Maria Contaldo
@unicampania.it
Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialities
University of Campania "Luigi Vanvitelli"
RESEARCH, TEACHING, or OTHER INTERESTS
Dentistry, General Dentistry, Multidisciplinary
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Sonia Triggiani, Maria T. Contaldo, Giulia Mastellone, Maurizio Cè, Anna M. Ierardi, Gianpaolo Carrafiello, and Michaela Cellina
Begell House
Liver lesions, including both benign and malignant tumors, pose significant challenges in interventional radiological treatment planning and prognostication. The emerging field of artificial intelligence (AI) and its integration with texture analysis techniques have shown promising potential in predicting treatment outcomes, enhancing precision, and aiding clinical decision-making. This comprehensive review aims to summarize the current state-of-the-art research on the application of AI and texture analysis in determining treatment response, recurrence rates, and overall survival outcomes for patients undergoing interventional radiological treatment for liver lesions. Furthermore, the review addresses the challenges associated with the implementation of AI and texture analysis in clinical practice, including data acquisition, standardization of imaging protocols, and model validation. Future directions and potential advancements in this field are discussed. Integration of multi-modal imaging data, incorporation of genomics and clinical data, and the development of predictive models with enhanced interpretability are proposed as potential avenues for further research. In conclusion, the application of AI and texture analysis in predicting outcomes of interventional radiological treatment for liver lesions shows great promise in augmenting clinical decision-making and improving patient care. By leveraging these technologies, clinicians can potentially enhance treatment planning, optimize intervention strategies, and ultimately improve patient outcomes in the management of liver lesions.
Romeo Patini, Gioele Gioco, Cosimo Rupe, Maria Contaldo, Rosario Serpico, Michele Giuliani, and Carlo Lajolo
Wiley
AbstractTo assess (i) the prevalence of oral colonization by Candida spp. in patients with psoriasis and (ii) the prevalence of oral lesions associated with Candida spp. in patients with psoriasis and identify the risk factors for oral lesions. A systematic review was conducted in accordance with PRISMA criteria. The PROSPERO registration code is CRD42019127178. PubMed, Scopus and Web of Science were used as search engines. Meta‐analyses and trial sequential analyses were performed. Among the 5805 retrieved records, nine articles were included. Among 530 psoriatic patients, 255 patients had an oral Candida spp. colonisation with an odds ratio (OR) = 3.44 (95% CI:2.38–5.00). Among 490 psoriatic patients, 43 patients developed oral Candida spp. lesions with an OR = 5.31 (95% CI:1.04–27.23). Among the patients without the main predisposing factors for infections, psoriatic patients had a higher OR (3.48, 95% CI: 2.0–6.0) for Candida spp. colonization, but not for Candida spp. infection, when compared with healthy controls (p‐value > 0.05). Meta‐analysis showed a higher risk of Candida spp. colonisation in patients with psoriasis. Patients who received immunosuppressive therapies were also at higher risk of developing oral lesions. Further studies are needed to understand these associations.
Maria Contaldo, Francesco D’Ambrosio, Giuseppe A. Ferraro, Dario Di Stasio, Maria Pia Di Palo, Rosario Serpico, and Michele Simeone
MDPI AG
Antibiotics have undoubtedly revolutionized medicine and the health and survival of patients with life-threatening infections, being nonetheless free from potential adverse effects, and the risk of intestinal dysbiosis, antimicrobial resistance, and the resulting consequences for the patient’s health and the public purse. The present study narratively reviewed the epidemiological data on worldwide antibiotic consumption and administration in dental practice, patients’ adherence to prescriptions, the antimicrobial resistance phenomenon in dentistry, and the evidence supporting and recommending appropriate antibiotic use in dental care. Eligible systematic reviews and original studies in humans published in the English language from January 2000 to 26 January 2023 were considered. A total of 78 studies, 47 on the epidemiology of antibiotic use and prescription in dentistry, 6 on antibiotic therapy in dentistry, 12 on antibiotic prophylaxis in dentistry, 0 on adherence of dental patients to antibiotic prescription, and 13 on antimicrobial resistance in dentistry, were presently considered. Retrieved evidence revealed that antibiotics are frequently overused and misused in dental practice, dental patients frequently do not adhere to prescriptions, and antimicrobial resistance in dentistry is a still rising phenomenon also secondary to improper oral antiseptics use. The present findings highlighted the need to establish more evidence-based and accurate antibiotic prescriptions to sensitize dentists and dental patients to minimize and rationalize the use of antibiotics only when it is indicated and necessary, improve patients’ adherence, and enhance knowledge and awareness of the antimicrobial resistance in dentistry.
Maria Contaldo, Dario Di Stasio, Antonio Romano, Fausto Fiori, Fedora Della Vella, Cosimo Rupe, Carlo Lajolo, Massimo Petruzzi, Rosario Serpico, and Alberta Lucchese
Bentham Science Publishers Ltd.
Abstract: Oral candidiasis is an opportunistic infection of the oral mucosa sustained by fungi of the genus Candida. Various Candida species, with a predominance of C. albicans, normally a saprophyte of the oral cavity, may become virulent and infect the oral mucosa with variegated clinical presentation, in case of imbalance of the oral microbiota, the presence of local predisposing factors and systemic conditions that weaken the immune system. Conventionally, oral candidiasis eradication is done with the help of antifungal drugs. However, the growing phenomena of drug resistance and the increase in infections sustained by non-albicans species being less responsive to common antifungals have orientied researches towards the experimentation of alternative therapies. The present review considered the most promising alternative therapeutic proposals. The use of plant derivatives with phytotherapy is a promising option, such as probiotics, to rebalance the oral microbiota in case of dysbiosis. Finally, antimicrobial photodynamic therapy (aPDT), with highly selective fungicidal activity and free of side effects, is also being studied as a powerful alternative to drug administration. All these therapies are alternatives or supportive to the conventional treatment of recurrent and non-drug-responsive forms of oral candidiasis. However, further studies are needed to define the most active compounds, the efficacy of the therapies compared with the conventional ones, and the planning of regulated and standardized protocols.
Federica Di Spirito, Francesco D’Ambrosio, Maria Pia Di Palo, Francesco Giordano, Nicoletta Coppola, and Maria Contaldo
MDPI AG
Various clinical manifestations of SARS-CoV-2 infections and adverse reactions to COVID-19 vaccination have been described in children. The present narrative review aimed to collect and synthesize reported findings on oral lesions detected in SARS-CoV-2-positive subjects following COVID-19 EMA-authorized and WHO Emergency Use Listing-approved vaccine administration in the pediatric population to detail their clinical features and highlight possible pathogenic aspects of those lesions based on current evidence. Few and incomplete reports were retrieved from the literature, probably because most lesions belonged to a broad spectrum of systemic diseases and syndromes and were nonspecific or inaccurately described. The most common oral lesions in pediatric SARS-CoV-2-positive patients were erosive–ulcerative lesions and macules/petechiae, primarily erythematous. In the context of COVID-19 vaccination, oral adverse reactions were rare and typically presented as erosive–ulcerative lesions, with EM-like or unspecified patterns. Future studies should investigate oral lesions in SARS-CoV-2-positive subjects and after COVID-19 vaccination in the pediatric population, taking into account viral variants and newly developed vaccines. Deeper insight into oral lesions detectable in pediatric SARS-CoV-2-positive subjects and after COVID-19 vaccination may increase clinicians’ ability to improve multidisciplinary pediatric oral and general care.
Andrea Ballini, Dario Di Stasio, Antonio Boccaccio, and Maria Contaldo
MDPI AG
Biosciences encompass an area of international scientific research that focuses on the mechanisms underpinning and regulating biological processes in organisms across all branches of life [...]
Massimo Pisano, Antonio Romano, Maria Pia Di Palo, Adone Baroni, Rosario Serpico, and Maria Contaldo
MDPI AG
Oral Candidiasis (OC) is an opportunistic fungal infection of the oral cavity, frequently reported under local and systemic predisposing circumstances. While the recurrence of OC HIV-infected subjects has been well described and reported, the association between oral candidiasis and the SARS-CoV-2 infection is a recent finding that still is worthy of further study. The present paper focuses on this novel association, reporting the incidence and prevalence of OC occurring during and after COVID-19 and the possible etiopathogenic mechanisms underlying the onset of OC in COVID-19 subjects. The work found that the immune inflammatory hypo reactions and immunosuppression found in children and adults with COVID-19 could favor the proliferation colonization of Candida species and the following infection. At the same time, poor oral hygiene and iatrogenic causes seem to be the main risk factors.
Alessandra Fusco, Maria Contaldo, Vittoria Savio, Adone Baroni, Giuseppe A. Ferraro, Dario Di Stasio, Alberta Lucchese, Adriana Chiaromonte, Giovanna Donnarumma, and Rosario Serpico
MDPI AG
Oral candidiasis (OC) is an opportunistic fungal infection of the oral mucosae, sustained by Candida albicans or other non-albican Candida species (NAC), usually eradicated by conventional antifungals of the classes of azoles, polyenes, or derivative from echinocandins. OC usually occurs under predisposing local or systemic factors. C. lusitaniae is an opportunistic strain that is rarely responsible for human infection and occurs mainly in severe immunocompromised states. The present work reported an unconventional case of OC in an otherwise healthy immunocompetent woman sustained by C. lusitaniae and a multi-resistant strain of C. albicans.
Maria Contaldo
IMR Press
Oral candidiasis is an opportunistic infection conventionally treated with antifungal drugs. However, the increasing number of fungal infections, parallel to the rising conditions sustained by non-albicans species, pose critical issues related to escalating drug resistances differently acquired by different species. Meanwhile, the knowledge of the interplay between oral microbiota and its host suggests alternative antifungal therapies based on the administration of probiotics. Probiotics are live microorganisms beneficial to the host, and literature reports consistent evidence for their use to treat gut diseases. The present work aimed to overview the primary mechanisms through which probiotics act against Candida species and the current status of knowledge on their use in clinical practice, particularly concerning oral candidiasis.
Giuseppina Malcangi, Alessio Danilo Inchingolo, Angelo Michele Inchingolo, Luigi Santacroce, Grazia Marinelli, Antonio Mancini, Luigi Vimercati, Maria Elena Maggiore, Maria Teresa D'Oria, Damiano Nemore,et al.
Elsevier
Federica Di Spirito, Alessandra Amato, Maria Pia Di Palo, Giuseppe A. Ferraro, Adone Baroni, Rosario Serpico, and Maria Contaldo
MDPI AG
In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people’s health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned.
Federica Di Spirito, Maria Contaldo, Alessandra Amato, Maria Pia Di Palo, Giuseppe Pantaleo, and Massimo Amato
Wiley
Dear Editor, Although effective and sufficiently safe, COVID19 vaccines may report metabolic, immuneinflammatory, and infectious adverse reactions (ARs) with prevalent renal, musculoskeletal, and gastrointestinal involvement (Caggiano et al., 2022). Orofacial ARs to COVID19 vaccines are still rarely (1:1000) reported (Cirillo, 2021). Specifically, oral lesions have generally been described in association with skin lesions, showing heterogeneous macromicroscopic features and a slight predilection for females and subjects with previous dermatological disorders (Caggiano et al., 2022; Riad, 2021). The main pathogenic mechanisms potentially implied in the onset of oral lesions following the COVID19 vaccination comprise hypersensitivity reactions, molecular mimicry, immune crossreactivity and autoimmunity, allergy to vaccine excipients, and reactivation of latent viral infections. The typical phenotypes reported for mucocutaneous hypersensitivity reactions are the lichenoid and erythema multiformelike patterns, putatively secondary to an immune response against coating lipid nanoparticles in mRNA vaccines (Hertel et al., 2022), or CD8+ cytotoxic T lymphocytes targeting vaccine antigens expressed on the oral epitheliocytes surface, thus causing their death (Caggiano et al., 2022). Although a cause– effect relationship has not been established yet, SARSCoV2 and COVID19 vaccineassociated autoimmunity, resulting from molecular mimicry and immune crossreactivity, has also been noticed with flareups of an underlying disease and new onsets in individuals susceptible to immune dysregulation. AntiSARSCoV2 antibodies may crossreact with unknown aminoacidic sequences of glycoproteins on the host oral epitheliocytes, structurally similar to the viral ones (Shafie'ei et al., 2022), promoting autoreactive B or T lymphocytes activation, as previously hypothesized for antibodies targeting protein S in hepatitis B vaccines (Drago & Rebora, 2002). Alternatively, vaccines generated Spike proteins may bind angiotensinconverting enzyme2 (ACE2) receptors on oral epitheliocytes, recruiting CD4+ lymphocytes (Zengarini et al., 2022). In addition, vaccine adjuvants, enhancing immune response, may determine the autoimmune/inflammatory syndrome induced by adjuvants known as ASIA (Gambichler et al., 2022). Oral lesions may also be the epiphenomenon of allergic reactions to excipients in vaccine preparations. Among them, polysorbate 80 (PS80), a vaccine excipient preventing mRNA rapid degradation, was proven to crossreact with polyethylene glycol, which is involved in delayed (>24 h) mucocutaneous lesions following mRNAbased COVID19 vaccines (Hatami et al., 2021). Accordingly, Manfredi et al. reported diffuse erythematous and ulcerative lesions in a subject vaccinated with mRNA BNT162b2 Comirnaty (PfizerBioNTech) containing PS80 (Di Spirito, Amato, et al., 2022; Di Spirito, Pelella, et al., 2022). A further pathogenic hypothesis may be linked to the reactivation of herpes simplex virus type 1 and varicellazoster virus (Di Spirito, Amato, et al., 2022; Di Spirito, Pelella, et al., 2022; Shafie'ei et al., 2022), observed in oral mucosal and cutaneous adverse reactions. Both viruses are also involved in the genesis of erythema multiforme and Bell's palsy (Cirillo & Doan, 2022), the last seeming increasingly documented following mRNA and inactivated COVID19 vaccines compared with the background rate. Herpesviruses establish a wellknown lifelong latent infection in neuronal ganglion cells, surveilled by resident ganglionic virusspecific CD8+ cytotoxic T lymphocytes preventing viral reactivation. In this scenario, COVID19 vaccines could act similarly to psychophysical stress or hormonal changes by promoting a massive T lymphocytes polarization toward the spike protein, thus temporarily disabling their surveillance on Herpesviridae, and indirectly favoring their reactivation, also supported by type I interferon and proinflammatory cytokine increase, after the corresponding reduction of tolllike receptor signaling. Such viral reactivations may be more frequent in immunocompromised subjects and the elderly due to their immunosenescence, reducing the cellmediated immune response and facilitating viral reactivation. In conclusion, the proposed pathogenic mechanisms should be furtherly elucidated, given the rapidly evolving findings concerning oral lesions following COVID19 vaccines, and considering the continuously emerging SARSCoV2 variants (Di Spirito, Pelella, et al., 2022) and the newly developed vaccines (Di Spirito, Amato, et al., 2022).
Antonio Romano, Federica Di Spirito, Alessandra Amato, Giuseppe Andrea Ferraro, Gianna Dipalma, Edit Xhajanka, Rosario Serpico, Francesco Inchingolo, and Maria Contaldo
MDPI AG
The innovative perspectives of the modern medical era aim to reach the highest performance and accuracy of therapeutic processes carried out for the evolution of diagnostic pathways. Digital planning and real-time diagnosis represent the hottest topics for researchers and clinicians in dentistry and oral medicine. To date, radiology is the gold-standard method for caries detection in the clinical setting. However, radiology poses a series of clinical limitations due to the use of ionizing radiation and its incapacity to recognize and detect enamel defects or early caries. In addition, radiology also presents issues surrounding its responsiveness to remineralizing agents and the microscopic gaps between the tooth and restorative treatments. To date, the evaluation of these conditions is only permitted ex vivo, with common methods in clinical practice not being applicable for establishing the actual condition of every case in every single patient. This work aims to develop state-of-the-art knowledge on conventional and unconventional innovative dental imaging techniques, focusing on those that not only promise to pursue the early and less invasive detection of dental disorders but also those that could be applied in clinical practice, with a particular interest in real-time in vivo confocal microscopy.
Mario Caggiano, Roberta Gasparro, Francesco D’Ambrosio, Massimo Pisano, Maria Pia Di Palo, and Maria Contaldo
MDPI AG
Since smoking is considered among the main risk factors for the onset and progression of periodontitis and peri-implantitis, the present systematic review aimed to evaluate the effect of smoking cessation on clinical, radiographic, and gingival crevicular periodontal parameters around natural teeth and dental implants in ex-smokers compared to current and non-smokers. The study protocol was developed based on the PRISMA guidelines, the research question was formulated according to the PICO model, and the literature search was conducted through PubMed/MEDLINE, Cochrane library, and BioMed Central databases. From the 916 title/abstracts initially identified, seven articles were included in the present systematic review and assessed for quality through the ROBINS-I tool. Reported findings on clinical and crevicular periodontal parameters around natural teeth were contrasting when comparing ex-smokers to current and non-smokers; thus, individualized recommendations for previous smoker periodontal patients are currently lacking. No data on radiographic parameters were retrieved. Similarly, data on periodontal parameters around dental implants were not available, highlighting the need for focused investigations assessing the role of both smoking habit and cessation on peri-implant health status and responsiveness to treatment.
Federica Di Spirito, Mario Caggiano, Maria Pia Di Palo, Maria Contaldo, Francesco D’Ambrosio, Stefano Martina, and Alessandra Amato
MDPI AG
A plethora of systemic manifestations of COVID-19 and adverse reactions to COVID-19 vaccines have been described in pediatric subjects. Therefore, the present systematic review primarily aimed to assess the prevalence and macro-microscopic features of oral lesions following SARS-CoV-2 infection, grading primary oral lesions based on COVID-19 forms, in pediatric subjects. The secondary aim was to evaluate the epidemiology, clinical appearance, and histopathology of oral lesions following the WHO Emergency Use Listing approved and EMA authorized vaccines, in relation to cases and vaccine characteristics. The study protocol was compliant with the PRISMA statement and registered on PROSPERO (CRD42022351821). Case reports, case series, and observational studies were electronically searched till 27 July 2022, on MEDLINE/PubMed, Scopus, and Cochrane library databases, and the PROSPERO register. Data from nine studies describing oral lesions following viral infection and two records reporting oral lesions following vaccine administration, evaluated through the ROBINS-I tool for quality, were independently extracted and qualitatively synthesized, resulting in scarce, jeopardized, and incomplete findings. Since most of the rare lesions recorded were a part of broad-spectrum systemic disorders and syndromes and, thus. undetailed or nonspecific, further studies should assess oral lesions following SARS-CoV-2 infection and vaccination in pediatric subjects, considering novel viral variants and newly developing vaccines.
Federica Di Spirito, Alessandra Amato, Antonio Romano, Gianna Dipalma, Edit Xhajanka, Adone Baroni, Rosario Serpico, Francesco Inchingolo, and Maria Contaldo
MDPI AG
Gender-specific medicine studies how sexual biology and gender-related cultural and behavioral differences may influence a person’s health and considers the differences in clinical features, prevention, therapies, prognosis, and psycho-social aspects of diseases with different impacts on women and men. The present work summarizes the main differential impact each risk factor for oral cancer and periodontitis has according to biological sex- and gender-oriented differences. It resulted in differences in epidemiology and the weight of various healthy determinants that may influence the incidence and prognosis of oral cancer and periodontitis. It is desirable to change the methodology of scientific studies with a higher focus on the weight that sexual variables may have on the well-being or the probability of getting ill of each person, thus promoting the development and diffusion of personalized gender dentistry.
Antonio Romano, Rossella Santoro, Fausto Fiori, Maria Contaldo, Rosario Serpico, and Alberta Lucchese
Elsevier BV
Federica Di Spirito, Alessandra Amato, Maria Pia Di Palo, Maria Contaldo, Francesco D’Ambrosio, Roberto Lo Giudice, and Massimo Amato
MDPI AG
Increasing evidence relate anti-SARS-CoV-2 vaccinations to orofacial adverse reactions, therefore, the present systematic review aimed to evaluate primary oral lesions diagnosed in adult subjects, following the WHO Emergency Use Listing approved and EMA authorized vaccines, also in relation to cases’ age, gender, comorbidities, and history of COVID-19, and in relation to vaccine type and doses. The study protocol, registered on PROSPERO (CRD42022339032) and compliant with the PRISMA statement, included an electronic search across Scopus, MEDLINE/PubMed, BioMed Central databases, and PROSPERO, ended on 18 June 2022 and succeeded by a manual search, an independent data extraction, and arisk of bias evaluation through ROBINS-I tool. Qualitatively synthesized data from the 13studies included showed an overall low prevalence (16 cases), though higher in females (68.8%), of oral lesions, mainly erosions and ulcers (34.5%). Nine cases were diagnosed following Pfizer-BioNTech, two Moderna, and one AstraZeneca, Serum Institute of India, Sinopharm, and Johnson&Johnson vaccines, respectively; specifically, eight after the first dose and seven after the second. In one case, vaccine type and dose were not specified. Considering newly developing vaccines, presented findings may be updated and further studies needed to highlight factors affecting oral lesion occurrence and specific macro-microscopic phenotypes in relation to cases’ and vaccines’ characteristics.
Dario Di Stasio, Antonio Romano, Marco Montella, Maria Contaldo, Massimo Petruzzi, Iquebal Hasan, Rosario Serpico, and Alberta Lucchese
MDPI AG
(1) Background: Ultrasonography is gaining popularity as a diagnostic tool in the study of the oral mucosa. The precision of ultrasound has made it possible to identify the various layers, based on their echogenicity. The aim of this study was to perform a quantitative analysis of healthy oral mucosa based on the analysis of greyscale, echo levels (dB), and attenuation values (dB/cm). (2) Methods: Thirty-three patients (17 females and 16 males; 58.42 ± 13.29 y.o) were recruited for this study. The images were acquired with the GE Logiq-e R7 with a linear probe at 18 MHz frequency (harmonic). For each tissue (epithelium, rete ridges, connective tissue, muscle, and bone), regions of interest were traced for the analysis of echo levels, grey levels, and attenuation values. One-way ANOVA and pairwise comparison were performed. (3) Results: Three-hundred and thirty images were analyzed. Analysis of echo levels and grey levels showed a significant difference between epithelium and rete ridges (p = 0.001), and between rete ridges and connective tissue (p = 0.001), but not between epithelium and connective tissue (p = 0.831) or connective and muscle layers (p = 0.383). The attenuation values appeared to be specific for each tissue layer (p = 0.001). (4) Conclusions: Quantitative analysis applied to ultrasound imaging of the oral mucosa allows the definition of specific tissue areas.
Lajolo C, Rupe C, Gioco G, Giuliani M, Contaldo M, Salo T, and Siponen M
Springer Science and Business Media LLC
Abstract Objectives To estimate the economic costs of oral lichen planus (OLP) through a multicenter university hospital–based outpatient study conducted in Italy and Finland. Materials and methods A multicenter retrospective study was conducted on patients affected by OLP to evaluate the economic cost of managing the disease. Direct costs concerning diagnostic procedures, therapeutic management, and follow-up visits were obtained from clinical records. Statistics was performed with IBM SPSS Statistics. Results One hundred and eight patients with a confirmed diagnosis of OLP (81 women and 27 men), 58 Italians and 50 Finnish, were enrolled in this study. The mean annual cost was 1087.2 euros per patient. The mean annual cost was higher in Finnish than in Italian cohort (1558.7 euros vs. 680.7 euros—p < 0.05). Within the Italian cohort, the local immunosuppressive therapy group and atrophic and erosive OLP type had a higher cost (p < 0.05). Within the Finnish cohort, the local immunosuppressive therapy group had a higher cost (p < 0.05). Conclusions OLP-related costs are very similar to other chronic oral disorders (i.e., periodontitis) with differences between investigated countries. Moreover, patients with more severe clinical features, who need immunosuppressive therapy, are facing more expensive costs. Clinical relevance. In this multicenter cost of illness study, we estimated the direct health care costs of OLP and we found that patients with more severe clinical features, who therefore need symptomatic therapy, are facing more expensive costs.
Massimo Petruzzi, Alberta Lucchese, Maria Contaldo, Marilina Tampoia, Maria Antonia Frassanito, Dorina Lauritano, and Fedora della Vella
Wiley
AbstractObjectiveThe aim of this study was to test the efficacy of autoantibodies to desmoglein 1 and desmoglein 3 detected by ELISA and indirect immunofluorescence in the diagnosis of oral pemphigus and to correlate the antibody titres with the severity of the disease.Materials and MethodsWe report a retrospective cohort study of 22 patients with oral pemphigus and 64 controls from a single tertiary centre. Data about histopathological examination, direct immunofluorescence, indirect immunofluorescence and ELISA were analysed. Global validation of ELISA and IIF both alone and combined was established by calculating sensitivity, specificity, accuracy and both positive predictive value and negative predictive value. The relationship between Oral Disease Severity Score values and ELISA titres was analysed using Pearson's coefficient.ResultsThe best diagnostic performance was observed for anti‐desmoglein 3 ELISA. The sensitivity was 75% and specificity 100% and positive predictive value and negative predictive value were 92.5% and accuracy 93.9%. The level of agreement with histopathology + direct immunofluorescence was substantial (k = .758). Anti‐desmoglein 3 titres showed a significant correlation with Oral Disease Severity Score (p < .05).ConclusionsSerological tests are commonly employed during clinical practice as adjunctive tools. Anti‐desmoglein 3 ELISA should be considered as a first‐instance diagnostic test for oral pemphigus early detection.