Chiara Cortelazzi

Aromatase inhibitor-induced skin adverse reactions: exemestane-related cutaneous vasculitis

Background  Three aromatase inhibitors, namely anastrozole, letrozole and exemestane, which reduce circulating oestrogen, are used to treat breast cancer patients; the therapeutic use of such aromatase inhibitors is quickly increasing.

Are Anti-TNF-α Agents Safe for Treating Psoriasis in Hepatitis C Virus Patients with Advanced Liver Disease? Case Reports and Review of the Literature

Tumor necrosis factor-alpha (TNF-α) inhibitors represent an effective treatment for severe psoriasis in hepatitis C virus (HCV) patients. The literature reports mainly on short-term treatment in patients with chronic hepatitis with minimum-to-moderate activity with an acceptable safety profile. We report the first 2 cases of hepatocellular carcinoma (HCC) arising in HCV psoriatic patients with advanced liver disease during long-term treatment with etanercept. Our first patient, known to have had HCV infection for 41 years, developed an HCC after 21 months of therapy with etanercept (50 mg/week). The second patient, HCV+ for 20 years, was treated for 58 months with the same therapy, and despite no signs of liver function impairment was diagnosed with HCC. Both of them presented with cirrhosis, which was diagnosed 9 and 5 years earlier, respectively. It remains to be clarified whether there is any connection between psoriasis treatment with anti-TNF-α agents and the development of HCC in HCV-infected patients. Further long-term, follow-up studies and registries of HCV patients with mild/moderate activity may contribute to clarify this issue.

Cytoplasmic β-catenin is lacking in a subset of melanoma-associated naevi, but is detectable in naevus-associated melanomas: potential implications for melanoma tumorigenesis?

Summary Background  An excess of intracellular β‐catenin protein is triggered by various genetic alterations in melanoma cell lines, and has been suggested to play a role in melanoma tumorigenesis.

Claimed Effects, Outcome Variables and Methods of Measurement for Health Claims Proposed Under European Community Regulation 1924/2006 in the Framework of Maintenance of Skin Function

Evidence suggests a protective role for several nutrients and foods in the maintenance of skin function. Nevertheless, all the requests for authorization to use health claims under Article 13(5) in the framework of maintenance of skin function presented to the European Food Safety Authority (EFSA) have received a negative opinion. Reasons for such failures are mainly due to an insufficient substantiation of the claimed effects, including the choice of inappropriate outcome variables (OVs) and methods of measurement (MMs). The present paper reports the results of an investigation aimed at collecting, collating and critically analyzing the information with relation to claimed effects (CEs), OVs and MMs related to skin health compliance with Regulation 1924/2006. CEs, OVs and MMs were collected from both the EFSA Guidance document and from the authorization requests of health claims under Article 13(5). The critical analysis of OVs and MMs was based on a literature review, and was aimed at defining their appropriateness (alone or in combination with others) in the context of a specific CE. The results highlight the importance of an adequate choice of OVs and MMs for an effective substantiation of the claims.

Comparative study of trichloroacetic acid vs. photodynamic therapy with topical 5‐aminolevulinic acid for actinic keratosis of the scalp

Photodynamic therapy with 5‐methyl‐aminolevulinate and photodynamic therapy with trichloroacetic acid 50% are the two techniques utilized in the management of actinic keratosis. This study was planned to compare the efficacy, adverse effects, recurrence and cosmetic outcome of these option therapies in patients with multiple actinic keratosis of the scalp.

Acute generalized exanthematous pustulosis following paracetamol ingestion in a child

Additional Supporting Information may be found in the online version of this article: Figure S1. Upon activation with TLR-agonists or cytokines TLR-receptors and IL-1 receptors (1) form a multimeric complex comprising MyD88 and IRAK4 (2). This complex (‘MyDDosome’) controls the phopshorylation of IRAK-1 which is degraded upon phosphorylation. (3) IRAK-1 degradation leads to the activation of ADAM17, which in turn controls the posttranslational clevage of CD62L from the cell surface on neutrophilic granulocytes. (4) IRAK-1 degradation also leads to the activation of a complex that phosphorylartes inhibitors of NFkB (the IKK) and to the activation of MAP –Kinases (MAPK). Both pathways control the transcription of cytokines or pro.cytokines which spur acute-phase reactions (5). Data S1. Methods.

Calcipotriol/betamethasone dipropionate ointment compared with tacrolimus ointment for the treatment of erosive pustular dermatosis of the scalp: a split-lesion comparison

Erosive pustular dermatosis of the scalp (EPDS) is a rare disorder of uncertain aetiology that mainly occurs on the sun-damaged scalps of elderly patients after trauma.Topical corticosteroids (TCS) have been widely used in the treatment of EPDS; anecdotal reports have described successful results with topical tacrolimus [1], calcipotriol [2] and dapsone [3, 4]. Nevertheless, due to the rarity of the disease, a comparison of topical treatments in terms of effectiveness and rate of clearing is lacking. [...]

Sind TNF-α-Hemmer eine sichere Option zur Behandlung von Psoriasis bei Patienten mit Hepatitis-C-Virus-Infektion und fortgeschrittener Lebererkrankung? Fallberichte und Literaturübersicht

Inhibitoren des Tumornekrosefaktor alpha (TNF-α-Hemmer) stellen eine wirksame Therapieoption zur Behandlung schwerer Psoriasis bei Hepatitis-C-Virus (HCV)-positiven Patienten dar. In der Literatur wird vorwiegend über die Kurzzeitbehandlung von Patienten mit chronischer Hepatitis von minimaler bis moderater Aktivität berichtet; bei akzeptablem Sicherheitsprofil. Wir berichten über die ersten beiden Fälle der Entstehung eines hepatozellulärem Karzinoms (HCC) bei HCV-positiven Psoriasis-Patienten mit fortgeschrittener Lebererkrankung während einer Langzeitbehandlung mit Etanercept. Beim ersten Patienten war die HCV-Infektion seit 41 Jahren bekannt; er entwickelte nach 21-monatiger Behandlung mit Etanercept (50 mg/Woche) ein HCC. Der zweite Patient war seit 20 Jahren HCV-positiv, wurde 58 Monate lang mit demselben Therapieschema behandelt und schließlich HCC-diagnostiziert, und obwohl keine Anzeichen einer Leberfunktionsstörung vorlagen. Beide Patienten hatten sich mit einer Zirrhose vorgestellt, die 9 bzw. 5 Jahre zuvor diagnostiziert worden war. Es bleibt zu klären, ob zwischen der Psoriasis-Behandlung mit einem Tnf-α-Hemmer und der Entwicklung des HCC bei den HCV-infizierten Patienten ein Zusammenhang besteht. Weitere Langzeit-Follow-up-Studien und Register von HCV-Patienten mit leichter/moderater Aktivität könnten zur Klärung dieser Frage beitragen.