Secukinumab in multi-failure psoriatic patients: the last hope?

Psoriasis is a multi-systemic chronic inflammatory disease that affects about 1.5-3% of the general population, of which almost 20% suffer from a moderate-severe form. Those patients can be treated with a systemic agent and in case of scarce response or contraindications, they may require a biologic therapy, such as tumor necrosis factor or interleukin-12/23 inhibitors. When also these agents fail, clinicians face a true therapeutic challenge. We report a case series of multi-failure 16 patients, successfully treated with secukinumab, a human monoclonal antibody that selectively neutralizes interleukin-17 A and is recently approved for the treatment of plaque psoriasis, psoriatic arthritis, and ankylosing spondylitis.

Aplasia cutis congenita in surviving co-twins: four unrelated cases.

Four unrelated patients born from twin pregnancies and showing extracranial aplasia cutis congenita are reported. All the patients lost their co-twins during the first half of the pregnancy. Two of the patients had the characteristic truncal and symmetrical type of aplasia cutis associated with fetus papyraceus and placental abnormalities. The presence of multiple hepatic hematomas in one of them gives further credit to a "vascular disruption" as the possible pathogenetic mechanism of the disorder. The two other patients were born with symmetrical aplasia cutis at the extensory aspects of both knees, which presumably represents a milder expression of the former defect. Thus the so-called aplasia cutis with fetus papyraceus shows heterogeneity in localization, extension, presence of extracutaneous abnormalities, and possible association with fetus papyraceus at birth. To include all the patients affected by this peculiar type of aplasia cutis congenita, the designation of aplasia cutis with extracranial symmetrical involvement is proposed.

Bath-photo-therapy with the thermal water of Comano: treatment of psoriasis.

Association between baths with the thermal water of Comano Springs and selective photo-therapy UVB (bath-photo-therapy) has proved to be effective in 94% of psoriatic patients with non-extensive disease. Therefore bath-photo therapy represents a valid alternative to traditional topical treatments and can be used as a adjuvant in the interval periods of the aggressive modern therapy.

Epidemiology of psoriasis: case-control study in the province of Trentino (preliminary reports).

In the province of Trento a case-control study on the main environmental risk factors for psoriasis has been performed. No correlation has been demonstrated between the investigated factors and psoriasis, with the exception of familial predisposition.

Risk factors for cutaneous malignant melanoma in a northern Italian population.

The relationship between cutaneous malignant melanoma (CMM) and the colour of skin, hair and eyes, the extent of sun exposure and reaction to it, education, and the occurrence of skin neoplasms in patients and their families was evaluated in a case-control study of 103 cases of CMM and 205 control subjects hospitalized for acute conditions other than malignant or hormonal disease. A significantly higher risk was associated with fair skin as compared to dark/medium skin (RR = 4.0; 95% CI: 1.5-10.5) and positive family history for CMM (RR = 8.1; 95% CI: 1.0-200.9). CMM seemed to occur more frequently, but not significantly so, in individuals with brown or blond hair, higher education and clinically diagnosed dysplastic naevi. Outdoor occupation and heavy sun exposure in the last 20 years seemed to increase the risk of CMM in sun-exposed sites but to be negatively associated with CMM in normally unexposed sites.

[Clinico-statistical study on hydropinic and balneothermal therapy of psoriatic patients using the low mineral-content waters of the Comano springs]. / Indagine clinico-statistica sulla terapia idropinica e balneotermale con acqua oligominerale delle Terme di Comano in soggetti affetti da psoriasi.

The authors report the results obtained treating 39 subjects affected from psoriasis with hydropinic therapy and thermal balneo-therapy, using the thermal water of Comano. At the end of the treatment the results were rather bad with an inclusive reduction of 8.5% of the lesions as regards the initial data, but after 3-6 months an average per cent reduction of the lesions about 50% and in some cases quite a total regression of the psoriasis has been noted. No kind of collateral effects has been noted.