Background Psoriasis (Ps) is a chronic systemic autoimmune disease associated with pruritus in 64-98% of patients. However, few modestly sized studies assess factors associated with psoriatic pruritus. Objective To investigate factors associated with Ps pruritus intensity. Methods Psoriasis patients 18 years or older seen in one of 155 centres in Italy between September 2005 and 2009 were identified from the Italian PsoCare registry. Patients without cutaneous psoriasis and those with missed information on pruritus were excluded. Results We identified 10 802 patients, with a mean age 48.8 +/- 14.3 years. Mild itch was present in 33.2% of patients, moderate in 34.4%, severe in 18.7% and very severe in 13.7%. Higher itch intensity was associated with female gender, lower educational attainment compared to university degree, pustular psoriasis, psoriasis on the head, face, palmoplantar areas, folds and genitalia, more severe disease, disease duration <15 years, and no or few prior systemic treatments. Limitations Effects of specific medication on itch were not assessed. Conclusions Pruritus should be evaluated during psoriasis visits, and physicians should be aware of patients at higher risk for itch. Further studies are needed to assess the effects of medications on itch, and establish therapy for psoriasis patients with persistent itch.

ABSTRACT Aim: Background Selective BRAF inhibition (BRAFi) by vemurafenib or dabrafenib has become approved standard treatment in BRAFV600 mutated advanced stage melanoma. While the response rate is high, the response duration is limited with a progression-free survival (PFS) of 5-6 months months. Our observation of accelerated disease progression within some patients after stopping vemurafenib treatment has fostered the idea of treatment beyond progression (TBP). Methods: In this retrospective study, we analyzed 70 metastatic melanoma patients, treated at our institute, who experienced progression after prior objective response upon treatment with vemurafenib. Thirtyfive patients that continued treatment beyond progression are compared with 35 patients who stopped BRAFi treatment at disease progression. Results: Median overall survival beyond documented progression was found to be 5.2 months versus 1.4 months (95% CI: 3.8-7.4 vs. 0.6-3.4; Log-Rank p = 0.0001) in favour of TBP. In the multivariate survival analysis, stopping treatment at disease progression was independently and significantly associated with shorter survival (Hazard Ratio: 1.92; 95% CI: 1.04-3.55; p = 0.04). Conclusions: Our results clearly suggest that continuing vemurafenib treatment beyond progression may be beneficial in advanced melanoma patients. Prospective confirmation, however, is warranted before implementation into daily practice. Disclosure: J.B.A.G. Haanen: Advisory role and research grant form GSK. All other authors have declared no conflicts of interest.

ABSTRACT Objective To investigate the time trend influence of socioeconomic status (SES) on Breslow thickness (BT) and survival in patients (pts) with stage I-II primary cutaneous melanoma (PCM). Patients and methods Pathologic and sociodemographic characteristics of prospectively collected, consecutive pts diagnosed with PCM between November 1, 1998, and July 31, 2009 were evaluated. We categorized SES into 3 levels: low (manual employees with primary education level), middle (non-manual employees with middle education level), and high (professionals, executives with tertiary education). We divided the representative years between 2000 and 2009 into three four-year (table 1). In the multilvariate analysis models the following variables were tested: SES, marital status, sex and age. Results A total of 1274 available pts were analyzed. Overall a progressive decrease of BT was observed (table 1). In the first four year period gender and age correlated with BT and ulceration [m vs f OR (95%CI): 1.66 (1.10-1.52) and (>60 vs Conclusion Our data for the first time demonstrates that BT and survival decreased over time but not for low SES patients. These pts should be considered the optimal target for future prevention campaign Table 1 Time Trend BT decrease in stage I-II primary cutaneous melanoma. MEASURE CLASS 2000_2002 2003_2005 2006_2009 PVALUE N. Group . 417 442 415 breslow_r (median (Q1-Q3) 0.60 (0.32-1.35) 0.50 (0.30-1.25) 0.45 (0.21-0.92) 0,0002 Disclosure All authors have declared no conflicts of interest.

e19004 Background: Breslow thickness (BT) and ulceration predict survival inprimary cutaneous melanoma (PCM). We investigatedthe influence of the socio-economic (SEC) status and educational grade on BT and ulceration inclinical stage I-II AJCC PCM. Methods: The study included all consecutive patients with PCM, diagnosed, treated and followed up prospectively between November 1998 and December 2008. Age, gender, education grade, SEC status, family context, site of the primary lesion, BT, ulceration, lymph node status were collected. Education grade was categorised into four groups: primary school; middle school; high school and higher degree. SEC classes were classified as: Classe 1: manager/professionals; class 2: craftsman, clerks, manual workers; class 3: housewives; retired; unemployed. Results: A total of 1,432 consecutive patients were included. Median age was 51 years, 55.7% of them were female. For the whole population, mean BT was 1.2 (± 2.4) mm, and ulceration was present in 251 patients (18.1%). In univariate analysis, male gender, lower education grade, SEC 2 and 3 classes, and age > 60 had a higher probability of thicker Breslow (0-1 vs. 1-3 vs. > 3 mm) and ulceration (yes/not). In a multivariate and stepwise analysis, male gender (OR 1.536, 95% CI 1.177-2.006), class 2 (OR 2.091, 95% CI 1.149-3.807), class 3 (OR 3.155, 95% CI 1.905-5.227 ) and patients > 60 yrs living alone (OR 2.16, 95% CI 1.32-3.53) remained statistically significant for BT, lower education for ulceration. Conclusions: This is the first prospective monoinstitutional study demonstrating that male gender, education grade and the some socioeconomic features are associated with thicker PCM and ulceration at diagnosis. Ongoing analysis on disease free and overall survival will show if these factors also have an influence on disease outcome for these patients. No significant financial relationships to disclose.

Background: To investigate if the tumour infiltrating lymphocytes (TILs) are able to predict the sentinel lymph node (SLN) positivity, the disease-free survival (DFS) and overall survival (OS) in clinical stages I-II AJCC primary cutaneous melanoma (PCM).Methods: The study included consecutive patients with PCM, all diagnosed, treated and followed up prospectively. Logistic regression was used to investigate the association between DFS, OS, SLN positivity and Breslow thickness, Clark level, TIL, ulceration, lesion site, gender, regression and age.Results: From November 1998 to October 2008, 1251 consecutive patients with PCM were evaluated. Median age was 51 (range 15-96) with 32.2% (N = 393) of them older than 60; 44.8% of them were males. Of the whole series, a total of 404 patients with primary vertical growth phase (VGP) melanoma and no clinical evidence of metastatic disease underwent SLN biopsy. Of these, 74 (18.8%) had a positive SLN. In a multivariate analysis, primary melanoma on the extremities versus that on the axial locations (truncal and head/neck) (OR 0.49, 95% CI 0.25-0.98, p 0.04) and TILs (TILs versus no TILs) (OR 0.47, 95%CI 0.25-0.90, p 0.02) were predictive for lower probability of SLN involvement, while thickness (>4 mm versus 0-1 mm) (OR 24, 19, 95% CI 4.91-119.13, p < .001) was predictive for higher risk of SLN positivity A multivariate stepwise analysis confirmed these results. The histological status of the SLN was the most significant predictor of DFS and OS. Patients with a negative SLN had a 5-year DFS of 75.9%, compared with 35.2% in patients with a positive SLN (p < .0001) and a 5-year OS of 88.7% versus 42.9%, respectively (p < .0001).Conclusions: Our study demonstrates that the absence of TILs predicts SLN metastasis, in multivariate analysis the SLN positivity predicts DFS and OS. (C) 2009 Elsevier Ltd. All rights reserved.

gli strati più superficiali cheratinizzati della cute e dei capelli.Le micosi cutanee sono dovute a funghi che colpiscono gli strati più profondi dell'epidermide, provocando in tal modo una maggiore distruzione dei tessuti e quindi una maggiore sintomatologia.Obiettivo.

Self-detection of suspicious pigmented skin lesion combined with rapid referral to dermatologic centres is the key strategy in the fight against melanoma. The investigation of factors associated with pattern of detection of melanoma (self- vs. nonself-detection) may be useful to refine educational strategies for the future. We investigated the frequency of melanoma self-detection in a Mediterranean population at intermediate melanoma risk. A multicentric survey identified 816 consecutive cases of cutaneous melanoma in the period January to December 2001 in 11 Italian clinical centres belonging to the Italian Multidisciplinary Group on Melanoma. All patients filled a standardized questionnaire and were clinically examined by expert dermatologists. Self-detected melanomas were 40.6%, while the remaining lesions were detected by a dermatologist (18.5%), the family physician (15.2%), other specialists (5%), the spouse (12.5%), a friend or someone else (8.2%). Variables associated with self-detected melanomas were female sex, young age, absence of atypical nevi, knowledge of the ABCD rule, habit of performing skin self-examination. Self-detected melanomas did not differ from nonself-detected tumours in term of lesion thickness; however, patients with self-detected melanomas waited a longer period before having a diagnostic confirmation (patient's delay) (> 3 months: odds ratio, 3.89; 95% confidence interval, 2.74-5.53). In order to reduce the patients' delays, educational messages should adequately stress the need for a prompt referral to a physician once a suspicious pigmented lesion is self-detected.

BACKGROUND. Nodular histotype represents the condition that is mostly associated with diagnosis of thick melanoma.OBJECTIVE. The objectives were to evaluate variables associated with and pattern of detection of nodular melanomas and to investigate variables associated with early diagnosis in accordance with histotype (nodular vs. superficial spreading melanomas).METHODS. From the original data set of 816 melanomas, all the invasive lesions classified as superficial spreading (n=500) and nodular (n=93) melanomas were considered for the study. A multivariate logistic analysis was performed.RESULTS. Nodular melanomas did not significantly differ from superficial spreading melanomas regarding sex, anatomic site, number of whole-body nevi, and the presence of atypical nevi. As expected, nodular melanomas were represented by a higher percentage of thick (>2 mm) lesions compared to superficial spreading melanomas (64.5% vs. 9.6%, p<0.001). The pattern of detection significantly differed between nodular and superficial spreading melanomas, the former being more frequently self-detected (44.1% vs. 38.0%) or detected by the family doctor (34.4% vs. 11.4%). Female sex, high level of education, and detection made by a dermatologist had an independent, protective effect against late (>1 mm in thickness) diagnosis in superficial spreading melanomas. No protective variable associated with nodular melanomas was found.CONCLUSION. Patterns of detection for nodular melanomas significantly differ from those for superficial spreading melanomas. For superficial spreading, but not for nodular, melanomas, variables associated with protective effect against late diagnosis can be identified.

This study was performed to evaluate eyelid dermatitis in a group of patients of our Allergy Unit between January 1990 and April 1991, Among the 1158 patients seen during this period. 150 had eyelid dermatitis: 135 females: and 15 males, with a mean age of 35 years. Of the 150 patients with eyelid dermatitis, 54 had eczema localized to the eyelids only, 49 to the eyelids and face, 19 to the eyelids and hands, and 28 to the eyelids and other sites. 98 patients (65,3%) were diagnosed as having allergic Contact dermatitis, 25 (16.6%) irritant contact dermatitis, 21 (14%) atopic dermatitis, and 6 (4%) seborrhoeic dermatitis. Patch lest Ructions to nickel sulphate. Kathon CG and fragrance‐mix occurred more frequently in patients with eyelid dermatitis then in those without.

Interleukin-2 (IL-2) is a lymphokine produced by activated T cells and its receptor (IL-2R) is expressed on T cells; one of the IL-2R components can be measured as a soluble serum protein (sIL-2R). Levels of sIL-2R were measured as a sign of T cell activation in serum of 12 patients suffering from alopecia areata (totalis or universalis) and in a group of healthy control subjects. An enzyme-linked immunosorbent assay was used to determine the levels of sIL-2R in blood samples drawn during both the active and resting phase of the disease. In patients with alopecia areata in active phase the sIL-2R concentrations were significantly higher than in stable phase and in controls. The biologic role of sIL-2R is still unknown, but one could speculate that T lymphocyte activation with subsequent secretion of IL-2 and IL-2R expression may contribute to the immune inflammatory mechanism of alopecia areata.

Journal Article Soluble interleukin‐2 receptor in lichen planus Get access R. Valsecchi, R. Valsecchi Department of Dermatology, Ospedali Riuniti of Bergamo Bergamo, Italy Search for other works by this author on: Oxford Academic Google Scholar M. Bontempelli, M. Bontempelli Department of Immunohaematology, Ospedali Riuniti of Bergamo Bergamo, Italy Search for other works by this author on: Oxford Academic Google Scholar A.Di Landro, A.Di Landro Department of Dermatology, Ospedali Riuniti of Bergamo Bergamo, Italy Search for other works by this author on: Oxford Academic Google Scholar G. Imberti, G. Imberti Department of Dermatology, Ospedali Riuniti of Bergamo Bergamo, Italy Search for other works by this author on: Oxford Academic Google Scholar T. Cainelli T. Cainelli Department of Dermatology, Ospedali Riuniti of Bergamo Bergamo, Italy Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 125, Issue 4, 1 October 1991, Pages 403–404, https://doi.org/10.1111/j.1365-2133.1991.tb14186.x Published: 01 October 1991

Contact DermatitisVolume 24, Issue 1 p. 70-71 Mitomycin C contact dermatitis R. Valsecchi, R. Valsecchi Department of Dermatology, Ospedalt Riuniti, I-24100 Bergamo, ItalySearch for more papers by this authorG. Imberti, G. Imberti Department of Dermatology, Ospedalt Riuniti, I-24100 Bergamo, ItalySearch for more papers by this authorT. Cainelli, T. Cainelli Department of Dermatology, Ospedalt Riuniti, I-24100 Bergamo, ItalySearch for more papers by this author R. Valsecchi, R. Valsecchi Department of Dermatology, Ospedalt Riuniti, I-24100 Bergamo, ItalySearch for more papers by this authorG. Imberti, G. Imberti Department of Dermatology, Ospedalt Riuniti, I-24100 Bergamo, ItalySearch for more papers by this authorT. Cainelli, T. Cainelli Department of Dermatology, Ospedalt Riuniti, I-24100 Bergamo, ItalySearch for more papers by this author First published: January 1991 https://doi.org/10.1111/j.1600-0536.1991.tb01645.xCitations: 11AboutPDF 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 No abstract is available for this article. References 1 Nissenkorn I, Herrod H, Soloway M S. Side-effects associated with intravesical mitomycin C. J Urol 1981; 126: 596– 597. 2 Hetherington J W, Newling D W W, Robinson M R G. Intravesical mitomycin C for the treatment of recurrent superficial bladder tumours. Br J Urol 1987; 59: 241– 259. 3 Colver G B, Inglis J A, McVittie E, Spencer M J, Tolley D A, Hunter J A A. Dermatitis due to intravesical mitomycin C: a delayed-type hypersensitivity reaction Br J Dermatol 1990; 122: 217– 434. 4 Merrett J, Merrett T G. Phadiatop, a novel IgE antibody screening test Clin Allergy 1987: 17: 409– 416. 5 Mishina T, Oda K., Murata S. Mytomycin C bladder instillation therapy for bladder tumours. J Urol 1975: 217– 219. Citing Literature Volume24, Issue1January 1991Pages 70-71 ReferencesRelatedInformation

Contact DermatitisVolume 23, Issue 5 p. 372-373 Contact allergy to acyclovir R. Valsecchi, R. Valsecchi Department of Dermatology, Ospedali Riuniti, 1-24100 Bergamo, ItalySearch for more papers by this authorG. Imberti, G. Imberti Department of Dermatology, Ospedali Riuniti, 1-24100 Bergamo, ItalySearch for more papers by this authorT. Cainelli, T. Cainelli Department of Dermatology, Ospedali Riuniti, 1-24100 Bergamo, ItalySearch for more papers by this author R. Valsecchi, R. Valsecchi Department of Dermatology, Ospedali Riuniti, 1-24100 Bergamo, ItalySearch for more papers by this authorG. Imberti, G. Imberti Department of Dermatology, Ospedali Riuniti, 1-24100 Bergamo, ItalySearch for more papers by this authorT. Cainelli, T. Cainelli Department of Dermatology, Ospedali Riuniti, 1-24100 Bergamo, ItalySearch for more papers by this author First published: November 1990 https://doi.org/10.1111/j.1600-0536.1990.tb05177.xCitations: 10AboutPDF 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 No abstract is available for this article.Citing Literature Volume23, Issue5November 1990Pages 372-373 RelatedInformation