Luca Grimaldi - Academia.edu (original) (raw)
Papers by Luca Grimaldi
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2010
Figure 1 (a) Pink lesion on the neck. (b) Epiluminescence dermoscopy with polarized light showed ... more Figure 1 (a) Pink lesion on the neck. (b) Epiluminescence dermoscopy with polarized light showed an atypical vascular pattern (circles) and transverse lighter bands (arrows). The rarity of true amelanotic melanoma and its elusive features make this a challenging disease for all dermatologists. Dermoscopy is a noninvasive technique that can assist the clinician in diagnosing skin lesions. The use of dermoscopy for true amelanotic melanoma has not been fully validated yet because of the lack of studies that are based on large series of these rare tumours. A 24-year-old woman presented with an erythematous lesion on the neck that appeared about 12 months earlier. The lesion had been mistaken for ringworm and then for discoid lupus erythematosus and treated with antimycotics (isoconazole nitrate 1%) and topical steroids (diflucortolone valerate 0.1%), respectively, without clinical improvement. Dermatological examination showed a roundish, slightly raised, non desquamative, erythematous lesion with clear borders (Figure 1a). Epiluminescence dermoscopy with polarized light showed an atypical vascular pattern with milky red globules, pinpoint vessels (dotted vessels) and transverse lighter bands (Figure 1b). An excisional biopsy was therefore performed. Histological examination indicated amelanotic epithelioid-cell melanoma, Clark level III, Breslow thickness 0.7 mm, with evidence of regression and abundant periand intralesional lymphocytic infiltrate. The dermal component showed no evidence of maturation. Mitotic figures were present in dermal melanocytes (1/mm2), including mitoses identified in deep dermal melanocytes. Amelanotic melanoma may appear as erythematous, sometimes scaly, macules, nodules or plaques with irregular borders, simulating benign inflammatory plaques or other benign and/or malignant skin neoplasms. The differential diagnosis for ‘true’ amelanotic melanoma is extremely wide. It frequently simulates basal cell carcinoma, squamous cell carcinoma, actinic keratosis, Paget’s or Bowen’s disease and discoid lupus erythematosus. In its most insidious forms, it mimicks even vascular lesions, such as haemangioma and pyogenic granuloma. Our case report demonstrates the relevance of dermoscopy in the early diagnosis of true amelanotic melanoma. Compared to non polarized, polarized dermatoscopes (noncontact
Journal of Clinical Medicine
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
Diagnostics
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
Journal of Clinical Medicine
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
Acta Bio Medica : Atenei Parmensis, 2021
Background and aim: The Sars-Cov-2 virus is characterized by a being highly contagiousness, and t... more Background and aim: The Sars-Cov-2 virus is characterized by a being highly contagiousness, and this is the reason why massive use of personal protective equipment is required by medical and paramedical staff of the COVID-19 dedicated departments. The aim of this manuscript is to describe and share our experience in the prevention and treatment of the personal protective equipment related pressure sores and other skin alterations in the medical and paramedical staff. Methods: All healthcare workers with PPE-related skin damages were registered at time 0. Age, sex, profession, type of skin damage, diseases and possible drugs were registered. Results: Two strategies were employed: the first strategy was to immediately treat the skin and the second one was to prevent pressure wounds formation both in already affected healthcare workers and the recurrence in healed staff. Three weeks after the two strategies were used, the incidence rate PPE-related skin damage was reduced in a statisti...
Journal of Investigative Surgery, 2020
Acta bio-medica : Atenei Parmensis, Jan 16, 2018
Paralleling the growth of bariatric surgery, the demand for post-bariatric body-contouring surger... more Paralleling the growth of bariatric surgery, the demand for post-bariatric body-contouring surgery is increasing. Weight loss is the main cause, although not the only one, that drives patients to arm lift surgery. Several surgical techniques have been proposed over the years. Our aim was to consider the complications and outcomes according to the performed technique, through a wide review of the literature. A search on PubMed/Medline was performed using "brachioplasty", "upper arm lifting", and "techniques" as key words. Embase, Medline (OvidSP), Web of Science, Scopus, PubMed publisher, Cochrane, and Google Scholar were searched as well. As inclusion criteria, we selected the clinical studies describing techniques of brachioplasty. We excluded the papers in which complications related to brachioplasty were not specified. We also excluded literature-review articles. We found 27 studies from 1995 to 2015. Overall, 1065 patients were treated. Different te...
Acta bio-medica : Atenei Parmensis, Oct 23, 2017
The high incidence of venous leg ulcers and the difficult to give a complete healing involves in ... more The high incidence of venous leg ulcers and the difficult to give a complete healing involves in an increase of costs for National Health System. Main therapies to obtain a fast healing are compressive bandages, treatment of abnormal venous flow and in-situ-strategies of wound care. Negative pressure therapy does not conventionally used, because these systems not allow the use of compression bandages. Recently the development of ultraportable devices has improved the compliance and the results. Ten patients with venous chronic ulcer on the lower extremities were recruited for this study: all patients had venous leg ulcers from at least one year. We treated the patients with autologous partial thickness skin graft and subsequently we applied NANOVA device included in compressive bandage. We used NANOVA for fourteen days and after we made traditional medications. We submitted a questionnaire to evaluate the impact of dressing and NANOVA device in the quality of life of patients. The d...
Journal of the Siena Academy of Sciences, 2014
Squamous cell carcinoma is the second most common malignant tumor of skin. We present a case of a... more Squamous cell carcinoma is the second most common malignant tumor of skin. We present a case of a 67 years-old patient with a squamous cell carcinoma developing on a cutaneous lichen planus lesion, located on his right upper eyelid.
Journal of the Siena Academy of Sciences, 2014
Giant genital warts (GGW) represent a rare form of sexually transmitted disease caused by the hum... more Giant genital warts (GGW) represent a rare form of sexually transmitted disease caused by the human papillomavirus, arising more frequently in the vulvar and perianal regions as large exophytic cauliflower-like mass. Estimated rate of recurrence is 60 to 66%, while malignant transformation is possible and it has been reported in 30 to 56% of cases. A 45- years-old woman was admitted to our Structure of Plastic and Reconstructive Surgery, Siena, Italy with an extensive cauliflower- like masses diffused on vulvar and perianal region. The patient was treated in general anaesthesia, with a wide en bloc excision up to free clinical edges and immediate reconstruction of the vulvar continuity. Buschke Lowenstein tumour or giant genital warts is a sporadic tumour with an elevate local recurrence rate. In some cases, surgery can be very difficult and it must be associated to other strategies. An accurate follow-up is always necessary
Journal of Dermatological Treatment, 2004
Ingrowing toenails are a common problem causing significant morbidity. Many of the procedures use... more Ingrowing toenails are a common problem causing significant morbidity. Many of the procedures used for treating this painful condition cause considerable discomfort and have high failure rates. In recent years, phenol cauterization of the nail bed has been used increasingly. A retrospective study was carried out of all patients treated by this method in the authors' clinic during the period January 1996 to December 2001. In this study, phenol cauterization is the standard form of treatment and 948 phenol cauterizations were carried out in 764 patients. There was no significant morbidity and the procedure was tolerated well by all patients. Overall recurrence was 4.3% (33 patients) after 18 months. All symptomatic recurrences were successfully treated by repeating phenol cauterization. Phenol cauterization compares favourably with other surgical ablation techniques for ingrowing toenails and may be the ablation procedure of choice of an ingrowing toenail.
Plastic and Reconstructive Surgery, 2019
W e had the great pleasure of reading the interesting article entitled "Seasonal Impact on Surgic... more W e had the great pleasure of reading the interesting article entitled "Seasonal Impact on Surgical-Site Infections in Body Contouring Surgery: A Retrospective Cohort Study of 602 Patients over a Period of 6 Years" by Duscher et al. 1 Body contouring surgery has increased a lot in recent years, because of the increase in bariatric surgery. Unfortunately, there are many complications that occur in body contouring surgery. We would like to congratulate the authors for the research that relate an increased rate of surgical-site infection, which is one of the most frequent complications during the summer season after body contouring surgery. Body contouring operations, as the authors have clearly highlighted, are elective procedures; very careful preoperative planning would be required to reduce the risks and complications that may occur as a result of the surgery itself. Furthermore, in our experience, and as reported in the literature, smokers and those with a high body mass index and comorbid conditions such as diabetes are more at risk of postoperative complications. 2 In our experience, postoperative infections after body contouring surgery are severe complications, in both winter and summer months. Even in our cases, we found an increase in the rate of infections and wound
Wound Repair and Regeneration
The ultra-filtered fat graft placed on the wound bed and edges was effective in reducing pain in ... more The ultra-filtered fat graft placed on the wound bed and edges was effective in reducing pain in chronic wounds. The reduction of pain was statistically significant.
Journal of Clinical Medicine, 2021
The development of research in genetic and biochemical fields has made it possible to investigate... more The development of research in genetic and biochemical fields has made it possible to investigate certain metabolic aspects of the microenvironment of chronic skin lesions, including altered cell signalling, highlighting its importance in determining the blockage of repair processes. The purpose of this prospective observational study is to evaluate the efficacy of a medical device consisting of a polyester scaffold enriched with an oleic matrix with controlled release of ROS in the management of LABC skin lesions. During the period from October 2018 to March 2020, 20 patients with locally advanced breast cancer were enrolled and ten were treated with the devices abovementioned. After 30 days of treatment all patients treated reported a general improvement in local conditions with reduction in ulceration area, exudate and odour. The results suggest that the application of these devices even in particular conditions (healthy and neoplastic tissue) does not lead to the onset of negati...
Journal of Plastic, Reconstructive & Aesthetic Surgery, 2010
Figure 1 (a) Pink lesion on the neck. (b) Epiluminescence dermoscopy with polarized light showed ... more Figure 1 (a) Pink lesion on the neck. (b) Epiluminescence dermoscopy with polarized light showed an atypical vascular pattern (circles) and transverse lighter bands (arrows). The rarity of true amelanotic melanoma and its elusive features make this a challenging disease for all dermatologists. Dermoscopy is a noninvasive technique that can assist the clinician in diagnosing skin lesions. The use of dermoscopy for true amelanotic melanoma has not been fully validated yet because of the lack of studies that are based on large series of these rare tumours. A 24-year-old woman presented with an erythematous lesion on the neck that appeared about 12 months earlier. The lesion had been mistaken for ringworm and then for discoid lupus erythematosus and treated with antimycotics (isoconazole nitrate 1%) and topical steroids (diflucortolone valerate 0.1%), respectively, without clinical improvement. Dermatological examination showed a roundish, slightly raised, non desquamative, erythematous lesion with clear borders (Figure 1a). Epiluminescence dermoscopy with polarized light showed an atypical vascular pattern with milky red globules, pinpoint vessels (dotted vessels) and transverse lighter bands (Figure 1b). An excisional biopsy was therefore performed. Histological examination indicated amelanotic epithelioid-cell melanoma, Clark level III, Breslow thickness 0.7 mm, with evidence of regression and abundant periand intralesional lymphocytic infiltrate. The dermal component showed no evidence of maturation. Mitotic figures were present in dermal melanocytes (1/mm2), including mitoses identified in deep dermal melanocytes. Amelanotic melanoma may appear as erythematous, sometimes scaly, macules, nodules or plaques with irregular borders, simulating benign inflammatory plaques or other benign and/or malignant skin neoplasms. The differential diagnosis for ‘true’ amelanotic melanoma is extremely wide. It frequently simulates basal cell carcinoma, squamous cell carcinoma, actinic keratosis, Paget’s or Bowen’s disease and discoid lupus erythematosus. In its most insidious forms, it mimicks even vascular lesions, such as haemangioma and pyogenic granuloma. Our case report demonstrates the relevance of dermoscopy in the early diagnosis of true amelanotic melanoma. Compared to non polarized, polarized dermatoscopes (noncontact
Journal of Clinical Medicine
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
Diagnostics
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
Journal of Clinical Medicine
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
Acta Bio Medica : Atenei Parmensis, 2021
Background and aim: The Sars-Cov-2 virus is characterized by a being highly contagiousness, and t... more Background and aim: The Sars-Cov-2 virus is characterized by a being highly contagiousness, and this is the reason why massive use of personal protective equipment is required by medical and paramedical staff of the COVID-19 dedicated departments. The aim of this manuscript is to describe and share our experience in the prevention and treatment of the personal protective equipment related pressure sores and other skin alterations in the medical and paramedical staff. Methods: All healthcare workers with PPE-related skin damages were registered at time 0. Age, sex, profession, type of skin damage, diseases and possible drugs were registered. Results: Two strategies were employed: the first strategy was to immediately treat the skin and the second one was to prevent pressure wounds formation both in already affected healthcare workers and the recurrence in healed staff. Three weeks after the two strategies were used, the incidence rate PPE-related skin damage was reduced in a statisti...
Journal of Investigative Surgery, 2020
Acta bio-medica : Atenei Parmensis, Jan 16, 2018
Paralleling the growth of bariatric surgery, the demand for post-bariatric body-contouring surger... more Paralleling the growth of bariatric surgery, the demand for post-bariatric body-contouring surgery is increasing. Weight loss is the main cause, although not the only one, that drives patients to arm lift surgery. Several surgical techniques have been proposed over the years. Our aim was to consider the complications and outcomes according to the performed technique, through a wide review of the literature. A search on PubMed/Medline was performed using "brachioplasty", "upper arm lifting", and "techniques" as key words. Embase, Medline (OvidSP), Web of Science, Scopus, PubMed publisher, Cochrane, and Google Scholar were searched as well. As inclusion criteria, we selected the clinical studies describing techniques of brachioplasty. We excluded the papers in which complications related to brachioplasty were not specified. We also excluded literature-review articles. We found 27 studies from 1995 to 2015. Overall, 1065 patients were treated. Different te...
Acta bio-medica : Atenei Parmensis, Oct 23, 2017
The high incidence of venous leg ulcers and the difficult to give a complete healing involves in ... more The high incidence of venous leg ulcers and the difficult to give a complete healing involves in an increase of costs for National Health System. Main therapies to obtain a fast healing are compressive bandages, treatment of abnormal venous flow and in-situ-strategies of wound care. Negative pressure therapy does not conventionally used, because these systems not allow the use of compression bandages. Recently the development of ultraportable devices has improved the compliance and the results. Ten patients with venous chronic ulcer on the lower extremities were recruited for this study: all patients had venous leg ulcers from at least one year. We treated the patients with autologous partial thickness skin graft and subsequently we applied NANOVA device included in compressive bandage. We used NANOVA for fourteen days and after we made traditional medications. We submitted a questionnaire to evaluate the impact of dressing and NANOVA device in the quality of life of patients. The d...
Journal of the Siena Academy of Sciences, 2014
Squamous cell carcinoma is the second most common malignant tumor of skin. We present a case of a... more Squamous cell carcinoma is the second most common malignant tumor of skin. We present a case of a 67 years-old patient with a squamous cell carcinoma developing on a cutaneous lichen planus lesion, located on his right upper eyelid.
Journal of the Siena Academy of Sciences, 2014
Giant genital warts (GGW) represent a rare form of sexually transmitted disease caused by the hum... more Giant genital warts (GGW) represent a rare form of sexually transmitted disease caused by the human papillomavirus, arising more frequently in the vulvar and perianal regions as large exophytic cauliflower-like mass. Estimated rate of recurrence is 60 to 66%, while malignant transformation is possible and it has been reported in 30 to 56% of cases. A 45- years-old woman was admitted to our Structure of Plastic and Reconstructive Surgery, Siena, Italy with an extensive cauliflower- like masses diffused on vulvar and perianal region. The patient was treated in general anaesthesia, with a wide en bloc excision up to free clinical edges and immediate reconstruction of the vulvar continuity. Buschke Lowenstein tumour or giant genital warts is a sporadic tumour with an elevate local recurrence rate. In some cases, surgery can be very difficult and it must be associated to other strategies. An accurate follow-up is always necessary
Journal of Dermatological Treatment, 2004
Ingrowing toenails are a common problem causing significant morbidity. Many of the procedures use... more Ingrowing toenails are a common problem causing significant morbidity. Many of the procedures used for treating this painful condition cause considerable discomfort and have high failure rates. In recent years, phenol cauterization of the nail bed has been used increasingly. A retrospective study was carried out of all patients treated by this method in the authors' clinic during the period January 1996 to December 2001. In this study, phenol cauterization is the standard form of treatment and 948 phenol cauterizations were carried out in 764 patients. There was no significant morbidity and the procedure was tolerated well by all patients. Overall recurrence was 4.3% (33 patients) after 18 months. All symptomatic recurrences were successfully treated by repeating phenol cauterization. Phenol cauterization compares favourably with other surgical ablation techniques for ingrowing toenails and may be the ablation procedure of choice of an ingrowing toenail.
Plastic and Reconstructive Surgery, 2019
W e had the great pleasure of reading the interesting article entitled "Seasonal Impact on Surgic... more W e had the great pleasure of reading the interesting article entitled "Seasonal Impact on Surgical-Site Infections in Body Contouring Surgery: A Retrospective Cohort Study of 602 Patients over a Period of 6 Years" by Duscher et al. 1 Body contouring surgery has increased a lot in recent years, because of the increase in bariatric surgery. Unfortunately, there are many complications that occur in body contouring surgery. We would like to congratulate the authors for the research that relate an increased rate of surgical-site infection, which is one of the most frequent complications during the summer season after body contouring surgery. Body contouring operations, as the authors have clearly highlighted, are elective procedures; very careful preoperative planning would be required to reduce the risks and complications that may occur as a result of the surgery itself. Furthermore, in our experience, and as reported in the literature, smokers and those with a high body mass index and comorbid conditions such as diabetes are more at risk of postoperative complications. 2 In our experience, postoperative infections after body contouring surgery are severe complications, in both winter and summer months. Even in our cases, we found an increase in the rate of infections and wound
Wound Repair and Regeneration
The ultra-filtered fat graft placed on the wound bed and edges was effective in reducing pain in ... more The ultra-filtered fat graft placed on the wound bed and edges was effective in reducing pain in chronic wounds. The reduction of pain was statistically significant.
Journal of Clinical Medicine, 2021
The development of research in genetic and biochemical fields has made it possible to investigate... more The development of research in genetic and biochemical fields has made it possible to investigate certain metabolic aspects of the microenvironment of chronic skin lesions, including altered cell signalling, highlighting its importance in determining the blockage of repair processes. The purpose of this prospective observational study is to evaluate the efficacy of a medical device consisting of a polyester scaffold enriched with an oleic matrix with controlled release of ROS in the management of LABC skin lesions. During the period from October 2018 to March 2020, 20 patients with locally advanced breast cancer were enrolled and ten were treated with the devices abovementioned. After 30 days of treatment all patients treated reported a general improvement in local conditions with reduction in ulceration area, exudate and odour. The results suggest that the application of these devices even in particular conditions (healthy and neoplastic tissue) does not lead to the onset of negati...