A vezzeggiativo usually conveys such meanings as: affection, sympathy, enjoyment, grace. The following are examples of suffissi alterativi (alternate endings) used to form vezzeggiativi (pet names or terms of endearment):
-acchiotto (considered a diminutive/pet name combination): lupo—lupacchiotto; orso—orsacchiotto; volpe—volpacchiotto; furbo—furbacchiotto
-uccio: avvocato—avvocatuccio; casa—casuccia; cavallo—cavalluccio; caldo—calduccio; freddo—fredduccio
-uzzo (a variant of -uccio): pietra—pietruzza
Paolo, a member of the About.com Italian Language Forums community and a native Italian speaker from Milano, gives an example of how vezzeggiativi are used: "I have a friend who calls me Paoletto. This doesn't sound very much like a man, of course, but it's out of affection. More realistically, my brother calls me Paolone, Big Paolo."
Alterati Peggiorativi (Pejoratives)
A peggiorativo usually conveys such meanings as: contempt, defiance, disdain, scorn (for), disregard, self-contempt, self-disgust. The following are examples of suffissi alterativi (alternate endings) used to form peggiorativi (pejoratives):
-ucolo: donna—donnucola; maestro—maestrucolo; poeta—poetucolo
-accio: coltello—coltellaccio; libro—libraccio; voce—vociaccia; avaro—avaraccio
-azzo (a variant of -accio): amore—amorazzo; coda—codazzo
-astro (has a pejorative sense when the root is a noun, and an attenuated sense when the root is an adjective): medico—medicastro; poeta—poetastro; politico—politicastro; bianco—biancastro; dolce—dolciastro; rosso—rossastro
Spelling Changes to Noun Root
When creating i nomi alterati, a few nouns, when modified, undergo a spelling change to the root. For example:
uomo—omone
cane—cagnone
Sex Changes to Noun Root
In some instances the root noun changes gender when creating i nomi alterati. For example:
barca (feminine noun)—un barcone (masculine noun): a large boat
donna (feminine noun)—un donnone (masculine noun): a big (large) woman
febbre (feminine noun)—un febbrone (masculine noun): very high fever
sala (feminine noun)—un salone (masculine noun): a large room
Alterati Falsi
Certain nouns that appear to be nomi alterati are actually nouns in and off themselves. For example, the following forms are falsi alterati (false altered nouns):
tacchino (not the diminutive of tacco)
bottone (not the augmentative of botto)
mattone (not the augmentative of matto)
focaccia (not the pejorative of foca)
occhiello (not the diminutive of occhio)
burrone (not the augmentative of burro)
colletto (not the diminutive of collo)
collina (not the diminutive of colla)
limone (not the augmentative of lima)
cerotto (not the augmentative of cero)
In addition, be aware when creating nomi alterati that not all nouns can be combined with all suffixes. Either the term sounds off-key to the ear (Italian is a musical language, after all), or the resulting word is linguistically awkward. In general, the repetition of the same sound element in both the root and suffix should be avoided: tetto can be modified into tettino or tettuccio, but not tettetto; contadino can be modified into contadinello or contadinetto, but not contadinino. It's best to use only forms you have observed in print or heard used by native speakers. When in doubt, consult a dictionary.
On the other hand, if you want to stretch your creative language skills, try coining a neologismo (neologism). Matching nouns with previously unused modifying suffixes is one way that new words are formed. After all, you'd get a big laugh from native Italians if, after eating an unappetizing pizza, you were to declare, "Che pizzaccia!".

