Erythema multiforme major after whole brain radiotherapy: a case of EMAR syndrome

We report the case of a woman with a 4-year history of metastatic breast carcinoma presenting a large erosive area on her scalp plus erosive lesions on the lips and in the mouth and erythematous plaques with vesicles on the trunk and upper limbs. In this case, contrary to other reports, the most important trigger for this syndrome was radiotherapy rather than the systemic medications administered. Therefore we propose the term EMAR (erythema multiforme associated to radiotherapy) to describe this cas

PEL, Kaposi's sarcoma HHV8+ and idiopathic T-lymphocitopenia CD4+. Clin Ter. 2007 Mar-Apr;158(2):151-5

We described a case report of a 36-year-old woman with a 10-year-history of idiopathic CD4+ T-lymphocitopenia and Kaposi's sarcoma HHV8+ who developed recurrent pleural effusion. Laboratory and instrumental tests with morphologic, immunophenotypic and molecular analysis of pleural sediment suggest us the diagnosis of primary effusion lymphoma (PEL). The term primary effusion lymphoma defines an extranodal non-Hodgkin's lymphoma HHV8-related, usually classified as a B-cell lymphoma, that grows in liquid-phase within body cavities. The case reported by the Authors appears to be of great interest for its epidemiological and clinical features

Physician-patient communication and patient-reported outcomes in the actinic keratosis treatment adherence initiative (AK-TRAIN): a multicenter, prospective, real-life study of treatment satisfaction, quality of life and adherence to topical field-directed therapy for the treatment of actinic keratosis in Italy

Background: Patients with multiple actinic keratoses (AKs) should be treated with field-directed therapy. Such treatments challenge patients’ adherence due to out-of-pocket costs, length of treatment and severity of local skin reactions (LSRs). Effective physician–patient communication (PPC) may buffer therapy-related distress, thus improving quality of life, treatment satisfaction and adherence. Objectives: We evaluated the interplay between PPC, LSR intensity (safety) and lesion clearance rates (effectiveness) on treatment satisfaction, quality of life and treatment adherence among patients with multiple AKs receiving topical field-directed therapies. Methods: In this observational, multicentre, longitudinal, cohort study, we included 1136 adult patients with discrete, clinically detectable, visible, multiple (three or more lesions in a 25 cm 2 area), Grade I/II AKs, for whom the attending dermatologist has prescribed treatment with a topical field-directed therapy. We matched self-reported data and medical information recorded by dermatologists in standard clinical forms. Patients were followed up at two time points (T1: 8 days; T2: 25–30 days). Results: Most patients were elderly, married, men with poor socio-economic status and multiple lesions of the scalp or face. The majority (n = 961) had a prescription of ingenol mebutate (IMB) and 175 received either diclofenac 3% in hyaluronic acid (DHA) or imiquimod 5% (IMQ). Clearance rate at 1 month was 84%. Most patients felt very supported (n = 819, 73%) and rated dermatologist's explanations very clear (n = 608, 54%). Treatment satisfaction (effectiveness and convenience scales) increased along the follow-up, especially for those on IMB (Δ pre-post = −4.00; other: Δ pre-post = −0.25; interaction P < 0.001). Communication clarity was associated with higher treatment satisfaction scores (β = 0.4–0.6, P < 0.01) and lower risk of non-adherence among IMB patients (risk difference: 16%, P < 0.01). Conclusion: Communication clarity was associated with patient-reported outcomes and adherence beyond AK-related clinical parameters. Our study questions the current episodic approach to AK management and provides the rationale to develop chronic care models fostering patients’ engagement and treatment alliance

Latent tuberculosis infection in patients with chronic plaque psoriasis: Evidence from the Italian Psocare Registry

Background The nationwide prevalence of latent tuberculosis infection (LTBI) in Italian patients with psoriasis has never been investigated.Objectives To estimate the nationwide prevalence of LTBI in Italian patients with psoriasis who are candidates for systemic treatment.Methods Data were obtained from the Psocare Registry on those patients (n = 4946) with age &gt; 18 years, systemic treatment at entry specified and tuberculin skin test (TST) performed according to the Mantoux method. LTBI diagnosis was based on a positive TST result in the absence of any clinical, radiological or microbiological evidence of active tuberculosis.Results Latent tuberculosis infection was diagnosed in 8.3% of patients with psoriasis (409 of 4946). The prevalence of LTBI was lower in patients on biologics than in those on conventional systemic treatments, ranging from 4.3% (19 of 444) of patients on adalimumab to 31% (eight of 26) of those on psoralenultraviolet A (P &lt; 0.05). Independent factors associated with LTBI were male sex [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.04-1.62; P = 0.02], age over 55 years (OR 2.93, 95% CI 2.18-3.93; P &lt; 0.001) and being entered into a conventional treatment (OR 3.83, 95% CI 3.10-4.74; P &lt; 0.001). Positive history of tuberculosis was seen in 1% of patients (n = 49).Conclusions The nationwide prevalence of LTBI in Italian patients with psoriasis candidate to systemic treatment is high, and screening is recommended prior to biological treatment

Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry

Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event

Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry.

NCBINCBI Logo Skip to main content Skip to navigation Resources How To About NCBI Accesskeys Sign in to NCBI PubMed US National Library of Medicine National Institutes of Health Search database Search term Clear input Advanced Help Result Filters Display Settings: Abstract Send to: J Eur Acad Dermatol Venereol. 2013 Jan;27(1):e30-41. doi: 10.1111/j.1468-3083.2012.04450.x. Epub 2012 Feb 7. Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry. Gisondi P1, Cazzaniga S, Chimenti S, Giannetti A, Maccarone M, Picardo M, Girolomoni G, Naldi L; Psocare Study Group. Collaborators (368) Author information Abstract OBJECTIVE: To evaluate variations in laboratory parameters and diagnoses of selected clinical conditions up to 16 weeks after starting a new systemic psoriasis treatment for Psocare Registry enrollees. DESIGN: Prospective cohort study. SETTING: Italian public referral centres for psoriasis treatment. PATIENTS: First-time recipients (n = 10,539) of continuous systemic psoriasis treatment for at least 16 weeks. MAIN OUTCOME MEASURE: Mean variations in (weeks 8 and 16) and proportions of patients reaching a clinically meaningful increase in serum levels (week 16) of total and low-density lipoprotein cholesterol, triglycerides, aspartate amino transferase, alanine amino transferase and creatinine, as well as week-16 cumulative incidences of new diagnoses of diabetes mellitus and arterial hypertension. RESULTS: Mean cholesterol and triglyceride levels significantly increased in patients treated with acitretin or cyclosporine. Mean triglyceride levels also increased in efalizumab- and etanercept-treated patients. Mean transaminase values increased in methotrexate-treated patients, and mean aspartate amino transferase levels increased in infliximab-treated patients. The average serum creatinine value increased in cyclosporine-treated patients. Acitretin and cyclosporine were associated with risk of hypercholesterolaemia (odds ratios 1.51 and 1.34) and acitretin with risk of hypertriglyceridaemia (odds ratio 1.43). Methotrexate and infliximab were associated with risk of more than doubling the upper normal aspartate amino transferase (odds ratios 2.06 and 1.87) and alanine amino transferase (odds ratios 2.38 and 1.74) values. The relative risk of developing arterial hypertension and diabetes was increased for patients receiving cyclosporine (odds ratios 3.31 and 2.88). CONCLUSION: Systemic treatments for psoriasis resulted in heterogeneous effects on the parameters analysed