Tildrakizumab in moderate-to-severe plaque psoriasis: A multicenter, retrospective, real-life study.

New biologic agents targeting interleukin (IL)23/T-helper17 axis, such as tildrakizumab, have been developed for the treatment of plaque psoriasis. To analyze the efficacy and safety of tildrakizumab in a real life setting of patients affected by moderate-to-severe psoriasis over a 28-week treatment period. A multicentric retrospective study was conducted in patients who initiated tildrakizumab between February 2020 and March 2021. Psoriasis Area and Severity Index-PASI was measured at baseline and after 4, 16 and 28 weeks. The percentage change in PASI value from baseline to the considered time-points, proportion of patients with absolute PASI <3 at week 28 and the percentages of achieving a PASI75 or PASI90 response were assessed. Data about potential safety issues and adverse events (AEs) were collected. Statistical analysis were performed for establish clinical efficacy and for variables predicting clinical response. Fifty nine patients with psoriasis were included. Overall mean PASI percentage reduction was of 88% from baseline to week 28 and 47 out of 59 patients (79.7%) at week 28 had an absolute PASI <3. PASI75 and PASI90 responses at week 28 were achieved by 48 (81.40%) patients and 38 (64.4.0%) patients, respectively. No substantial associations between gender, body mass index - BMI, PASI at baseline and prior exposition to biological therapies and the efficacy endpoints were retrieved. No serious safety issues or discontinuations related to adverse events were reported. In our real-life study, tildrakizumab showed high efficacy and a favorable safety profile, regardless of patient- and disease-related factors.

Maculopapular sarcoidosis: the importance of skin signs.

Sarcoidosis is a multisystem disease that affects the skin in 20 to 30% of cases. Skin findings are often the initial presenting signs, and cutaneous sarcoidosis may appear with a wide variety of lesions; it is often considered an imitator of many other skin diseases. Clinical appearance and specific dermoscopic criteria, confirmed by a typical pathology, may guide to the correct diagnosis. We report the case of a man affected by maculo-papular sarcoidosis on the back, in which the detection of cutaneous lesions was the initial step to determine the systemic nature of the disease.

Systemic Photoprotection in Melanoma and Non-Melanoma Skin Cancer.

Non-melanoma skin cancers (NMSCs), which include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and actinic keratosis (AK), are the most common cancer diseases in the Caucasian race. If diagnosed late and improperly treated, BCC and SCC can become locally advanced and metastasize. Malignant melanoma (MM) is less frequent but more lethal than NMSC. Given the individual and social burdens of skin cancers, performing an adequate prevention is needed. Ultraviolet (UV) ray exposure is one of the main risk factors for skin cancer. Thus, the first-choice prevention strategy is represented by photoprotection that can be both topical and systemic. The latter consists of the oral administration of molecules which protect human skin against the damaging effects of UV rays, acting through antioxidant, anti-inflammatory, or immunomodulator mechanisms. Although several compounds are commonly used for photoprotection, only a few molecules have demonstrated their effectiveness in clinical trials and have been included in international guidelines for NMSC prevention (i.e., nicotinamide and retinoids). Moreover, none of them have been demonstrated as able to prevent MM. Clinical and preclinical data regarding the most common compounds used for systemic photoprotection are reported in this review, with a focus on the main mechanisms involved in their photoprotective properties.

Mobile applications in otolaryngology for patients: An update.

OBJECTIVE: Recently smartphones and tablets have spread in developed countries, and healthcare-related apps are growing incredibly in different specialties. The aim of this study is to provide an up-to-date review of the current OtoHNS (otolaryngology-head and neck surgery) apps developed for patients. METHODS: This mobile applications review was conducted in September 2017. Relevant apps about OtoHNS were searched in the Apple Store and in the Google Play using various keywords. We included helpful apps for OtoHNS patients. Apps for medical students, physician (95 apps) and non-English apps (6 apps) were excluded. RESULTS: At the end of our selection process, 216 apps have been included for mobile applications review. The number of apps published per year in OtoHNS has increased each year. The most common apps were about hearing, in particular 63 of 216 (29%) were hearing test; 75 of 216 (35%) for tinnitus treatment; 10 of 216 (5%) for sounds measurement around the patients; and 7 of 216 (3%) to treat vertigo. One hundred thirty-seven of 216 (63%) apps were free of charge. Physicians were clearly involved in the app's development in only 73 of 216 (34%) apps. One hundred sixty-three of 216 (75%) had no user ratings. CONCLUSIONS: Apps are increasingly and easily accessible, although their use in clinical practice is not yet totally accepted. Our review showed that most apps have been created with no guidance from otolaryngologist. Further steps are needed to regulate apps' development. Hoping an "App Board," such as editorial board for scientific journal, to assess app quality, validity, and effectiveness before they can be fully incorporated into clinical practice and medical education. LEVEL OF EVIDENCE: N/A.