Papers by roberto verdolini
Clinical and Experimental Dermatology, 2017
A 57-year-old white woman presented with a 13-year history of discoloured saggy skin on her left ... more A 57-year-old white woman presented with a 13-year history of discoloured saggy skin on her left buttock and thigh. The patches were intermittently itchy, and had increased in size over the years. The patient's medical history was not relevant. On physcal examination, two patches of red/brown saggy skin, approximately 150 mm in diameter, were noted at the patient's left pelvic girdle (Fig. 1a,b).
Journal of the European Academy of Dermatology and Venereology, 2001
Fatal calciphylaxis (CPX) occurred in two 71-year-old females both requiring haemodialysis for en... more Fatal calciphylaxis (CPX) occurred in two 71-year-old females both requiring haemodialysis for end-stage renal disease. Case 2 also had an associated follicular lymphoplasmocytoid lymphoma. Although laboratory tests disclosed normal coagulation parameters, this woman had a striking cutaneous histological picture of vessel thrombosis and finally died of disseminated intravascular coagulation. CPX is a rare but potentially life-threatening complication of renal failure. The clinical picture is primarily characterized by livedoid purpura with subsequent cutaneous ischaemia and painful ulcerations. Cutaneous ischaemic phenomena are sustained by a progressive process of vascular calcification and thrombosis involving small to medium size arteries of the dermis and subcutis. Although not yet clearly explained, the pathogenetic role of a predisposing hypercoagulability state is currently the most frequently considered hypothesis.
Dermatology, 2004
Travel Fellowship 2005, for her work 'Aging of human sebocytes in vitro induced by exposure to a ... more Travel Fellowship 2005, for her work 'Aging of human sebocytes in vitro induced by exposure to a defined hormone environment' Dr. WenChieh Chen, Kaohsiung, Taiwan: Albert M. Kligman Travel Fellowship 2005, for his work 'Atrophogenic and inhibitory effect of corticosteroids on proliferation and differentiation of sebaceous glands' Marina K. Oeff, Berlin/Dresden, Germany: Albert M. Kligman Travel Fellowship 2005, for her work 'Differential regulation of Toll-like receptor and CD14 pathways by retinoids and corticosteroids in human sebocytes' Prof. Andrea Koreck, Szeged, Hungary: Albert M. Kligman Travel Fellowship 2005, for her work 'Polymorphisms of interleukin 1 receptor antagonist, Toll-like receptor 2 and 4 genes in patients with acne'
Annali italiani di chirurgia
The retroperitoneal tumors are seldom met in their several histological expressions. Authors tota... more The retroperitoneal tumors are seldom met in their several histological expressions. Authors totally considered 27 patients with retroperitoneal tumors and they were observed from 1975 to 1996: 21 of them were primitively cured in this Institute whereas 6 were affected with relapse or metastasis after a surgical approach which had been performed by other structures. Their operability resulted of 100% with an 87% resectability rate. The surgical mortality resulted nil while the morbidity rate was of 44%. The global survival resulted of 60% to 5 years while the disease-free interval was of 35%. The outliving to 5 years resulted of 65% with a 60% disease-free interval only in the patients who were treated in first instance. The surgical therapy represents the only treatment which can modify the clinical history of such neoplasms. Exeresis should be aggressive enough in order to obtain a total extirpation of the mass and grant a right margin of safety of sound tissue. Such radical proce...
Case Reports in Dermatology, 2012
This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCo... more This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License (www.karger.com/OA-license), applicable to the online version of the article only. Distribution for non-commercial purposes only.
Journal of the European Academy of Dermatology and Venereology, 2005
We present a case of an intriguing mesenchymal neoplasm of the scalp that recurred several times ... more We present a case of an intriguing mesenchymal neoplasm of the scalp that recurred several times over 10 years before a final diagnosis was possible. The case was sent for expert opinions to various international dermatopathological authorities and was, for a long time, unanimously interpreted as malignant melanoma. This diagnosis was supported by immunohistochemical examinations demonstrating S-100 positivity. Nevertheless, the clinical behaviour, as well as some histopathological features raised doubt regarding the diagnosis. Only after the last recurrence, followed by a repeat extensive immunohistochemical study, the diagnosis of epithelioid angiosarcoma was made. Histologically malignant melanoma can be highly misleading and in literature, reports of misinterpreted cases of melanoma are published. In contrast, tumours that can simulate melanoma are also not infrequent and it is essential to perform immunohistochemistry to confirm diagnosis and exclude a melanocytic lesion.
Journal of the American Academy of Dermatology, 2011
The American Journal of Dermatopathology, 2000
We describe two cases of adult rhabdomyoma. One was located in the lip of a 66-year-old woman and... more We describe two cases of adult rhabdomyoma. One was located in the lip of a 66-year-old woman and was removed because it was clinically suspicious for infiltrating carcinoma. The other arose in the eyelid of a 60-year-old woman with a glass eye and was initially interpreted as a reactive process due to the prosthesis. Both lesions were composed of cells with oval nuclei and deeply eosinophilic cytoplasms with occasional cross striations. Immunoreactivity for desmin and myoglobin excluded the diagnosis of other tumors with similar morphology. The unusual association of the eyelid tumor with the prosthesis suggests a role for chronic irritation in the pathogenesis of rhabdomyoma.
The Journal of Laryngology & Otology, 2022
BackgroundEczematous external otitis is a common chronic condition that can have a significant im... more BackgroundEczematous external otitis is a common chronic condition that can have a significant impact on the life of sufferers, causing constant discomfort and pruritus, and leading to sleep deprivation. Treatment is based on the use of topical steroids, moisturisers and occasionally antibiotics. Results, however, can be disappointing, especially over the long term.MethodsThis study compared the long-term response to pimecrolimus, administered to a group of 11 patients, against clobetasone butyrate, administered to an equivalent number of patients. Response to the treatment was assessed and statistically analysed at 3 and 12 months.ConclusionWhereas the degree of improvement following the use of pimecrolimus and clobetasone butyrate was similar for the two groups at month 3, a highly statistically significant difference was documented at month 12, with a much greater and sustained improvement in the pimecrolimus group.
Journal of Dermatological Treatment, 2020
Abstract Background Although molluscum contagiosum virus (MCV) infection is a common disease wide... more Abstract Background Although molluscum contagiosum virus (MCV) infection is a common disease widespread among children and young adults, there is no shared opinion on treatment that 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 clearance of MCV lesions in a sample of pediatric patients. It compares outcomes in treated with Imiquimod cream, compared with non-treated patients. Methods The sample consits of 48 pediatric patients affected by MVC clinically diagnosed. It was divided into two groups: Group I, treated with Imiquimod 5% cream once/day until the onset of a visible inflammatory reaction. Once the reaction was illicited, application was suspended until the irritation resolved. If the lesion was still present, drug was administered again using the same regimen. The cycle was repeated until complete clinical resolution. Group II, control, comprises non-treated patients. Follow up visits were carried out 12, 16, 20, 48, and 52 weeks from the beginning of treatment. Results At week 20, all patients except one in the treated group were lesion free. Persistence of MCV lesions was documented in one patient only until week 48. In the control group all patients were still affected by MCV lesions during the follow-up period. Spontaneous clinical resolution of the infection was observed in only 2 patients at week 52. The results of the study show Imiquimod’s significant efficacy. Conclusions Our study is one of the few case-control studies in pediatric population carried out with such long-term follow-up. Efficacy of this personalized treatment, scarce recurrence, absence of cicatricial sequelae and lack of necessity for deep sedation, in the case of children with disseminated lesions, makes the use of Imiquimod the first line of treatment compared with other destructive treatments or with no-treatment at all.
Giornale italiano di dermatologia e venereologia : organo ufficiale, Società italiana di dermatologia e sifilografia, 2015
Repair following excision of large tumours of the face can be problematic; primary closure may no... more Repair following excision of large tumours of the face can be problematic; primary closure may not be achievable and grafting or secondary intention healing carry the risk of necrosis and lengthy healing times. Flaps are usually associated with earlier healing and better cosmetic results, as the skin used for closure is similar to the tissue requiring repair. However, large wound sizes and difficulty in finding a suitable donor area means flaps can be complicated to perform. The aim of this paper was to identify a comparatively quick and simple alternative to standard repair techniques for the closure of large wound defects in critical anatomical areas, when the only realistic alternative would be grafting, offering both good cosmetic results and minimal risk of complications. We have developed a flap, modified from the classic, single lobe transposition flap. Two similar lobes placed symmetrically and perpendicularly to two opposite sides of the surgical wound are incised with fulc...
European journal of dermatology : EJD, 2000
We present a case of mycetoma by Madurella mycetomatis on the foot of a Chinese young man, living... more We present a case of mycetoma by Madurella mycetomatis on the foot of a Chinese young man, living in Italy for more than ten years. Clinically the lesion closely resembled and was initially misinterpreted as a vascular neoformation. We analyze the histological and morphological features of the Madurella mycetomatis infection through which we managed to type the etiological agent. Our case is worth reporting because of the rarity of this disease in Europe and the unusual clinical presentation. It also offers the opportunity to stress the need for the clinical suspicion of this dermatosis, considering the increase of immigration towards our regions.
Journal of the European Academy of Dermatology and Venereology, 2012
Background Despite recent insights into its aetiology, hidradenitis suppurativa (HS) remains an i... more Background Despite recent insights into its aetiology, hidradenitis suppurativa (HS) remains an intractable and debilitating condition for its sufferers, affecting an estimated 2% of the population. It is characterized by chronic, relapsing abscesses, with accompanying fistula formation within the apocrine glandbearing skin, such as the axillae, ano-genital areas and breasts. Standard treatments remain ineffectual and the disease often runs a chronic relapsing course associated with significant psychosocial trauma for its sufferers. Objective To evaluate the clinical efficacy of Metformin in treating cases of HS which have not responded to standard therapies. Methods Twenty-five patients were treated with Metformin over a period of 24 weeks. Clinical severity of the disease was assessed at time 0, then after 12 weeks and finally after 24 weeks. Results were evaluated using Sartorius and DLQI scores. Results Eighteen patients clinically improved with a significant average reduction in their Sartorius score of 12.7 and number of monthly work days lost reduced from 1.5 to 0.4. Dermatology life quality index (DLQI) also showed a significant improvement in 16 cases, with a drop in DLQI score of 7.6. Conclusion Metformin helps control HS with minimal side effects and good patient compliance and can represent a further agent in the spectrum of treatments available in the treatment of this disease.
Journal of Cutaneous Pathology, 2001
Metalloproteinases (MMPs) are thought to be involved in the process of destruction of basement me... more Metalloproteinases (MMPs) are thought to be involved in the process of destruction of basement membranes and stromal invasion by neoplastic epithelial cells. In order to investigate the role of MMPs in cutaneous oncogenesis we studied the expression of MMP-2 and MMP-9 in 34 cases of epidermal preinvasive neoplastic lesions and invasive carcinomas. We also studied their relationship with the expression of tissue inhibitors of MMPs and with proliferative activity and p53 expression in neoplastic epithelial cells. MMP-9 was found to be focally expressed by neoplastic epithelial cells at the infiltrative edges in microinvasive carcinomas and in dyskeratotic foci in Bowen's disease and widely invasive carcinomas. Gradation of Mib-1 positivity and p53 expression was found with increasing abnormality in the spectrum of malignancy. Our results seem to suggest the involvement of MMPs in microinvasive carcinomas, which show also low proliferative activity and p53 expression, whether other factors seem to be more important in widely invasive carcinomas.
Current Drug Target -Inflammation & Allergy, 2003
Cell migration is mediated by a group of chemotactic cytokines called chemokines: low molecular w... more Cell migration is mediated by a group of chemotactic cytokines called chemokines: low molecular weight molecules that have been shown as important leukocyte chemical attractants to sites of inflammation and infection. Eotaxin-1, also called CCL11, was first described in 1994, as a highly specific eosino-phils chemokine. Many cell types including lymphocytes, macrophages, bronchial smooth muscle cells, endothelial cells and eosinophils, are able to produce this chemokine, predominantly after cytokine stimulation, however little is known about its expression in human skin in vivo. Eotaxin-1 also regulates the chemiotaxis and, in some conditions, activation of basophils, mast cells and T lymphocytes. Chemokine receptors are named from their ligand families, thus the CC chemokine eotaxin-1 binds to the CCR3 receptor which is expressed on eosinophis, mast cells, Th2 type lymphocytes and even on keratinocytes. It seems that eotaxin-1 is one of the most important cytokines involved in tissue inflammation playing a central role in the pathogenesis of allergic airway diseases (asthma and rhinitis), in inflammatory bowel disease and gastrointestinal allergic hypersensitivity and recently it has been proposed as a therapeutical target for these conditions. Our group has studied the role of eotaxin-1 in the pathogenesis of two skin conditions: dermatitis herpetiformis and AIDS-associated eosinophilic folliculitis, demonstrating that this chemokine, together with Th2 type cytokines (IL-13 and IL-4) is important in cell recruitment, inflammation and tissue damage; moreover eotaxin has proven to paly an important role in other skin conditions such as, bullous pemphigoid, pemphigoid gestationis, atopic dermatitis and allergic drug reactions Recent advances in the understanding of eotaxin-1-mediated mechanisms of chemotaxis in allergic and inflammatory conditions may predict that therapeutic antagonism is achievable. This paper will focus on the role that eotaxin and its receptor play in the pathogenetical mechanism in a number of dermatologic diseases, some of which, like atopic dermatitis, may benefit from the introduction of novel and more selective therapeutic options.
Clinical and Experimental Dermatology, 2013
1 Pattee SF, Silvis NG. Keratoacanthoma developing in sites of previous trauma: a report of two c... more 1 Pattee SF, Silvis NG. Keratoacanthoma developing in sites of previous trauma: a report of two cases and review of the literature. J Am Acad Dermatol 2003; 48 (Suppl.): S35–8. 2 Gewirtzman A, Meirson DH, Rabinovitz H. Eruptive keratoachanthomas following carbon dioxide laser resurfacing. Dermatol Surg 1999; 25: 666–8. 3 Dessoukey MW, Omar MF, Abdel-Dayem H. Eruptive keratoachantomas associated with immunosuppressive therapy in a patient with systemic lupus erythematosus. J Am Acad Dermatol 1997; 37: 478–80. 4 D Addario S, Carrington PR. Multiple keratoacanthomas as an untoward response to imiquimod therapy for actinic keratoses. Acta Derm Venereol 2006; 86: 366–7. 5 Marcollo Pini A, Koch S, Scharer L et al. Eruptive keratoacanthomas following topical imiquimod for in situ squamous cell carcinoma of the skin in a renal transplant recipient. J Am Acad Dermatol 2008; 59: S116–17.
British Journal of Dermatology, 2002
We report a 22-year-old woman who developed systemic lupus erythematosus (SLE) immediately after ... more We report a 22-year-old woman who developed systemic lupus erythematosus (SLE) immediately after an Epstein-Barr virus (EBV)-induced mononucleosis infection. The link between these two conditions has long been suspected. The close temporal relationship, the course of the pathological events and the development of immunological changes in this case provide further evidence supporting the hypothesis that EBV infection could work as a trigger in some cases of SLE, particularly if the patient is genetically susceptible.
Acta Dermato-Venereologica, 2001
The pathogenesis of AIDS-associated eosinophilic folliculitis is D ysregulation towards a predomi... more The pathogenesis of AIDS-associated eosinophilic folliculitis is D ysregulation towards a predominant Th2 cytokines expresstill unknown. The expression of chemokines and Th2-type sion (IL-4 and IL-5) has been implicated in diseases charactercytokines is increased in other conditions associated with tissue ized by eosinophilic activation, such as parasitic infection, as eosinophilia and in allergic reactions. We evaluated the mRNA well as atopic or allergic diseases (8). It has been suggested expression by reverse transcriptase polymerase chain reaction that Th2 cytokines play a role in Ofuji disease (9), a disease of two Th2 cytokines (interleukin-4 and interleukin-5) and of which is closely related to AID S-EF. IL-5 mediates blood two chemokines (RANTES and eotaxin) in the skin of 6 patients eosinophilia (10) and in the tissue it could prolong mature with AIDS-associated eosinophilic folliculitis; the tissue localizeosinophils survival and stimulate their proin ammatory funcation of eotaxin was shown by immunohistochemistry. We tions (11). R ecently, it has been shown that this cytokine demonstrated the increased expression of interleukin-4, exerts its eOE ects on eosinophils, enhancing the chemotactic interleukin-5, RANTES and eotaxin in lesional skin of the eOE ects of chemokines such as regulated upon activation normal patients compared to normal skin of HIV + individuals. We
British Journal of Dermatology, 2000
The dermal and perivascular infiltrate in dermatitis herpetiformis (DH), which is mainly composed... more The dermal and perivascular infiltrate in dermatitis herpetiformis (DH), which is mainly composed of CD4+ lymphocytes, neutrophils and eosinophils, is believed to play an important part in the pathogenesis of the disease. Previous studies suggest that cytokines such as interleukin (IL) -8, granulocyte-macrophage colony-stimulating factor, IL-4 and IL-5 could be involved in the pathogenesis of DH. These cytokines appear to drive tissue infiltration and maturation of eosinophils. Part of the effect of T-helper (Th) 2-type cytokines (IL-4, IL-5) on eosinophils could be mediated by eotaxin, which is a highly specific chemotactic protein induced by various cytokines [IL-4, IL-13, tumour necrosis factor (TNF) -alpha and interferon-gamma]. To evaluate the expression of eotaxin and its inducers, IL-13 and TNF-alpha, in DH. METHODS We examined lesions collected from 10 DH patients with active disease. Sections from each specimen were incubated with anti-IL-13, anti-TNF-alpha and anti-eotaxin antibodies. Chloroacetyl esterase reaction was performed to show mast cell infiltration. Eotaxin was mainly expressed at the tips of the dermal papillae, within the microabscesses. Positivity was also found in the lymphomonocytic infiltrate in the dermis. IL-13 was expressed in the dermal infiltrate and TNF-alpha was found in the inflammatory infiltrate and in dermal vascular cells. These findings confirm the importance of the lymphomonocytic infiltrate and of Th2 cytokines in the pathogenesis of this disease, suggesting that tissue infiltration in DH is mediated by cell-specific chemokines such as eotaxin and not only by non-specific chemokines such as IL-8.
British Journal of Dermatology, 2021
BACKGROUND Palmoplantar pustulosis (PPP) is a rare, debilitating, chronic inflammatory skin disea... more BACKGROUND Palmoplantar pustulosis (PPP) is a rare, debilitating, chronic inflammatory skin disease affecting the hands and feet. Clinical, immunological and genetic findings suggest a pathogenic role for interleukin (IL)-1. OBJECTIVE To determine whether anakinra (an IL-1 receptor antagonist) delivers therapeutic benefit for PPP. METHODS A randomised (1:1), double-blind, two-staged, adaptive, UK multi-centre, placebo-controlled trial. Participants had a diagnosis of PPP (>6 months) requiring systemic therapy. Treatment was eight weeks of anakinra or placebo via daily self-administered subcutaneous injections. The primary outcome was the Palmoplantar Pustulosis Psoriasis Area and Severity Index (PPPASI) at 8 weeks. RESULTS A total of 374 patients were screened and 64 were enrolled (31 anakinra, 33 placebo) with mean baseline PPPASI 17.8 (SD=10.5); PPP investigator's global assessment severe (50%) or moderate (50%). The baseline adjusted mean difference in PPPASI favoured anakinra but did not demonstrate superiority in intention-to-treat analysis, -1.65, 95% CI [-4.77 to 1.47], p=0.300. Secondary objective measures including fresh pustule count (2.94, 95% CI [-26.44 to 32.33] favouring anakinra), total pustule count (-30.08, 95% CI [-83.20 to 23.05] favouring placebo), and patient-reported outcomes, similarly did not show superiority of anakinra. When modelling the impact of adherence, the PPPASI complier average causal effect (CACE) for an individual who receives ≥90% total treatment (48% anakinra group), was -3.80, 95% CI [-10.76 to 3.16], p=0.285. No serious adverse events occurred. CONCLUSIONS No evidence for superiority of anakinra was found. IL-1 blockade is not a useful intervention for the treatment of PPP.
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Papers by roberto verdolini