Bullous pemphigoid (BP) is the most frequent autoimmune subepidermal blistering disease provoked by autoantibodies directed against two hemidesmosomal proteins: BP180 and BP230. Its pathogenesis depends on the interaction between predisposing factors, such as human leukocyte antigen (HLA) genes, comorbidities, aging, and trigger factors. Several trigger factors, such as drugs, thermal or electrical burns, surgical procedures, trauma, ultraviolet irradiation, radiotherapy, chemical preparations, transplants, and infections may induce or exacerbate BP disease. Identification of predisposing and trigger factors can increase the understanding of BP pathogenesis. Furthermore, an accurate anamnesis focused on the recognition of a possible trigger factor can improve prognosis by promptly removing it.

Pemphigus is a life-threatening autoimmune blistering disease affecting skin and mucous membranes. Despite its etiopathogenesis remains largely unknown, several trigger and predisposing factors have been reported. Pemphigus is caused by autoantibodies that target desmoglein 1 and desmoglein 3, impacting desmosome function. However, circulating autoantibodies are often the consequence of a precipitating factor that occurs in predisposed individuals. This review aims to describe and discuss almost all trigger and predisposing factors reported as possible or probable cause of the disease. Among the reported trigger factors that may induce or exacerbate pemphigus, we have found of particular interest: drug intake (especially thiol- and phenol-containing compounds), vaccines, infections, as well as some reports about pregnancy, radiations, emotional stress, pesticides and physical trauma. Moreover, we discuss the possible role of food intake in pemphigus onset and particular attention is given to dietary factors containing thiol, phenol and tannin compounds. A trigger factor is “the straw that breaks the camel’s back,” and often acts together with predisposing factors. Here we discuss how pemphigus onset may be influenced by genetic susceptibility and comorbidities like thyroid diseases, malignancies and other autoimmune disorders.To identify other hitherto unknown trigger and predisposing factors, well designed prospective studies are needed. In this context, future research should explore their connection with the aim to advance our understanding of pemphigus pathogenesis.

(1) Background: Vitiligo is an autoimmune skin disorder characterized by melanocyte destruction. Despite metabolic disturbances and oxidative stress also playing a key role in its pathogenesis, accumulating evidence highlights a prominent role for cytokine dysregulation. (2) Methods: A systematic search was conducted to identify meta-analyses published in the last decade that investigated cytokine involvement in vitiligo. (3) Results: Based on predefined inclusion criteria, nine meta-analyses were retrieved and reviewed. The findings confirm a central role for interferon-gamma (IFN-γ) in vitiligo pathogenesis, although recent meta-analyses suggest that IFN-γ gene polymorphisms are more broadly associated with autoimmunity rather than being vitiligo-specific. Elevated interleukin-17 (IL-17) levels have been consistently reported in vitiligo patients, supporting its contribution to immune-mediated melanocyte destruction. Regulatory T cell dysfunction appears to play a crucial role in disease progression. Additionally, TNF-α-308 G/A polymorphism has been linked to a genetic susceptibility to vitiligo, particularly in specific populations, reinforcing the role of TNF-α in immune dysregulation. Lastly, chemokines involved in immune cell recruitment to melanocytes further illustrate the complex inflammatory network underlying the disease. (4) Conclusions: This systematic review consolidates evidence from a decade of meta-analyses, underscoring the significance of cytokine dysregulation in vitiligo and highlighting potential therapeutic targets.

Non-melanoma skin cancers (NMSC) are the most common epithelial malignancies in organ transplantation recipients (OTRs). In Italy, incidence rates of post-transplantation NMSC are approximately 5% after 5 years and 10% after 10 years since organ transplantation. The objective was to describe risk factors associated with NMSC in a cohort of renal and liver transplant recipients, in a single-center longitudinal study. Renal and liver transplant patients, who underwent transplantation between June 1985 and December 2015, were visited for the first time or followed-up in a dedicated outpatient clinic every six months until July 2016. We included 356 renal and 76 liver transplant patients. 108 OTRs (25.6%) presented 299 NMSC. 74 patients developed actinic keratosis (17.1%), 36 patients squamous cell carcinoma (8.5%), and 52 patients basal cell carcinoma (12.3%). Time from transplantation and kidney transplant were the main risk factors for NMSC. Higher incidences of all NMSC were observed in patients >60 years, males and smokers, while decreased incidences were detected in individuals with higher educational levels. Multiple logistic regression models confirmed that male gender (RR 3.3, P=0.001), cigarette smoking (RR 2.0, P=0.026), light eye color (RR 2.9, P=0.001) and family history of cancer (RR 1.8, P=0.042) were independently associated with NMSC. Dermatological follow-up is important in OTRs, due to the higher risk of tumors and mainly NMSC. Clinical and environmental factors, including cigarette smoking, are useful in characterizing OTR with higher risk of NMSC.

Advanced cutaneous squamous cell carcinoma (aCSCC) comprises locally advanced and metastatic disease not amenable to curative surgery or radiotherapy and is associated with substantial morbidity, mortality, and healthcare costs. This narrative review summarizes current knowledge on the epidemiology, biology, clinical presentation, and staging of aCSCC and critically appraises therapeutic strategies with a focus on programmed death 1 (PD-1) blockade. Immune checkpoint inhibitors now represent the main systemic treatment for advanced cSCC, with clinical trials and observational studies reporting response rates around 45–60%, sustained benefit in a subset of patients, and a manageable yet clinically relevant profile of immune-related toxicities. However, outcomes remain heterogeneous, particularly in elderly, comorbid, and immunosuppressed patients. We therefore review established and emerging prognostic determinants spanning clinical, anatomical, histopathological, metabolic, inflammatory, and on-treatment domains. Priorities for biomarker-enriched studies and harmonized real-world registries to enable more refined risk stratification and genuinely personalized, multidisciplinary management of aCSCC are also outlined.

Background: Laser-assisted drug delivery is a promising strategy that enhances topical treatment by increasing cutaneous permeation and reducing side effects. In cosmetic settings, the efficacy and safety profiles of a treatment must meet the need of a painless procedure with fast recovery. In this context, Q-switched laser appears promising as it can open cutaneous pores without creating a carbonisation barrier. Methods: A split-face study on patients presenting for cosmetic procedures at IDI-IRCCS, Rome (30 September–18 October 2023), was conducted. Pan-facial Q-Switched laser was followed by a topical biostimulator applied on half of the face. Post-procedure local reactions were recorded together with patients’ perceptions. Cutaneous elasticity and hydration were assessed at baseline and three-week follow-up. The Skindex17 questionnaire evaluated the procedure’s impact on patients’ life quality. Also, participants and physicians expressed satisfaction with the treatment. Results: The procedure was well tolerated by patients; local reactions include transitory erythema, superficial bleeding, and oedema, none of which had an impact on daily life. An improvement in skin quality was documented objectively and subjectively by patients and physicians. Conclusion: Q-switched lasers emerge as promising devices for drug delivery, especially for cosmetic reasons. Indeed, the low risk of local reactions together with a remarkable increase in cutaneous permeation make this a suitable strategy for cosmetic procedures.