HIDRAdisk: validation of an innovative visual tool to assess the burden of hidradenitis suppurativa

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 psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for HS and generic dermatologic questionnaires are used. Objective The objective of this study was to demonstrate the validity, reliability and responsiveness of HIDRAdisk, a new innovative tool designed for rapid assessment of HS burden and, at the same time, an intuitive graphic visualization of the measurement outcome. Methods A multicentre, longitudinal, observational study was conducted to validate the HIDRAdisk compared with other validated questionnaires [Skindex‐16, Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment–General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of HS severity, as measured by Hurley stage and HS Physician Global Assessment (HS‐PGA). Results A total of 140 patients (59% women; mean age 34.9 ± 11.0 years) were enrolled in 27 dermatologic centres. HIDRAdisk showed a strong correlation with Skindex‐16 and DLQI, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and HS‐PGA. Very good internal consistency (Cronbach coefficient >0.80; intraclass correlation coefficient >0.6), with correlation between the 10 items, good test–retest reliability (Spearman correlation coefficient, 0.8331; P < 0.0001) and responsiveness to changes were demonstrated. Conclusion Our study shows that HIDRAdisk, a short and innovative visual HS QoL instrument, has been psychometrically validated in Italian language and it may help improve the management of HS once implemented in routine clinical practice

HIDRAdisk: validation of an innovative visual tool to assess the burden of hidradenitis suppurativa

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 psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for HS and generic dermatologic questionnaires are used. Objective The objective of this study was to demonstrate the validity, reliability and responsiveness of HIDRAdisk, a new innovative tool designed for rapid assessment of HS burden and, at the same time, an intuitive graphic visualization of the measurement outcome. Methods A multicentre, longitudinal, observational study was conducted to validate the HIDRAdisk compared with other validated questionnaires [Skindex‐16, Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment–General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of HS severity, as measured by Hurley stage and HS Physician Global Assessment (HS‐PGA). Results A total of 140 patients (59% women; mean age 34.9 ± 11.0 years) were enrolled in 27 dermatologic centres. HIDRAdisk showed a strong correlation with Skindex‐16 and DLQI, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and HS‐PGA. Very good internal consistency (Cronbach coefficient >0.80; intraclass correlation coefficient >0.6), with correlation between the 10 items, good test–retest reliability (Spearman correlation coefficient, 0.8331; P < 0.0001) and responsiveness to changes were demonstrated. Conclusion Our study shows that HIDRAdisk, a short and innovative visual HS QoL instrument, has been psychometrically validated in Italian language and it may help improve the management of HS once implemented in routine clinical practice

Effectiveness of extracorporeal photochemotherapy in the treatment of a case of refractory erosive lichen planus

Erosive lichen planus is characterized by painful, multi-focal erythematous-ulcerative areas affecting mucosal oral and genital areas. Topical therapies are usually ineffective, whereas systemic steroids and immunosuppressive agents are frequently associated with a wide spectrum of side effects. Herein, we presented our positive experience in the treatment of a case of multi-resistant erosive lichen planus with extracorporeal photochemotherapy

Fluorescence-Advanced-Videodermatoscopy (FAV): a new method for in-vivo skin evaluation

Dermatoscopy is a non-invasive technique that allows a rapid and magnified in-vivo observation of the skin (1-3) . Manual dermatoscopy uses optical systems that work by modifying the cutaneous air-tissue optical interference (1) . Videodermatoscopy, on the other hand, is supported by digital systems allowing an image acquisition at higher magnification. This article is protected by copyright. All rights reserved

Clinical and prognostic reports from 270 patients with multiple primary melanomas: a 34-year single-institution study

Background Development of more than one primary melanoma in a sole patient is frequent, accounting for 1.2\u20138.2% of melanoma patients in most recent series. Objective and methods Clinical, histological and epidemiological characteristics of 270 multiple primarymelanomas patients were reviewed. Results Two-hundred and seven patients (76.7%) had two melanomas, whereas in the remaining 63 the number of primary ranged from three to eight; on the whole, 639 multiple primary melanomas were identified. Synchronous melanomas developed more frequently in patients with three or more lesions; median age was significantly lower in the group of patients with more than three melanomas than in the others. Mean Breslow\u2019s thickness significantly decreases (P < 0.001) from the first (1.77 \ub1 1.76 mm) to subsequent primaries (0.85 \ub1 1.25 mm for the second and 0.66 \ub1 0.48 mm for the third melanoma). Percentage of \u2018in situ\u2019 melanomas was 5.6% as first diagnosis, but increased to 24.8% for the second melanoma; number of nodular melanomas was significantly lower for succeeding diagnosis. AJCC stage at diagnosis showed a statistical prognostic significance, whereas outcome and survival did not depend on the number of primary lesions. Multivariate analysis confirmed the prognostic role of Breslow\u2019s thickness, ulceration, gender and patient age, and the better prognosis of patients with multiple melanomas, respect to those with single primary melanoma. Conclusions Skin examination and long-term follow-up are mandatory for patients affected by melanoma, with the intent to promptly diagnose not only a disease progression but also possible new primary melanomas

The large spectrum of spitzoid tumours: a retrospective survival study.

Abstract BACKGROUND: There is no universally-accepted classification of spitzoid tumours. This makes difficult to assign a correct diagnosis and select a treatment that minimises the risk of overestimating, or worse, underestimating, the malignant potential of these tumours. To describe the clinical-pathological and epidemiological features of spitzoid tumours, as well as to assess mortality in these patients. METHODS: This retrospective cohort study looked at data on spitzoid tumours excised in 1999-2012 at the Dermatologic Clinic of the Turin University Hospital. Spitzoid melanoma specific survival curves were generated with the Kaplan-Meier method and compared using the log-rank test. RESULTS: in this time period, 1663 lesion were described at the pathologic report as spitzoid. 262 were (15.75%) Spitz naevi, 307 (18.46%) Reed naevi, 827 (49.73%), 810 (48.71%) spitzoid dysplastic naevi, 17(1.02%) atypical spitzoid tumours, and 267 (16.06%) spitzoid melanomas. Median follow up time was 9 years. Out of the entire cohort only 24 patients died from melanoma. All of them received a diagnosis of spitzoid melanoma. None of the patients with a diagnosis of not melanoma spitz tumour died for melanoma during the follow up. CONCLUSION: In the large mayority of the cases, spitz tumour should be considered as benign lesion and excised only if melanoma features are seen. The used clinical pathological classification avoid misdiagnoses, inappropriate treatment and the risk of death for melanoma

HIDRAdisk: validation of an innovative visual tool to assess the burden of hidradenitis suppurativa

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 psoriasis and atopic eczema, and its improvement is an important goal in disease management. Nowadays, there are no specific validated QoL instruments available for HS and generic dermatologic questionnaires are used. Objective The objective of this study was to demonstrate the validity, reliability and responsiveness of HIDRAdisk, a new innovative tool designed for rapid assessment of HS burden and, at the same time, an intuitive graphic visualization of the measurement outcome. Methods A multicentre, longitudinal, observational study was conducted to validate the HIDRAdisk compared with other validated questionnaires [Skindex-16, Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment–General Health (WPAI:GH)] and to evaluate its correlation with disease severity in Italian patients with any degree of HS severity, as measured by Hurley stage and HS Physician Global Assessment (HS-PGA). Results A total of 140 patients (59% women; mean age 34.9 11.0 years) were enrolled in 27 dermatologic centres. HIDRAdisk showed a strong correlation with Skindex-16 and DLQI, and a good one with WPAI:GH (correlation coefficient: 0.7568, 0.6651 and 0.5947, respectively) and a statistically significant correlation with both Hurley stage and HSPGA. Very good internal consistency (Cronbach coefficient &gt;0.80; intraclass correlation coefficient &gt;0.6), with correlation between the 10 items, good test–retest reliability (Spearman correlation coefficient, 0.8331; P &lt; 0.0001) and responsiveness to changes were demonstrated. Conclusion Our study shows that HIDRAdisk, a short and innovative visual HS QoL instrument, has been psychometrically validated in Italian language and it may help improve the management of HS once implemented in routine clinical practic

The large spectrum of Spitzoid tumors: a retrospective survival study

There is no universally-accepted classification of Spitzoid tumors. This makes it difficult to assign a correct diagnosis and select a treatment that minimizes the risk of overestimating, or worse, underestimating, the malignant potential of these tumors. The aim of this study was to describe the clinical-pathological and epidemiological features of Spitzoid tumors, as well as to assess mortality in these patients