Sexually Transmitted Diseases (STDs) and neglected tegumentary infections

Research group on emerging STIs and neglected infections of the skin, with a specific interest on tegumentary leishmaniosis.

Scope of Research:

 The STD clinic is a center for the diagnosis, prevention, epidemiological surveillance (for Emilia-Romagna Region and Superior Sanitary Institution), and counseling for sexually transmitted diseases. The following are our research aims:

  1.  Epidemiological study of the emerging epidemics of STDs, in particular syphilis and venereal lymphogranuloma,  with a specific focus on a few patient risk categories (MSM and immigrant patients).
  2. Screening and follow-up of pre-cancerous skin lesions and of anal canal carcinoma, through research on oncogenetic HPV via anal cytology (Pap Test) and anal molecular biology.
  3. Monitoring study on the outbreak of neurosyphilis, in particular its involvement at the ocular level and syphilis in pregnancy.
  4. Study of resistant strains of gonococcus.
  5. Screening and monitoring of STDs in pre-exposure prophylaxis for HIV (Prep).
  6. Clinical-pathological study on adverse cutaneous reactions to TARV (antiretroviral therapies) in HIV patients.
  7. Clinical, epidemiological, and laboratory surveillance study of neglected cutaneous infections, in particular cutaneous and mucosal leishmaniosis.
  8. Clinical-histopathological study of cutaneous reactions over the course of infection from SARS-COV2 and of adverse reactions to anti-COVID vaccines.

 

Ongoing Research Projects:

 The research projects are primarily focused on the clinical epidemiologial monitoring of the recent epidemics of MTS, in particular: neurosyphilis, syphilis in pregnancy, and venereal lymphogranuloma—diseases with incidence rates that have been increasing exponentially for the last several years.

The research project on precancerous skin lesions related to HPV foresees the evaluation of the prevalence and incidence of anal precancerous lesions in a cohort of patients with elevated risk (HIV-positive and MSM with positive anamnesis for HPV-related pathology, history of progressive HPV-related vulvar or cervical neoplasia, progressive or current high-risk intra-epithelial neoplasia at the cervical or vulvar level, etc.). It also forsesees the evaluation of the coordination of cytological and molecular screening exams and endoscopic/histological exam.

Beyond STDs, the scope also includes research into neglected cutaneous reactions, in particular tegumentary leishmaniosis and cutaneous manifestations of SARS-COV2. Currently our particular focus is the continuation of research on adverse cutaneous reactions to anti-COVID vaccines.

 

 

Updated objectives of research:

 Study of emergent epidemics: After 2000, the number of cases of syphilis I-II increased significantly. In 2005, there were approximately five times as many diagnoses as in 2000, followed by a reduction and then a new peak in 2016. From that time, the increment has been constant. In light of these data, the epidemiological surveillance and the study of strategies for the prevention of this disease have become even more critical.

Research on oncogenetic anal HPV:

  1.  The identification of predictive factors for the evolution of pre-cancerous anal lesions.
  2. The development and validation of a predictive model of the risk of evolution and a proposition of stratified intervals for the surveillance of the risk of evolution.
  3. The implementation and validation of the NBI classification for precancerous lesions in practical clinical settings.

 

Regarding the screening and monitoring of STDs in PrEP patients, the preliminary results observed in the cohort of patients currently in the study (64.4% of new STDs in PrEP patients compared to 22.7% in non-PrEP patients – the majority being Chlamydia and Gonorrhea infections) underline the importance of continuing to monitor these diseases, particularly in high-risk patients (MSM, TGW).

For neglected cutaneous infections, in particular leishmaniosis, our objective is to map the cases of mucosal cutaneous leishmaniosis identified in Emilia-Romagna between 2017 and 2020. We have therefore asked the principal regional hospital centers to include the cases which have not yet reached the attention of the IRCDCS Polyclinic of Sant’Orsola to their ongoing surveillance data, and if possible to send our group the paraffin-embedded biopsies of these cases so we can test them retrospectively through PCR. The objective is to have the most complete set of data possible, both clinical and laboratory, in the regional territory.

 

Objectives related to other research projects remain unchanged.

Research Group Director

Collaborators: 

Anna Lanzoni, team member

Lidia Sacchelli, team member

How to reach us

Pavillion n.29 - Via Massarenti ,1