Background:Clinical trials have demonstrated the efficacy of guselkumab in psoriasis, however, limited data are available from real-life studies evaluating the long-term effectiveness and drug survival (DS) of guselkumab. Objective:This multicenter study assessed the 5-year efficacy, DS, and predictors of treatment response in a large cohort of patients with psoriasis. Methods:In this retrospective, longitudinal study, we analyzed data from 1024 patients with moderate-to-severe psoriasis treated with guselkumab between 2019 and 2024. PASI scores were evaluated at baseline, 6 months, and 1-5 years. DS (ie, duration of continuous treatment with guselkumab without discontinuation) was assessed using Kaplan-Meier analysis, and logistic regression analysis was used to identify predictors of PASI response. Results:Mean PASI decreased from 14.3±8.8 at baseline to 1.3±2.4 at 6 months, with sustained improvement from 12-60 months (PASI values ranging from 1.0±2.2 to 1.3±3.5). Bioexperienced (ie having previous biological treatment) patients and obese individuals had lower PASI response. Subgroup analyses revealed significantly lower PASI response rates in obese patients, those previously treated with biologics, and those switched from anti-IL-17 agents (p<0.05).Multivariate logistic regression analysis revealed that previous biologic exposure and obesity remained significant negative predictors of achieving PASI 75, PASI 90, and PASI 100 across different time points. Cardiovascular disease emerged as a negative predictor for PASI 90 at 3 months (OR 0.64, 95% CI: 0.42-0.97, p=0.035). The probability of remaining on treatment at 12, 24, 36, 48, and 60 months were 95.85%, 91.73%, 89.74%, 87.08%, and 85.76% respectively. Female sex, ≥3 prior biologics, longer disease duration, and previous anti-IL-17 therapy increased the risk of treatment discontinuation. No significant differences in drug discontinuation were noted between patients with or without comorbidities. Conclusion:This real-world study demonstrates the sustained long-term efficacy and DS of guselkumab in patients with psoriasis. Prior biologic exposure, obesity, and patient history are important factors to consider when initiating treatment for long-term management.

Purpose:Elderly patients with age ≥65 years represent an increasing percentage of the population with moderate-severe psoriasis. The definition of "frail elderly" is not easily framed, generally meaning a patient with unstable homeostasis. To date, there is no study in the literature examining possible differences between frail and non-frail elderly with psoriasis being treated with tildrakizumab. Patients and Methods:The present multicentre retrospective study evaluated the effectiveness, drug survival and safety up to 2 years of treatment with tildrakizumab in the elderly (≥65 years) comparing frail and non-frail patients. Frail patients were defined as those with: i) 2 major comorbidities, or 1 major comorbidity and low economic level ii) and/or 2 of the following 5 parameters: weight loss, weakness, sluggishness, low activity level, and exhaustion. Results:A total of 217 patients aged ≥65 years were enrolled, of whom 89 (41%) were grouped in the frail patient category. In the entire population, 2-year drug survival was ≥80%, and PASI 90 and ≤2 was achieved in 75% and 87.5% of patients, respectively. No difference in effectiveness or safety was found between frail and non-frail populations. Adjusting for baseline characteristics at Cox-regression, frail patients did not show a greater risk of discontinuation (HR 0.51, p=0.091). Conclusion:Tildrakizumab showed good safety and effectiveness at 2 years in the elderly population with or without frailty, confirming it as a possible treatment of choice in psoriatic patients with significant comorbidities and older frail patients who deserve systemic treatments.

OBJECTIVE:The use of biologic agents, mainly tumor necrosis factor (TNF)-α and interleukin (IL)-17A inhibitors, was associated with cutaneous side effects, but the factors associated with eczematous reactions occurring during biologic treatments are not completely known. PATIENTS AND METHODS:An observational, retrospective, multicentre Italian study evaluated the clinical features and the management of eczematous eruptions in 54 patients with chronic plaque psoriasis who developed eczema after treatment with biological agents (anti-IL-17 or 23). RESULTS:Many of these patients had personal and family history of atopy. Eczematous reactions developed between a few days and 3 years after initiation of the biologic drug. The highest proportion of cases associated with eczematous reactions during biologic treatments was seen in patients on anti-IL-17 agents, including brodalumab. We observed that eczema rapidly remitted without relapse in all patients who switched to anti-IL-23 agents. Among our cases, fast responders to psoriasis therapy seem to have more persistent eczematous reactions. CONCLUSIONS:Patients with psoriasis and a history of atopic dermatitis should be treated with an IL-23 inhibitor due to its efficacy in psoriasis and the rarely reported eczematous reaction.

Journal of the European Academy of Dermatology and VenereologyEarly View LETTER TO THE EDITOR Nodular colloid degeneration on the face: Clinical, histopathological and imaging findings A. Paradisi, Corresponding Author A. Paradisi [email protected] orcid.org/0000-0001-5863-8347 UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy Correspondence Paradisi Andrea, UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy. Email: [email protected]Search for more papers by this authorA. P. Lugli, A. P. Lugli UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorG. Palmisano, G. Palmisano orcid.org/0009-0000-9681-1681 UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorG. Annessi, G. Annessi Servizio Dermatopatologia, IDI-IRCCS, Rome, ItalySearch for more papers by this authorA. Capponi, A. Capponi Associato Medica Institute, Latina, ItalySearch for more papers by this authorC. De Simone, C. De Simone UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorK. Peris, K. Peris orcid.org/0000-0003-1957-6600 UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this author A. Paradisi, Corresponding Author A. Paradisi [email protected] orcid.org/0000-0001-5863-8347 UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, Italy Correspondence Paradisi Andrea, UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy. Email: [email protected]Search for more papers by this authorA. P. Lugli, A. P. Lugli UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorG. Palmisano, G. Palmisano orcid.org/0009-0000-9681-1681 UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorG. Annessi, G. Annessi Servizio Dermatopatologia, IDI-IRCCS, Rome, ItalySearch for more papers by this authorA. Capponi, A. Capponi Associato Medica Institute, Latina, ItalySearch for more papers by this authorC. De Simone, C. De Simone UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorK. Peris, K. Peris orcid.org/0000-0003-1957-6600 UOC Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche Addominalied Endrocrino Metaboliche, Fondazione Policlinico Universitario A. Gemelli – IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this author First published: 30 March 2024 https://doi.org/10.1111/jdv.20002Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Open Research DATA AVAILABILITY STATEMENT Data sharing is not applicable to this article as no datasets were generated or analysed during the current study. REFERENCES 1Choi WJ, Kim BC, Park EI, Cho HJ, Kim KH. Nodular colloid degeneration. Am J Dermatopathol. 2011; 33: 388–391. 10.1097/DAD.0b013e3181e3d294 PubMedWeb of Science®Google Scholar 2Labadie JH. Colloid degeneration of the skin: report of a case. Arch Dermatol Syphilol. 1927; 16: 156–165. 10.1001/archderm.1927.02380020028004 Google Scholar 3Chu H, Kim HJ, Lee MG. Xanthoma-like multiple yellowish nodular colloid degeneration on the face and scalp. J Eur Acad Dermatol Venereol. 2017; 31(4): e195–e196. 10.1111/jdv.13937 CASPubMedWeb of Science®Google Scholar 4Sullivan M, Ellis FA. Facial colloid degeneration in plaques. Arch Dermatol. 1961; 84: 816–823. 10.1001/archderm.1961.01580170110015 CASPubMedWeb of Science®Google Scholar 5Kawashima Y, Matsubara T, Kinbara T, Hirone T, Kitamura K, Himi A, et al. Colloid degeneration of the skin. J Dermatol. 1977; 4: 115–121. 10.1111/j.1346-8138.1977.tb01023.x CASPubMedGoogle Scholar 6Dupre A, Bonafe J, Pieraggi M, Perrot H. Paracolloid of the skin. J CutanPathol. 1979; 6: 304–309. CASWeb of Science®Google Scholar 7Patterson J, Wilkin J, Schatzki P. Nodular colloid degeneration: distinctive histochemical and ultrastructural features. Cutis. 1985; 36: 355–358. CASPubMedWeb of Science®Google Scholar 8Preston P, Orpin S, Muc R, Zaki I. Penile colloid degeneration. Clin Exp Dermatol. 2006; 31: 674–676. 10.1111/j.1365-2230.2006.02196.x CASPubMedWeb of Science®Google Scholar 9Mittal RR, Singh SP, Gupta S, Sethi PS. Nodular colloid degeneration over herpes zoster scars. Indian. J Dermatol Venereol Leprol. 1996; 62: 181–182. CASPubMedGoogle Scholar 10Ghanadan A, Kamyab-Hesari K, Daneshpajouh M, Balighi K, Normohammadpour P. Nodular colloid degeneration of the skin: report of three cases with review and update. Indian Dermatol Online J. 2014; 5: S36–S39. 10.4103/2229-5178.144527 PubMedGoogle Scholar Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

Purpose of the article: The aim of this multicenter observational study is to report data from real world on the use of bimekizumab in patients aged >= 65 years with moderate-to-severe plaque psoriasis. Elderly patients are poorly represented in clinical trials on bimekizumab for plaque psoriasis, and real-world studies are important to guide clinical choices. Materials and methods: A retrospective multicenter study was conducted in 33 dermatological outpatient clinics in Italy. Patients aged >= 65 years, with moderate-to-severe plaque psoriasis and treated with bimekizumab were enrolled. No exclusion criteria were applied. Bimekizumab was administered following the Italian Guidelines for the management of plaque psoriasis and according to the summary of product characteristics, in adult patients who were candidates for systemic treatments. Overall, 98 subjects were included, and received bimekizumab up to week 36. Clinical and demographic data were collected before the initiation of treatment with bimekizumab. At baseline and each dermatological examination (4, 16, and 36 weeks), clinical outcomes were measured by the following parameters: (1) PASI score; (2) site-specific (scalp, palmoplantar, genital, nail) Psoriasis Global Assessment (PGA). At each visit, the occurrence of any adverse events (AEs) was recorded, including serious AEs and AEs leading to bimekizumab discontinuation. Results: The mean PASI score was 16.6 +/- 9.4 at baseline and significantly decreased to 4.3 +/- 5.2 after 4 weeks (p < 0.001), and 1.1 +/- 1.7 after 16 week (p < 0.001). This level of improvement was maintained after 36 weeks (p < 0.001). PASI <= 2 was recorded in 36 (36.7%) at week 4, 68% and 69.4% at week 16 and 36, respectively. By week 16, 86/98 (87.8%) patients reached PASI75, 71/98 (72.4%) obtained PASI90, and 52/98 (53.1%) PASI100. Binary logistic regression tests showed a significant association of PASI100 by week 4 with lower PASI at baseline. PASI 100 at 16 or 36 weeks was not associated with baseline PASI, obesity, age, gender, previously naive state, and presence of psoriatic arthritis. Patients naive to biologics at baseline had similar response to bimekizumab as non-naive subjects. Conclusions: Bimekizumab is a suitable option for elder patients as it is effective, tolerated and has a convenient schedule.

Journal of the European Academy of Dermatology and VenereologyEarly View LETTER TO THE EDITOR Spesolimab in patients with flare of generalized pustular psoriasis: A multicentre case-series F. Bellinato, Corresponding Author F. Bellinato [email protected] orcid.org/0000-0002-6163-6921 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy Correspondence F Bellinato, Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, Verona 37126, Italy. Email: [email protected]Search for more papers by this authorP. Gisondi, P. Gisondi orcid.org/0000-0002-1777-9001 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, ItalySearch for more papers by this authorA. Dattola, A. Dattola orcid.org/0000-0001-9504-5882 Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, ItalySearch for more papers by this authorA. G. Richetta, A. G. Richetta Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, ItalySearch for more papers by this authorA. Costanzo, A. Costanzo orcid.org/0000-0001-9697-2557 Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalySearch for more papers by this authorM. Valenti, M. Valenti orcid.org/0000-0001-9140-9263 Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalySearch for more papers by this authorC. De Simone, C. De Simone orcid.org/0000-0002-0898-0045 Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorA. V. Marzano, A. V. Marzano orcid.org/0000-0002-8160-4169 Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorM. Zussino, M. Zussino Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorE. Pezzolo, E. Pezzolo orcid.org/0000-0003-0121-4812 Dermatology Unit, Ospedale San Bortolo, Vicenza, ItalySearch for more papers by this authorM. Nacca, M. Nacca [email protected] A.O.R.N. Sant'Anna e San Sebastiano Caserta, Caserta, ItalySearch for more papers by this authorG. Pellacani, G. Pellacani orcid.org/0000-0002-7222-2951 Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, ItalySearch for more papers by this authorG. Girolomoni, G. Girolomoni orcid.org/0000-0001-8548-0493 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, ItalySearch for more papers by this author F. Bellinato, Corresponding Author F. Bellinato [email protected] orcid.org/0000-0002-6163-6921 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy Correspondence F Bellinato, Section of Dermatology and Venereology, Department of Medicine, University of Verona, Piazzale A. Stefani 1, Verona 37126, Italy. Email: [email protected]Search for more papers by this authorP. Gisondi, P. Gisondi orcid.org/0000-0002-1777-9001 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, ItalySearch for more papers by this authorA. Dattola, A. Dattola orcid.org/0000-0001-9504-5882 Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, ItalySearch for more papers by this authorA. G. Richetta, A. G. Richetta Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, ItalySearch for more papers by this authorA. Costanzo, A. Costanzo orcid.org/0000-0001-9697-2557 Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalySearch for more papers by this authorM. Valenti, M. Valenti orcid.org/0000-0001-9140-9263 Dermatology Unit, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy Dermatology Unit, Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, ItalySearch for more papers by this authorC. De Simone, C. De Simone orcid.org/0000-0002-0898-0045 Dermatologia, Dipartimento Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Dermatologia, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorA. V. Marzano, A. V. Marzano orcid.org/0000-0002-8160-4169 Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorM. Zussino, M. Zussino Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorE. Pezzolo, E. Pezzolo orcid.org/0000-0003-0121-4812 Dermatology Unit, Ospedale San Bortolo, Vicenza, ItalySearch for more papers by this authorM. Nacca, M. Nacca [email protected] A.O.R.N. Sant'Anna e San Sebastiano Caserta, Caserta, ItalySearch for more papers by this authorG. Pellacani, G. Pellacani orcid.org/0000-0002-7222-2951 Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, ItalySearch for more papers by this authorG. Girolomoni, G. Girolomoni orcid.org/0000-0001-8548-0493 Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, ItalySearch for more papers by this author First published: 12 December 2023 https://doi.org/10.1111/jdv.19678Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1Genovese G, Moltrasio C, Cassano N, Maronese CA, Vena GA, Marzano AV. Pustular psoriasis: from pathophysiology to treatment. Biomedicine. 2021; 9(12): 1746. CASGoogle Scholar 2Bellinato F, Gisondi P, Marzano AV, Piaserico S, De Simone C, Damiani G, et al. Characteristics of patients experiencing a flare of generalized pustular psoriasis: a multicenter observational study. Vaccines (Basel). 2023; 11(4): 740. 10.3390/vaccines11040740 CASPubMedWeb of Science®Google Scholar 3Costanzo A, Bardazzi F, Simone C DE, Fabbrocini G, Foti C, Marzano AV, et al. Pustular psoriasis with a focus on generalized pustular psoriasis: classification and diagnostic criteria. An Italian Expert Consensus. Ital J Dermatol Venerol. 2022; 157(6): 489–496. PubMedGoogle Scholar 4Krueger J, Puig L, Thaçi D. Treatment options and goals for patients with generalized pustular psoriasis. Am J Clin Dermatol. 2022; 23(Suppl 1): 51–64. 10.1007/s40257-021-00658-9 PubMedWeb of Science®Google Scholar 5Zema CL, Valdecantos WC, Weiss J, Krebs B, Menter AM. Understanding flares in patients with generalized pustular psoriasis documented in US electronic health records. JAMA Dermatol. 2022; 158(10): 1142–1148. 10.1001/jamadermatol.2022.3142 PubMedWeb of Science®Google Scholar 6 European Medicines Agency. Committee for Medicinal Products for Human Use (CHMP) summary of positive opinion: Spevigo (spesolimab). 2022. [Accessed 2022 Oct 27] https://www.ema.europa.eu/en/documents/smop-initial/chmp-summary-positive-opinion-spevigo_en.pdf Google Scholar 7Bachelez H, Choon SE, Marrakchi S, Burden AD, Tsai T, Morita A, et al. Trial of spesolimab for generalized pustular psoriasis. N Engl J Med. 2021; 385(26): 2431–2440. 10.1056/NEJMoa2111563 CASPubMedWeb of Science®Google Scholar 8Navarini AA, Burden AD, Capon F, Mrowietz U, Puig L, Köks S, et al. European consensus statement on phenotypes of pustular psoriasis. J Eur Acad Dermatol Venereol. 2017; 31(11): 1792–1799. 10.1111/jdv.14386 CASPubMedWeb of Science®Google Scholar 9Navarini AA, Prinz JC, Morita A, Tsai TF, Viguier MA, Li L, et al. Spesolimab improves patient-reported outcomes in patients with generalized pustular psoriasis: results from the Effisayil 1 study. J Eur Acad Dermatol Venereol. 2023; 37(4): 730–736. 10.1111/jdv.18820 CASPubMedWeb of Science®Google Scholar Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation

We described a case of IPEX syndrome successfully controlled with dupilumab, an anti-IL4 receptor alpha subunit inhibitor. IPEX syndrome is a rare and generally fatal genetic disorder characterized by immune dysregulation, polyendocrinopathy and enteropathy, mostly diagnosed in early childhood. Nonetheless, cases reported in the last 20 years demonstrated that IPEX clinical spectrum encompasses more than the classical triad of early-onset intractable diarrhea, type 1 diabetes and eczema. Atypical cases of IPEX include patients with late-onset of symptoms, single-organ involvement, mild disease phenotypes or rare clinical features. A 21-year-old caucasian man presented with immune dysregulation (hypereosinophilia and elevated IgE), protein-losing enteropathy, polyendocrinopathy (thyroiditis, osteoporosis, delayed puberty), weight loss, eczema manifestations and celiac disease. IPEX syndrome was diagnosed because of the presence of a hemizygous mutation in FOXP3 gene (c.543C>T (p.S181S) in the exon 5). During the course of the disease, the patient developed erosive proctitis, pyoderma gangrenosum, and erythema nodosum. Symptoms improved only after enteral and parenteral corticosteroid therapy and the patient soon developed steroid-dependence. Notwithstanding various therapies including azathioprine, sirolimus, tacrolimus, adalimumab, vedolizumab, the patient failed to achieve a good control of symptoms without steroids. Almost exclusive enteral nutrition with a hypoallergenic, milk-protein free, amino acid-based food for special medical purposes. He continued to lose weight (BMI 14.5 kg/m2) with a consequent high limitation of physical activity and a progressive worsening of the quality of life. In consideration of the poor response to conventional immunosuppressants and the presence of type 2 inflammatory manifestations, treatment with dupilumab at an initial dose of 600 mg, followed by a maintenance dose of 300 mg every other week, according to atopic dermatitis labeled dose, was started and combined to oral budesonide 6 mg/day and 6-mercaptopurine 75 mg/day. The patient experienced a rapid improvement in bowel and skin symptoms, leading to a progressive tapering of steroids. By our knowledge, this is the first report of IPEX syndrome successfully treated by antiIL-4/IL-13 therapy. In this case dupilumab demonstrated to be an effective, safe and steroid-sparing option.

Background: Tralokinumab is a human monoclonal antibody targeting interleukin-13 that is approved for the treatment of moderate-severe atopic dermatitis. Studies analyzing the efficacy and safety of tralokinumab in a real-world setting are scarce.Research design and methods: A European, multicentric, real-world, retrospective cohort study was defined to assess the effectiveness and safeness profile of tralokinumab, investigating the achievement of pre-specified treatment goals; and to detect potential differences in terms of effectiveness and safeness across some selected patient subcohorts.Results: A total of 194 adult patients were included in this study. A significant improvement in physician-assessed disease severity was detected at each follow-up visit as compared with baseline and similar trend was observed for patient-reported outcomes and quality of life. No meaningful difference in effectiveness was found when considering patient age (<65 versus >= 65 years), neither dissecting patient cohort in dupilumab-naive vs dupilumab-treated subjects. Among tralokinumab-treated patients, 88% achieved at least one currently identified real-world therapeutic goal at week 16.Conclusions: This retrospective multicenter study confirmed the effectiveness and safeness of tralokinumab throughout 32 weeks of observation, showing the achievement of therapeutic goals identified in both trial and real-world settings in a large proportion of tralokinumab-treated patients.

BACKGROUND:Confirmatory data on the long-term effectiveness and safety of ixekizumab in psoriatic patients from real-world studies are needed. OBJECTIVES:The primary aim was to evaluate the 3-year drug survival of ixekizumab in the treatment of patients with moderate-to-severe plaque psoriasis, in a multicenter real-world setting. The secondary aim was to assess the influence of predictive factors on the drug survival of ixekizumab. METHODS:A retrospective analysis was performed on a cohort of patients with chronic plaque psoriasis, who received at least one dose of ixekizumab before December 2018. The drug survival analysis was performed and descriptively analyzed using Kaplan-Meier survival curves. Multivariable Cox regression analyses were carried out including variables considered to be of clinical importance. RESULTS:A total of 306 patients were enrolled. The overall drug survival at 12, 24, and 36 months of treatment with ixekizumab was 92.11%, 83.85%, and 80.19%, respectively. A higher probability (HR 2.34) of drug withdrawal was found among patients who had already received an anti-IL-17 agent compared with bio-naive patients (p 0.017). CONCLUSIONS:We found that ixekizumab is a biological agent characterized by long-term effectiveness, not influenced by several clinical factors and associated with a good safety profile.

The knowledge regarding the risk of bullous pemphigoid (BP) in patients with type 2 diabetes (T2D) taking dipeptidyl peptidase 4 inhibitors (DPP4i) is based on case reports, pharmacovigilance database analyses, randomized clinical trials and retrospective observational studies. To further investigate the relationship between taking DPP4i and the risk of BP and to characterize demographic, clinical and immunological profile of DPP4i associated patients we conducted a prospective case-control study in an Italian population. Two hundred and nine BP and 308 T2D consecutive patients were enrolled in two referral centers for autoimmune bullous diseases from 2019 to 2022. One hundred and eight patients were BP, while one hundred and one were T2D BP (48%), demonstrating a high prevalence of T2D in BP patients. Almost half of T2D BP patients were DPP4i users showing that 1 of 4 BP patients had an induced disease caused by a known drug. Overall, DPP4i intake was associated with a 2.3-fold increased risk for BP (95% CI, 1.7-3.0) and the most used DPP4i was linagliptin with a 2.1-fold increased risk for BP (95% CI, 1.2-3.7). It is interesting to note that mean age increased together with the male proportion from 108 non-T2D BP to 51 non-DPP4i users T2D PB and to 50 DPP4i users T2D PB (75.0 years old and male 50%; 77.9 years old and male 51%; 80.0 years old and male 60%, respectively). Immunoglobulin (Ig)G humoral response of DPP4i users BP to BP180 and BP230 antigens was reduced in frequency and titers compared with those of patients non-DPP4i users. In particular, a peculiar immunological profile was characterized by reactivity to multiple BP180 epitopes. This study demonstrates that treatment with DPP4i, especially linagliptin, was significantly associated with an increased risk of BP among T2D patients. In addition, DPP4i users BP present specific demographic and immunological features.

Background Pemphigus vulgaris and pemphigus foliaceus are potentially life-threatening autoimmune disorders triggered by IgG autoantibodies against mucosal and epidermal desmogleins. There is an unmet need for fast-acting drugs that enable patients to achieve early sustained remission with reduced corticosteroid reliance. Objectives To investigate efgartigimod, an engineered Fc fragment that inhibits the activity of the neonatal Fc receptor, thereby reducing serum IgG levels, for treating pemphigus. Methods Thirty-four patients with mild-to-moderate pemphigus vulgaris or foliaceus were enrolled in an open-label phase II adaptive trial. In sequential cohorts, efgartigimod was dosed at 10 or 25 mg kg(-1) intravenously with various dosing frequencies, as monotherapy or as add-on therapy to low-dose oral prednisone. Safety endpoints comprised the primary outcome. The study is registered at ClinicalTrials.gov (identifier NCT03334058). Results Adverse events were mostly mild and were reported by 16 of 19 (84%) patients receiving efgartigimod 10 mg kg(-1) and 13 of 15 (87%) patients receiving 25 mg kg(-1), with similar adverse event profiles between dose groups. A major decrease in serum total IgG and anti-desmoglein autoantibodies was observed and correlated with improved Pemphigus Disease Area Index scores. Efgartigimod, as monotherapy or combined with prednisone, demonstrated early disease control in 28 of 31 (90%) patients after a median of 17 days. Optimized, prolonged treatment with efgartigimod in combination with a median dose of prednisone 0 center dot 26 mg kg(-1) per day (range 0 center dot 06-0 center dot 48) led to complete clinical remission in 14 of 22 (64%) patients within 2-41 weeks. Conclusions Efgartigimod was well tolerated and exhibited an early effect on disease activity and outcome parameters, providing support for further evaluation as a therapy for pemphigus.

Journal of the European Academy of Dermatology and VenereologyVolume 36, Issue 11 p. e876-e879 COVID-19 SPECIAL FORUM - Letter to the editor Cutaneous adverse reactions following SARS-CoV-2 vaccine booster dose: a real-life multicentre experience G. Avallone, Corresponding Author G. Avallone [email protected] orcid.org/0000-0001-7253-2370 Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared first authorshipCorrespondence: G. Avallone. E-mail: [email protected]Search for more papers by this authorF. Cavallo, F. Cavallo orcid.org/0000-0001-9296-826X Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared first authorshipSearch for more papers by this authorC. Astrua, C. Astrua Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalySearch for more papers by this authorG. Caldarola, G. Caldarola orcid.org/0000-0002-8837-9232 UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, ItalySearch for more papers by this authorC. Conforti, C. Conforti orcid.org/0000-0001-5126-8873 Dermatology Clinic, Maggiore Hospital, Trieste, ItalySearch for more papers by this authorC. De Simone, C. De Simone UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, Italy Sezione di Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del S. Cuore, Rome, ItalySearch for more papers by this authorN. di Meo, N. di Meo Dermatology Clinic, Maggiore Hospital, Trieste, ItalySearch for more papers by this authorA. di Stefani, A. di Stefani UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, ItalySearch for more papers by this authorG. Genovese, G. Genovese orcid.org/0000-0002-7636-958X Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorC.A. Maronese, C.A. Maronese orcid.org/0000-0002-9449-849X Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorA.V. Marzano, A.V. Marzano orcid.org/0000-0002-8160-4169 Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorR. Parente, R. Parente Department of Pathology, Humanitas-Gradenigo Hospital, Turin, ItalySearch for more papers by this authorP. Quaglino, P. Quaglino orcid.org/0000-0003-4185-9586 Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalySearch for more papers by this authorG. Roccuzzo, G. Roccuzzo Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalySearch for more papers by this authorF. Tassone, F. Tassone UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, ItalySearch for more papers by this authorI. Zalaudek, I. Zalaudek Dermatology Clinic, Maggiore Hospital, Trieste, ItalySearch for more papers by this authorR. Senetta, R. Senetta Department of Oncology, Pathology Unit, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared senior authorshipSearch for more papers by this authorS. Ribero, S. Ribero orcid.org/0000-0002-0098-1406 Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared senior authorshipSearch for more papers by this author G. Avallone, Corresponding Author G. Avallone [email protected] orcid.org/0000-0001-7253-2370 Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared first authorshipCorrespondence: G. Avallone. E-mail: [email protected]Search for more papers by this authorF. Cavallo, F. Cavallo orcid.org/0000-0001-9296-826X Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared first authorshipSearch for more papers by this authorC. Astrua, C. Astrua Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalySearch for more papers by this authorG. Caldarola, G. Caldarola orcid.org/0000-0002-8837-9232 UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, ItalySearch for more papers by this authorC. Conforti, C. Conforti orcid.org/0000-0001-5126-8873 Dermatology Clinic, Maggiore Hospital, Trieste, ItalySearch for more papers by this authorC. De Simone, C. De Simone UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, Italy Sezione di Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del S. Cuore, Rome, ItalySearch for more papers by this authorN. di Meo, N. di Meo Dermatology Clinic, Maggiore Hospital, Trieste, ItalySearch for more papers by this authorA. di Stefani, A. di Stefani UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, ItalySearch for more papers by this authorG. Genovese, G. Genovese orcid.org/0000-0002-7636-958X Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorC.A. Maronese, C.A. Maronese orcid.org/0000-0002-9449-849X Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorA.V. Marzano, A.V. Marzano orcid.org/0000-0002-8160-4169 Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, ItalySearch for more papers by this authorR. Parente, R. Parente Department of Pathology, Humanitas-Gradenigo Hospital, Turin, ItalySearch for more papers by this authorP. Quaglino, P. Quaglino orcid.org/0000-0003-4185-9586 Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalySearch for more papers by this authorG. Roccuzzo, G. Roccuzzo Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalySearch for more papers by this authorF. Tassone, F. Tassone UOC Dermatologia, Dipartimento di scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario 'A.Gemelli' IRCCS, Rome, ItalySearch for more papers by this authorI. Zalaudek, I. Zalaudek Dermatology Clinic, Maggiore Hospital, Trieste, ItalySearch for more papers by this authorR. Senetta, R. Senetta Department of Oncology, Pathology Unit, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared senior authorshipSearch for more papers by this authorS. Ribero, S. Ribero orcid.org/0000-0002-0098-1406 Dermatology Clinic, Department of Medical Sciences, University of Turin, Turin, ItalyThese authors contributed equally to this article and shared senior authorshipSearch for more papers by this author First published: 30 June 2022 https://doi.org/10.1111/jdv.18386Citations: 9 Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume36, Issue11November 2022Pages e876-e879 RelatedInformation

Background Psoriasis (PSO) is a systemic immune-mediated disorder, characterized by inflammation skin and joint manifestations: it is known that up to 30% of PsO patients develop PsA. PsO and PsA share common etiopathogenetic pathways, as IL-23/IL-17 axis. In Italy, Guselkumab (GUS), a selective IL-23 inhibitor, was approved in 2018 for the treatment of PsO, and recently it was also approved for PsA therapy. Today, there are few “real-world” studies regarding the use of GUS in PsA patients. Objectives A multicenter Italian study group of dermatologists and rheumatologists aimed at evaluate GUS efficacy and safety in patients with concomitant PsO and PsA in real word setting on both skin and joint domains. Methods An observational retrospective, multicentric study was performed in 69 PsO patients with a confirmed diagnosis of moderate to severe PsA. PASI and DLQI were used for the evaluation of skin response, and the number swollen/tender joints, presence or absence of dactylitis or enthesitis or axial involvement and painVAS were evaluated for the articular and periarticular efficacy. These analyses were performed at baseline T0 (beginning of the therapy), T1 (12 weeks) and T2 (24 weeks). Results 38/69 patients (55,1%) presented oligoarthritis, 31/69 (44,9%) showed polyarthritis, none of the patients had enthesitis or axial involvement. Moreover, co-morbidities were diagnosed: hypertension (52,2%), hypercholesterolemia (34,8%), Hypertriglyceridemia (29%), diabetes (24,6%), obesity (23,2%), HIV-positive (20,3%), psychiatric disorders (17,4%), cardiopathies (15,9%), inflammatory bowel disease (7,3%), Latent Tubercolosis (4,4%), Chronic B-Hepatitis (2,9%), Chronic C-Hepatitis (1,5%). In all these patients, skin and joint responses were evaluated at week 12 and week 24. Concerning skin efficacy, PASI 90 was achieved at week 24. Concerning Joint response: painVAS progressively improved till T2, tender joint count decreased in patients with oligo and polyarthritis at T1 and maintained at T2, while swollen joint count decreased in polyarthritis patients at T1 and maintained at T2. In oligo-arthritis patients, this parameter was not improved. The number of dactylitis did not decrease during the period of study (see Table 1). No safety concerns were reported in this population. Conclusion Efficacy and safety of GUS was confirmed in this study group of PsO patients with concomitant PsA and several comorbidities in a real-life setting. Disclosure of Interests None declared

Introduction Bullous pemphigoid is the most common autoimmune bullous dermatosis. In recent years several studies have tried to identify the main factors of the disease related with an increased risk of death. The aim of this multicenter Italian study was to assess the risk score of death considering epidemiologic, clinical, immunological, and therapeutic factors in a cohort of patients affected by bullous pemphigoid and try to identify the cumulative survival up to 120 months. Methods We retrospectively reviewed the medical records of patients with bullous pemphigoid who were diagnosed between 2005 and 2020 in the 12 Italian centers. Data collected included sex, age at the time of diagnosis, laboratory findings, severity of disease, time at death/censoring, treatment, and multimorbidity. Results A total of 572 patients were included in the study. The crude mortality rate was 20.6%, with an incidence mortality rate of 5.9 x 100 person/year. The mortality rate at 1, 3, 5, and 10 years was 3.2%, 18.2%, 27.4% and 51.9%, respectively. Multivariate model results showed that the risk of death was significantly higher in patients older than 78 years, in presence of multimorbidity, anti-BP180 autoantibodies >72 U/mL, or anti-BP230 > 3 U/mL at diagnosis. The variables jointly included provided an accuracy (Harrel's Index) of 77% for predicting mortality. Conclusion This study represents the first nationwide Italian study to have retrospectively investigated the mortality rates and prognostic factors in patients with bullous pemphigoid. A novel finding emerged in our study is that a risk prediction rule based on simple risk factors (age, multimorbidity, steroid-sparing drugs, prednisone use, and disease severity) jointly considered with two biomarkers routinely measured in clinical practice (anti-BP230 and anti-BP180 autoantibodies) provided about 80% accuracy for predicting mortality in large series of patients with this disease.

EffeCtiveness of biologic treAtmeNts for plaque psOriasis in Italy: An obserVAtional (CANOVA) study was aimed at providing real-world evidence of the effectiveness of biologics in Italian patients with moderate–severe psoriasis. It was an observational, retro-prospective cohort study conducted in 17 Italian dermatology clinics. Adult patients with moderate–severe plaque psoriasis, who started a biologic treatment between 24 weeks and 24 months before enrolment, were included. With a follow-up visit at 6 months after enrolment, each patient had at least 12 months of observation. The primary objective was to describe the clinical response rates (PASI 75) after 16/24/52 weeks from biologic treatment start. Secondary outcomes were sustained response, quality of life, and treatment satisfaction. Of the 669 eligible patients (64% males), 52% were naïve to biologics, though a mean duration of psoriasis since first diagnosis of 18.6 years ( 13.2). The most frequently prescribed biologics were secukinumab (41%), ustekinumab (25%), TNF-inhibitors (22%) and ixekizumab (12%). PASI 75 was achieved by 86% of patients (95% CI: 82%–89%) at 16 weeks, 90% (87%–93%) at 24 weeks, and 91% (89%–94%) at 52 weeks. Patients achieving PASI 90 and PASI 100 at 52 weeks were 75% (71%–79%) and 53% (49%–57%), respectively. Sustained PASI 75 response after 1 year from treatment start was achieved by 78% (74%–82%) of patients. Mean DLQI total score was 2.3 ( 3.9) at enrollment and decreased at the final visit to 1.8 (3.6). A high level of treatment satisfaction was expressed by patients over the study period. This large real-world study confirms in the clinical practice the good effectiveness and acceptability of biologics in psoriasis patients.

Background: Psoriasis is a systemic inflammatory disease often associated with NAFLD. Risk factors for progressive metabolic liver disease in psoriatic patients has not been explored so far. The aim of this study was to assess liver outcomes (progressive liver fibrosis) in a cohort of NAFLD patients affected by psoriasis.

Journal of the European Academy of Dermatology and VenereologyVolume 35, Issue 10 p. e684-e685 Letter To The Editor Morphea-like changes in the setting of cancer immunotherapy C. De Simone, C. De Simone Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorM. Mannino, M. Mannino Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorP. Sollena, P. Sollena orcid.org/0000-0002-1632-7791 Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, ItalySearch for more papers by this authorF. Deilhes, F. Deilhes Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, FranceSearch for more papers by this authorV. Sibaud, V. Sibaud Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, FranceSearch for more papers by this authorK. Peris, K. Peris orcid.org/0000-0003-1957-6600 Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this author C. De Simone, C. De Simone Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorM. Mannino, M. Mannino Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this authorP. Sollena, P. Sollena orcid.org/0000-0002-1632-7791 Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, ItalySearch for more papers by this authorF. Deilhes, F. Deilhes Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, FranceSearch for more papers by this authorV. Sibaud, V. Sibaud Oncodermatology Department, Institut Universitaire du Cancer, Toulouse Oncopole, Toulouse, FranceSearch for more papers by this authorK. Peris, K. Peris orcid.org/0000-0003-1957-6600 Dermatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy Dermatologia, Università Cattolica del Sacro Cuore, Rome, ItalySearch for more papers by this author First published: 20 May 2021 https://doi.org/10.1111/jdv.17388Citations: 1 *Correspondence: P. Sollena, E-mail: pietrosollena@virgilio.it Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume35, Issue10October 2021Pages e684-e685 RelatedInformation