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See detailNON-DERMATOPHYTE DERMATOSES MIMICKING DERMATOPHYTOSES IN HUMANS
Libon, Florence ULg; TASSOUDJI, Nazli ULg; DEZFOULIAN, Bita ULg et al

in Mycopathologia (2016)

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the ... [more ▼]

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the intertriginous regions (feet, inguinal, axillar, submammary), dermatophytic colonisations and infections manifest as whitish, slightly hyperkeratotic, pruritic and sometimes fissurated lesions. On the scalp, dermatophytic infections commonly lead to single or multiple more or less inflammatory and alopecic lesions. On the plantar and palmar aspects of the feet and hand, dermatophytosis presents as an eczema-like chronic dermatosis. Abscess-like lesions may occur due to zoophilic dermatomycosis. Dermatophytic infections of the nails reveal ill-defined whitish-yellowish colorations of the distal end or the lateral aspects of the nails, sometimes combined with partial nail embrittlement or even complete destruction. Despite the ubiquity of dermatophytic skin infections and their usually highly typical clinical features, a differential diagnosis has to be considered, in particular when treatment is not efficient or when treatment resistance occurs. This review presents the differential diagnosis in terms of frequency as well as the diagnostic methods permitting the distinction of annular, intertriginous, alopecic, palmoplantar, abscess-like and onychodystrophic lesions. [less ▲]

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See detailHERPES ZOSTER IN PSORIASIS PATIENTS UNDERGOING TREATMENT WITH BIOLOGICAL AGENTS: PREVALENCE, IMPACT, AND MANAGEMENT CHALLENGES
EL HAYDERI, Lara ULg; COLSON, Fany ULg; DEZFOULIAN, Bita ULg et al

in PSORIASIS: TARGETS AND THERAPY (2016)

As TNF-α is a major factor in the immune defense against herpes zoster (HZ); an increased incidence and severity of HZ cases were suspected in patients undergoing treatment with TNF antagonists. Several ... [more ▼]

As TNF-α is a major factor in the immune defense against herpes zoster (HZ); an increased incidence and severity of HZ cases were suspected in patients undergoing treatment with TNF antagonists. Several studies and clinical experience provided evidence that the incidence of HZ increases by twofold to threefold in this patient category. The number of severe cases of HZ, with multisegmental, disseminated cutaneous, and/or systemic involvement, is also increased. Concerning psoriasis patients under biologicals, the clinician should be more alert for an eventual HZ event, in particular during the first year of biological treatment, and be aware of the possibility of more severe HZ cases. HZ may also undergo an age-shift toward younger patients. Rapid identification of risk factors for severe HZ, such as severe prodromal pains and/or the presence of satellite lesions, is recommended. The treatment recommendations of HZ in this patient group are identical to the recently published guidelines for the management of HZ. The live attenuated viral vaccine OKA/Merck strain anti-HZ vaccination is recommended before initiating biological treatment in psoriasis patients. The new adjuvanted anti-HZ vaccine will probably also benefit patients while on biological treatment. [less ▲]

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See detailLICHEN ET DERMATOSES LICHENOIDES - SPECTRE CLINIQUE ET BREF RAPPEL DE LA PRISE EN CHARGE
COLSON, Fany ULg; CAO, Sandrine ULg; MANSUY, Marion ULg et al

in SKIN (2016)

Bien connu dans sa forme typique, le lichen peut présenter des visages très variés dans ses formes atypiques (1-4). La reconnaissance de celles-ci est importante pour orienter le diagnostic et la prise en ... [more ▼]

Bien connu dans sa forme typique, le lichen peut présenter des visages très variés dans ses formes atypiques (1-4). La reconnaissance de celles-ci est importante pour orienter le diagnostic et la prise en charge. le mot lichen vient du Grec et signifie plante parasite. Le lichen a été décrit pour la première fois sous le nom de "lichen ruber" par Ferdinand Von Hebra en 1860. En effet, le réseau blanchâtre à la surface des lésions papuleuses ressemble au champignon lichen qui forme une symbiose avec un partenaire capable de photosynthèse (souvent une algue verte), généralement observée à la surface des rochers. L'appellation "lichen planus" a été proposée par Erasmus Wilson en 1866. Le lichen constitue le prototype de dermatoses lichénoïdes (Tableau 1). Ces maladies inflammatoires sont caractérisées, d'un point de vue clinique, par des lésions papuleuses et, d'un point de vue histologique, par un dense infiltrat lymphocytaire en bande dans le derme superficiel avec lésions des couches kératinocytaires inférieures de l'épiderme. [less ▲]

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See detailZosteriform dermatoses-A review
EL HAYDERI, Lara ULg; LIBON, Florence ULg; TASSOUDJI, Nazli ULg et al

in Global Dermatology (2015), 2 (4)

The zosteriform distribution of cutaneous lesions is a common disease pattern in dermatology. It describes a unilateral girdle-like distribution restricted to the sensitive nerve territory of a dermatome ... [more ▼]

The zosteriform distribution of cutaneous lesions is a common disease pattern in dermatology. It describes a unilateral girdle-like distribution restricted to the sensitive nerve territory of a dermatome. Three different pathogenic pathways can lead to a zosteriform pattern. The neural pathway uses the axons of a nerve ganglion for viral transport to a specific dermatome. The arche type is Herpes Zoster (HZ) followed by Zosteriform Herpes Simplex Virus Type (HSV) I infection. The Blaschkoid pathway uses the Blaschko lines that represent embryonic migration patterns, often mimicking a dermatomal distribution, particularly on the trunk. The isotopic pathway defines a dermatosis that exclusively develops on the site of a previously healed HZ eruption. Before a zosteriform eruption, a history of prior HZ guides the diagnosis to the isotopic pathway, mainly represented by granulomatous reactions followed by, among others, lichen planus, vasculitis and basal cell carcinoma. With no prior history of HZ recent eruptions orientate towards HZ and zosteriform HSV, whereas chronic eruptions should primarily evoke cutaneous metastases, principally from breast, ovary and lung carcinoma. This review summarizes the relevant literature and presents a clinical algorithm for the differential diagnosis of zosteriform dermatoses. [less ▲]

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See detailVISMODEGIB ET CARCINOMES BASOCELLULAIRES LOCALEMENT AVANCES
LEBAS, Eglantine ULg; RORIVE, Andrée ULg; EL HAYDERI, Lara ULg et al

in Revue Médicale de Liège (2015)

Basal cell carcinoma is the most frequent skin cancer. Even though metastases are exceptional, these cancers may be locally highly aggressive. The Hedgehog signaling pathway plays a significant role in ... [more ▼]

Basal cell carcinoma is the most frequent skin cancer. Even though metastases are exceptional, these cancers may be locally highly aggressive. The Hedgehog signaling pathway plays a significant role in the pathogenesis of basal cell carcinoma. Vismodegib is a selective inhibitor of this pathway and may be administered orally. Its main indication is locally advanced basal cell carcinoma, when other therapeutic options have failed or are contra-indicated. Vismodegib can also be used as prophylactic therapy in the Gorlin syndrome or basal cell nevomatosis. Its principal adverse effects are muscle spasms, alopecia and altered taste. They are frequent, but often moderate in intensity; they sometimes restrict continuation of treatment. Two clinical cases are presented, relating the efficacity and tolerance of this new therapeutic option. [less ▲]

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See detailLa rosacée
LIBON, Florence ULg; EL HAYDERI, Lara ULg; TASSOUDJI, Nazli ULg et al

in Revue Médicale de Liège (2015)

Rosacea is a common centro-facial dermatosis with a high socio-esthétic impact. Ocular involvement is not uncommon. Different stypes are distinguished, classified into grades according to their severity ... [more ▼]

Rosacea is a common centro-facial dermatosis with a high socio-esthétic impact. Ocular involvement is not uncommon. Different stypes are distinguished, classified into grades according to their severity. This classification is essential for therapeutic management. In general, rosacea remains difficult to treat as its pathophysiology is still not entirely understood. Future research is needed for a better understanding of this disease and the development of targeted treatments. [less ▲]

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See detailRéaction immédiate à l'alcool
LIBON, Florence ULg; DEZFOULIAN, Bita ULg; NIKKELS, Arjen ULg

Poster (2014, April 17)

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See detailSeasonal variations in vitamin D levels in melanoma patients: a single-centre prospective pilot comparative study
FAILLA, Valérie ULg; CAVALIER, Etienne ULg; EL HAYDERI, Lara ULg et al

in Journal of the European Academy of Dermatology & Venereology (2012), 26(5), 651-3

BACKGROUND: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D ... [more ▼]

BACKGROUND: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D deficiency has been demonstrated in these patients. Melanoma patients are also instructed to avoid sun exposure and may hence be expected to be vitamin D deficient. MATERIALS AND METHODS: Winter and summer vitamin D levels were compared in a group of melanoma patients (n =61) and age- and phototype-matched controls (n = 53) without photosensitive disorders. RESULTS: Oral supplementary vitamin D intake was reported in 32.7% of the melanoma patients and in 15.1% in the control group. Despite oral supplementation, only 25% of the melanoma patients and the controls presented with vitamin D levels of 30 ng/mL or higher. In non-supplemented subjects in the melanoma and control groups, respectively, mean winter vitamin D levels were below the recommended threshold at 12.6 ng/mL vs. 13.2 ng/mL, respectively, but not statistically different. These values increased significantly in both groups during the summer to 24.6 and 23.8 ng/mL respectively. CONCLUSION: Unexpected, significant increases in vitamin D levels were seen in melanoma patients during summer, suggesting non-adherence with photoprotective measures and reflecting a heliophilic behaviour. Vitamin D supplementation is recommended in melanoma patients during both winter and summer. [less ▲]

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See detailLa photoprotection en 2012
LIBON, Florence ULg; DEZFOULIAN, Bita ULg; NIKKELS, Arjen ULg

in Skin Inc (2012)

La photoprotection est essentielle dans la prévention du processus de photovieillissement et de la carcinogenèse cutanée. Elle peut être comportementale, naturelle, induite, vestimentaire, topique et ... [more ▼]

La photoprotection est essentielle dans la prévention du processus de photovieillissement et de la carcinogenèse cutanée. Elle peut être comportementale, naturelle, induite, vestimentaire, topique et systémique. La photoprotection vestimentaire inclut le port de vêtements protecteurs, de lunettes solaires et de chapeau. La photoprotection externe topique repose sur l'utilisation de différents véhicules contenant siot des filtres minéraux, ayant pour but une réflexion de la radiation ultraviolette incidente, soit des agents chimiques qui absorbent une partie de la radiation incidente. La photoprotection systémique consiste en l'administration, par voie orale, de substances photoprotectrices. D'autres nouvelles voies de photoprotection sont les stimulations chimique ou hormonale de la mélanogenèse. Cet article revoit les dernières évolutions dans ce domaine. [less ▲]

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See detailLa gestion des médicaments photosensibilisants
DEZFOULIAN, Bita ULg; LEBAS, Eglantine ULg; DE SCHAETZEN VAN BRIENEN, Virginie ULg et al

in Skin Inc (2012), 15(3), 16-21

L'arrivée de l'été nous confronte à nouveau aux réactions médicamenteuses photo-induites. Deux types de réactions photosensibles sont rencontrés : la photoallergie médicamenteuse, plutôt rare, et la ... [more ▼]

L'arrivée de l'été nous confronte à nouveau aux réactions médicamenteuses photo-induites. Deux types de réactions photosensibles sont rencontrés : la photoallergie médicamenteuse, plutôt rare, et la phototoxicité médicamenteuse, beaucoup plus fréquente. Ces réactions peuvent se produire aussi bien avec des médicaments topiques que systémiques. La liste des médicaments classiquement en cause est actuellement enrichie de nouveaux médicaments tels que le voriconazole, l'ipilimumab et le vémurafénib. Cette revue présente les pricipaux mécanismes en cause, une mise à jour de la liste des médicaments photosensibilisants et la gestion prophylactique et thérapeutique des patients. [less ▲]

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See detailLes effets cutanés indésirables des antagonistes du TNF alpha
FAILLA, Valérie ULg; SABATIELLO, Murielle ULg; LEBAS, Eglantine ULg et al

in Revue Médicale de Liège (2012)

The TNF alpha antagonists, including adalimumab, etanercept and infliximab, represent a class of anti-inflammatory and immunosuppressive drugs. Although cutaneous adverse effects are uncomon, they are ... [more ▼]

The TNF alpha antagonists, including adalimumab, etanercept and infliximab, represent a class of anti-inflammatory and immunosuppressive drugs. Although cutaneous adverse effects are uncomon, they are varied. There is no particular risk profile to develop cutaneous adverse effects. The principal acute side effects are injection site reactions and pruritus. The major long term cutaneous side effects are infectious and inflammatory conditions. Neoplastic skin diseases are exceptional. the association with other immunosuppressive agents can increase the risk of developing cutaneous adverse effects. Some adverse effects, such as lupus erythematosus, require immediate withdrawal of the biological treatment, while in other cases temporary withdrawal is sufficient. The majority of the other cutaneous adverse effects can be dealt without interrupting biologic treatment. Preclinical and clinical investigations revealed that the new biologics, aiming IL12/23, IL23 and IL17, present a similar profile of cutaneous adverse effects, although inflammatory skin reactions may be less often encountered compared to TNF alpha antagonists. [less ▲]

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See detailL'allergie au liquide séminal
DEZFOULIAN, Bita ULg; RATY, Laurent ULg; NIKKELS, Arjen ULg

in Skin Inc (2011), 14(N°5), 140

L'allergie au liquide séminal est une affection rare dont le diagnostic est difficile et souvent tardif. Divers degrés de sévérité clinique peuvent se rencontrer, allant d'une forme fruste, chronique et ... [more ▼]

L'allergie au liquide séminal est une affection rare dont le diagnostic est difficile et souvent tardif. Divers degrés de sévérité clinique peuvent se rencontrer, allant d'une forme fruste, chronique et localisée, à une symptomatologie aiguë pouvant conduire au choc anaphylactique. Des réactions croisées ont récemment été identifiées entre certains allergènes prostatiques humains et certains allergènes du chien. Ce phénomène pourrait expliquer l'apparition d'une réaction allergique au liquide séminal dès le premier rapport. Nous présentons ici le cas d'une jeune femme avec une allergie au liquide séminal, mise en évidence par un prick test positif à un extrait centrifugé et filtré à partir du sperme de son partenaire. [less ▲]

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See detailAllergologie cutanée
NIKKELS, Arjen ULg; DEZFOULIAN, Bita ULg

in Skin Inc (2011)

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See detailLes mastocytoses
AUSSEM, C.; BENOIT, A.; LOMBARD, Xavier ULg et al

in Derm'Actu (2011), 125

Les mastocytoses sont des entités rares qui peuvent se manifester sous une forme cutanée solitaire, disséminée ou comme atteinte systémique. Elle sont caractérisées par une prolifération des mastocytes ... [more ▼]

Les mastocytoses sont des entités rares qui peuvent se manifester sous une forme cutanée solitaire, disséminée ou comme atteinte systémique. Elle sont caractérisées par une prolifération des mastocytes, soit d'origine réactionnelle, liée à la sécrétion de certains facteurs de croissance, soit constitutionnelle, suite à diverses mutations. Les signes cliniques sont d'une part dus à la libération massive de médiateurs mastocytaire et d'autre part, à une éventuelle infiltration tumorale des tissus. Si la prise en charge d'une mastocytose relève principalement de la médecine spécialisée, cet article aura pour but de rappeler au praticien les principaux signes cliniques, les différentes répercussions ainsi que les méthodes diagnostiques. Il est également primordial de connaître les aliments riches en histamine et histamino-libérateurs ainsi que les méidcament histamino-libérateurs car ils peuvent être responsables de réactions sévères, pouvant aller jusqu'au choc de type anaphylactique. Les thérapeutiques font essentiellement appel aux antihistaminique de type anti-H1 de deuxième génération. [less ▲]

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See detailCOMPLICATIONS DERMATOLOGIQUES DES TATOUAGES DEFINITIFS ET TEMPORAIRES
CAUCANAS, MARIE; EL HAYDERI, Lara ULg; LEBAS, Eglantine ULg et al

in Annales de Dermatologie et de Vénéréologie (2011)

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See detailAlitrétinoïne : une nouvelle arme dans l'eczéma chronique des mains
DEZFOULIAN, Bita ULg; FAILLA, Valérie ULg; RATY, Laurent ULg et al

in Skin Inc (2011)

L'eczéma chronique des mains représente une difficulté thérapeutique majeure en dermatologie, et en particulier, quand l'exploration allergologique ne permet pas d'identifier l'agent responsable de l ... [more ▼]

L'eczéma chronique des mains représente une difficulté thérapeutique majeure en dermatologie, et en particulier, quand l'exploration allergologique ne permet pas d'identifier l'agent responsable de l'affection ou que l'éviction de celui-ci est difficile à obtenir pour raisons professionnelles. La première approche thérapeutique consiste en l'application de dermocorticoïdes. Cependant, leur utilisation chronique n'est pas recommandée en raison de leurs effets secondaires tels que l'atrophie cutanée. L'application topique des inhibiteurs de la calcineurine, comme le tacrolimus ou le pimecrolimus peut être envisagée comme traitement complémentaire. La photothérapie par UVB ou par PUVA est un traitement de deuxième ligne. Le méthotrexate et la ciclosporine sont des médicaments à réserver aux cas graves et multirésistants. L'alitrétinoïne, rétinoïde endogène et agoniste des récepteurs aux rétinoïdes, est une nouvelle thérapeutique contre l'eczéma chronique des mains qui ne répond plus aux dermocorticoïdes et est réfractaire aux autres options thérapeutiques. Plusieurs études randomisées, multicentriques et contrôlées contre placebo ont montré l'efficacité et l'innocuité de l'alitrétinoïne dans l'eczéma chronique des mains résistant aux traitements classiques. [less ▲]

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See detailSeasonal variations in vitamin D levels in melanoma patients : a single-centre prospective pilot comparative study
FAILLA, Valérie ULg; CAVALIER, Etienne ULg; EL HAYDERI, Lara ULg et al

in Journal of the European Academy of Dermatology & Venereology (2011)

Background: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D ... [more ▼]

Background: More than 90% of vitamin D synthesis is dependent on UV exposure. Photosensitive disorders such as lupus erythematosus, protoporphyria and xeroderma require strict sun avoidance, and vitamin D deficiency has been demonstrated in these patients. Melanoma patients are also instructed to avoid sun exposure and may hence be expected to be vitamin D deficient. Materials and method : Winter and summer vitamin D levels were compared in a group of melanoma patients (n=61) and age- and phototype-matched controls (n=53) without photosensitive disorders. Results : Oral supplementary vitamin D intake was reported in 32.7% of the melanoma patients and in 15.1 % in the control group. Despite oral supplementation, only 25% of the melanoma patients and the controls presented with vitamin D levels of 30 ng/mL or higher. In non-supplemented subjects in the melanoma and control groups, respectively, mean winter vitamin D levels were below the recommended threshold at 12,6 ng/mL vs 13.2 ng/mL, respectively, but not statistically different. These values increased significantly in both groups during the summer to 24.6 and 23.8 ng/mL respectively. Conclusion: Unexpected, significant increases in vitamin D levels were seen in melanoma patients during summer, suggesting non-adherence with photoprotective measures and reflecting a heliophilic behaviour. Vitamin D supplementation is recommended in melanoma patients during both winter and summer. [less ▲]

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See detailA propos de la réticence à l’immunothérapie spécifique chez les personnes allergiques : les nouvelles données de la littérature
Dezfoulian, Bita ULg; Caucanas, Marie ULg; Wauters, Odile ULg et al

in Revue Médicale de Liège (2010)

The increasing number of allergic subjects and the alteration of their quality of life are major concerns of public health. Symptomatic treatments of allergic diseases are not always able to improve the ... [more ▼]

The increasing number of allergic subjects and the alteration of their quality of life are major concerns of public health. Symptomatic treatments of allergic diseases are not always able to improve the patient’s complaints. Allergic exploration aims to identify IgE-dependant mechanisms and subsequently to prove the responsibility of the detected allergen in the allergic disease. The efficacy of the specific immunotherapy (SIT ) using allergens in either subcutaneous or sublingual forms has been proven in rhinitis, conjunctivitis, asthma and IgE-induced reactions to hymenoptera venom. The lack of training in allergology is an important reticence of general practitioners and specialists to prescribe SIT . Furthermore, the duration of the treatment and its important cost in Belgium (where, only venom SIT is reimbursed by the Social Security) interfere significantly with the compliance of the patients. [less ▲]

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See detailTHE CLINICAL RELEVANCE OF OFF-LABEL PHOTODYNAMIC THERAPY IN ONCO-DERMATOLOGY
WAUTERS, Odile ULg; CAUCANAS, Marie; RICHERT, Bertrand et al

in American Journal of Clinical Dermatology (2010)

Background : Besides actinic keratosis, Bowen's disease, as well as superficial and small nodular basal cell carcinoma, aminolevulinic acid and methylaminolevulinic acid photodynamic therapy (ALA-PDT, MAL ... [more ▼]

Background : Besides actinic keratosis, Bowen's disease, as well as superficial and small nodular basal cell carcinoma, aminolevulinic acid and methylaminolevulinic acid photodynamic therapy (ALA-PDT, MAL-PDT) present a broad potential of experimental indications in oncologic skin conditions. AIM : To present the various off-label indications with their respective PDT protocols, treatment results, level of evidence (A, B, C, D levels), and potential clinical interest. MATERIAL AND METHODS : A Pubmed search matched PDT with actinic cheilitis, anal, vulvar, and penile intraepithelial neoplasia (AIN, VIN, PIN), verrucous carcinoma, Paget disease, extramammary Paget disease, cutaneous B-cell lymphoma (CBCL), cutaneous T-cell lymphoma (CTCL), and cutaneous metastases of breast carcinoma. RESULTS : All indications presented interesting complete and partial cures, even in cases faling on previous standard treatments. All publications score C and D levels of evidence. The best PDT outcomes and the lowest recurrence rates concerned unifocal oncologic skin conditions with limited extension. Direct comparison of treatment data was difficult, as PDT protocols were highly variable. Comparative therapeutic trials vs standard care were rarely available. CONCLUSION : PDT represents a valuable treatment alternative in selected off-label oncologic skin conditions. However, literature data are too limited to support a hierarchic treatment position for PDT or a preferential protocol in these specific indications. There is a clear need for clinical trials evaluationg PDT vs standard treatments. In contrast to the approved PDT indications, where clinical evaluation accurately matches histologica evaluation, histology is required in these off- label indications to ensure treatment efficacy. Off-label use of PDT should be measured against the advantages and inconveniencies of standar treatment procedures. [less ▲]

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