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See detailEffect of Apremilast and Etanercept on Pruritus and Health-Related Quality of Life in Patients With Moderate to Severe Plaque Psoriasis : Results From the LIBERATE Study
Green, Lawrence; Thaçi, Diamant; Zhang, Zuoshun et al

in Journal of the American Academy of Dermatology (2016)

Psoriasis is a chronic, systemic inflammatory disease with skin maniifestations resulting from a dysregulated immune response. Itching is one of the most bothersome psoriasis symptoms for patients and ... [more ▼]

Psoriasis is a chronic, systemic inflammatory disease with skin maniifestations resulting from a dysregulated immune response. Itching is one of the most bothersome psoriasis symptoms for patients and important factor contributing to disease severity. Apremilast , is an oral small-molecule phosphodiesterase 4 (PDE4) inhibitor, works intracellularly within immune cells to regulate the production of inflammatory médiators associated with the pathogenesis of psoriasis by increasing cyclic adenosine monophophate (cAMP) levels. Apremilast was approved by the US Food and Drug Administration for the treatment of adult patients with patients with active psoriatic arthritis and for patients with moderate to severe plaque psoriasis. Apremilast has since been approved in multiple countries, including those in European Union,as well as Switzerland, Canada and Australia. LIBERATE (Evaluation in Placebo-Controlled Study of Oral Apremilast and Etanercept in Plaque Psoriasis; NCT01690299) is global phase 3b study evaluating the efficacity, safety, and tolerability of apremilast or etarnercept, compared with placebo, for the treatment of biologic-naive patients with moderate to severe plaque psoriasis. [less ▲]

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See detailNouveau traitement contre le carcinome basocellulaire avancé
NIKKELS, Arjen ULg

in Mediaplanet (2015)

Chaque année, entre 17 000 et 18 000 nouveaux cas du carcinome basocellulaire sont diagnostiqués en Belgique

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See detailAbsence of Varicella Zoster Virus Reactivation after Infliximab Administration for Plaque Psoriasis
EL HAYDERI, Lara ULg; BONTEMS, Sébastien ULg; MEEX, Cécile ULg et al

in Dermatology (2015)

Background: Herpes zoster (HZ) in patients receiving tumor necrosis factor (TNF) antagonists may be more severe and the incidence seems increased. The influence of TNF antagonists on varicella zoster ... [more ▼]

Background: Herpes zoster (HZ) in patients receiving tumor necrosis factor (TNF) antagonists may be more severe and the incidence seems increased. The influence of TNF antagonists on varicella zoster virus (VZV) reactivation is unknown. Objective: To prospectively search in a pilot study for VZV DNA in sequential blood samples before and after infliximab administration. Setting: University medical center. Subjects and Methods: Blood samples of six patients with longstanding and severe plaque psoriasis were taken on day 1 (before infliximab administration) and on days 2, 7, 21 and 42 for the determination of VZV viremia by ORF21 real-time polymerase chain reaction. Patients with varicella, HZ and normal subjects were included as controls. Results: None of the six patients presented VZV viremia at any of the time points. Highload viremia was present during varicella, low-load viremia in some HZ patients and no viremia in the control patients. Limitations: Small number of patients. Conclusions: In this pilot study, infliximab did not reactivate VZV and did not induce subclinical VZV viremia. [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 detailInfections par les virus herpès simplex 1 et 2
EL HAYDERI, Lara ULg; NIKKELS, Arjen ULg

in Mokni, Mourad (Ed.) Dermatologie infectieuse (2014)

Les virus herpès simplex de type 1 (HSV-1) et de type 2 (HSV-2) font partie de la famille des alpha-herpesviridae, tout comme le virus de la varicelle et du zona (VZV). Ces virus partagent certaines ... [more ▼]

Les virus herpès simplex de type 1 (HSV-1) et de type 2 (HSV-2) font partie de la famille des alpha-herpesviridae, tout comme le virus de la varicelle et du zona (VZV). Ces virus partagent certaines caractéristiques biologiques, entre autres, l'épidermo-neurotropisme, les mécanismes de réplication, la latence ganglionnaire et un effet cytopatique. En revanche, les manifestations cliniques les distinguent clairement. L'HSV-1 et l'HSV-2 sont des virus icosaédriques à ADN linéaire et bicaténaire de 150 à 200 nm. Ils se différencient par certains critères structuraux et épidémiologiques. Ils partagent des antigènes communs et il existe un grand degré d'homologie génomique. Ils sont constitués d'une nucléocapside, renfermant l'ADN viral, et d'une enveloppe glycoprotéique. De manière générale, l'HSV-1 infecte plutôt la partie supérieure du corps, notamment la sphère otorhinolaryngologique (ORL) tandis que l'HSV-2 a un tropisme préférentiel anogénital. L'HSV est transmis par contact direct interhumain à partir des lésions herpétiques ou par des gouttelettes de salive. Il peut s'auto-inoculer et être transféré d'une lésion herpétique à un autre site anatomique chez le même individu. [less ▲]

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See detailInfection par le virus de la varicelle et du zona
EL HAYDERI, Lara ULg; NIKKELS, Arjen ULg

in EL HAYDERI, Lara; NIKKELS, Arjen (Eds.) Dermatologie infectieuse (2014)

Le virus de la varicelle et du zona (VZV) appartient à la famille des alpha-herpesviridae. Son cycle de réplication est similaire à celui des virus herpès simplex virus de type 1 et 2. Le VZV possède ... [more ▼]

Le virus de la varicelle et du zona (VZV) appartient à la famille des alpha-herpesviridae. Son cycle de réplication est similaire à celui des virus herpès simplex virus de type 1 et 2. Le VZV possède également un tropisme neuro-épidermique, une latence ganglionnaire et induit un effet cytopathique dans la cellule hôte. Le virus VZV se compose d'un ADN bicaténaire au sein de la capside virale. Le tout est enrobé d'une enveloppe contenant des glycoprotéines de sruface, qui ont un rôle important dans l'induction d'une réponse immunitaire de la part de l'hôte. L'ADN viral a été complètement séquencé. Il contient 124 884 paires de base, 71 ORF (Open Reading Frames) qui codent pour 67 protéines dont environ 33 ont été identifiées. Au stade latent, le VZV n'exprime que des protéines de latence, comme l'IE (protéine immédiate précoce) 4, 62 et 63. Lors de la réactivation virale, le VZV exprimera les gènes E et ensuite L, qui produiront respectivement des protéines E (protéines précoces), nécessaires à la synthèse de l'ADN viral et à la construction de la nucléocapside, et des protéines L (protéines tardives) consitutuant l'enveloppe virale. [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 detailRecurrent In Situ Melanoma Successfully Treated with Ingenol Mebubate
MANSUY, Marion ULg; TASSOUDJI, Nazli ULg; ARRESE ESTRADA, Jorge ULg et al

in Dermatologic Therapy (2014)

Background:Treatment options for melanoma in situ (MIS) include imiquimod, radiation therapy, cryotherapy, excisional and Mohs surgery. Ingenol mebutate is a new topical treatment option recognized for ... [more ▼]

Background:Treatment options for melanoma in situ (MIS) include imiquimod, radiation therapy, cryotherapy, excisional and Mohs surgery. Ingenol mebutate is a new topical treatment option recognized for actinic keratosis. Although in vitro effectiveness has been demonstrated on melanoma cell lines, its therapeutic potential for in vivo melanomas is unknown. Case Report: In 2011, a 91-year-old woman presented a thick melanoma of her cheek. The lateral sections revealed persisting in situ melanoma, which were again excised. She presented for follow-up and a recurrent MIS was evidenced centered on the previous scar. She refused further surgery and ingenol mebutate (0.015% gel) was administered on three consecutive days. One month later, a complete clinical resolution was observed. Histology and immunohistology revealed no residual MIS. Conclusion: In this patient, ingenol mebutate was successful and well-tolerated as a topical, alternative therapy for MIS after failure of other treatment options. [less ▲]

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See detailHyaluronan Metabolism in Human Keratinocytes and Atopic Dermatitis Skin Is Driven by a Balance of Hyaluronan Synthases 1 and 3
Malaisse; Bourguignon, Virginie; De Vuyst, Evelyne et al

in Journal of Investigative Dermatology (2014), 134

Hyaluronan (HA) is a glycosaminoglycan synthesized directly into the extracellular matrix by three hyaluronan synthases (HAS1, HAS2, and HAS3). HA is abundantly synthesized by keratinocytes but its ... [more ▼]

Hyaluronan (HA) is a glycosaminoglycan synthesized directly into the extracellular matrix by three hyaluronan synthases (HAS1, HAS2, and HAS3). HA is abundantly synthesized by keratinocytes but its epidermal functions remain unclear. We used culture models to grow human keratinocytes as autocrine monolayers or as reconstructed human epidermis (RHE) to assess HA synthesis and HAS expression levels during the course of keratinocyte differentiation. In both the models, epidermal differentiation downregulates HAS3 mRNA expression while increasing HAS1 without significant changes in hyaluronidase expression. HA production correlates with HAS1 mRNA expression level during normal differentiation. To investigate the regulation of HAS gene expression during inflammatory conditions linked to perturbed differentiation, lesional and non-lesional skin biopsies of atopic dermatitis (AD) patients were analyzed. HAS3 mRNA expression level increases in AD lesions compared with healthy and non-lesional skin. Simultaneously, HAS1 expression decreases. Heparin-binding EGF-like growth factor (HB-EGF) is upregulated in AD epidermis. An AD-like HAS expression pattern is observed in RHE incubated with HB-EGF. These results indicate that HAS1 is the main enzyme responsible for HA production by normal keratinocytes and thus, must be considered as an actor of normal keratinocyte differentiation. In contrast, HAS3 can be induced by HB-EGF and seems mainly involved in AD epidermis [less ▲]

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See detailChronic Cutaneous Hyalophomycosis by Paecilomyces
BOUFFLETTE, Nicolas ULg; Arrese Estrada, Jorge ULg; LEONARD, Philippe ULg et al

in Open Dermatology Journal (2014), 8

Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in ... [more ▼]

Paecilomyces lilacinus is a ubiquitous saprophytic fungus that rarely causes infections in humans, frequently affecting the eyes and the skin. Cutaneous and subcutaneous infections mainly occur in immunocompromised hosts but have occasionally been reported in immunocompetent patients. The clinical spectrum is highly heterogeneous and diagnosis is often delayed. A 60-year-old woman with idiopathic chronic necrotizing vasculitis treated since 10 years with a series of immunosuppressive therapies presented since three years various clinical presentations of chronic hyalohyphomycosis caused by P. lilacinus. Diagnosis was only obtained three years after the first clinical signs, following the histologic analysis of the surgical excision of a cutaneous abscess. Treatment with oral voriconazole was successful. This case report illustrates the highly heterogeneous clinical aspects of hyalohyphomycosis by P. lilacinus leading to a delay in diagnosis and treatment, particularly in the immunosuppressed patient. [less ▲]

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See detailFacharztprüfung Dermatologie und venerologie
Rübben, Albert; NIKKELS, Arjen ULg

in von Stebut, Esther; Berneburg, Mark; Maurer, Marcus (Eds.) et al Dermatologie und venerologie (2014)

Frage und antwort über Herpesviren

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See detailHERPES SIMPLEX VIRUS REACTIVATION AND DENTAL PROCEDURES
EL HAYDERI, Lara ULg; DELVENNE, Philippe ULg; ROMPEN, Eric ULg et al

in Clinical Oral Investigations (2013)

Objectives : Dental extraction is reportes to trigger recurrent herpes labialis (RHL). Aim : This aims to prospectively study the clinical occurrence of RHL and the oral herpes simplex virus type 1 (HSV-1 ... [more ▼]

Objectives : Dental extraction is reportes to trigger recurrent herpes labialis (RHL). Aim : This aims to prospectively study the clinical occurrence of RHL and the oral herpes simplex virus type 1 (HSV-1) viral shedding before and 3 days after different dental procedures. Materials and methods : Oral HSV-1 DNA was measured by real-time PCR before and 3 days after dental procedures of the inferior dentition in 57 immunocometent patients (mean age 32.4 years) who were selected and divided into four distinct subgroups (dental inspection without anesthesia, n=14; molar extraction under local anesthesia, n=15; and molar extraction under general anesthesia, n=9) and compared to 32 healthy controls (mean age 33 years). Results : None of the patients suffered from RHL at day 3. Oral HSV-1 DNA was detected before and after procedure in 1.7 % (1/57) and 5.3 % (3/57), respectively [dental inspection without anesthesia, 5.3 % (1/19); molar extraction under local anesthesia, 6.7 % (1/15); and molar extraction under general anesthesia, 11 % (1/9)]. None of the controls presented RHL or detectable oral HSV-1 DNA. There was no statistically significant difference between the study groups and controls. [less ▲]

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See detailHair Loss after Varicella Zoster Virus
EL HAYDERI, Lara ULg; NIKKELS, Nazli ULg; Nikkels, Arjen ULg

in Case Reports in Dermatology (2013)

Varicella zoster virus (VZV) cutaneous infection occurs predominantly in epidermal and infundibular keratinocytes and accessorily in dermal dendritic cells. These latter cells play a role in cicatricial ... [more ▼]

Varicella zoster virus (VZV) cutaneous infection occurs predominantly in epidermal and infundibular keratinocytes and accessorily in dermal dendritic cells. These latter cells play a role in cicatricial processes. Two patients are presented with localized alopecia after VZV infection. A 4-year-old girl presented localized hair loss affecting about 20% of her upper right eyelash immediately following the resolution of the varicella skin lesions. No regrowth was observed after 3 months. An 80-year-old woman with a prior history of localized alopecia areata of the left occipital area presented severe left herpes zoster affecting the V1 and V2 dermatomes. At precisely the same site of the previous episode, a localized plaque of alopecia areata recurred. After topical corticosteroid therapy, a progressive hair regrowth occurred after about 3 months. These case reports are the first relating cutaneous VZV infection as the origin for permanent cicatricial alopecia and transitory alopecia areata. Localized hair loss should be added to the cutaneous complications of VZV skin infection. [less ▲]

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See detailMelanotan-associated transverse melanonychia
Paurobally, Dilshad; EL HAYDERI, Lara ULg; Richert, Bernard et al

in Journal of the European Academy of Dermatology & Venereology (2013), 27

Transverse melanonychia has multiple causes, but is principally observed as adverse effect to drug intake, such as minocyclin, zidovudine and chemotherapies, like pemetrexed,VAD (vincristine, adriamycin ... [more ▼]

Transverse melanonychia has multiple causes, but is principally observed as adverse effect to drug intake, such as minocyclin, zidovudine and chemotherapies, like pemetrexed,VAD (vincristine, adriamycin and dexamathasone) and hydroxyurea. Other causes include radiation therapy and electron beam therapy. [less ▲]

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See detailSkin color is relevant to vitamin D synthesis
LIBON, Florence ULg; CAVALIER, Etienne ULg; NIKKELS, Arjen ULg

in Dermatology (2013), 227(3), 250-4

BACKGROUND: Whether dark skin produces less vitamin D after UVB radiation than fair skin remains controversial. OBJECTIVE: To compare 25-hydroxyvitamin D [25-(OH)-D] levels after a single UVB exposure in ... [more ▼]

BACKGROUND: Whether dark skin produces less vitamin D after UVB radiation than fair skin remains controversial. OBJECTIVE: To compare 25-hydroxyvitamin D [25-(OH)-D] levels after a single UVB exposure in fair (phototype II-III) and black-skinned (phototype VI) volunteers. METHODS: Fair-skinned volunteers (n = 20, 4 males/16 females, mean age: 23.2 years) and black-skinned (n = 11, 6 males/5 females, mean age: 23.8 years) received a single total body UVB exposure (0.022 J/cm(2)). The 25-(OH)-D levels were measured on days 0, 2 and 6. RESULTS: On day 0, all volunteers were severely vitamin D deficient. On day 2, 25-(OH)-D levels of fair-skinned volunteers increased significantly (median: 11.9-13.3 ng/ml, p < 0.0001), but not in black-skinned people (median: 8.60-8.55 ng/ml, p = 0.843). Again, on day 6, 25-(OH)-D levels of fair-skinned volunteers increased significantly (median: 11.9-14.3 ng/ml, p < 0.0001), but not in black-skinned people (median: 8.60-9.57 ng/ml, p = 0.375). CONCLUSION: This study suggests that skin pigmentation negatively influences vitamin D synthesis. [less ▲]

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See detailDermatological manifestations of varicella
EL HAYDERI, Lara ULg; NIKKELS, Arjen ULg

in Berhardt, Leon V. (Ed.) Advances in Medicine and Biology (2013)

The Varicella zoster virus (VZV) is responsible for chickenpox and herpes zoster (HZ). VZV displays neuro- and epidermotropism, although other cells lines may be infected. A permissive type of VZV ... [more ▼]

The Varicella zoster virus (VZV) is responsible for chickenpox and herpes zoster (HZ). VZV displays neuro- and epidermotropism, although other cells lines may be infected. A permissive type of VZV infection in the epidermal and/or infundibular keratinocytes forms the majority of the skin lesions. This infections leads to intra-epidermal blistering, clinically characterized by vesicular lesions. During varicella, the haematogenous dissemination of VZV virions infects the dermal endothelial cells, which in their turn infect dermal dendrocytes who transport he virions to the keratinocytes of the basal layer. During HZ, the VZV virions arrive in the keratinocytes after release by the free nerve endings in close contact with the basal keratinocytes. The skin-associated immune system (SALT) furthermore determines the outcome of the virus/host cell relation. The spectrum of the VZV-related skin infections is presented with their pathogenic mechanisms, including lichenoid HZ, granulomatous HZ, verrucous HZ and follicular HZ. It is important to be aware of these manifestations of the VZV, in particular as VZV may present serious morbidity int eh immunocompromised patient. [less ▲]

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See detailPsoriasis : State of the art 2013 Part II :Therapeutics
de LA BRASSINNE, Michel ULg; NIKKELS, Arjen ULg

in Acta Clinica Belgica (2013), 68-6

The treatment of psoriasis is mainly based on anti-inflammatory and/or anti-hyperproliferative agents. The topical steroids appeared in the fifties and were the first therapeutic breakthrough for ... [more ▼]

The treatment of psoriasis is mainly based on anti-inflammatory and/or anti-hyperproliferative agents. The topical steroids appeared in the fifties and were the first therapeutic breakthrough for psoriasis, followed by methotrexate and phototherapy in the sixties, photochemotherapy (PUVA) in the seventies and acitretin and cyclosporine in the eighties. The targeted biologic therapies represent a whole new era of therapeutic possibilities with a highly beneficial safety record. The choice of treatment depends on a large series of factors, including the type and extend of the psoriasis, the patient's preferences, co-medications, comorbidities and drug tolerance. This overview presents the currently available topical and systemic agents for treating psoriasis, including topical corticosteroids, vitamin D derivatives, UV-light based therapies, methotrexate, cyclosporine, acitretin, and the biologic agents such as the TNF antagonists etanercept, adalimumab and infliximab, as well as the anti-p40 IL12/23 agent ustekinumab. Newer, very promising, agents aiming the Th17 pathway are under development for psoriasis. [less ▲]

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See detailPsoriasis : State of the Art 2013 : Part I : Clinical, Historical, Epidemiological and Genetic aspects, Co-Morbidities and Pathogenesis
de la brassine, michel; FAILLA, Valérie ULg; NIKKELS, Arjen ULg

in Acta Clinica Belgica (2013), 68-6

Psoriasis affects about 2 to 3 % of the caucasian population. It is a chronic inflammatory disease affecting predominantly the skin with the involvement of autoimmune mediated mechanisms. Typical ... [more ▼]

Psoriasis affects about 2 to 3 % of the caucasian population. It is a chronic inflammatory disease affecting predominantly the skin with the involvement of autoimmune mediated mechanisms. Typical pathogenic features include an increased renewal of epidermal keratinocytes, the enlargement of the germinating compartment, papillomatosis, altered epidermal differentiation, angiogenesis, lymphangiogenesis and inflammatory infiltration. Several types of psoriasis are distinguished and may be present simultaneously in some patients. Up to 20 candidate genes have been evidenced in psoriasis. Genetic variability explains different types of the disease and influences response to therapeutics. Furthermore, psoriasis is triggered or aggravated by infections, traumatisms, medications, stress, tobacco, alcohol and endocrine factors. Severe psoriasis is frequently associated with comorbidities as obesity, diabetes, metabolic syndrome and cardiovascular diseases. For this reason, the similar pathogenic mechanisms of psoriasis and other IMID's (Immune Mediated Inflammatory Diseases) and the use of systemic treatments shared with other specialties, an updated vision of psoriasis for the internist is mandatory. [less ▲]

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