for MF. The second...

IntroductionTreat-to-target strategies are used in several chronic diseases to improve outcomes. Treatment goals have also been suggested for psoriasis, but there is currently no consensus on targets, and guidance is needed to implement this strategy in clinical practice. The project ‘Treat to Target Italia’ was launched by a scientific board (SB)...

Basosquamous carcinoma is a rare clinical entity, which comprises 1.7–2.7% of all skin carcinomas. It is described as a basal cell carcinoma with features of squamous differentiation. To date, studies of the epidemiology of basosquamous carcinoma have been few and small in size. We report here the most extensive series of basosquamous carcinomas pu...

This study evaluated whether secukinumab treatment for patients with moderate to severe plaque psoriasis correlates with improvements in symptoms of anxiety and depression. SUPREME was a 24-week, phase IIIb, multicentre, prospective study conducted across 50 centres in Italy with an extension period of up to 72 weeks. Assessments used were: Psorias...

Background: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic. Methods: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the imp...

Background The susceptibility of patients with chronic plaque psoriasis and the risks or benefits related to the use of biological therapies for COVID-19 are unknown. Few data about prevalence, clinical course and outcomes of COVID-19 among psoriatic patients were reported. The aims of this study were 1) to assess the prevalence and severity of COV...

In the present work, we analyzed some emotional mechanisms (emotion dysregulation—ED, negative affect—NA, and emotional vulnerability) involved in chronic diseases by means of an interdisciplinary approach. We started from the conceptualization of emotions as a complex dynamic system that can be investigated and understood within a framework inspir...

The safety of immunosuppressive treatment in patients with Immune‐Mediated Inflammatory Diseases (IMIDs) during the Coronavirus pandemic is questioned and it is utmost important for public health. We searched studies trough MEDLINE/EMBASE database, including patient with IMID, undergoing immunosuppressive treatment with a positive diagnosis for SAR...

Background Knowledge regarding differences in care for psoriatic patients is limited. The aim of this study was to investigate factors influencing prescription of systemic treatments for patients with psoriasis with a special focus on socioeconomic factors. Methods and findings This was a non-interventional, cross-sectional study, conducted in 18...

A demographic "revolution" has been taking place in the last decades: the world population, due to an increase in life expectancy , is aging [1]. Centenarians are no longer a rarity: they are 14.000 in Italy, other countries, such as Japan have more than 70.000 most of which are women [2]. Data on skin surgery in the elderly have been reported only...

Background and aim: Isolated exercise-induced pulmonary hypertension (ExPH) associates with cardiovascular (CV) events in patients with left heart disease. We investigated its prognostic significance in scleroderma patients at risk for pulmonary arterial hypertension (PAH). Methods: In 26 consecutive scleroderma female patients with either low (...

IntroductionKeratinocyte tumors (KT) are frequently observed. Surgery is the treatment gold standard. In some cases, a surgical approach might not be the best option. Radiotherapy (RT) and systemic treatments can frequently cause side effects or be contraindicated. Intralesional methotrexate (MTX) can be a conservative yet effective alternative. We...

The aim of the study was to analyse the differences in emotion regulation mechanisms between psychosomatic chronic diseases (psoriasis, hypertension) by applying chaos theory specific concepts. Thus, for estimating the instability on perturbations (Butterfly effect) we considered a "flavour" of the Lyapunov Function method which supposes monitoring...

The popularity of tattoos in the today’s society brings with it a significant increase of the incidence of associated cutaneous reactions. Among the several complications that may occur after a tattooing procedure, allergic and photo‐allergic reactions, infections and Koebner phenomenon are the most common ones observed. Most of these complications...

Melanomas are skin tumors that show a variety of biological behavior. Some develop very fast and some other grow extremely slow, with metastasis appearing, eventually, many years after the diagnosis. The number of mitoses in primary melanoma has been related to a more aggressive tumor and may have a potential as predictive factor for cutaneous mela...

Background: Although molluscum contagiosum virus (MCV) infection is a common disease widespread among children and young adults, there is no shared opinion on treatment which can be divided into: physical, chemical, medical( immunomodulating or anti-viral). According to some authors, MCV is best left to clear by itself. Objectives: To assess the cl...

In this work, we propose an interdisciplinary chaos analysis of emotion dysregulation (ED) and emotional vulnerability in adults. One of the main goals was the assessment of incongruences that occur in the evaluation of one’s own emotional dysregulation mechanisms in the presence of an extremely weak stimulus (Butterfly Effect). Thus, we considered...

Introduction : Several studies have been conducted that show that there is a significant relation between psychological stress and psoriasis. The existence of a relationship between stress, emotional regulation and the exacerbation of diffuse plaque psoriasis has been hypothesized

Atopic dermatitis (AD) places significant burden not only on quality of life, but is also associated with considerable costs to healthcare systems. Diagnosis of AD may be challenging when it starts in adolescence or adulthood, and is further complicated as its manifestations are different from those generally seen in children. Accordingly, better d...

Background: To date, serological markers to monitor melanoma progression and response to therapy are lacking. In this context cytokines appear to be promising biomarkers of the disease. Objective: To compare cytokine and chemokine levels in melanoma patients and in healthy controls and to assess possible variations according to melanoma stage....

The main goal of this study was to assess the emotion regulation (ER) mechanisms, such as expressive suppression and cognitive reappraisal, in patients with psoriasis, as compared with healthy persons not afflicted by dermatological diseases. Moreover, the study intended to carry on a multidimensional assessment of emotional mechanisms in persons w...

In our retrospective study, we included 69 adult patients affected by moderate-to-severe plaque psoriasis and treated with ixekizumab therapy following discontinuation of 300-mg secukinumab therapy. Patients referred to the outpatient clinics of the dermatology units belonging to Italian referral centres. Patient demographic and clinical/anamnesti...

Background Hidradenitis suppurativa (HS) is a chronic, relapsing, inflammatory skin disease characterized by painful inflamed nodules, recurrent abscesses and fistulas located in apocrine gland–bearing body sites. The negative impact of HS on patient's quality of life (QoL) has been reported to be greater than other dermatologic conditions as psori...

Loss of efficacy of biological therapies in psoriatic patients is a well‐known event. Biological switching is common in clinical practice, especially in TNF‐α and IL‐12/23 inhibitors treatment1,2. Recently, anti‐IL‐17A drugs such as secukinumab have provided a new therapeutic opportunity This article is protected by copyright. All rights reserved.

Functional infrared imaging (fIRI) is used to provide information on circulation, thermal properties and thermoregulatory function of the cutaneous tissue in several clinical settings. This study aims to evaluate the application of fIRI in rheumatoid arthritis (RA) assessment, evaluating the thermoregulatory alterations due to joint inflammation in...

Bullous Pemphigoid is an autoimmune bullous disorder characterized by production of IgG against an hemidesmosomal antigen (230 kDa, 180 kDa) responsible for blistering of the skin. In the past several mediators have been implicated in the pathogenesis of the disease such as proteases and collagenases secreted by local inflammatory cells. In order t...

New scientific knowledge of rosacea hides possible medico-legal consequences. Indeed, the solid molecular basis surrounding rosacea exacerbation and progression has been shown among genetically prone people who are exposed to trigger factors, such as moderately hot temperatures associated with employment. If this is ignored in the phase of preventi...