References of "Nikkels, Arjen"
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See detailProlonged imiquimod treatment and graft-versus-host reaction: histological mimicry in the skin infiltration pattern of the monocyte-macrophage-dendrocyte lineage.
Hermanns-Le, Trinh ULg; Paquet, Philippe ULg; Nikkels, Arjen ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(4), 361-365

Factor-XIIIa-positive dendrocytes belong to the monocyte-macrophage-dendrocyte (MMD) lineage which is considered to play a pivotal role in the skin response to the immune response modifier imiquimod. The ... [more ▼]

Factor-XIIIa-positive dendrocytes belong to the monocyte-macrophage-dendrocyte (MMD) lineage which is considered to play a pivotal role in the skin response to the immune response modifier imiquimod. The same cells are also boosted in low-grade graft-versus-host reaction (GVHR) with skin manifestations. Both conditions are characterized by specific epidermal damage. The aim of the present study was to compare them using immunohistochemistry to identify MMD subsets and other inflammatory cells in the dermis. We compared 3 cases of long-term (4, 9 and 11 months) imiquimod topical applications on normal skin, 25 low-grade GVHR controlled by immunosuppressive therapy and 25 control cases with normal skin. Compared to the normal dermis, cells of the MMD lineage were considerably boosted in the dermis of GVHR and at the imiquimod-treated sites. By contrast, only minimal accumulations of lymphocytes and Langerhans cells were disclosed in the dermis. The pattern of dermal infiltration by MMD cells was similar in GVHR and after imiquimod treatment. However, intraindividual differences in densities were obvious irrespective of the skin condition. In conclusion, there is great mimicry in the MMD involvement in the dermis during low-grade GVHR and after chronic applications of imiquimod. [less ▲]

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See detailL'image du mois. Un chancre mou.
Nikkels, Arjen ULg; Arrese Estrada, Jorge ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2003), 58(2), 64-6

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See detailNecrotizing varicella zoster virus folliculitis.
Nikkels, Arjen ULg; Pierard, Gérald ULg

in European Journal of Dermatology (2003), 13(6), 587-9

Although the usual clinical features of the varicella zoster virus (VZV)-induced lesions are readily recognized, the same virus is also responsible for a series of atypical lesions. A patient is presented ... [more ▼]

Although the usual clinical features of the varicella zoster virus (VZV)-induced lesions are readily recognized, the same virus is also responsible for a series of atypical lesions. A patient is presented with a single large infiltrated plaque on the abdomen. Although histology showed a necrotizing folliculitis surrounded by a dense perifollicular inflammatory infiltrate, the clinical presentation was not suggestive of folliculitis. Subtle cyto-histological clues for viral infection were suggested. Immunohistochemistry revealed the presence of VZV in the remnants of the follicular structures. This report underlines one of the protean clinical presentations of VZV skin infections and highlights the discreteness of typical VZV-related cyto-histological alterations. Complementary VZV identification methods such as immunohistochemistry, are helpful in order to increase the diagnostic accuracy of unusual VZV lesions. [less ▲]

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See detailFraming the future of antifungals in atopic dermatitis.
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(4), 398-400

Atopic dermatitis (AD) is a frequent chronic inflammatory skin disease. Some fungal colonization or infection of the skin may exacerbate AD severity, particularly the so-called head and neck variant. In ... [more ▼]

Atopic dermatitis (AD) is a frequent chronic inflammatory skin disease. Some fungal colonization or infection of the skin may exacerbate AD severity, particularly the so-called head and neck variant. In addition, excessive intestinal colonization by Candida albicans may represent an additional triggering factor. Hence, there is a rationale to use antifungals in selected AD patients. Early trials with topical ketoconazole in head and neck AD showed a decrease in Malassezia colonization, but no significant improvement was observed in the clinical severity. In contrast, clinical improvement and decreased serum IgE were obtained in patients with positive Malassezia radioallergosorbent tests (RASTs) who were treated by oral ketoconazole. Some preliminary data suggested that oral itraconazole treatment in AD patients reduced the need for topical corticosteroids, provided clinical improvement particularly in head and neck AD, reduced the cutaneous and intestinal fungal colonization that may trigger AD, reduced the percentage of positive Malassezia cultures and demonstrated a decrease in C. albicans and Malassezia RAST values. Furthermore, beside its antifungal action, itraconazole in part relieves pruritus and inflammation. In conclusion, oral itraconazole treatment can alleviate AD severity in selected patients. Fluconazole is also effective. Further research is warranted to identify whether the load in skin surface fungal agents, the fungal RAST values and specific prick testing should be assessed in order to optimize the antifungal management in AD patients. [less ▲]

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See detailAtypical recurrent varicella in 4 patients with hemopathies.
Nikkels, Arjen ULg; Simonart, Thierry; Kentos, Alain et al

in Journal of the American Academy of Dermatology (2003), 48(3), 442-7

Relapsing varicella may occur in children with HIV infection and more rarely in younger adults. Our aim was to report unusual clinical, histologic, and virologic aspects of 4 elderly patients with ... [more ▼]

Relapsing varicella may occur in children with HIV infection and more rarely in younger adults. Our aim was to report unusual clinical, histologic, and virologic aspects of 4 elderly patients with malignant hemopathies who had an unusual form of recurrent varicella develop. Conventional microscopy, immunohistochemistry, and in situ hybridization were applied to smears and skin biopsy specimens. The patients presented a few dozen, scattered, large, papulovesicular lesions with central crusting. No zoster-associated pain or dermatomal distribution of the lesions was noted. Conventional microscopy revealed vascular changes and epidermal alterations typical for alpha-herpes virus infection. The varicella zoster virus major viral envelope glycoproteins gE and gB, and the immediate-early varicella zoster virus IE63 protein and the corresponding genome sequence for gE were detected on Tzanck smears; they were localized in endothelial cells and keratinocytes on skin biopsy specimens. The varicella zoster virus infection in endothelial cells, the vascular involvement, and the widespread distribution of the lesions suggest that the reported eruptions are vascular rather than neural in origin. These findings invalidate the diagnosis of herpes zoster but strongly support the diagnosis of recurrent varicella in an indolent and yet unreported presentation. Furthermore, these eruptions differ from relapsing varicella in children and young adults by the age of the patients, the paucity of clinical lesions, the larger diameter of the lesions and their peculiar clinical aspect, the significantly longer time interval between primary varicella and the recurrence, the prolonged healing time of the lesions, their mild disease course, and the fact that all the lesions are in the same stage of development. [less ▲]

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See detailComment je traite ... un herpès labial récurrent
Petit, L.; Braham, C.; Nikkels, Arjen ULg et al

in Information Dentaire (L') (2002), 22

L'herpès labial récurrent est une affection fréquente. Il fait suite à la réactivation du virus herpétique (HSV1 et au plus rarement HSV2) au niveau du ganglion de Gasser. Le traitement et la prévention ... [more ▼]

L'herpès labial récurrent est une affection fréquente. Il fait suite à la réactivation du virus herpétique (HSV1 et au plus rarement HSV2) au niveau du ganglion de Gasser. Le traitement et la prévention de l'herpès labial récurrent font classiquement appel à des agents antiviraux spécifiques. Les résultats spectaculaires obtenus chez les patients immunodéprimés sont beaucoup moins convaincants chez des sujets par ailleurs sains. D'autres voies prospectives de thérapeutique sont à l'étude utilisant des lipopeptides et des moyens physiques induisant une modification du pH cutané. [less ▲]

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See detailPharma clinics. Le médicament du mois. L'imiquimod (Aldara): un immunomodulateur pour la peau.
Hermanns-Le, Trinh ULg; Nikkels, Arjen ULg; Uhoda, Isabelle et al

in Revue Médicale de Liège (2002), 57(2), 116-8

Imiquimod is the first drug of a new therapeutic class encompassing cutaneous immune response modifiers. This molecule induces the synthesis and release of macrophage-related cytokines. It boosts some ... [more ▼]

Imiquimod is the first drug of a new therapeutic class encompassing cutaneous immune response modifiers. This molecule induces the synthesis and release of macrophage-related cytokines. It boosts some local immune responses. These properties are used to treat cutaneous viral condylomas. Other prospective therapeutic goals are presently scrutinized. [less ▲]

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See detailOral antivirals revisited in the treatment of herpes zoster: what do they accomplish?
Nikkels, Arjen ULg; Pierard, Gérald ULg

in American Journal of Clinical Dermatology (2002), 3(9), 591-8

Oral antiviral agents currently represent the most important therapeutic keystone in the treatment of herpes zoster. Three oral antiviral agents are available for the treatment of herpes zoster: acyclovir ... [more ▼]

Oral antiviral agents currently represent the most important therapeutic keystone in the treatment of herpes zoster. Three oral antiviral agents are available for the treatment of herpes zoster: acyclovir, its derivative valacyclovir, and famciclovir. Meta-analysis of published data has shown that oral acyclovir significantly reduces various herpes zoster-related symptoms as well as the duration, intensity and prevalence of zoster-associated pain (ZAP). However, this drug does not influence postherpetic neuralgia. The newer agents famciclovir and valacyclovir exhibit a better oral bioavailability than acyclovir. These agents have demonstrated similar efficacy to acyclovir with ZAP and they require less frequent administration. When initiated within 72 hours, oral antiviral therapy of herpes zoster is beneficial in selected, elderly immunocompetent patients, reducing the duration and intensity of ZAP and providing more rapid skin lesion healing. Oral antivirals are also of benefit in immunocompromised patients with uncomplicated herpes zoster. However, signs of cutaneous and visceral dissemination should be monitored; if signs occur, intravenous antiviral therapy is indicated. [less ▲]

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See detailL'allergie aux aromes et parfums: anathème sur un attrait épicurien?
Goffin, Véronique ULg; Nikkels, Arjen ULg; Cornil, F. et al

in Revue Médicale de Liège (2002), 57(9), 605-9

Aromas and fragrances are present in many cosmetics, some topical drugs, food and various hygiene, household and industrial products. They can be responsible for contact dermatitis. Multiple ... [more ▼]

Aromas and fragrances are present in many cosmetics, some topical drugs, food and various hygiene, household and industrial products. They can be responsible for contact dermatitis. Multiple sensitizations can even involve in various combinations some fragrance compounds, a given degradation product or a contaminant. The diagnosis relies on clinical examination and oriented anamnesis. A histological examination is sometimes necessary. Specific path testing brings insight on the culprit chemical compounds. [less ▲]

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See detailTreatment of mucocutaneous presentations of herpes simplex virus infections.
Nikkels, Arjen ULg; Pierard, Gérald ULg

in American Journal of Clinical Dermatology (2002), 3(7), 475-87

Infections by herpes simplex virus (HSV) types I and II are diverse and quite frequent. After primary infection, the virus establishes a life-long latency in the sensory ganglia and recrudescences may ... [more ▼]

Infections by herpes simplex virus (HSV) types I and II are diverse and quite frequent. After primary infection, the virus establishes a life-long latency in the sensory ganglia and recrudescences may occur at an unpredictable rate. Recurrent labial and genital herpes infections represent the majority of clinical manifestations of HSV infections. Their management is currently well established using evidence-based medicine data. Primary labial herpes is generally not treated with antivirals in otherwise healthy children, although intravenous aciclovir may be offered in severe primary infections, particularly in the immunocompromised patient. The decision whether or not to treat recurrent labial herpes should be evaluated individually and depends on the frequency and severity of relapses, the impairment of the quality of life, and the cost of therapy. Patients with mild disease may benefit from topical therapy, and those with severe and frequent recurrences may be considered for intermittent or long-term oral antiviral therapy. Primary genital herpes is treated with oral or intravenous antivirals, depending on the severity of the infection and associated symptoms. Recurrent genital herpes can be managed with episodic short courses of oral antivirals in patients whose recurrences are moderate to severe and rare, and have a clear prodrome. Patients with >5 episodes/year, severe recurrences or unrecognisable prodromes may be best managed with long-term suppressive antiviral prophylaxis. HSV is also responsible for a variety of other clinical manifestations, including herpetic whitlow, neonatal infection, disseminated and atypical cutaneous infections, traumatic herpes, eczema herpeticum, and HSV-associated erythema multiforme. HSV infection may also represent a complication following cosmetic procedures of the oro-facial region, surgical and dental interventions, sun exposure and burns. Precise treatment guidelines for these HSV infections are not firmly established. [less ▲]

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See detailL'image du mois. Une tumeur du cuir chevelu révélatrice d'une naevomatose basocellulaire.
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2002), 57(4), 185-6

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See detailAllergic reactions to decorative skin paintings
Nikkels, Arjen ULg; Henry, Frédérique ULg; Pierard, Gérald ULg

in Allergy Review series (2002), 3

Three children presented with contact sensitization to decorative skin paintings applied during their summer holidays. Patch testing revealed severe contact hypersensitivity to p-phenylenediamine (PPD) in ... [more ▼]

Three children presented with contact sensitization to decorative skin paintings applied during their summer holidays. Patch testing revealed severe contact hypersensitivity to p-phenylenediamine (PPD) in all patients. The eruptions healed following spontaneous elimination of the dyes and application of topical corticosteroids, but left postinflammatory depigmentation. PPD was the main allergen identified in allergic reactions to decorative skin paintings. [less ▲]

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See detailCurrent treatments of muco-cutaneous herpes simplex virus infections
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Current Medicinal Chemistry - Anti-Infective Agents (2002), 1(1), 83-98

Infection by Herpes Simplex Virus (HSV) types I and II represent a worldwide medical problem. After the primary infection the virus establishes a life-long latency in the dorsal root ganglia and ... [more ▼]

Infection by Herpes Simplex Virus (HSV) types I and II represent a worldwide medical problem. After the primary infection the virus establishes a life-long latency in the dorsal root ganglia and recurrences may occur at unpredictable times and rate. The most frequent clinical presentation of HSV infection is recurrent herpes labialis and herpes genitalis. The clinical expression varies according to the body site, the infected cell type, the relationship between HSV and the host immune status. Viral identification techniques such as immunohistochemistry and in situ hybridization on Tzanck smears and muco-cutanenous biopsies are helpful in the diagnosis of atypical cutaneous lesions. The treatment modalities of HSV infections include the reduction of viral load using antiviral agents, the non-specific immune stimulation of the host and specific vaccination in order to prevent new acquisition and to mitigate symptoms in already infected individuals. This review addresses various therapeutic options, their mode of action, and clinical value as well as the indications of the various drugs. [less ▲]

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See detailImage du mois. Une tumeur préauriculaire.
Tassoudji, Nazli ULg; Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2002), 57(2), 65-66

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See detailComment j'explore ... le syndrome d'Alport par la biopsie cutanée. Quand la peau parle pour le rein.
Delanaye, Pierre ULg; Nikkels, Arjen ULg; Martalo, O. et al

in Revue Médicale de Liège (2002), 57(10), 670-1

Alport's syndrome is a severe hereditary renal disease. Type IV collagen is abnormal in its molecular composition both in the kidneys and the skin. Immunohistochemistry performed on a conventional skin ... [more ▼]

Alport's syndrome is a severe hereditary renal disease. Type IV collagen is abnormal in its molecular composition both in the kidneys and the skin. Immunohistochemistry performed on a conventional skin biopsy allows to prove the diagnosis in the affected subjects and in healthy women exhibiting the mutation on a single X chromosome. [less ▲]

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See detailPharma clinics. Comment je traite ... un herpes labial récurrent.
Petit, L.; Braham, C.; Nikkels, Arjen ULg et al

in Revue Médicale de Liège (2002), 57(2), 67-71

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent ... [more ▼]

Recurrent herpes labialis is a frequent disorder. It occurs following the reactivation of the Herpesvirus (HSV1 and more rarely HSV2) inside the Gasser ganglion. Treatment and prevention of recurrent labial herpes are targeted by specific antiviral agents. Spectacular benefits obtained in the immunocompromised patients are less convincing in otherwise healthy subjects. Other prospective ways of therapy are under consideration, including lipopeptides and physical means aiming at modifying the cutaneous pH. [less ▲]

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See detailPerspectives de dialogue entre des neuromédiateurs et les kératinocytes.
Pierard-Franchimont, Claudine ULg; Faska, N.; Nikkels, Arjen ULg et al

in Dermatologie Actualité (2002), 65

Les neuromédiateurs contrôlant l’activité de l’axe hypothalamo-hypophysaire sont aussi exprimés dans la peau. D’autres neuromédiateurs liés au stress le sont également. En fait, près d’une vingtaine de ... [more ▼]

Les neuromédiateurs contrôlant l’activité de l’axe hypothalamo-hypophysaire sont aussi exprimés dans la peau. D’autres neuromédiateurs liés au stress le sont également. En fait, près d’une vingtaine de ces molécules sont synthétisées in situ et sont connues pour avoir des récepteurs spécifiques et exprimer une activité biologique dans cet organe. Certaines exercent un impact fonctionnel sur les kératinocytes. Il s’agit en fait de systèmes paracrines neuro-kératinocytaires et autocrines par lesquels les kératinocytes expriment de nombreux récepteurs pour les neuromédiateurs qu’ils libèrent eux-mêmes. [less ▲]

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See detailImages in Clinical Medicine. A Medical Mystery: Alkaptonuric ochronosis
Nikkels, Arjen ULg; Pierard, Gérald ULg

in New England Journal of Medicine (2001), 344(21), 1642-1643

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See detailComment j'explore ... le risque metastatique du melanome
Pierard, Gérald ULg; Arrese, J. E.; Pierard-Franchimont, Claudine ULg et al

in Revue Médicale de Liège (2001), 56(2), 120-3

The development of new therapeutic protocols for malignant melanoma calls for an upgraded assessment of the individual risk to develop metastases. The predictive sentinel lymph node method is best ... [more ▼]

The development of new therapeutic protocols for malignant melanoma calls for an upgraded assessment of the individual risk to develop metastases. The predictive sentinel lymph node method is best practiced in a multidisciplinary approach. The selective lymphadenectomy of the first draining lymph node is followed by minutely detailed histologic examination combined with immunohistochemistry. [less ▲]

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