Papers by Federica Arginelli
Il basalioma \ue8 la forma di tumore cutaneo maligno pi\uf9 comune nella razza caucasica; esiston... more Il basalioma \ue8 la forma di tumore cutaneo maligno pi\uf9 comune nella razza caucasica; esistono numerose soluzioni terapeutiche per il suo trattamento. Scopo del nostro studio \ue8 stato quello di trattare basaliomi nodulari ed infiltranti utilizzando la combinazione di laser CO2 e successiva terapia fotodinamica sulle stesse lesioni. Sono state trattate 4 lesioni su altrettanti pazienti: 2 presentavano basaliomi infiltranti e 2 basaliomi nodulari. Il periodo medio di follow-up \ue8 stato di 8 mesi. Le lesioni trattate sono state fotografate e sottoposte a valutazione con videodermoscopia e microscopio laser confocale prima e dopo i trattamenti, ad intervalli di tempo standardizzati. Tutte le lesioni hanno mostrato un\u2019eccellente risposta terapeutica e nessuna complicanza significativa \ue8 stata riscontrata. L\u2019utilizzo sequenziale di laser CO2 e terapia fotodinamica, nel trattamento dei basaliomi infiltranti e nodulari, ha determinato una guarigione completa degli stess...
Dimethyl fumarate treatment for psoriasis in a real‐life setting: A multicentric retrospective study
Dermatologic Therapy, 2021
Dimethyl fumarate (DMF) is a fumaric acid esters derivate approved for plaque psoriasis as first‐... more Dimethyl fumarate (DMF) is a fumaric acid esters derivate approved for plaque psoriasis as first‐line systemic therapy. It has been available in Italy since 2017 and an increasing number of patients are treated with this drug. To evaluate DMF effectiveness, side effects and drug survival in a dermatological real‐life setting. We performed a retrospective multi‐center study in five dermatologic clinics in Emilia‐Romagna, Northern Italy, which included all consecutive patients affected by moderate–severe psoriasis treated with DMF. We assessed effectiveness (in terms of PASI50 and PASI75 in an intention to treat observation) and safety (occurrence of side effects) of DMF and their association with demographic and disease characteristics, mean daily dose taken and treatment discontinuation. We included 103 patients, 78 (75.72%) had at least one comorbidity including 19 (18.44%) with a history of cancer; the mean treatment duration was 23.61 ± 17.99 weeks (min 4, max 130) and the mean daily dose was 262.13 ± 190.94 mg. Twenty‐four patients (23.30%) reached PASI75 at week 12, while a further 18 patients (17.47%) reached it at week 26. Side effects occurred in 63 patients (61.16%), the most frequent were diarrhea, epigastric discomfort, nausea, and flushing. Sixteen patients (15.53%) showed an alteration of laboratory tests. In some cases side effects were transitory, while in 53 patients (51.45%) they led to cessation of therapy. The median daily dose showed a direct association with PASI50 achievement and an indirect association with treatment discontinuation. Our study shows the peculiarities of DMF in a real‐world setting: effectiveness is often reached after 12 weeks of treatment and side effects could limit the continuation of the therapy but, at the same time, DMF has no major contraindications and, due to the wide range of dosage, it can allow both to manage side effects and to personalize the prescription for each patient.
Annals of Plastic Surgery, 2014
Background: Basal cell carcinomas (BCCs) are often seen by general practitioners, plastic surgeon... more Background: Basal cell carcinomas (BCCs) are often seen by general practitioners, plastic surgeons, and dermatologists in the outpatient setting. Photodynamic therapy (PDT) and CO 2 laser when used as monotherapy have been successfully used to treat small BCC, with greatest success in the superficial histological subtype but have limitations compared to surgical excision due to a limited depth of penetration of PDT (2 mm absorption) limiting efficacy. We describe our experience of dual-modality treatment improving efficacy, cosmetic outcomes, and minimizing recurrence. Methods: One hundred ten patients with a total of 177 lesions mainly on the head and neck were treated with combined therapy using an UltraPulse CO 2 laser and PDT using methyl aminolevulinate (METVIX) at the same sitting, with repeat PDT 1 week later. We evaluated recurrences, cosmetic outcomes, patient satisfaction, and costs. Results: The mean age of patients was 67 years. The mean follow-up period was 32.2 months, with a range of 7.7 to 68.5 months. Eighty six lesions were followed up for more than 3 years. A total of 177 lesions were diagnosed and treated. Only biopsy-proven BCCs were included in this study. Histologically, 34 (19.2%) were superficial subtype, 50 (28.2%) nodular, 9 (5.08%) infiltrative, 7 (3.95%) morpheic, 3 (1.69%) mixed, and in 74 (41.8%) diagnosis was simply BCC. All lesions responded to treatment as assessed by clinical evaluation with regular follow-up. The total recurrence-free rate was 97.1%. In 88.1% lesions, a single cycle of treatment was required; 9.03% had 2 cycles and 0.56% underwent 3 cycles. In 3 of the patients, no data were available. Recurrences were noted in 5 (2.82%) cases. All recurrences were treated successfully, all but one using repeat laser-PDT. One patient underwent surgical excision. No significant complications were encountered, although mild hypopigmentation was occasionally seen and some discomfort is experienced with PDT. Conclusions: Combined CO 2 laser and PDT have equivalent cure rates to surgery for BCCsVnotably of the nodular subtypeVthese modalities acting synergistically. This strategy provides cure often with scarless outcomes as illustrated. Laser with PDT is most appropriate for patients who value excellent cosmetic outcomes and where avoidance of an invasive procedure is an important factor. In addition, this modality comes into its own for specific groups of patients, such as those on Warfarin or those with diffuse or multiple lesions.
Efficacy of dermocosmetic lightening product on the solar lentigines of the hands.xlsx
The current data refer to a study designed to evaluate solar lentigines hyperpigmentation, skin a... more The current data refer to a study designed to evaluate solar lentigines hyperpigmentation, skin architecture and clinician and patient assessments comparing a dermocosmetic lightening product with a moisturizing product according to clinical, digital and subjective analyses in a large population with a long (12-month) application and follow up period.
PLOS ONE, 2019
Solar lentigo, benign lesions which mostly appear on chronically, sun-exposed surfaces, are assoc... more Solar lentigo, benign lesions which mostly appear on chronically, sun-exposed surfaces, are associated with ageing. Patients are increasingly requesting a more uniform skin texture, especially for hands. Treatment options include dermoabrasion, intense pulsed light, cryotherapy, peelings, and laser therapy. Topical compounds can be employed, in alternative or associated with dermatologic procedures. The current study was designed to evaluate solar lentigo hyperpigmentation, skin architecture and clinician and patient assessments comparing a dermocosmetic lightening product (active) with a moisturizing product (control) according to clinical, digital and subjective analyses in 72 lesions over 12-month follow up period. Statistically significant differences were observed between the lesions treated with the active compared to the control in terms of papillary brightness (p = 0.03) and contrast (p = 0.03), and in the limitation of dermal-epidermal junction destructuring (p = 0.03) according to dermal-epidermal junction destructuring score at Reflectance Confocal Microscopy. Luminance (p = 0.04) and redness (p = 0.03) were improved at color analysis, and physician and patient evaluations favored the active in efficacy and patient satisfaction investigations. The dermocosmetic lightening product utilized in the current study proved to be more effective, according to clinical, digital and subjective analyses in reducing lesion hyperpigmentation, stabilizing the lesion skin architecture and increasing patient satisfaction compared to the control in a cohort of 36 subjects, over a 12-month period. Beside demonstrating the efficacy of this topical lightening product, we propose a "destructuring score", which improves the robustness of solar lentigo's evaluation, and can be used in future studies to standardize the quantitative comparisons of different treatment options.
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery, Jan 16, 2016
Non-melanoma skin cancers are the most frequent skin tumours; in 25.5% of cases, they are reporte... more Non-melanoma skin cancers are the most frequent skin tumours; in 25.5% of cases, they are reported to affect the nasal area. For an excellent surgical outcome, first of all the radical excision of the lesion is important, with appropriate margins of healthy skin in order to avoid recurrences. Moreover is important to achieve a good aesthetical result, avoiding distortion of the aesthetic units and preserving their functions. We have applied the modified crescentic flap, described by Smadja in 2007, to 24 nasal skin defects left by oncologic surgery. It consists of the crescent-shaped resection of Burow's triangle all around the alar groove that allows the advancement of the flap to the tip of the nose, hiding the scar in the alar groove. The outcome and the long-term follow-up were completely satisfactory both for patients and for surgeons. For skin defects localized in the midline or paramedian line of the dorsum of the nose, the crescentic flap seems to be a good solution to o...
Ineffectiveness of infliximab CT-P13 for the treatment of scleromyxedema: A case report
Dermatologic therapy, 2018
To the Editor, Scleromyxedema is a rare and progressive disease, characterized by dermal depositi... more To the Editor, Scleromyxedema is a rare and progressive disease, characterized by dermal deposition of mucin and fibroblasts proliferation, with the subsequent appearance of progressive joint and cutaneous stiffness (Cokonis Georgakis, Falasca, Georgakis, & Heymann, 2006; Rongioletti et al., 2013). Because of the rarity of the disease, there are no official guidelines for the management and long-term treatment. Only few therapeutic options are described in literature, mainly as case series or isolated case reports (Efthimiou & Blanco, 2008; Korber, Franckson, Grabbe, & Dissemond, 2007; Majeski, Taher, Grewal, Dytoc, & Lauzon, 2005). A 64-year-old man, suffering from a severe form of scleromyxedema (histologically confirmed) limited to the skin, referred to our Department of Dermatology (University-Hospital of Modena, Italy) in November 2012. The patient had no visceral involvement, but a functional limitation in pharyngoesophageal motility, mainly due to cutaneous and subcutaneous involvement in the neck area. The patient had no major comorbidities, apart from arterial hypertension (in pharmacotherapy) and a monoclonal gammopathy (k-type). The patient had already undergone different cycles with systemic corticosteroids, photochemotherapy (P-UVA), plasmapheresis, and photopheresis (Rongioletti, 2006). As no other conventional treatments were available, an intravenous therapy with high-dose immunoglobulins (Gholam, Hartmann, & Enk, 2007; 2 g/kg monthly) was started with quick improvement of the general conditions (Figure 1). After 2 years, we observed a progressive loss of efficacy and, therefore, the treatment was stopped. Clinical worsening of the disease persisted despite the association of systemic prednisone and thalidomide (50 mg, 3 times a day, for 3 months; Amini-Adle, Thieulent, Dalle, Balme, & Thomas, 2007). Recently a role for inflammatory cytokines (IL1, TNF alpha, and TGF beta) in the pathogenesis of mucinosis has been hypothesized (through direct stimulation of glycosaminoglicans synthesis and fibroblasts proliferation) so, in the absence of other therapeutical options, we decided to evaluate a possible treatment with TNFa inhibitors (McKeage, 2014). After excluding the presence of contraindications to biological therapy, we started an intravenous treatment with infliximab CT-P13 at dose of 5 mg/kg, with the same administration intervals currently used for psoriasis. After the first two infusions, no improvement was observed, on the contrary the patient experienced a clinical worsening of the cutaneous signs and symptoms, with a sudden reduction of joint mobility. The skin appeared widely and intensely erythematous and edematous, giving the patient a typical “orange-peel” aspect all over the body. Confluent papules were particularly evident on the face, especially in the glabellar region, with infiltrated plaques associated with centrofacial erythema. Given the clinical worsening in course of treatment, we decided to interrupt infliximab CT-P13 for lack of efficacy (Figure 2). We, therefore, scheduled a new cycle with intravenous immunoglobulins at the dosage of 2 g/kg monthly with a rapid clinical improvement of lesions. Our case briefly synthesizes the main features of scleromyxedema, also called generalized and sclerodermoid lichen myxedematosus, because of the presence of the typical clinical appearance, the association with a monoclonal gammopathy and the mucin deposition in the anatomy specimens.
The aim of this study was to compare morphological aspects of basal cell carcinoma (BCC) as asses... more The aim of this study was to compare morphological aspects of basal cell carcinoma (BCC) as assessed by two different imaging methods: in vivo reflectance confocal microscopy (RCM) and multiphoton tomography with fluorescence lifetime imaging implementation (MPT-FLIM). Methods: The study comprised 16 BCCs for which a complete set of RCM and MPT-FLIM images were available. The presence of seven MPT-FLIM descriptors was evaluated. The presence of seven RCM equivalent parameters was scored in accordance to their extension. Chi-squared test with Fisher's exact test and Spearman's rank correlation coefficient were determined between MPT-FLIM scores and adjusted-RCM scores. Results: MPT-FLIM and RCM descriptors of BCC were coupled to match the descriptors that define the same pathological structures. The comparison included: Streaming and Aligned elongated cells, Streaming with multiple directions and Double alignment, Palisading (RCM) and Palisading (MPT-FLIM), Typical tumor islands, and Cell islands surrounded by fibers, Dark silhouettes and Phantom islands, Plump bright cells and Melanophages, Vessels (RCM), and Vessels (MPT-FLIM). The parameters that were significantly correlated were Melanophages/Plump Bright Cells, Aligned elongated cells/ Streaming, Double alignment/Streaming with multiple directions, and Palisading (MPT-FLIM)/Palisading (RCM). Conclusion: According to our data, both methods are suitable to image BCC's features. The concordance between MPT-FLIM and RCM is high, with some limitations due to the technical differences between the two devices. The hardest difficulty when comparing the images generated by the two imaging modalities is represented by their different field of view.
Ameloblastoma as criterion for Nevoid Basal Cell Carcinoma (Gorlin) Syndrome identification
doi:10.1155/2012/810749 Review Article Multiphoton Laser Microscopy and Fluorescence Lifetime Imaging for the Evaluation of the Skin
Copyright © 2012 Stefania Seidenari et al. This is an open access article distributed under the C... more Copyright © 2012 Stefania Seidenari et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Multiphoton laser microscopy is a new, non-invasive technique providing access to the skin at a cellular and subcellular level, which is based both on autofluorescence and fluorescence lifetime imaging. Whereas the former considers fluorescence intensity emitted by epidermal and dermal fluorophores and by the extra-cellular matrix, fluorescence lifetime imaging (FLIM), is generated by the fluorescence decay rate. This innovative technique can be applied to the study of living skin, cell cultures and ex vivo samples. Although still limited to the clinical research field, the development of multiphoton laser microscopy is thought to become suitable for a practical application in the next few years: in this paper, we performed an ac...
Dabigatran-Induced Nephropathy and Gastrointestinal Bleeding and Its Successful Treatment with Idarucizumab: A Case Report
Hospital Pharmacy, 2021
Recently, the atrial fibrillation treatment guidelines have been updated to now recommend Non-vit... more Recently, the atrial fibrillation treatment guidelines have been updated to now recommend Non-vitamin K antagonist oral anticoagulants (NOACs) as the preferred alternative to warfarin for systemic ...
Dermoscopy, confocal microscopy and optical coherence tomography features of main inflammatory and autoimmune skin diseases: A systematic review
The Australasian journal of dermatology, 2021
BACKGROUND/OBJECTIVES Non-invasive skin imaging features of main skin inflammatory and autoimmune... more BACKGROUND/OBJECTIVES Non-invasive skin imaging features of main skin inflammatory and autoimmune diseases have been reported, although a comprehensive review of their correlation with histopathologic features is currently lacking. Therefore, the aim of this paper was to review the correlation of dermoscopic, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) criteria of main inflammatory and autoimmune skin diseases with their corresponding histopathologic criteria correlation. METHODS Studies on human subjects affected by main inflammatory and autoimmune diseases, defining the correlation of dermoscopic, RCM or OCT with histopathologic criteria, were included in the review. Five groups of diseases were identified and described: psoriasiform, spongiotic and interface dermatitis, bullous diseases and scleroderma. RESULTS Psoriasiform dermatitis was typified by white scales, corresponding to hyperkeratosis, and vessels, observed with RCM and OCT. Spongiosis,...
Ameloblastoma as criterion for Nevoid Basal Cell Carcinoma (Gorlin) Syndrome identification
Dimethyl fumarate treatment for psoriasis in a real‐life setting: A multicentric retrospective study
Dimethyl fumarate (DMF) is a fumaric acid esters derivate approved for plaque psoriasis as first‐... more Dimethyl fumarate (DMF) is a fumaric acid esters derivate approved for plaque psoriasis as first‐line systemic therapy. It has been available in Italy since 2017 and an increasing number of patients are treated with this drug. To evaluate DMF effectiveness, side effects and drug survival in a dermatological real‐life setting. We performed a retrospective multi‐center study in five dermatologic clinics in Emilia‐Romagna, Northern Italy, which included all consecutive patients affected by moderate–severe psoriasis treated with DMF. We assessed effectiveness (in terms of PASI50 and PASI75 in an intention to treat observation) and safety (occurrence of side effects) of DMF and their association with demographic and disease characteristics, mean daily dose taken and treatment discontinuation. We included 103 patients, 78 (75.72%) had at least one comorbidity including 19 (18.44%) with a history of cancer; the mean treatment duration was 23.61 ± 17.99 weeks (min 4, max 130) and the mean d...
PloS one, 2017
Reflectance confocal microscopy (RCM) is an imaging device that permits non-invasive visualizatio... more Reflectance confocal microscopy (RCM) is an imaging device that permits non-invasive visualization of cellular morphology and has been shown to improve diagnostic accuracy of dermoscopically equivocal cutaneous lesions. The application of double reader concordance evaluation of dermoscopy-RCM image sets in retrospective settings and its potential application to telemedicine evaluation has not been tested in a large study population. To improve diagnostic sensitivity of RCM image diagnosis using a double reader concordance evaluation approach; to reduce mismanagement of equivocal cutaneous lesions in retrospective consultation and telemedicine settings. 1000 combined dermoscopy-RCM image sets were evaluated in blind by 10 readers with advanced training and internship in dermoscopy and RCM evaluation. We compared sensitivity and specificity of single reader evaluation versus double reader concordance evaluation as well as the effect of diagnostic confidence on lesion management in a r...
Évaluation De L’Intérêt D’Un Topique Sur La Régénération Cutanée
Annales de Dermatologie et de Vénéréologie, 2015
Introduction Le laser fractionne CO2 est un traitement physique ablatif indique pour ameliorer l’... more Introduction Le laser fractionne CO2 est un traitement physique ablatif indique pour ameliorer l’aspect d’une peau lors du photo vieillissement. Il est efficace mais necessite un temps de reparation important qui peut entrainer des effets indesirables et alterer le resultat esthetique. Pour les prevenir, les praticiens associent une prescription topique a leur acte esthetique. L’objectif de ces etudes est d’evaluer l’effet d’un produit sur des lesions cutanees provoquees par un acte esthetique. Materiel et methodes Le produit teste (Matricium®) est un dispositif medical sterile (classe IIa) indique pour la regeneration tissulaire des peaux alterees en cas de lesions cutanees superficielles, notamment dues a des interventions dermatologiques. Une etude ex vivo a ete realisee sur des explants de peau humaine. Un jour apres la realisation d’une lesion mecanique standardisee, le produit etudie et un controle positif etaient appliques (2 mg/cm2) a la surface des explants, une fois tous les deux jours. Des photographies de coupes histologiques realisees a j0, j4 et a j10 ont permis pour chaque condition de mesurer la longueur des bourgeons de croissance et d’evaluer la morphologie de l’explant. Une etude clinique a ete conduite sur 16 patients de phototype II a III, âges de 27 a 46 ans. Sur les avant-bras, 3 zones A, B et C etaient determinees de facon aleatoire, puis traitees par laser fractionne CO2 (SmartXide DOT, Deka, Florence, Italie), selon une procedure standardisee. Les trois zones etaient ensuite respectivement traitees par de la vaseline 2 fois par jour, de la vaseline 1 fois par jour et du Matricium® 1 fois par jour ou Matricium® 2 fois par jour. Les differentes zones ont ete evaluees avant et apres le traitement par laser, cliniquement et grâce a des photographies acquises par microscopie confocale (Vivascope 3000®, MAVIG GmbH, Munich, Allemagne). Resultats Ex vivo, apres 4 jours d’application de Matricium®, la longueur du bourgeon de croissance est significativement plus importante que celle de l’explant non traite. Des j10, le bourgeon commence a se differencier et son adherence au derme est bonne. In vivo, l’utilisation de Matricium® permet d’accelerer le processus de reparation cutanee. La re-epidermisation est plus rapide et de meilleure qualite et la neo-synthese de collagene est acceleree. Discussion Ces etudes montrent que Matricium® permet de reduire la duree de reparation cutanee post-lesionnelle et d’en ameliorer la qualite. Conclusion Matricium® peut etre utilise en suite d’acte esthetique, en particulier le laser fractionne CO2. Il reduit en effet le temps de reparation et les risques d’effets indesirables qui y sont associes et ameliore le resultat esthetique de l’acte.
Effetto combinato di esercizio fisico e ultrasuoni nel miglioramento della composizione corporea
MATERIALS AND METHODS The study was performed according to the directives of the Local Ethics Committee in accordance with ethical standards on human experimentation and with the Helsinki Declaration
Dermoscopic yellow structures in basal cell carcinoma
Journal of the European Academy of Dermatology and Venereology, 2014
Yellowish structures in dermoscopy comprise milia-like cysts (MLCs) and yellow lobular-like struc... more Yellowish structures in dermoscopy comprise milia-like cysts (MLCs) and yellow lobular-like structures. This study aimed at establishing the frequency of these features in BCC and at describing their dermoscopic details. A retrospective analysis of digital dermoscopic images referring to 400 BCCs was performed. Images were evaluated for the presence of starry and cloudy MLCs and yellow lobular-like structures. Among the 400 BCCs constituting our database, 40 presented yellowish structures (10%). "Yellow" BCCs were located more frequently on the head and were mainly of the nodular type. MLCs were observed in 7.75% of the cases (with a mean number of 4.9 MLCs per lesion), whereas yellow globules were noticed in 4.2% /ucodep of the lesions. In the presence of BCC specific dermoscopic criteria, the observation of MLCs and yellow lobular-like structures should not prompt the dermatologist to exclude the diagnosis of BCC.
Dermatology Research and Practice, 2012
Multiphoton laser microscopy is a new, non-invasive technique providing access to the skin at a c... more Multiphoton laser microscopy is a new, non-invasive technique providing access to the skin at a cellular and subcellular level, which is based both on autofluorescence and fluorescence lifetime imaging. Whereas the former considers fluorescence intensity emitted by epidermal and dermal fluorophores and by the extra-cellular matrix, fluorescence lifetime imaging (FLIM), is generated by the fluorescence decay rate. This innovative technique can be applied to the study of living skin, cell cultures andex vivosamples. Although still limited to the clinical research field, the development of multiphoton laser microscopy is thought to become suitable for a practical application in the next few years: in this paper, we performed an accurate review of the studies published so far, considering the possible fields of application of this imaging method and providing high quality images acquired in the Department of Dermatology of the University of Modena.
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Papers by Federica Arginelli