Giulio Gualdi - Academia.edu (original) (raw)

Papers by Giulio Gualdi

Journal of The European Academy of Dermatology and Venereology, Jul 17, 2023

Acta dermato-venereologica, 2014

Psoriatic arthritis (PsA) is a potentially severe inflammatory condition (entheso-arthro-osteopat... more Psoriatic arthritis (PsA) is a potentially severe inflammatory condition (entheso-arthro-osteopathy), and early diagnosis is important to guide treatment choices in patients with psoriasis. The objective of this study is to further validate the PsA Screening and Evaluation (PASE) questionnaire, and to assess its field performance. Data were collected in 10 Italian centres, and the PASE was administered at baseline, after 3 days and after 3 months. The Skindex-29 was also administered. To determine the best cutoff value to identify patients with PsA we produced receiver operating characteristic (ROC) curves using the rheumatologist's diagnosis as outcome. Of the 298 patients that were enrolled, 28% were classified as having PsA according to the CASPAR criteria, while 19% had received a diagnosis of PsA from a rheumatologist. PASE score were always significantly different in patients with or without PsA, while Skindex-29 scores never were. The internal consistency of the PASE was very good (Cronbach's α of 0.90-0.95), the test-retest reliability was also very high (intraclass correlation coefficients 0.91-0.93), and the PASE scores showed good responsiveness to clinical change over time. The optimal cutoff identified through the ROC curves was ≥ 48 on the total PASE score, which was able to distinguish PsA from non-PsA patients with a 73.2% sensitivity and a 76.1% specificity. Our results confirm the good psychometric properties of the PASE, and indicate that it may be a useful tool for the dermatologists, both to screen for PsA and to obtain a standardized patientreported measure to monitor and evaluate the health status of the patients with PsA.

Dermatologic Therapy, Nov 23, 2022

Wound management & prevention, Aug 1, 2022

BACKGROUND: Chronic leg ulcers affect approximately 1% to 2% of the European population, with an ... more BACKGROUND: Chronic leg ulcers affect approximately 1% to 2% of the European population, with an increasing prevalence. The treatment of chronic wounds is a socioeconomical problem worldwide. PURPOSE: The main purpose of the current investigation was to detect the etiology of leg ulcers treated in a dermatologic wound clinic from January 1, 2010, to December 31, 2019. METHODS: This retrospective observational study was performed at the Dermatologic Clinic of Spedali Civili in Brescia, Italy. The authors enrolled 465 patients with chronic leg ulcers. RESULTS: The 3 most represented causes of ulcers were vascular (238 patients, 51.2%), inflammatory (71 patients, 15.3%) and traumatic (43 patients, 9.3%). Altogether, a total of 13 different entities were identified as a cause of leg ulcer. CONCLUSION: Vascular genesis was the most common etiology of leg ulcers in this population, even though uncommon causes were also represented. These findings are in agreement with other studies reported in the literature.

Annals of Oncology, Sep 1, 2021

Journal of The European Academy of Dermatology and Venereology, Nov 8, 2020

Bioengineering, Apr 5, 2024

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Pediatric Dermatology

A 12‐year‐old boy affected by severe combined immunodeficiency due to a heterozygous variant in t... more A 12‐year‐old boy affected by severe combined immunodeficiency due to a heterozygous variant in the CARD domain of CARD11, c.169G>A; p.Glu57Lys, developed severe atopic dermatitis and alopecia areata. After failure of conventional systemic therapy, dupilumab was administered at a dose of 400 mg subcutaneously, followed by 200 mg every 14 days. The patient had an excellent clinical response after 1 month and complete remission after a year, with the absence of side effects, demonstrating good efficacy and safety profile.

Journal der Deutschen Dermatologischen Gesellschaft, Dec 5, 2014

Dermatologic Therapy, Sep 14, 2020

The safety of immunosuppressive treatment in patients with Immune‐Mediated Inflammatory Diseases ... more The safety of immunosuppressive treatment in patients with Immune‐Mediated Inflammatory Diseases (IMIDs) during the Coronavirus pandemic is questioned and it is utmost important for public health. We searched studies trough MEDLINE/EMBASE database, including patient with IMID, undergoing immunosuppressive treatment with a positive diagnosis for SARS‐CoV 2. We included 11 studies for the descriptive analysis and 10 studies for the pooled analysis, with a total population of 57 and 53 IMID‐affected SARS‐CoV‐positive patients respectively. Overall no death was reported; 16 patients were hospitalized (30.2%) and only two cases were admitted to Intensive Care Unit (ICU) (3.8%). We found a significant association between the risk of hospitalization and older age (P .03), obesity (P .02), and presence of multi‐comorbidity (P .03). No significant association was found between the risk of hospitalization and the use of biological or conventional DMARDs (respectively P .32 and .26), neither when they are used combined (P .85). We found consistent results in the sub‐analysis of Psoriasis: 10 patients were hospitalized (31.3%) and only one case was admitted to Intensive Care Unit (ICU) (3.1%) Particular attention should be placed for patients with older age, obesity and multi‐comorbidity that are at higher risk of hospitalization.

British Journal of Dermatology, Dec 12, 2015

Background Surgical excision represents the most common elective treatment for basal cell carcino... more Background Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo determination of tumour margin, in order to achieve radical removal. Objectives To propose a new approach through the combination of dermoscopy and reflectance confocal microscopy (RCM) for lateral margin detection in BCC. Methods Ten patients with lesions clinically suggestive of nonpigmented BCCs with ill-defined margins were enrolled. All BCCs were dermoscopically evaluated first and the ill-defined margins were marked with a superficial cut and then inspected using RCM. Results RCM evaluation showed BCC foci beyond the presurgical marker in three out of 10 lesions. Histology confirmed the RCM results: the presence of BCC features across the cut, corresponding to two superficial BCCs and a morpheaform BCC. Conclusions This new procedure helped to improve the identification of proper margins for surgical excision in nonpigmented BCC with clinically and dermoscopically ill-defined margins. What's already known about this topic? • Mohs surgery is considered the most efficient technique for complete removal of basal cell carcinoma (BCC), but it is time consuming and expensive.

Life, Apr 5, 2023

Dermatology practical & conceptual, Apr 29, 2023

British Journal of Dermatology, Jun 23, 2019

Infantile hemangioma (IH) is the most common benign vascular tumor of infancy. IHs follow a typic... more Infantile hemangioma (IH) is the most common benign vascular tumor of infancy. IHs follow a typical course: they appear within few days to weeks after birth and usually grow rapidly during the first year of life, sometimes continuing up to 24 months. After a period of stabilization lasting few months, IHs undergo spontaneous involution. This usually occurs after several years. This article is protected by copyright. All rights reserved.

Journal of Tissue Viability, Feb 1, 2021

INTRODUCTION Nested graft is a surgical technique that allows to manage difficult-to-treat medica... more INTRODUCTION Nested graft is a surgical technique that allows to manage difficult-to-treat medical conditions such as chronic cutaneous ulcers, thanks to the high efficacy it has in reverting the fibroblasts senescence. Because of its peculiar regenerative property, nested graft is a surgical technique suitable also for the treatment of cutaneous ulcers developing on fibrotic scar tissue. CASE REPORT We reported the case of a 45-year-old man, drug-addict, with a large ulcer on the back of the right forearm in the context of scar fibrotic tissue. This lesion resulted from a previous heroin extravasation treated with a dermo-epidermal skin graft, that was accidentally scratched away by mechanical trauma. After several therapeutic failures with topical medications, we decided to treat the ulcer performing a skin graft using the nested graft technique. No adverse events were reported by the patient during or after the surgery. At the clinical evaluation performed three years later the wound was completely healed. CONCLUSIONS Nested graft represents a safe and easy-to-use technique that can be successfully used to treat ulcers on scar tissue, ensuring the achievement and the long-term maintenance of optimal resistance and aesthetic results.

Clinical and Experimental Dermatology, Jul 20, 2015

ABSTRACT Epidemiological and clinical data suggest that actinic damage to the skin is an importan... more ABSTRACT Epidemiological and clinical data suggest that actinic damage to the skin is an important predictor of skin carcinogenesis. To investigate the association of squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) with sun-damage alterations seen by histopathology. In the current prospective study, perilesional skin of SCC or BCC lesions was evaluated for presence of alterations associated with chronic photodamage. Presence of scarring, perineural/perivascular invasion, haemorrhage/haemorrhagic crust, ulceration/erosion and margin involvement were also assessed. Of 6038 included lesions, 4523 (74.9%) were BCCs and 1515 (25.1%) were SCCs. Presence of actinic damage was five times more frequent in SCC than in BCC (OR = 5.29, 95% CI 4.44-6.00, P < 0.001), and diagnosis of SCC was twice as common in photo-exposed than nonphoto-exposed body sites (OR = 2.34, 95% CI 2.03-2.70, P < 0.001). There were twofold higher odds for actinic damage in SCC compared with Bowen disease (OR = 2.015, 95% CI 1.55-2.61, P < 0.001). Assessing the different BCC histological subtypes, we found that nodular BCC had at least twofold higher odds (OR = 2.63, 95% CI 2.09-3.32), infiltrative BCC had 48% higher odds (OR = 1.487, 95% CI 1.18-1.87) and basosquamous BCC had fourfold higher odds (OR = 4.10, 95% CI 3.01-5.57) of having actinic damage compared with superficial BCC. Histological verification of ultraviolet-associated alterations in the perilesional skin in patients with NMSC in our study confirms the aetiopathogenic link between sun exposure and epithelial carcinogenesis on a histopathological basis. This correlation was stronger for SCCs than for BCCs. © 2015 British Association of Dermatologists.

Journal of The European Academy of Dermatology and Venereology, Sep 19, 2021

The long-term efficacy and safety of the IL-23 inhibitor risankizumab, has been demonstrated in c... more The long-term efficacy and safety of the IL-23 inhibitor risankizumab, has been demonstrated in clinical trials, and only in a few real-world studies. We recently reported an Italian multicentre 16-week real-life experience in 57 adult patients with moderate-to-severe psoriasis treated with risankizumab. Herein, we report an extension analysis of our study beyond 16 weeks, collecting data on effectiveness of risankizumab on psoriasis characteristics (PASI, PGA, DLQI, NRS itch, NRS pain) after 36 and 52 week treatment.