O De Pità

Istituto Dermopatico dell'Immacolata, Roma, Latium, Italy

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Publications (121)417.64 Total impact

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    ABSTRACT: Pemphigus vulgaris (PV) is an autoimmune blistering disease mediated by IgG autoantibodies targeting desmogleins (Dsgs). The anti-CD20 monoclonal antibody rituximab is increasingly used in corticosteroid-resistant PV patients. In a subset of rituximab-treated patients in remission, high ELISA index values have been reported; however, their significance remains so far unclear. To address the discrepancy between anti-Dsg3 serum antibody titers and disease severity. 6 rituximab-treated PV patients were prospectively followed-up for two years and anti-Dsg3 autoantibodies levels and pathogenic activity were measured. All patients achieved complete remission without any serious side effects. Both anti-Dsg3 autoantibodies (p = 0.031) and their pathogenic activity (p = 0.003) were significantly related to disease severity. However, in selected patients, the dissociation index was a more sensitive indicator for PV clinical activity than the ELISA index. Our findings have demonstrated the existence of non-pathogenic autoantibodies in PV patients in remission, establishing the basis for the design of a system able to precisely monitor the course of disease.
    No preview · Article · Nov 2015
  • A. Migliore · F. Cusano · G. Bianchi · G. Malara · O. Epis · O. De Pità
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    ABSTRACT: Psoriatic arthritis is an inflammatory seronegative spondyloarthropathy that occurs in approximately 25% of patients with psoriasis and is a progressive and severely disabling disease. Most patients have had psoriasis for several years before the development of arthritis or develop the joint and skin condition simultaneously. Given the absence of specific diagnostic test for psoriatic arthritis, clinical findings remain the standard criteria for the diagnosis. Patients with psoriasis presenting to the dermatologist for management of their skin disease may have joint symptoms related or not to psoriatic arthritis and similarly arthritic patients presenting to a rheumatologist for the management of psoriatic arthritis may have skin lesions related or not to psoriasis. In this paper an expert panel of specialist belonging to the “Associazione Dermatologi Ospedalieri Italiani” (ADOI) and “Collegio dei Reumatologi Ospedalieri Italiani” (CROI) analysed the international literature and scientific recommendations and also investigated the Italian setting. It has been demonstrated in the literature that a multidisciplinary clinical setting may benefit patients with psoriatic arthritis from both diagnostic and therapeutic points of view. The comparative analysis of the Italian clinical records used by ADOI and CROI have highlighted some substantial differences. Collaboration between the dermatologist and rheumatologist allows for a more complete appreciation of the overall skin and musculoskeletal disease burden, and subsequently leads to a more comprehensive treatment approach.
    No preview · Article · Jul 2015 · Journal of biological regulators and homeostatic agents
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    ABSTRACT: Non-specific lipid transfer proteins (nsLTPs) represent a major cause of systemic food allergic reactions in the Mediterranean area. This study investigate hierarchical patterns and cluster relationships of IgE sensitization to different nsLTPs, and the relationship to clinical allergy in a large Italian cohort. 568 nsLTPs positive subjects after IgE ImmunoCAP ISAC microarray analysis with Ara h 9, Art v 3, Cor a 8, Jug r 3, Pla a 3, Pru p 3 and Tri a 14 allergens, were studied. IgE inhibition experiments were carried out with mugwort and plane tree pollen extracts. 82% of nsLTP positive participants (94% if <6 years old) were Pru p 3(pos) and 71% were Jug r 3(pos) . Participants who reacted to >5 nsLTPs reported a higher incidence of food-induced systemic reactions. Only Art v 3 and Pla a 3 (mugwort and plane tree nsLTPs, respectively) were associated with respiratory symptoms, and a correlation was observed between sensitization to pollen and plant food nsLTPs, particularly between Pla a 3 and tree nut/peanut nsLTPs. Co-sensitization to Par j 2 and PR-10 or profilin pan-allergens was associated with a lower prior prevalence of severe food-induced reactions. In inhibition assays, plane and mugwort pollen extracts inhibited 50%-100% of IgE binding to food nsLTPs in microarrays. Testing IgE reactivity to a panel of nsLTP allergens unveils important associations between nsLTP sensitization profiles and clinical presentation, and allows the identification of novel cluster patterns indicating likely cross-reactivities and highlighting potential allergens for nsLTP immunotherapy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Full-text · Article · Apr 2015 · Allergy
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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.
    No preview · Article · Mar 2015 · Giornale italiano di dermatologia e venereologia: organo ufficiale, Societa italiana di dermatologia e sifilografia
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    ABSTRACT: The complexity of the medical diagnosis is faced by practitioners relying mainly on their experiences. This can be acquired during daily practices and on-the-job training. Given the complexity and extensiveness of the subject, supporting tools that include knowledge extracted by highly specialized practitioners can be valuable. In the present work, a Decision Support System (DSS) for hand dermatology was developed based on data coming from a Visit Report Form (VRF). Using a Bayesian approach and factors significance difference over the population average for the case, we demonstrated the potentiality of creating an enhanced VRF that include a diagnoses distribution probability based on the DSS rules applied for the specific patient situation.
    No preview · Article · Aug 2014 · Studies in health technology and informatics
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    ABSTRACT: Backgrounddata on epidemiological impact and clinical characteristics of chronic hand eczema in Southern Europe are lacking.Objectivesto estimate prevalence of chronic hand eczema and its different stages of severity and refractoriness to standard therapy among patients accessing Italian dermatological reference centers, and to evaluate socio-demographic and clinical factors associated with each different stage.MethodsA cross-sectional multicenter study was conducted. Adult hand eczema patients, consecutively accessing 14 centers through a 6-month period, were enrolled. Patients were classified according to disease duration, severity and response to standard therapy with potent topical corticosteroids. Logistic regression analyses were performed to investigate relationship between socio-demographic and clinical data with different stages of eczema.Results981 patients participated. Hand eczema was chronic in 83.5% of patients. Among them, 21.3% were severe, 62% of these patients being refractory to standard therapy. Food processing and related works, health professions, craft and related trades works (builders, plumbers, electricians), hairdressers/beauticians and handicraft works were the jobs most frequently associated with having chronic hand eczema. Severe chronic hand eczema was more likely to be among men, older patients and those with lower education. Severe and refractory hand eczema was also more likely among unemployed and patients with allergic rhinitis and/or atopic dermatitis.Conclusions Chronic hand eczema is frequent among hand eczema patients accessing dermatology centers. Many patients were severe and refractory to standard therapy. The appropriate identification of hand eczema is a first step necessary to implement effective and efficient treatments.This article is protected by copyright. All rights reserved.
    Full-text · Article · Jun 2014 · British Journal of Dermatology
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    ABSTRACT: Abstract Chronic inflammatory diseases represent a heterogeneous group of conditions that can affect practically any organ or system. An increasing number of biologic agents have been developed to selectively target the cell populations and signaling pathways involved in chronic inflammation, including cytokines, monoclonal antibodies and engineered receptors. This approach has been remarkably successful in alleviating some of the signs and symptoms of refractory autoimmune diseases. The use of this therapeutic strategy is likely to increase with the introduction of biosimilar agents. The different nature of these biological products makes the comparison of their pharmaceutical and clinical characteristics difficult, including safety and potency and these issues may be particularly relevant in the case of biosimilars. In addition, the heterogeneity of autoimmune diseases and of autoimmune patients, further adds to the complexity of choosing the right drug for each patient and predicting efficacy and safety of the treatment. In this review, we summarize actual knowledge about current biological agents and their use in autoimmune diseases, with a special emphasis for rheumatoid arthritis, inflammatory bowel diseases and psoriasis. The purpose of this analysis is to address the most critical issues raised by the rapid advancements in this field over recent years, and to acknowledge the potentially valuable gains brought about by the increasing availability of these new biologic agents.
    Full-text · Article · Apr 2014 · Autoimmunity
  • Ornella De Pità · Francesca Lupi · Giuseppe Cianchini

    No preview · Article · Mar 2014 · Clinical Management Issues
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    ABSTRACT: The ingestion of nickel (Ni)-rich foods may result in allergic contact mucositis (ACM), a not yet well defined condition identifiable by oral mucosa patch test (omPT). Our aim was to characterize immunologically the ACM taking advantage from the allergen exposure that occurs during the omPT for Ni. Thirty-seven symptomatic patients underwent to omPT for Ni. Before and after omPT, serum and urine Ni concentrations were determined by mass spectrometry, the white blood cells were counted by hemochromocytometric assay, the peripheral lymphocyte typing was carried out by flow cytometry, total IgE and cytokine serum concentrations were measured by immunoenzymatic assays. The local lymphocyte typing was performed by immunohistochemistry only after omPT. According to the omPT outcomes, 25 patients were defined as Ni-sensitive and the remaining 12 as controls. After omPT, serum and urine Ni concentrations increased significantly in all patients, while a significant increment of circulating lymphocytes and neutrophils was highlighted, respectively, in Ni-sensitive and control patients. Consistently, the Th and Tc circulating lymphocytes, as well as the Th/Tc ratio increased significantly in Ni-sensitive patients after omPT. No noteworthy increment in serum concentrations of total IgE and selected cytokines was observed in any patient after omPT. The presence of CD3+, CD4+, and CD8+ cells was highlighted on the oral mucosa biopsy samples taken from Ni-sensitive patients after omPT. In patients with ACM, a local adaptive response with increased lymphocyte trafficking appears to be the most likely mechanism of reaction to Ni administered with the omPT.
    Full-text · Article · Mar 2014 · Immunobiology
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    ABSTRACT: Background Systemic sclerosis (SSc) is characterized by progressive microvascular abnormalities that lately may appear as skin telangiectasias (TA). Microangiopathy associated with SSc is typically visualized using nailfold videocapillaroscopy (NVC). Objectives To describe skin SSc TA distribution through the investigation of altered capillaries using skin dermoscopy (DC) and search possible correlations with NVC SSc patterns (“early”, “active” and “late”) and clinical status. Methods Thirty-one female SSc patients (mean age 53.5±29.5 yrs, disease duration 19±18 yrs), diagnosed according to the LeRoy criteria and showing at DC analysis cutaneous-mucous TA, were recruited after informed consent and Ethical Committee approval. Patients were grouped according to diffuse (dSSc) and limited (lSSc) subtypes. We used DC (at 25x and 40x magnifications) to evaluate TA on the face, décolleté, shoulders, back of hands and palms. Qualitative SSc NVC patterns (“early”, “active”, “late” at 200x magnifications) and specific autoantibodies (Scl70 and ACA) were searched. Patients were classified into subgroups (lSSC/dSSC, Scl70/ACA) and analysed according to modified ROC analysis, scoring 0 or 1 to indicate absence or presence of a feature. Analysis was done using Prism 5 for Windows (graphPad Software, Inc, LA Jolla, CA), with statistical significance set at p≤0.03. Results Seven-teen SSc patients were found lSSc (17/31, 54.83%; mean disease duration 8.70 yrs) the remaining four-teen were found dSSc (14/31, 45.1% mean disease duration 11.14 yrs). The predominant DC TA patterns observed were “spot” (violet and suffused pink sometimes associated to punctiform vessels) on the hands and “reticular” (alveolar and branched vessels) on the other sites (mainly face). “Spot” DC TA pattern (prevalent in the hands) was found mainly associated with “early”/“active” NVC patterns in lSSc patients (91% vs. 9% “early”/“active” vs “late” NVC pattern, respectively), whereas “reticular” DC TA pattern was found mainly associated with “active”/“late” NVC patterns in dSSc patients, (92% vs 8% “active”/“late” vs “early” NVC pattern, respectively). In addition, TA on the palms appeared as “spot” DC pattern in 15 of 31 patients, including 13in the ACA positive patients (13/20; ROC area 0.7, p=0.03). A DC TA pattern consisting of suffused pink was observed on the palms of 13 patients, including 10 of 11 patients in the anti-Scl-70-positive group (ROC area 0.8, p=0.009). Conclusions Both DC and NVC are confirmed sensitive techniques describing the progressive skin microvascular changes in SSc patients. DC detects better than NVC, the alterations of horizontal plexus (``reticular” DC pattern) that are mainly evident in advanced SSc disease and due to angiogenesis (``late” NVC pattern). On the contrary, NVC allows the crucial early detection of the skin papillary microvascular damage (SSc NVC “early” pattern: giant capillaries and micro-haemorrhages) that DC may only partially distinguish (especially on the hands). Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Background: This is the first randomized, double-blind, placebo-controlled trial (EUDRACT No. 2009-013923-43) evaluating nickel oral hyposensitizing treatment (NiOHT) in patients with "systemic nickel allergy syndrome" (SNAS), characterized by Ni-allergic contact dermatitis and systemic reactions after eating Ni-rich food. Methods: Adults with positive Ni-patch test, who reported symptoms suggesting SNAS, which improved after Ni-poor diet, and were positive to Ni-oral challenge were eligible. Patients were randomly assigned to three treatments (1.5 μg, 0.3 μg, or 30 ng Ni/week) or placebo for a year, with progressive reintroduction of Ni-rich foods form the 5(th) month. Out of 141 patients randomized, 113 completed the trial. Endpoints were efficacy and tolerability of treatment. Results: During Ni-rich food re-introduction, the 1.5 μg Ni/week group had a mean VAS score significantly higher than placebo (p = 0.044), with significant improvement of gastrointestinal symptoms (p = 0.016;) and significantly fewer rescue medications. Cutaneous manifestations also improved but without reaching statistical significance. After the treatment, oral challenge with higher Ni doses than at baseline were needed to cause symptoms to flare-up in significantly more patients given 1.5 μg Ni/week than placebo (p = 0.05). Patients reported no side-effects. Conclusions: NiOHT is effective in SNAS, in particular on gastrointestinal manifestations, with trend toward improvement of cutaneous symptoms.
    Full-text · Article · Nov 2013 · Annals of Medicine
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    ABSTRACT: Little is known about the socio-economic burden of severe chronic hand eczema in patients refractory to treatment with potent corticosteroids. To estimate the socio-economic burden of severe chronic hand eczema refractory to potent topical corticosteroids, and to establish an algorithm for the estimation of the health-related quality of life EuroQol five-dimensional (EQ-5D) utility index from the Dermatology Life Quality Index (DLQI) summary score. A multicentre cost of illness study was conducted, adopting the societal perspective. Adult patients with severe and refractory chronic hand eczema were enrolled. Direct (e.g. drug treatment and travel) and indirect (i.e. loss of productivity) mean costs/patient-month were estimated. Health-related quality of life was assessed with the EQ-5D and DLQI questionnaires. An ordinary least square regression model was used to investigate relationships between health-related quality of life scores. One hundred and four valid patients (mean age 44.5 years, 39.4% male) participated. Overall mean costs were €418.3/patient-month: loss of productivity contributed 43.7%, followed by hospitalization (16.1%) and travel (10.3%). Health-related quality of life scores were, on average, 0.50 (EQ-5D utility) and 11.3 (DLQI). Utility and DLQI summary were significantly related to each other. Wellbeing and loss of productivity are the most important consequences in these patients. Appropriate treatment is necessary to improve patient health and productivity, which will contribute to reducing societal costs.
    Full-text · Article · Sep 2013 · Contact Dermatitis
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    ABSTRACT: The complexity of the medical diagnostic practices is faced nowadays mainly with an extensive and long education and with on-the-job training for GPs. Despite these efforts, a big part of the diagnostic process remains implicit in the everyday practicies of skilled professionals. This project aims at an explicit tracking of this ability through the filling-in of an additional importance level for the voices in the Electronic Medical Record. The collected data leads to the extraction of rules that can empower a Decision Support System for hand dermatological practictioner with suggestios and/or diagnoses distribution probability for a specific situation.
    No preview · Chapter · Jan 2013
  • C. Rota · F. Lupi · M. Castriota · A. Frezzolini · O. De Pitá
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    ABSTRACT: Introduction and objectives: allergic contact dermatitis is a condition whose main feature is the impairment in skin barrier functionality. The aim of the present observational study was to assess efficacy and tolerability of a hydrating and repairing cream containing glycerol (15%), vaseline (8%) and liquid paraffin (2%) (Dexeryl®), applied through sonophoresis in subjects affected by contact dermatitis. Materials and methods: twenty subjects were enrolled and treated for 28 days with Dexeryl®. Each lesion was evaluated both clinically (modified Total Lesion System Score - mTLSS) and instrumentally, through ultrasounds and Trans Epidermal Water Loss (TEWL) measurement, before and after treatment. Results: all the 20 enrolled subjects reported a significant reduction in mean mTLSS values at 14 and 28 days of treatment. A significant improvement in TEWL scores was also observed 2 hours after cream application. The increased skin hydration state was observed and confirmed by ultrasound imaging. Conclusions: Dexeryl® has proven to be effective in improving significantly the clinical symptoms of mild contact dermatitis, showing benefits also on the skin hydration state.
    No preview · Article · Jan 2013 · Journal of Plastic Dermatology
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    ABSTRACT: Psoriasis vulgaris (PsV) and psoriatic arthritis (PSA) are inter-related heritable inflammatory skin diseases. Psoriatic lesions develop as a result of abnormal immune responses, hyperproliferation and altered differentiation of keratinocytes, and a notable subset of psoriatic patients develops PsA, characterized by joints inflammation. Recently, biological drugs were introduced to treat these diseases. However, this therapy has already been associated with the development of serious life-threatening infections, such as the reactivation of human polyomavirus JC (JCV), responsible for the progressive multifocal leukoencephalopathy (PML), a lethal demyelinating disease caused by oligodendrocytes lytic infection. Therefore, the aims of our study were the investigation of the possible JCV reactivation in PsV and PsA patients treated with adalimumab, etanercept, and methotrexate, performing quantitative real-time PCR in sera and skin biopsies at the time of recruitment (T0) and after 3 (T3) and 6 (T6) months of treatment, and the sequencing analysis of the JCV non-coding control region (NCCR). We found JCV DNA in 5/15 PsV patients and in 2/15 PsA patients and JCV NCCR sequence analysis always showed a structure similar to non-pathogenic CY archetype, with random occurrence of a few irrelevant point mutations. Nevertheless the poor number of patients analyzed, our preliminary data can pave the way for taking into account that the follow-up of JCV DNA detection and the JCV NCCR sequence analysis in psoriatic patients may be important to evaluate the risk of PML onset, considering that patients affected by autoimmune diseases and treated with biologics continue to rise.
    Full-text · Article · Dec 2012 · Journal of Cellular Physiology
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    ABSTRACT: Calcipotriol, a vitamin D analogue, and betamethasone dipropionate, a high potency corticosteroid, are complementary agents for the topical treatment of psoriasis vulgaris. Robust evidence on the efficacy and safety of their fixed combination has been provided by randomized, double-blind, controlled clinical trials involving more than 7000 patients with the ointment formulation in psoriasis of the body and more than 4000 patients with the gel formulation in scalp psoriasis. These trials have shown that the fixed combination ointment is more effective and better tolerated, not only than placebo, but also than calcipotriol and tacalcitol monotherapies. In addition, it has proved, in most instances, to be more effective than betamethasone and at least as well tolerated. The same applies to the gel for scalp and body psoriasis. Safety studies have excluded that repeated courses of treatment with the fixed combination for up to one year produce systemic effects. Studies have also shown that the fixed combination treatment improves quality of life to a significantly greater extent than calcipotriol, with the once daily regimen most appreciated by patients, in both active disease and recurrency. Because of the extensive evidence, American and European guidelines recommend the calcipotriol/betamethasone dipropionate fixed combination as first line topical treatment for mild to moderate plaque psoriasis of the body and scalp.
    No preview · Article · Dec 2012 · Giornale Italiano di Dermatologia e Venereologia
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    ABSTRACT: Background Epidermolysis bullosa acquisita (EBA) is a rare autoimmune mucocutaneous bullous disease caused by autoantibodies against type VII collagen, a component of anchoring fibrils that stabilizes dermoepidermal adherence. Type VII collagen is composed of a collagenous domain linked by the noncollagenous (NC)1 and NC2 domains. Objectives To assess the repeatability, sensitivity and specificity of a recently developed enzyme-linked immunosorbent assay (ELISA) for detection of anti-type VII collagen autoantibodies, and to ascertain whether they may be a marker of disease activity in EBA. Methods Using this ELISA, which was able to recognize autoantibodies against the NC1 and NC2 epitopes of type VII collagen, we tested 14 EBA sera, 30 healthy control sera and 113 disease control sera. Results In the EBA sera group, 12 out of the 14 samples were positive in ELISA, with autoantibody titres varying from 7·2 to 127·9 U mL−1 (cutoff value < 6), the sensitivity of the method being 86%. Among the controls, only two bullous pemphigoid sera tested positive, the specificity being 98·6%. A good correlation was found between EBA disease severity, expressed as autoimmune bullous skin disorder intensity score, and the serum levels of anti-collagen VII autoantibodies, measured by ELISA (n = 14; r = 0·965; P = 0·0001). The intra- and interassay coefficients of variation of the ELISA method ranged from 6·3% to 18·3%. Conclusions This NC1 + NC2 ELISA can be a practical assay for the diagnosis of EBA. The correlation between autoantibody titres and disease severity suggests its usefulness as a marker of disease activity in EBA However, this should be confirmed by studies on larger series of patients.
    Full-text · Article · Aug 2012 · British Journal of Dermatology
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    ABSTRACT: Rituximab induces depletion of B cells and has shown efficacy in antibody-mediated autoimmune disorders. In studies on small series of patients with pemphigus, rituximab administration results in significant improvement. However, differences in inclusion criteria, treatment protocols, and follow-up make it difficult to derive uniform conclusions. We sought to test the efficacy and tolerability of rituximab as adjuvant therapy to corticosteroids in the treatment of pemphigus. In all, 42 patients with pemphigus were treated with rituximab and followed up for up to 5 years. No additional immunosuppressive agents were used. Steroids were rapidly tapered. Outcomes were the proportion of patients who achieved a complete response on or off therapy, the rate of discontinuation of corticosteroid within 6 months, length of remission, time to relapses, and occurrence of adverse events. In all, 36 of 42 patients (86%; 95% confidence interval 75%-96%) achieved a complete response on or off therapy and discontinued steroids within 6 months from induction therapy. Six patients had a complete response off therapy with an additional infusion of rituximab 6 months after initial treatment. Twenty patients experienced a total of 34 relapses; the time to relapse was 8 to 64 months. Every relapse was treated with rituximab (500 mg) without corticosteroids, which induced a new complete response. No serious adverse events were observed. Lack of a control group is a limitation. Rituximab therapy induces prolonged clinical remission in patients with pemphigus. Coadministration of other immunosuppressive agents is not necessary. Relapses can be managed with additional infusions administered on demand.
    No preview · Article · Jan 2012 · Journal of the American Academy of Dermatology

  • No preview · Article · Nov 2011 · Value in Health

  • No preview · Article · Nov 2011 · Value in Health

Publication Stats

3k Citations
417.64 Total Impact Points


  • 1983-2014
    • Istituto Dermopatico dell'Immacolata
      Roma, Latium, Italy
  • 2012
    • Ospedale di San Raffaele Istituto di Ricovero e Cura a Carattere Scientifico
      Milano, Lombardy, Italy
  • 1990-2012
    • Sapienza University of Rome
      Roma, Latium, Italy
  • 2005-2009
    • Istituto di Cura e Cura a Carattere Scientifico Basilicata
      Rionero in Vulture, Basilicate, Italy
  • 2007
    • University of Verona
      Verona, Veneto, Italy
  • 2006
    • Hospital Clínic de Barcelona
      • Servicio de Enfermedades Autoinmunes y Sistémicas
      Barcino, Catalonia, Spain
  • 2002
    • Università degli Studi di Bari Aldo Moro
      Bari, Apulia, Italy
  • 1997
    • Università degli Studi di Siena
      Siena, Tuscany, Italy