Chiara Retrosi
@units.it
Dermatology Clinic
University of Trieste, Maggiore Hospital, Trieste, Italy
Scopus Publications
Scopus Publications
Claudio Conforti, Chiara Retrosi, Marina Agozzino, Caterina Dianzani, Ermanno Nardon, Anselmo Oliveri, Eros Azzalini, Stefania Guida, Giovanni Pellacani, Giovanni Di Lella,et al.
MDPI AG
This comprehensive study delves into the intricate landscape surrounding the role of human papillomavirus (HPV) in extragenital keratinocyte skin tumors, specifically exploring Bowen’s disease (BD) and in situ squamous-cell carcinoma (iSCC). Through a multifaceted examination, this research study elucidates the nuanced interplay of HPV, gender dynamics, anatomical site variations, and potential implications for the etiopathogenesis of these malignancies.
Chiara Retrosi, Andrea Diociaiuti, Cristiana De Ranieri, Marialuisa Corbeddu, Claudia Carnevale, Simona Giancristoforo, Maria Rosaria Marchili, Guglielmo Salvatori, Marta Luisa Ciofi degli Atti, May El Hachem,et al.
Springer Science and Business Media LLC
Abstract Background Epidermolysis bullosa (EB) is a disabling and chronic genodermatosis characterized by mucocutaneous fragility with blister formation after minimal trauma. Severity ranges between very mild forms to extremely severe or lethal subtypes. Depending on disease subtypes, blisters may be localized also in larynx, bladder, esophagus, and most frequent disease complications are malnutrition, chronic anemia, osteoporosis, limb contracture and early development of squamous cell carcinomas. EB is classified into four major groups: EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB) and Kindler EB (KEB). No specific treatment is available; however, a multidisciplinary management is mandatory in order to treat the lesions, to prevent complication, and to give a psychological support to the patient and family members. Objective To report the experience on a therapeutic education plan of an Italian reference center for epidermolysis bullosa in the last 30 years. Methods In our study we included all patients with EB from 1990 to the present, dividing them into three age groups (< 5 years, > 5–12 years and > 12–18 years). The therapeutic plan involved all multidisciplinary team members, since born until adolescence. The multidisciplinary team has been progressively established; the dermatologists act as patient case manager, in collaboration with the pediatrician, endocrinologist, dietician, dentist, plastic surgeon, digestive surgeon, geneticist, psychologist and a dedicated nurse. Other dedicated specialists are involved upon patient needs. Results Two hundred fifteen patients have been recruited and followed in our hospital since 1990. One hundred forty patients (65%) are on follow-up, 27 patients (13%) died and only 11 (5%) were lost to follow-up. Our patients manifested the specific complications related to their EB subtype in keeping with the data reported in the literature. Eighteen (8%) patients affected with JEB severe died within the first year of life, 9 patients (5%) died for squamous cell carcinoma in adulthood and were affected with recessive DEB; only 1 patient died for squamous cell carcinoma at the age of 16. Conclusions An adequate management of EB patients require a multidisciplinary approach with an educational plan to guarantee an appropriate treatment and to support and accompany patients and their families since birth along life. The dynamic educational plan adopted in our hospital showed good clinical and psychological outcome in our population, allowing adherence to treatment, reducing the frequency of complications and improving life expectancy and quality of life.
C. Carnevale, A. Diociaiuti, C. Retrosi, G. Gualdi, A. Fabiano, A. Stracuzzi, and M. El Hachem
Wiley
Nicola DI MEO, Claudio CONFORTI, Roberta VEZZONI, Chiara RETROSI, Michela LONGONE, Mattia FADEL, and Iris ZALAUDEK
Edizioni Minerva Medica
Chiara RETROSI, Claudio CONFORTI, Roberta VEZZONI, Paola CORNELI, Iris ZALAUDEK, Giovanni MAGATON RIZZI, and Nicola DI MEO
Edizioni Minerva Medica
Claudio CONFORTI, Chiara RETROSI, Roberta VEZZONI, Paola CORNELI, Vincenzo PICCOLO, Roberta GIUFFRIDA, Nicola DI MEO, and Iris ZALAUDEK
Edizioni Minerva Medica
Nicola DI MEO, Paola CORNELI, Silvia VICHI, Mattia FADEL, Chiara RETROSI, and Iris ZALAUDEK
Edizioni Minerva Medica
Roberta Vezzoni, Ludovica Toffoli, Claudio Conforti, Arianna Dri, Chiara Retrosi, Nicola di Meo, Giovanni Magaton Rizzi, Diego Signoretto, and Iris Zalaudek
S. Karger AG
Neoplastic alopecia (NA) is defined as an organized hair loss in single or multiple areas of the scalp caused by a primary tumor that has metastasized to the skin of the scalp. Due to its localization and clinical appearance, NA should be placed in differential diagnosis with alopecia areata or other entities. To date, pathognomonic dermoscopic criteria of NA have not yet been described: the absence of classical criteria of other scalp diseases in addition to a major neovascularization with on-focus arborizing vessels and erosions or ulcerations may help the clinician to suspect a diagnosis of secondary alopecia. Dermatologists should pay more attention to these rare forms of secondarism because in exceptional cases, a simple alopecia of the scalp can hide a new, relapsing or metastatic neoplasia.
Roberta Rotunno, Andrea Diociaiuti, Maria Lisa Dentici, Martina Rinelli, Michele Callea, Chiara Retrosi, Giovanna Zambruno, Emanuele Bellacchio, and May El Hachem
MDPI AG
Ectodermal dysplasia-syndactyly syndrome 1 (EDSS1) is characterized by cutaneous syndactyly of the toes and fingers and abnormalities of the hair and teeth, variably associated with nail dystrophy and palmoplantar keratoderma (PPK). EDSS1 is caused by biallelic mutations in the NECTIN4 gene, encoding the adherens junction component nectin-4. Nine EDSS1 cases have been described to date. We report a 5.5-year-old female child affected with EDSS1 due to the novel homozygous frameshift mutation c.1150delC (p.Gln384ArgfsTer7) in the NECTIN4 gene. The patient presents brittle scalp hair, sparse eyebrows and eyelashes, widely spaced conical teeth and dental agenesis, as well as toenail dystrophy and mild PPK. She has minimal proximal syndactyly limited to toes 2–3, which makes the phenotype of our patient peculiar as the overt involvement of both fingers and toes is typical of EDSS1. All previously described mutations are located in the nectin-4 extracellular portion, whereas p.Gln384ArgfsTer7 occurs within the cytoplasmic domain of the protein. This mutation is predicted to affect the interaction with afadin, suggesting that impaired afadin activation is sufficient to determine EDSS1. Our case, which represents the first report of a NECTIN4 mutation with toe-only minimal syndactyly, expands the phenotypic and molecular spectrum of EDSS1.
Eleonora FARINAZZO, Roberta GIUFFRIDA, Caterina DIANZANI, Roberta VEZZONI, Chiara RETROSI, Iris ZALAUDEK, and Claudio CONFORTI
Edizioni Minerva Medica
Inflammatory response in the skin is important for host defence against a broad spectrum of insults including microorganisms, chemicals, radiation and physical trauma. When the inflammatory process becomes prolonged and self-perpetuating, illness occurs. In this review, we discuss recent findings regarding the complex inflammatory mechanisms in allergic contact dermatitis, atopic dermatitis and psoriasis.
Claudio Conforti, Damiano Currado, Luca Navarini, Chiara Retrosi, Roberta Giuffrida, Enrico Zelin, Antonella Afeltra, Nicola di Meo, Caterina Dianzani, and Iris Zalaudek
Wiley
Dear Editor, Psoriasis (PsO) is a frequent immune-mediated disease with cutaneous manifestations and there is increasing evidence that PsO is related to higher risk of cardiovascular (CV) events, probably due to elevated prevalence of traditional CV risk factors in psoriatic patients, potential adverse effects of drugs, such as corticosteroids, and chronic inflammation. Many CV risk algorithms have been designed over time and it was recently demonstrated that they tend to underestimate CV burden in patients with psoriatic arthritis, thus highlighting that psoriatic disease could have a greater impact than previously supposed. For this reason, CV risk assessment in patients suffering from PsO is essential to improve preventive strategies, encourage lifestyle changes and introduce pharmacological treatments, if needed. With the aim to evaluate baseline clinical and serological variables in psoriatic patients with and without CV events during a 10-year follow-up period and to compare CV risk in patients with moderate and severe PsO (Psoriasis Area Surface Index [PASI] <10% and ≥10%, respectively), we retrospectively evaluated a cohort of psoriatic patients in Trieste (Italy) from December 2009 to December 2019 according to seven different algorithms. The 10-year general Framingham Risk Score (FRS) for CVD, QRISK2, QRISK3, CUORE, Reynold's Risk Score (RRS), ASSIGN and SCORE was calculated using already published algorithms. Data from 43 patients (430 patient-years) were analyzed; main demographic and clinical characteristics of the study population are reported in Table 1. The patient population was Caucasian (100%), with a large preponderance of males (69.67%), with a median age at baseline of 52 (39-60) years. Disease duration was 255 (60-426) months. There were significant differences in some variables between PsO patients with and without CV event during 10 years. In this study, among the traditional CV risk factors, the two groups of patients (with and without CV event) differed in age (P = .01), family history of CV diseases (P = .005), smoke (P = .007), total cholesterol (P = .006), systolic blood pressure (P = .004) and prevalence of antihypertensive treatment, weight (P = .002), C-reactive protein (P = .008), erythrocyte sedimentation rate (P = .001) and PASI measured at baseline (P = .003). Therefore, focusing on probable PASI burden on CV event, we divided our patient population into mild (PASI > 3%), moderate (3% < PASI < 10) and severe PsO (PASI ≥ 10). In particular, we found a significant difference in all the algorithms for calculating CV risk between patients affected by mild PsO compared with patients with moderate-to-severe PsO; P-values of .0001, .0008, .0002, .001, .002, .002 and .001 for SCORE, CUORE, FRS, RRS, QRISK2, QRISK3 and ASSIGN, respectively, were found (Table 2). This study confirmed that severe PsO (PASI ≥ 10%) is associated with a worst outcome, with an increased probability of lethal and nonlethal CV events, in accordance with seven different algorithms. A “dose-effect” relationship is recognizable, being higher PASI associated with higher CV morbidity. Interestingly, the assessed risk could be even underestimated, as this was already demonstrated in patients with psoriatic arthritis, whose outcomes are worse than predicted by algorithms. As far as concerns regarding clinical management, each psoriatic patient should be screened for CV risk, receive correct counseling to promote a healthy lifestyle and begin adequate preventive treatment if necessary (adopting antihypertensive and lipid-lowering therapy, hypocaloric and hypoglycemic diet, etc.). Our study confirmed that, besides traditional risk factors, PASI is a very important index to predict 10-year CV morbidity and mortality in psoriatic patients. Further prospective studies with larger population and long-term follow-up are needed to confirm our results and to better predict CV risk in psoriatic patients. Moreover, additional researches are needed to understand if biologic therapies could be useful in this setting and effective in lowering CV risk together with adequate prevention.
Paola Corneli, Nicola Meo, Serena Fagotti, Claudio Conforti, Eleonora Farinazzo, Alberto Zacchi, Chiara Retrosi, Roberta Vezzoni, Maria A. Pizzichetta, and Iris Zalaudek
Wiley
[This corrects the article DOI: 10.5826/dpc.1002a28.].
Claudio Conforti, Nicola di Meo, Roberta Giuffrida, Chiara Retrosi, Roberta Vezzoni, Paolo Romita, Rossana Bussani, and Iris Zalaudek
Wiley
Dear Editor, Acute generalized exanthematous pustulosis (AGEP) is a severe skin reaction that is typically triggered by infectious diseases or drugs. The diagnosis is clinical and it is characterized by the presence of numerous nonfollicular pustules that are located on the face and/or body. It manifests itself in an acute way, resolving itself in about 15 days during which the clinical conditions of the patient can be poor. Herein we describe the case of an otherwise healthy 47-year-old man which on February 2019 came to our dermatology department for the presence of a widespread erythematous-papular rash. He had a history of atrial fibrillation for about 3 years in treatment with flecainide 100 mg and bisoprolol 3.5 mg. Because of the refractoriness to flecainide therapy, treatment with propafenone (antiarrhythmic drug class IC used for atrial fibrillation and other types of arrhythmia) was started on January 2019. After 10 days of therapy, the patient developed vesicular-papular lesions in the context of a suberythrodermic skin appearance; for this reason, he was hospitalized. On clinical examination, multiple confluent papules with erythematous background and vesicles-pustules were observed, mainly located on the trunk, limbs, and face (Figure 1A-C). There was no mucosal involvement and the clinical conditions were poor, with fatigue and fever (38.7 C). Blood tests carried out at hospitalization showed mild neutrophilia and eosinophilia, a considerable increase in the C reactive protein (= 92.3 mg/dL) with negativity of skin swabs to bacteria or fungi. Polymerase chain reaction and serological test for chickenpox, rubella, herpes virus, cytomegalovirus, HIV, and syphilis were all negative. The dermatoscopic examination performed with DermLite 3Gen (polarized, 20X) showed dotted vessels on an erythematous background associated with yellowish crust, compatible with an
Claudio Conforti, Iris Zalaudek, Roberta Vezzoni, Chiara Retrosi, Annatonia Fai, Sara Fadda, Eleonora Di Michele, and Caterina Dianzani
Edizioni Minerva Medica
The skin is a dynamic organ that continuously eliminates an infinite number of keratinized cells through physological mechanism. Chemical peeling is a widely used cosmetic procedure in medical practice. This technique consists of the application of one or more chemical ablative agents to the skin's surface in order to induce keratolysis or keratocoagulation. Exfoliation is followed by skin and epidermal regeneration from the adjacent epithelium and skin adnexa. Moreover, through an inflammatory reaction and the activation of the inflammation mediators, an increase in fibroblastic synthesis and in the production of new collagen and glycosaminoglycan fibres is induced. After the first treatment session, the appearance and the texture of the skin are significantly improved. Peeling agents may be divided into superficial (epidermis-papillary dermis), medium-depth (papillary to upper reticular dermis) and deep subtypes based on the depth of their penetration (mid-reticular dermis).1 Superficial peel is mainly used for dyschromia, acne, post- inflammatory hyperpigmentation, melasma and actinic keratosis. Medium depth peel mainly treats solar keratosis or lentigines, pigmentary disorders and superficial scars. Skin photo-ageing, deep scars or wrinkles and precancerous skin lesions require a deep chemical peeling. The aim of this article is to review recent advances in chemical peel of melasma and acne.
Claudio Conforti, Roberta Giuffrida, Nicola Di Meo, Michela Longone, Silvia Vichi, Claudia Colli, Teresa Deinlein, Roberta Vezzoni, Chiara Retrosi, Enzo Errichetti,et al.
Wiley
The male genitalia are a common site of dermatoses. Patients with penile diseases often delay or avoid medical care due to anxiety and embarrassment. In this narrative review, we describe some of the main benign dermatoses localized to male genital, focusing on their epidemiology, clinical and dermoscopic features, as well as available therapies.
Claudio Conforti, Chiara Retrosi, Roberta Giuffrida, Roberta Vezzoni, Damiano Currado, Luca Navarini, Eleonora Farinazzo, Carmen Dell'Aquila, Katiuscia Nan, Nicola Di Meo,et al.
Wiley
Dear Editor, Drug-induced lupus erythematosus (DILE) is a well-known entity first described as an adverse effect of hydrochlorothiazide, terbinafine, and TNF-alfa inhibitors. Among the possible drugs associated with DILE, recently an association with IL-17 inhibitors has been reported, highlighting new and little-known side effects of biological therapies. We present a case of a 62-year-old man with a history of plaque psoriasis, previously treated with methotrexate, acitretin and antiTNF-alfa, switched on treatment with secukinumab 300 mg due to a loss of efficacy of other drugs. After the fourth dose at week 4, he developed a generalized itchy rash with multiple scaly erythematous plaques localized on his trunk, neck, and back; in addition, a widespread desquamation associated with severe blepharitis and mild ectropium, not present at the beginning of therapy, was observed on the face (Figure 1A,B). Lesions were first interpreted as an early onset of erythrodermic psoriasis; photosensitive dermatitis and drug reaction were also considered in the differential diagnosis. The dermoscopic examination (DermLite3G, 20×) showed telangiectatic vessels, with erythematous background, some yellowish areas and minimal desquamation, contrary to classical dermoscopic psoriatic criteria (Figure 1C). Therefore, either a severe seborrheic dermatitis or a subacute lupus was considered in differential diagnosis. Two punch biopsies of 4 mm on two patches of the back, skin swab, and microbiological research of fungi were performed, with blood tests analysis and complete study of autoimmunity. Results showed positivity of antinuclear
Roberta Vezzoni, Claudio Conforti, Silvia Vichi, Roberta Giuffrida, Chiara Retrosi, Giovanni Magaton-Rizzi, Nicola Di Meo, Maria Antonietta Pizzichetta, and Iris Zalaudek
International Dermoscopy Society
The association of melanoma with a preexisting nevus is still a debated subject. Histopathological data support an associated nevus in approximately 30% of all excised melanomas. The annual risk of an individual melanocytic nevus becoming malignant is extremely low and has been estimated to be approximately 0.0005% (or less than 1 in 200,000) before the age of 40 years, to 0.003% (1 in 33,000) in patients older than 60 years. Current understanding, based on the noticeable, small, truly congenital nevi and nevi acquired early in life, is that the first develops before puberty, presents with a dermoscopic globular pattern, and persists for the lifetime, becoming later a dermal nevus in the adult. In contrast, acquired melanocytic nevi develop mostly at puberty and usually undergo spontaneous involution after the fifth decade of life. The purpose of this review is to analyze the data of the literature and to propose, on the basis of epidemiological and clinical-dermoscopic characteristics, a new model of melanogenesis of nevus-associated melanoma.
Claudio Conforti, Roberta Vezzoni, Chiara Retrosi, Michela Longone, Paola Corneli, Giovanni Magaton Rizzi, Katiuscia Nan, Nicola Di Meo, and Iris Zalaudek
Edizioni Minerva Medica
Lyme disease is a tick-borne illness, which is tipically caused by Borrelia Burgdoferi. Over time, a typical Borreliosis skin reaction takes shape, i.e. the formation of an annular erythema that tends to expand centrifugally with erythematous edges whose diameter can reach up to 20 cm. The symptoms of Lyme disease are not only cutaneous but there may be a systemic involvement. Obviously, this disease can also affect pregnant women and for this reason this review aims to summarize the main ways of treatment to avoid worsening of the clinical condition in the mother and an eventual, albeit rare, involvement of the fetus.
N. Meo, C. Conforti, P. Corneli, R. Vezzoni, C. Retrosi, M. A. Pizzichetta, G. M. Rizzi, and I. Zalaudek
Wiley
Recently the first case of genital lichen sclerosus (LS) involving the vulval, perineal and perianal areas during treatment with Nivolumab was published1 . Nivolumab is a human monoclonal antibody, approved by the US Food and Drug Administration (FDA) in December 2014 for the treatment of metastatic melanoma (MM)2 . It works by inhibiting the interaction between programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1), whose unimpeded interaction downregulates T cells allowing cancer cells to evade immune surveillance.
Paola Corneli, Claudio Conforti, Chiara Retrosi, Roberta Vezzoni, Nicola Meo, Vincenzo Piccolo, Eleonora Farinazzo, Teresa Russo, Giovanni Magaton Rizzi, Roberta Giuffrida,et al.
Wiley
Cutaneous squamous cell carcinoma (cSCC) is the second most frequent nonmelanoma skin cancer (NMSC). The majority of in situ cSCC [cSCC (Tis)] can be cured surgically, while local advanced and metastatic ones require other treatments, but there are no therapies approved by U.S. Food and Drug Administration (FDA). Available treatments for these stages included radiotherapy, chemotherapy as cisplatin, but responses to these treatments are usually of short duration. Programmed death‐1 (PD‐1) inhibitors (pembrolizumab, nivolumab, and cemiplimab) are an innovative immunologic treatment that now has been shown to be useful for the treatment of advanced cSCC. Nowadays, data about the response rate with the use of PD‐1 inhibitors in cSCC are still few and, especially, the duration of the response after the start of treatment is short. Moreover, the number of cases is too small to express the beneficial effects of these treatments, although most data reported in the literature show quite good response rates. This review focused on some of the studies and associated results through an interesting research on search engines of all the cases about these systemic drugs, analyzing effects and side effects, and the research has been conducted considering published cases since March 2016 to October 2019.
Claudio Conforti, Ludovica Toffoli, Roberta Giuffrida, Chiara Retrosi, Roberta Vezzoni, Nicola Di Meo, and Iris Zalaudek
Wiley
Dear Editor, Herpes simplex virus (HSV) infection is a common cause of genital ulcers (Looker, Garnett, & Schmid, 2008). Clinical presentation includes vesicles, erosions and ulcers, usually bilaterally with local adenitis. An overlapping common disease in elderly women is lichen sclerosus et atrophicus (LSA), characterized by white atrophic areas with erosions, painful ulcers and permanent scar tissue on genital areas (Resende, Conforti, Giuffrida, de Barros, & Zalaudek, 2018). In this context, herpes genital lesions may be difficult to identify and can be confused with other diseases (Fergus et al., 2020). An 82-year-old woman came to our clinic complained of a 3-years history of burning sensation and painful ulcers over the vulvar area. On clinical examination white atrophic patches on the labia majora were observed, with two 0.5 cm nonhealing ulcers on the left labia majora and 1 cm nonhealing ulcer on the right labia majora (Figure 1). Furthermore, in the vaginal introitus, a diffuse mucosal inflammation with multiple erosions was present. Nonmalodorous cervical discharge and inguinal lymphadenopathy were noted. No urinary or systemic symptoms nor history of oral ulcers were reported. The genital symptoms started 3 years earlier, after a hysteronannessiectomy for metrorrhagia and pyometra. A long history of ineffective therapies (topical steroids, metronidazole/clotrimazole cream, tacrolimus cream, and oral antibiotics) for LSA and bacterial vaginosis was reported. Therefore, a biopsy was performed. Histopathology showed areas of LSA and ulcerated vulvar wall with fibrohematic areas, neutrophils, eosinophils and plasma cells, parakeratosis and signs of herpetic infection. Vaginal swab detected HSV-2DNA. Genital diseases can produce painful erosions and/or ulcers, but diagnosis based only on physical examination sometimes is inaccurate, especially if clinical features are atypical or the patient's history does not give the right clues. If there are suspicious lesions resistant to first-line therapy, a biopsy should be performed. Clinical manifestations of our patient included symptoms and signs of LSA and herpes genitalis (HG). The goal of therapy was to control both diseases, considering that topical corticosteroids alone can lead to reactivation of HG and delay the healing of HSV lesions. Therefore, it is important to associate a systemic antiviral therapy (Grinde, 2003).We treated the patient with acyclovir 400 mg thrice daily for 7 days, as proposed by Patel et al. (2017), and in addition clobetasol propionate 0.05% cream for 10 days. Then, the patient was treated with acyclovir 400 mg twice daily and clobetasol propionate 0.05% cream for 1 month. This combined treatment allowed to achieve healing after 30 days (Figure 2). In conclusion, for patients affected by concomitant LSA and GH, we recommend a combination of therapies of the coexisting diseases: first, a treatment of LSA with clobetasol propionate 0.05% cream oneto-two times daily and, second, the control of viral reactivation with acyclovir 400 mg twice/thrice daily for 1 month. In our case, a good response with clinical remission of all symptoms was observed after 1 month of treatment. Topical corticosteroids can be applied for two
Nicola Meo, Paola Corneli, Chiara Retrosi, Claudio Conforti, Serena Fagotti, Michela Longone, Roberta Vezzoni, Rossana Bussani, and Iris Zalaudek
Wiley
Dear Editor, Erosive pustular dermatosis (EPD) is a rare, but probably underreported inflammatory disease with prediction for chronically sun-damage scalp of men, less frequently lower extremities (Jaller, Borda, & Kirsner, 2019). There is an isolated case of pediatric manifestation (LaCour, Allen, Wilkerson, Nguyen, & Gibson, 2019). EPD is an underdiagnosed dermatosis, affecting same areas of other common diseases such as actinic keratosis (AK), basal cell carcinoma (BCC), or squamous cell carcinoma (SCC).
Iris Zalaudek, Paola Corneli, Sibil Vernoni, Dahlia Fedele, Giovanni Papa, Claudio Conforti, Chiara Retrosi, Roberta Vezzoni, Serena Fagotti, Michela Longone,et al.
Wiley
F IGURE 1 (a) Previously treated, inoperable metastatic Stage III cSCC at baseline. (b) Significant clinical response at second cycle, 3 weeks after first administration of pembrolizumab. (c) Possible pseudo-progression at third cycle of pembrolizumab. (d) Partial response at fifth cycle of pembrolizumab. (e) Evident progressive disease at time of sixth cycle of pembrolizumab. (f) Progressive disease after two applications of intralesional methotrexate and seventh cycle of pembrolizumab. cSCC, cutaneous squamous cell carcinoma Received: 16 July 2019 Revised: 11 September 2019 Accepted: 4 October 2019 DOI: 10.1111/dth.13107
Claudio Conforti, Roberta Giuffrida, Chiara Retrosi, Nicola di Meo, and Iris Zalaudek
Elsevier BV
Dermatoscopy is a noninvasive diagnostic technique that was used mostly for diagnosing pigmented lesions,1,2 but more recently, it has been employed in the diagnosis of infectious and inflammatory skin lesions, also known as entomodermoscopy and inflammoscopy,3 as well as for hair4 and scalp disorders, called trichoscopy.5 The initial name of epiluminescence microscopy has evolved into dermatoscopy and dermoscopy but not without controversy.