Spiny keratoderma of the palms in a patient with diabetes mellitus type1. What came first, the chicken or the egg?

Spiny keratoderma (SK) was firstly reported by Brown in 1971 as punctate keratoderma. It is a rare disorder, characterized by asymptomatic keratotic projections on the palms and soles, resembling a music box. Sometimes lesions could be mildly painful or pruritic, but usually they are completely asymptomatic. It has been described two distinct types of SK: the idiopathic and the inherited form. We report the case of a 60-year-old Caucasian male with acquired SK

Spiny keratoderma of the palms in a patient with diabetes mellitus type 1: what came first, the chicken or the egg?

Spiny keratoderma (SK) was firstly reported by Brown in 1971 as punctate keratoderma. It is a rare disorder, characterized by asymptomatic keratotic projections on the palms and soles, resembling a music box. Sometimes lesions could be mildly painful or pruritic, but usually they are completely asymptomatic. It has been described two distinct types of SK: the idiopathic and the inherited form. We report the case of a 60-year-old Caucasian male with acquired SK

Efficacy of certolizumab pegol in naïve versus multi-treated patients affected by psoriatic arthritis

The efficacy and safety of Certolizumab Pegol over 52 weeks was compared in two groups of patients: Group 1 comprised patients naïve to biologic treatments; Group 2 comprised patients previously treated with one or more anti-Tumor necrosis factor (TNF)-alpha and/or antiinterleukin (IL) agents

Flares as dynamic predictive factor of response to adalimumab in hidradenitis suppurativa: real-life data

BACKGROUND: Hidradenitis suppurativa (HS) is characterized by periodic worsening of both clinical manifestations and symptoms. The aim of this study was to investigate the role of flare outbreak as a possible predictive factor of response to adalimumab. METHODS: One hundred fifteen HS patients in treatment with adalimumab, with moderate-severe HS, 3 abscesses and inflammatory-nodules (ANs) from 5 Italian centers were included in this retrospective analysis. The information about gender, ages at onset/baseline, therapeutic delay, family history, body mass index, smoking, comorbidities, phenotypes, body areas, severity indexes at baseline was collected. Baseline characteristics, total number and timeline of flares were analyzed by regression and survival analysis with Hidradenitis Suppurativa Clinical Response (HiSCR). RESULTS: During the observational period, 80.9% of patients developed flares, detecting 252 flares. Univariate model identified five factors as-sociated with the absence of response: age (P=0.020), comorbidities (P=0.030), genital-perineal involvement (P=0.004), no response at week 12 (P=0.027), and flares outbreak (P=0.010). Joint analysis of recurrent and terminal events showed a positive correlation between flare recurrence and no response (P<0.001). Among the identified variables associated with poor response to the therapy: occurrence of a flare before week 12 was the one with the highest risk of no response (P<0.001). CONCLUSIONS: The analysis of a "dynamic" variable, as flares evaluation together with an appropriate clinical baseline assessment can be a useful approach to predict the middle-long-term response to adalimumab. (Cite this article as: Caposiena Caro RD, Chiricozzi A, Sechi A, Molinelli E, Venturini M, Candi E, et al. Flares as dynamic predictive factor of re-sponse to adalimumab in hidradenitis suppurativa, real-life data. Ital J Dermatol Venereol 2022;157:240-6. DOI: 10.23736/S2784-8671.21.07049-3

Factors related to the onset and recurrence of flares in hidradenitis suppurativa patients treated with adalimumab

Hidradenitis suppurativa (HS) is characterized by periodic worsening of symptoms. However, clinical parameters associated with flare are still to be established. The aim was too investigate factors associated with flare outbreak in HS patients in treatment with adalimumab

Bullous pemphigoid: Italian guidelines adapted from the EDF/EADV guidelines

Bullous pemphigoid is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and presents with itch and localized or generalized bullous lesions. In up to 20% of affected patients blister may be completely absent, and only excoriations, prurigo-like lesions, eczematous lesions, urticated lesions, and/or infiltrated plaques are observed. The disease is significantly associated with neurological disorders. The morbidity of bullous pemphigoid and its impact on the quality of life are significant. So far, a limited number of national treatment guidelines have been proposed, but no common European consensus has emerged. This guideline for the treatment of bullous pemphigoid has been developed by an Italian group of experts taking in account the Italian legislation and local pharmacological governance. Guidelines are adapted from the original article under the guidance of the European Dermatology Forum (EDF) in collaboration with the European Academy of Dermatology and Venereology (EADV). It summarizes evidence-based and expert-based recommendations (S2 level)