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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 detailIn vitro reconstruction of epidermis from primary Darier's disease keratinocytes replicates the histopathological phenotype
LAMBERT DE ROUVROIT, CATHERINE; CHARLIER, CELINE; LEDERER, DAMIEN et al

in Journal of Dermatological Science (2013)

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See detailLa vitamine D et la peau
LIBON, Florence ULg; CAVALIER, Etienne ULg; NIKKELS, Arjen ULg

in Revue Médicale de Liège (2013), 68(9), 458-464

Vitamin D is well known for its beneficial effects on phosphocalcic homeostasis. The discovery of the role of vitamin D in cancers, infections, cardiovascular or autoimmune pathologies have promoted ... [more ▼]

Vitamin D is well known for its beneficial effects on phosphocalcic homeostasis. The discovery of the role of vitamin D in cancers, infections, cardiovascular or autoimmune pathologies have promoted interest for this molecule. Skin and vitamin D are closely related. The skin is not only the site of vitamin D synthesis, but also a target organ as calcitriol plays an important hormonal and regulatory role, acting on cell proliferation, differentiation and immunomodulation. Furthermore, vitamin D influences the incidence and therapeutic response of certain dermatoses. In addition, many medical situations, mainly dermatological, require strict photoprotection and may therefore indirectly be responsible for a vitamin D deficiency in patients. The current role of vitamin D in skin cancers, inflammatory and autoimmune skin diseases is summarized. [less ▲]

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See detailLa place de l'échographie à haute fréquence dans la dermatologie aujourd'hui
CASTRONOVO, Charlotte ULg; Boufflette, Nicolas ULg; NIKKELS, Arjen ULg

in SKIN (2013), 16(N°5), 14-16

L'échographie cutanée est une technique d'imagerie cutanée non invasive avec plusieurs indications en dermatologie, qui est fondée sur la réflexion différentielle d'une onde ultrasonique en fonction des ... [more ▼]

L'échographie cutanée est une technique d'imagerie cutanée non invasive avec plusieurs indications en dermatologie, qui est fondée sur la réflexion différentielle d'une onde ultrasonique en fonction des structures sous-jacentes, incluant la kératine, le collagène et l'eau. Les différentes possibilités techniques et le rôle de la fréquence des sondes sont brièvement expliqués. L'échographie cutanée est rapide, sans douleurs, non invasive, reproductible et peut être répétée sans risque. Cette technique a une place dans l'évaluation préopératoire de l'épaisseur des lésions tumorales, telles que le mélanome et les carcinomes basocellulaires et spinocellulaires. Elle est également utilisée dans l'évaluation des maladies inflammatoires. [less ▲]

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See detailLa dermoscopie digitalisée séquentielle dans la dermatologie d'aujourd'hui
LIBON, Florence ULg; COLSON, Fany ULg; CAO, Sandrine ULg et al

in SKIN (2013), 16(N°5), 8-12

La dermoscopie a significativement augmenté la spécificité et la sensibilité du diagnostic des lésions pigmentaires suspectes en dermatologie. Une assistance diagnostique informatisée des images ... [more ▼]

La dermoscopie a significativement augmenté la spécificité et la sensibilité du diagnostic des lésions pigmentaires suspectes en dermatologie. Une assistance diagnostique informatisée des images dermoscopiques, souvent fondée sur une comparaison informatisée des couleurs et des structures de toute une série de mélanomes préenregistrés, n'augmente par contre pas la précision diagnostique. Le suivi au long cours par des images photographiques du corps entier (total body photography : TBP) et/ou de lésions pigmentaires individuelles suspectes (dermoscopie digitalisée séquentielle : DDS) est très intéressant, car il diminue nettement le nombre d'excisions inutiles et augmente encore la sensibilité diagnostique. Ces techniques augmenteraient également l'adhérence du patient et le conscientiseraient davantage devant sa pathologie. Les applications à visée diagnostique et de suivi des lésions pigmentaires sur smartphone sont à déconseiller aux patients à risque vu leur très faible fiabilité et leur haut taux de faux négatifs. Cette brève revue de la littérature résume les avantages, les inconvenients, les bénéfices et le rythme recommandé des examens et donne des conseils pratiques pour une utilisation à bon escient de la DDS et de la TBP. [less ▲]

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See detailPaclitaxel-Related Lymphedema and Scleroderma-Like Skin Changes
COLSON, Fany ULg; SIGHA, Berline; ARRESE ESTRADA, Jorge ULg et al

in Journal of Clinical Case Reports (2013), 3(11),

Paclitaxel is an antimucrotubule agent used for the treatment of metastatic breast cancer. The development of scleroderma-like skin changes is an exceptional adverse effect. We report two patients with ... [more ▼]

Paclitaxel is an antimucrotubule agent used for the treatment of metastatic breast cancer. The development of scleroderma-like skin changes is an exceptional adverse effect. We report two patients with metastatic breast cancer treated by paclitaxel who presented an enexplained unilateral lymphedema of the upper limb. Medical work-up did not demonstrate any mechanical or tumor obstruction of the lymphatic vessels. Dermatologic examination revealed cutaneous and bucutaneous indurations and hardening of certain areas of the involved arm. The clinical suspicion of scleroderma was confirmed by histology and immunohistology. Treatment was initiated with methotrexate and methylprednisolone, resulting in a clear reduction of the lymphedema and a regression of the scleroderma. These two cases suggest a pathogenic role of paclitaxel-induced scleroderma in the subsequent development of severe localized lymphedema. [less ▲]

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

in Advances in Medicine and Biology (2013), 67

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 detailDermatologic Manifestations of the LEOPARD Syndrome
CAO, Sandrine ULg; NIKKELS, Arjen ULg

in The Open Dermatology Journal (2013), 7

The LEOPARD syndrome is an exceptional autosomal dominant genetic disease with a missence mutation of the PTPN11 gene in more than 90% of the cases. The principal clinical manifestations include extensive ... [more ▼]

The LEOPARD syndrome is an exceptional autosomal dominant genetic disease with a missence mutation of the PTPN11 gene in more than 90% of the cases. The principal clinical manifestations include extensive lentiginosis, heart conduction abnormalities, hypertrophic obstructive cardiomyopathy, ocular hypertelorism, pulmonary stenosis, genital anomalies, mental retardation, growth retardation and deafness. A woman with a LEOPARD syndrome illustrates the progressive development of melanocytic nevi. In fact, the majority of lentigines are actually melanocytic nevi. Seqential digital demroscopy evidences progressive growth of some melanocytic lesions. The ever-increasing number of melanocytic nevi in the LEOPARD syndrome is a risk factor for melanoma and full body photography and dermoscopy are recommended for follow-up. [less ▲]

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See detailMyxofibrosarcoma
CASTRONOVO, Charlotte ULg; ARRESE ESTRADA, Jorge ULg; QUATRESOOZ, Pascale ULg et al

in Rare Tumors (2013), 5(15), 60-61

Myxofibrosarcoma (MFS) is a variant of the group of malignant fibrous histiocytomas. It is one of the most aggressive types of soft tissue neoplasms. The clinical presentation is not pathognomonic and the ... [more ▼]

Myxofibrosarcoma (MFS) is a variant of the group of malignant fibrous histiocytomas. It is one of the most aggressive types of soft tissue neoplasms. The clinical presentation is not pathognomonic and the histological aspects are highly heterogenous, frequently delaying the diagnosis or leading to misdiagnosis. Complementary histochemical and immunohistochemical stainings are mandatory to achieve the diagnosis of MFS. A 78-year-old male patient is presented illustrating this diagnostic pitfall. Extensive surgery followed by radiotherapy is the first choice treatment. [less ▲]

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See detailChronic annular lesions of the cheeks
LOTHER, Anne Sophia; ARRESE ESTRADA, Jorge ULg; NIKKELS, Arjen ULg

in International Journal of Dermatology (2013), (52), 649-650

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See detailChronic annular lesions of the cheeks
LOTHER, Anne-Sophia; ARRESE ESTRADA, Jorge ULg; NIKKELS, Arjen ULg

in International Journal of Dermatology (2012)

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See detailIpilimumab induces simultaneous regression of melanocytic naevi and melanoma metastases
LIBON, Florence ULg; ARRESE ESTRADA, Jorge ULg; RORIVET, A. et al

in Clinical & Experimental Dermatology (2012), (4452), 1-4

Background : Ipilimumab blocks cytotoxic T-lymphocyte-associated antigen (CTLA)-4, potentiating the antimelanoma T-cell host reponse. Ipilimumab has been shown to improve overall survival in patients with ... [more ▼]

Background : Ipilimumab blocks cytotoxic T-lymphocyte-associated antigen (CTLA)-4, potentiating the antimelanoma T-cell host reponse. Ipilimumab has been shown to improve overall survival in patients with previously treated metastatic melanoma. CTLA-4 antibodies generate immune responses to the melanoma-associated antigens Melan-A, NY-ESO-1 and glycoprotein (gp) 100 in metastatic melanoma. Digital epiluminescence microscopy (DELM) is a noninvasive method permitting the monitoring of the morphology of melanocytic lesions over time. Observation : A 50-year-old man with metastatic melanoma received four ipilimumab injections after failure of dacarbazine chemotherapy. Positron emission tomography revealed regression of pulmonary metastases, and simultaneously, DELM showed regression of several melanocytic naevi. On histological examination of the regressing naevi, prominent CD8+, CD4+ and CD45R0 lichenoid lymphohistiocytic infiltrates were seen, whereas nonregressing naevi were almost free of inflammatory infiltrate. Conclusion : Expression of melanoma-associated antigens in benign melanocytic naevi may explain the induction of naevus regression by ipilimumab. DELM could represent a valuable noninvasive method to monitor ipilimumab efficacy. [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 (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 detailLe vemurafenib, une avancée majeure dans le traitement du mélanome métastatique exprimant le BRAF V600E
EL HAYDERI, Lara ULg; RORIVE, Andrée ULg; NIKKELS, Arjen ULg

in Skin Inc (2012)

Malgré une sensibilisation de la population concernant les dangers du soleil, des techniques diagnostiques très sensibles comme la dermoscopie et une diminution constante de l'épaisseur des mélanomes lors ... [more ▼]

Malgré une sensibilisation de la population concernant les dangers du soleil, des techniques diagnostiques très sensibles comme la dermoscopie et une diminution constante de l'épaisseur des mélanomes lors du premier diagnostic, il existe toujours des cas où le diagnostic arrive trop tard. Le pronostic du mélanome métastatique (stade IV) reste alors péjoratif avec une survie n'excédant pas les 5% à 5 ans. Les traitements par agents chimiothérapeutiques comme le DTIC (dacarbazine), les immunothérapies comme l'interféron ou les vaccinations à base de cellules dendritiques ne donnent que très peu d'espoir dans cette indication. Heureusement, des avancées significatives sont rapportées dans le traitement du mélanome métastatique exprimant la mutation BRAF V600E avec un inhibiteur de la BRAF kinase, le vemurafinib. Les résultats d'une étude de phase III montrent une diminution de 63 % du risque de décès et de 74 % du risque de progression avec le vemurafenib, par rapport à la chimiothérapie par DTIC. Le vemurafenib est associé à de nombreux effets indésirables cutanés (rash, alopécie, kérato-acanthome, carcinomes spinocellulaires, photosensibilité ...), qu'il est important de reconnaître pour pouvoir assurer une prise en charge thérapeutique adéquate. [less ▲]

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See detailHerpes zoster in patients treated with biologicals
FAILLA, Valérie ULg; JACQUES, Jessica ULg; CASTRONOVO, Charlotte ULg et al

in Dermatology (2012)

Background : The incidence and severity of herpes zoster (HZ) appear increased in patients receiving tumor necrosis factor-alpha antagonists. Objective : To study the incidence and clinical features of HZ ... [more ▼]

Background : The incidence and severity of herpes zoster (HZ) appear increased in patients receiving tumor necrosis factor-alpha antagonists. Objective : To study the incidence and clinical features of HZ in 1,220 patients (4.206 patient-years) receiving either adalimumab, etanercept, infliximumab, rituximab or ustekinumab. Results: Twenty-two HZ cases were identified (1.26% of total cohort; adalimumab: 11/1,546 patient-years, incidence rate (IR) 7.1; etanercept: 4/789 patient-years, IR5.1; rituximab: 1/168 patient-years, IR 5.2; ustekinumab: 2/37 patient-years, IR53.5; infliximab: 4/1.666 patient-years, IR 2.4). The time to event varied widely (1.5-108 months). Extensive HZ was reported in 45 and 32% of the cases, respectively. Persistent postzoster neuralgia (PHN;>6months) was observed in 5/20 patients. Conclusions: The Hz incidence was 2.1-fold higher among patients over 60 years, compared with a reference population, although not statistically significant. Severe, multidermatomal HZ and persistent PHN were common. [less ▲]

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See detailChronic mucocutaneous herpes simplex virus and varicella zoster virus infections
Wauters, Odile ULg; Lebas, Eglantine ULg; Nikkels, Arjen ULg

in Journal of the American Academy of Dermatology (2012)

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See detailVitamine D et mélanome
NIKKELS, Arjen ULg; RORIVE, Andrée ULg; CAVALIER, Etienne ULg

in Skin Inc (2012), 15(3), 35

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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 detailHerpes Simplex Virus Infections of the Nipple
EL HAYDERI, Lara ULg; CAUCANAS, Marie ULg; NIKKELS, Arjen ULg

in Open Dermatology Journal (The) (2012)

The usual sites of herpes simplex virus (HSV) type 1 and 2 infections are orolabial and anogenital, respectiverly. HSV infection of the nipple and periareolar area is exceptional but probably ... [more ▼]

The usual sites of herpes simplex virus (HSV) type 1 and 2 infections are orolabial and anogenital, respectiverly. HSV infection of the nipple and periareolar area is exceptional but probably underrecognized. Typical features include severe pain and erosive or ulcerated erythematous confluent clusters of lesions of the nipple and periareolar area. It is usually unilateral and not recurring. HSV infection of the nipple is originating from autoinoculation, sexual transmission or breastfeeding. Diagnosis is often delayed. The Tzanck smear is the most rapid and adequate method of dagnosis. Immunohistochemistry enables viral identification. The treatment relies on topical disinfection and oral antiviral therapy, such as aciclovir, famciclovir or valaciclovir. Scarring is uncommon. [less ▲]

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