Often this becomes a matter of private judgment and context.
These rules and suggestions do not apply to newspaper writing, which has its own set of regulations in this matter.
Italics do not include punctuation marks (end marks or parentheses, for instance) next to the words being italicized unless those punctuation marks are meant to be considered as part of what is being italicized: "Have you read Stephen King's Pet Semetary?
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Thanks to today’s computer keyboards, we now have access to italics.
So we need a sensible plan for when to use them and when to use quotation marks.
Other titles that we would italicize include the following: Long Musical Pieces: Puccini's Madama Butterfly, Tchaikovsky's Nutcracker Suite (but "Waltz of the Flowers"), Schubert's Winterreise (but "Ave Maria").
For musical pieces named by type, number and key Mozart's Divertimento in D major, Barber's Cello Sonata Op.
to distinguish certain words from others within the text.
These typographical devices mean the same thing; therefore, it would be unusual to use both within the same text and it would certainly be unwise to italicize an underlined word.