BACKGROUND:Psoriasis is an immune-mediated chronic skin disease associated with multiple extracutaneous comorbidities, causing a severe quality of life impairment, whose treatment with risankizumab, a humanized anti-IL-23 monoclonal antibody, is very effective, with good safety profile and long-term outcomes. However, prescription in a real-world setting is conditioned by local health care system constraints, as the proven ineffectiveness or appearance of adverse events to first-line drugs. Such delay and selection of multi-failure patients might affect efficacy and outcomes. METHODS:A prospective multicenter study, approved by the Ethical Independent Committee of AOU Cagliari, acronym ESSOS-BIO-PSO, Prot N° 2023/2532, was conducted to evaluate risankizumab's effectiveness and safety in Sardinian psoriasis centers over 6, 12, and 24 months. RESULTS:73 patients with moderate-to-severe psoriasis treated with risankizumab over at least 6 months were recruited, predominantly male (70%) with a median age of 50 years and a median disease duration of 22 years. Most patients had extensive, difficult-to-treat areas involved, psoriasis arthritis and other comorbidities. Prior treatments included traditional systemic therapies and biologics (60%). At week 52, 74% achieved PASI-90, increasing to 76.7% at week 104, with all initial PASI-90 responders maintaining the response. Faster and sustained responses were observed in biologic-naïve patients and those with shorter disease duration. The difference between groups was statistically significant at week 16 (Mann-Whitney P=0.042), identifying naïve patients as "super-responders." No severe adverse events occurred; risankizumab was well tolerated and adherence was 100%. CONCLUSIONS:This real-world study investigates effectiveness and safety of Risankizumab in a population with a distinctive historical and genetic background, as well as environmental factors which may influence disease patterns and response to treatments. This first Sardinian study confirms durable results with excellent adherence in moderate-to-severe psoriasis patients, regardless of prior treatments and comorbidities burden, although in biologic-naïve patients the response is quicker.
BACKGROUND:Atopic (AD) and contact (CD) dermatitis can interfere with everyday function. Non-prescription topical formulations can aid AD/CD symptom relief and alleviate exacerbation. In this post-marketing clinical investigation, performance and safety of a foam containing sodium butyroyl/formoyl hyaluronate, glycerol and panthenol was investigated. METHODS:This multicenter, open-label, uncontrolled, post-marketing clinical follow-up investigation included 37 adults with mild-to-moderate AD, irritant CD (ICD) or allergic CD (ACD). The foam was applied twice-a-day to affected areas for 42 days and assessed on Days 14, 28 and 42 using the Investigators Global Assessment score (ICA; rated 0-5); the Eczema Area and Severity Index (EASI); the Dermatology Life Quality Index (DLQI); visual analogue scales (VAS) for pruritus, scratching, pain and burning; investigator's global evaluation of performance and participant overall treatment acceptability. Primary endpoint was IGA score change from baseline to Day 28. Success was prespecified as an IGA score decrease ≥1. RESULTS:At Day 28, mean IGA score decreased from baseline by 1.11 (standard deviation 0.68) with treatment success in 88.6% of participants (P<0.0001). At Days 14/42, 52.8%/94.3% (P<0.0001) showed an improved IGA. Progressive improvements were shown in EASI, VAS and DLQI scores to Day 42, significant at each timepoint (P<0.001). For participant and investigator performance evaluation, 94.3% reported improvement. Most participants rated the foam's acceptability as "very much satisfied" or "satisfied." The foam was generally well-tolerated. CONCLUSIONS:Use of a foam containing sodium butyroyl/formoyl hyaluronate, glycerol and panthenol led to significant alleviation of AD, ICD or ACD and decreased associated quality of life impacts.
BACKGROUND:Hyaluronic acid (HA) fillers are commonly used for facial augmentation and contour enhancement, particularly to improve deficient skeletal projection. Their application to reduce the perceived prominence of the chin has not been previously reported. The aim is to describe indications, technique, safety, and aesthetic outcomes of HA filler injections into the labiomental crease for camouflage of apparent chin protrusion in selected patients. METHODS:This retrospective study included 24 female patients with skeletal Class II hypodivergent profiles treated between 2019 and 2024. High-elastic modulus (G'>300 Pa) cross-linked HA fillers were injected intradermally into the labiomental sulcus using a linear retrograde threading technique. Clinical and photographic evaluations were performed at 1, 3, and 6 months. Patient satisfaction was assessed using a 10-point Visual Analog Scale (VAS). RESULTS:All patients completed follow-up. Mild, transient erythema and edema occurred in all cases and resolved within 48 hours. Temporary blanching was observed in 12.5% of patients and resolved spontaneously. No severe or delayed adverse events were reported. Treatment resulted in consistent softening of the labiomental crease, an augmentation of the labiomental angle, and improved lower facial harmony. Mean VAS satisfaction score at 6 months was 8.7. In selected patients, results remained stable for up to 36 months. CONCLUSIONS:Labiomental crease injection with HA fillers is a safe, effective, and predictable minimally invasive technique to reduce perceived chin prominence in selected Class II hypodivergent patients, expanding the conceptual use of fillers beyond augmentation alone.
BACKGROUND:Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the pilosebaceous unit that can rarely harbor squamous cell carcinoma (SCC). Despite its clinical relevance, comprehensive characterization of HS-SCC - including risk factors, histological and molecular features, and outcomes - remains limited. METHODS:A systematic review of the literature was performed to identify all published cases of HS-associated SCC. Data on demographics, HS features, tumor characteristics, human papillomavirus (HPV) status, treatments, and outcomes were extracted to identify risk phenotypes and prognostic factors. RESULTS:A total of 174 cases were included. Most patients were male (78.4%), with a mean age of 53 years, and nearly all presented Hurley stage III HS affecting the lower trunk, predominantly the gluteal region. Tumors were generally large, often arising from sinus tract epithelium, and were commonly well-differentiated. HPV infection was detected in 28.6% of cases, predominantly HPV-16. Metastasis occurred in 54.3% of patients. Overall mortality was 52.8%, with mean survival until death of 11.9 months. Male sex, gluteal location, poor histologic differentiation, and presence of metastasis were associated with worse outcomes. Risk phenotypes include males >50 years, long-standing HS (>10 years), Hurley III disease with complex sinus tracts involving the lower trunk; in females, vulvar involvement is an additional risk factor. CONCLUSIONS:HS-SCC is rare but highly aggressive. Early recognition of high-risk phenotypes, regular monitoring of chronic HS lesions, timely surgery, and imaging assessment are essential to improve outcomes. HPV vaccination may offer preventive benefits in susceptible patients.
BACKGROUND:Eosinophilic fasciitis (EF) is a rare autoimmune disorder within the sclerodermatous disease spectrum, characterized by inflammation and fibrosis of the subcutaneous fat and fascia, often accompanied by peripheral eosinophilia. Although its exact etiology remains uncertain, potential triggers include intense physical exertion, infections, malignancies, and drug exposure - most recently, immune checkpoint inhibitors such as anti-PD-1/PD-L1 agents. Histopathological findings consistently reveal eosinophilic infiltration and fibrosis of subcutaneous fat and fascia. Corticosteroids remain the cornerstone of treatment, often supplemented with immunosuppressants in refractory cases. Emerging therapies, such as anti-IL-5 agents (mepolizumab and benralizumab), offer targeted approaches for corticosteroid-resistant EF by directly modulating eosinophilic inflammation. METHODS:A systematic review of PubMed and Ovid was conducted according to PRISMA guidelines until October 2024, including studies on clinical, histological, or therapeutic aspects of eosinophilic fasciitis. RESULTS:The mean age was 45.95 years, with balanced sex distribution (51.1% females). Most cases involved both upper and lower limbs (56.2%), followed by lower limbs (11.2%) and upper limbs alone (9.8%). Eosinophilia was present in 92.4% of patients, hypergammaglobulinemia in 19.9%, and elevated CRP in 13.5%. Histology showed eosinophilic infiltration in 68.9%. Identifiable triggers included intense exercise (8.7%), drugs - especially anti-PD1 checkpoint inhibitors (5.6%) - infections (2.8%), and paraneoplastic causes (2.3%). Treatments included corticosteroids (89.3%), methotrexate (27.5%), cyclosporine (6.7%), hydroxychloroquine (3.6%), azathioprine (3.9%), and rituximab (1.7%). Anti-IL5 agents (N.=7) were used in refractory cases, with full resolution in 2 and mild improvement in 5. CONCLUSIONS:This review provides a systematic analysis of the clinical, biological, and histological characteristics of EF, its associated triggers, and therapeutic strategies based on a comprehensive review of reported cases. We found that poor prognostic factors include diagnostic delay (>6 months), trunk involvement, early-onset disease (<12 years), and morphea-like skin lesions.
Cutaneous melanoma (SKCM) is a highly aggressive malignant tumor of the skin, characterized by rapid progression, strong metastatic potential, and poor clinical prognosis, which poses a serious threat to human health and imposes a heavy burden on global healthcare systems. Despite significant advances in therapeutic strategies such as targeted therapy and immunotherapy in recent years, the clinical outcomes of SKCM patients remain suboptimal, highlighting the urgent need to identify novel molecular biomarkers and therapeutic targets that can facilitate early diagnosis, accurate prognosis evaluation, and effective treatment of this disease. RUVBL2, a member of the AAA+ ATPase family, has been increasingly recognized as a key regulator in tumorigenesis and progression. Accumulating evidence from previous studies has demonstrated that RUVBL2 exerts oncogenic effects in multiple human malignancies. For instance, knockdown of RUVBL2 can inhibit cell proliferation, promote apoptosis, induce senescence, and suppress migration in hepatocellular carcinoma, and its high expression is closely associated with poor prognosis and chemoresistance. In colorectal cancer, RUVBL2 mRNA modified by m6A can be recognized and bound by YTHDF1 to enhance translation initiation and protein expression, and depletion of RUVBL2 impairs YTHDF1-driven oncogenic translation, leading to cell cycle arrest and apoptosis. Additionally, RUVBL2 has been shown to participate in the regulation of oncogenic signaling pathways, immune evasion, and therapeutic sensitivity in pancreatic cancer, bladder cancer, and breast cancer. However, the expression pattern of RUVBL2 in SKCM, its correlation with clinical prognosis and tumor immune microenvironment, as well as its potential functional role in SKCM progression, have not been fully elucidated to date. In view of the critical role of immune cell infiltration in the pathogenesis and progression of SKCM, and the clinical significance of immune checkpoint inhibitors (e.g., anti-PD-1 and anti-CTLA-4 agents) in SKCM treatment, exploring the association between RUVBL2 and tumor immune infiltration, as well as its predictive value for immunotherapeutic efficacy, is of great importance. Therefore, the present study aims to systematically investigate the expression level of RUVBL2 in SKCM and its correlation with clinical prognosis by integrating public database resources (TCGA, GTEx, and HPA) and in vitro experimental validation. Furthermore, we intend to explore the functional role of RUVBL2 in regulating SKCM cell proliferation, migration, invasion, and apoptosis, and clarify its association with immune cell infiltration and sensitivity to immunotherapy. The findings of this study are expected to provide a theoretical basis for the development of novel diagnostic markers and therapeutic strategies for SKCM.
