References of "Dermatology : International Journal for Clinical & Investigative Dermatology"
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See detailSeborrheic dermatitis today, gone tomorrow? The link between the biocene and treatment.
Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(3), 187-8

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See detailSkin weathering: the face at the interface.
Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 207(3), 248-50

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See detailTreatment failures and relapses in onychomycosis: a stubborn clinical problem.
Arrese Estrada, Jorge ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 207(3), 255-60

The therapeutic outcome of onychomycoses is uncertain. Comparative short-term efficacy studies on antifungals abound and report contradictory findings. Few unbiased follow-up studies have scrutinized the ... [more ▼]

The therapeutic outcome of onychomycoses is uncertain. Comparative short-term efficacy studies on antifungals abound and report contradictory findings. Few unbiased follow-up studies have scrutinized the long-term outcome. Basically, none of the current antifungals can guarantee cure in all instances. In addition, relapses are not rare. The causes of therapeutic failure in onychomycoses are multiple. The most important are the lack of diagnostic accuracy, inadequate antifungal choice or delivery modality, and presence of dormant conidia, sequestrated mycelium pockets or resistant fungal species. The concept of fungicidal drug derived from selected in vitro studies appears irrelevant in clinical practice. [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 detailFactor-XIIIa-positive dendrocytes in drug-induced toxic epidermal necrolysis (Lyell's syndrome): paradoxical activation in skin and rarefaction in lymph nodes.
Paquet, Philippe ULg; Quatresooz, Pascale ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(4), 374-8

BACKGROUND: Drug-induced toxic epidermal necrolysis (TEN) is a rare life-threatening disease characterized by the extensive destruction of the epidermis contrasting with the discreteness of lymphoid cell ... [more ▼]

BACKGROUND: Drug-induced toxic epidermal necrolysis (TEN) is a rare life-threatening disease characterized by the extensive destruction of the epidermis contrasting with the discreteness of lymphoid cell infiltration. The precise pathomechanism of the disease remains unclear. METHODS: Skin specimens and peripheral and thoracic lymph nodes (LNs) were collected from 2 TEN patients. They were examined by conventional histology and immunohistochemistry using antibodies directed to factor XIIIa (dermal dendrocytes), CD1a (Langerhans cells), CD15 (granulocytes), CD20 (B lymphocytes), CD45RO (activated T lymphocytes), CD68 (macrophages) and the proliferation marker Ki-67. LNs from patients with mycosis fungoides, from subjects dead from acute cardiac failure or traumatic injuries, as well as metastasis-free sentinel LNs of cutaneous melanoma served as positive and negative controls. RESULTS: TEN LNs showed absence of germinal centers but a moderate hyperplasia of the paracortical T cell zone. Immunohistochemistry did not reveal any distinctive aspect in LN cellular densities between TEN and other control conditions except for the factor-XIIIa+ dendritic cells which were dramatically reduced in numbers in TEN LNs. This rarefaction in LNs contrasted with the great number of these cells in the skin of the same patients. CONCLUSION: The structure of TEN LNs rules out the involvement of an antibody-mediated response. As dendritic factor-XIIIa+ cells are involved in most cutaneous T-cell-mediated responses, their depletion in TEN LNs could explain the sparse lymphoid cell infiltrate in lesional TEN skin. [less ▲]

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See detailIncidental control of rosacea by somatostatin.
Pierard, Claudine ULg; Quatresooz, Pascale ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(3), 249-51

BACKGROUND: The precise pathomechanism of rosacea remains elusive. The disease commonly requires long-term treatments using topical or oral therapies. OBJECTIVE: This report presents incidental findings ... [more ▼]

BACKGROUND: The precise pathomechanism of rosacea remains elusive. The disease commonly requires long-term treatments using topical or oral therapies. OBJECTIVE: This report presents incidental findings about the possible modulatory role of somatostatin in the outcome of rosacea. METHOD: Four patients presenting long-standing recalcitrant facial rosacea were treated with octreotide for diabetic retinopathy. RESULTS: Rosacea improved rapidly and even cleared without any recurrence in 3 of the patients. CONCLUSION: The beneficial effect might be attributed to inhibitory actions on the sebaceous gland, the neovascularization and/or on the inflammatory process. [less ▲]

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See detailNudging epidermal field cancerogenesis by imiquimod.
Uhoda, Isabelle; Quatresooz, Pascale ULg; Pierard, Claudine ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(4), 357-60

BACKGROUND: The coexistence of malignancies close to each other on the skin has been occasionally reported. The concept of field cancerogenesis applies to such cases. Given the purported mechanism of ... [more ▼]

BACKGROUND: The coexistence of malignancies close to each other on the skin has been occasionally reported. The concept of field cancerogenesis applies to such cases. Given the purported mechanism of action of imiquimod, it should not be surprising that this treatment could inhibit epidermal field cancerogenesis. AIM: To assess the effect of imiquimod applied twice weekly on incipient bowenoid changes disclosed in the vicinity of basal cell carcinomas. MATERIALS AND METHOD: Biopsies were taken before treatment and after 4-6 weeks and 12 weeks of imiquimod treatment. RESULTS: Large atypical bowenoid keratinocytes and dyskeratotic cells were cleared in time while factor-XIIIa-positive dermal dendrocytes appeared boosted and admixed with a brisk lymphocytic infiltration. CONCLUSION: Epidermal field cancerogenesis appears to be controlled by imiquimod. Dermal dendrocytes might play a pivotal role in this regression phenomenon. [less ▲]

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See detailHistometric assessment of psoriatic plaques treated by vitamin D3 derivatives.
Uhoda, Isabelle; Quatresooz, Pascale ULg; Hermanns-Lê, Trinh ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2003), 206(4), 366-9

BACKGROUND: Psoriasis is an immunogenetic disorder. Factor XIIIa+ dermal dendrocytes (DD) are part of the pathobiological changes in the plaque type of the disease. OBJECTIVE: The present study aimed at ... [more ▼]

BACKGROUND: Psoriasis is an immunogenetic disorder. Factor XIIIa+ dermal dendrocytes (DD) are part of the pathobiological changes in the plaque type of the disease. OBJECTIVE: The present study aimed at comparing the effect of 3 vitamin D(3) derivatives on the epidermis, microvasculature and DD in psoriasis. METHOD: Twenty men suffering from chronic plaques of psoriasis on the trunk were enrolled in this study. They applied twice a day for 3 weeks calcipotriol, tacalcitol and calcitriol, each to one plaque. Another similar lesion received petrolatum as a placebo treatment. Skin biopsies were taken at entry and at completion of the 3-week treatment phase. Immunohistochemistry was performed using the lectin of Ulex europaeus and an antibody to factor XIIIa. Computerized image analysis served to measure the stratum Malpighii area, the microvasculature area and the DD numerical density in the papillary dermis. RESULTS: At entry in the study, the 4 test sites were indistinguishable with regard to the stratum Malpighii area, the papillary microvasculature area and the papillary DD density. The 3 histometric parameters appeared correlated with each other. At completion of the 3-week treatment phase, the 3 vitamin D derivatives had decreased the size of the stratum Malpighii. In addition, calcitriol had also reduced the DD density in the papillary dermis. No other significant changes were yielded. CONCLUSION: As assessed by histometry, the psoriatic epidermis responded to a short treatment using the 3 vitamin D derivatives. The better result compared to the control site was achieved by calcitriol. DD appeared to be most controlled by the same drug. The microvasculature did not appear to be decreased at the 3-week time point in treatment. [less ▲]

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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-Lê, 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 detailSkin tensile properties in patients treated for acromegaly.
Braham, Catherine; Betea, Daniela ULg; Pierard, Claudine ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 325-9

BACKGROUND: Somatotropic effects are described in the skin. Indeed, acromegaly is in part clinically recognized by cutaneous coarsening. The actual changes in tensile properties associated with the ... [more ▼]

BACKGROUND: Somatotropic effects are described in the skin. Indeed, acromegaly is in part clinically recognized by cutaneous coarsening. The actual changes in tensile properties associated with the cutaneous manifestations are largely unknown. OBJECTIVES: To study the relationships between the skin tensile properties and the severity of acromegaly as assessed by serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). PATIENTS AND METHOD: Assessments were made in 13 patients with acromegaly treated by somatostatin agonists combined or not with surgery. A total of 39 age- and sex-matched healthy subjects served as controls. Skin tensile properties were measured on the forearm and nape of the neck using a computerized suction device. RESULTS: Significant differences were yielded between the skin tensile properties in patients and normal subjects. The highest IGF-1 values in the patients' medical records were positively correlated with both skin distensibility and biologic elasticity. The most recent IGF-1 serum levels were negatively correlated with the visco-elastic ratio. No correlations were yielded between any of the biomechanical parameters and GH levels, disease duration and treatment dosages, respectively. CONCLUSION: The skin in acromegaly appears to be functionally more redundant and elastic than normal skin. The biomechanical changes appear quite different from those observed in other diseases with collagen deposition such as diabetes mellitus and scleroderma. [less ▲]

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See detailGamma-probe-directed lymphatic mapping and sentinel lymphadenectomy in primary cutaneous melanoma.
Belhocine, T.; Pierard, Gérald ULg; Gielen, Jean-Louis ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 355-61

BACKGROUND: Radiotracer and blue-dye lymphatic mapping is a recommended combined method to guide sentinel lymphadenectomy and full regional lymph node dissection in selected patients with cutaneous ... [more ▼]

BACKGROUND: Radiotracer and blue-dye lymphatic mapping is a recommended combined method to guide sentinel lymphadenectomy and full regional lymph node dissection in selected patients with cutaneous melanoma. OBJECTIVE: To evaluate the diagnostic accuracy and the prognostic value of gamma-probe-directed lymphatic mapping in cutaneous melanomas. METHODS: Sixty-five stage I and II melanoma patients underwent gamma-probe-directed lymphatic mapping. Sentinel lymph nodes were studied by both conventional and immunohistochemical stainings. The median follow-up was 11 months. RESULTS: Sensitivities of preoperative and intraoperative sentinel lymph node detection were 100 and 98%, respectively. Only 1 failure of detection and 1 missed same-basin metastasis were experienced in the axillary and cervical areas, respectively. Eleven patients (16.9%) had sentinel node metastases leading to adjuvant therapy. CONCLUSION: Gamma-probe-directed lymphatic mapping is useful for staging melanoma. However, in the expectation of a more specific identification of the sentinel lymph node, the standard protocol remains recommended for exploring the axillary and cervical areas. The histological examination supported in some cases by immunohistochemistry remains mandatory in all cases. [less ▲]

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See detailAssessment of topical hypopigmenting agents on solar lentigines of Asian women.
Hermanns, Jean-François ULg; Petit, Ludivine; Pierard, Claudine ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 281-6

BACKGROUND: So-called darkened age spots encompass distinct pathological processes. The efficacy of topical depigmenting agents is difficult to objectivate. OBJECTIVE: To assess the hypopigmenting effect ... [more ▼]

BACKGROUND: So-called darkened age spots encompass distinct pathological processes. The efficacy of topical depigmenting agents is difficult to objectivate. OBJECTIVE: To assess the hypopigmenting effect of three cosmetic formulations using objective biometrological methods. METHODS: 50 women of South-East Asian ancestry were enrolled in this pilot study. They had solar lentigines according to dermoscopic criteria. The lesions were treated by topical hypopigmenting formulations. Products were applied twice daily for 2 or 3 months. Assessments at 1-month intervals were made using narrow-band reflectance spectrophotometry, image analysis of video-recorded ultraviolet light reflection and photodensitometry- and image-analysis-assisted corneomelametry. RESULTS: A 20% azelaic acid formulation and another one containing 5% ascorbyl glucosamine, 1% kojic acid and alpha-hydroxyacid esters appeared inefficacious on solar lentigines. A stabilized soy extract showed a better although modest lightening effect when assessed by corneomelametry. The subclinical or faint mottled skin revealed by ultraviolet light examination better responded (p < 0.05) to treatments. CONCLUSION: Focal epidermal hyperpigmentation is better controlled by topical whitening agents when the increase in melanin content reflects a modest functional hyperactivity of melanocytes. [less ▲]

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See detailInvasive tricholemmal carcinoma of the nose.
Van Zele, Dirk; Arrese Estrada, Jorge ULg; Heymans, Olivier et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 315-7

Tricholemmal carcinoma is a rare entity. It must be distinguished from the benign proliferating variant of the tricholemmal cyst. We report a case of tricholemmal carcinoma massively invading the nose ... [more ▼]

Tricholemmal carcinoma is a rare entity. It must be distinguished from the benign proliferating variant of the tricholemmal cyst. We report a case of tricholemmal carcinoma massively invading the nose. The neoplasm was excised surgically with a satisfactory outcome. [less ▲]

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See detailPostmenopausal aging of the sebaceous follicle: a comparison between women receiving hormone replacement therapy or not.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(1), 17-22

BACKGROUND: The endocrine control of sebaceous follicles is complex in women. During aging, a decline in sebum output is often experienced. However, some women report increased seborrhea after the ... [more ▼]

BACKGROUND: The endocrine control of sebaceous follicles is complex in women. During aging, a decline in sebum output is often experienced. However, some women report increased seborrhea after the menopause. OBJECTIVE: In this study, the follicular reservoir function was studied during the first decade following the menopause. METHODS: Four evaluations were made at 3-week intervals in two parallel age-matched groups of 50 postmenopausal women receiving hormone replacement therapy (HRT) or not. The Sebumeter served to measure the casual sebum level and the sebum excretion rate on the forehead. In addition, a Visioscan equipped with an ultraviolet-recording camera was used with and without lipid-sensitive tapes interposed between the camera and the skin surface. Follicular openings and sebum pore patterns were studied by image analysis. RESULTS: There was enormous diversity among individual values of sebum output at the skin surface. In untreated women, a significant decline in sebum excretion rate accompanied by an increase in both the sebum replacement time and the mean pore size were evidenced during the first decade after the menopause. The sebum excretion rate and casual level showed a wide range of interindividual differences early after the menopause. These physiological changes were less prominent in women receiving HRT. CONCLUSION: Postmenopausal aging affects the sebum production, but HRT does not significantly control the complex process of seborrhea. However, HRT mitigates the progressive enlargement of the openings of the sebum follicular reservoir. [less ▲]

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See detailThe beneficial toxicity paradox of antimicrobials in leg ulcer healing impaired by a polymicrobial flora: a proof-of-concept study.
Fumal, I.; Braham, C.; Paquet, Philippe ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204 Suppl 1

BACKGROUND: Some of the views contrasting the beneficial and toxic effects of antimicrobials upon wound healing remain controversial. OBJECTIVE: To assess the clinical relevance of histological findings ... [more ▼]

BACKGROUND: Some of the views contrasting the beneficial and toxic effects of antimicrobials upon wound healing remain controversial. OBJECTIVE: To assess the clinical relevance of histological findings following antimicrobial applications on chronic leg ulcers. METHOD: The present study was performed in three parallel groups of 17 patients suffering from at least 2 similar chronic leg ulcers. Clinical planimetric assessments were performed before and after 3 and 6 weeks of treatment using hydrocolloid dressings. In addition, 1 ulcer in each patient received applications of povidone-iodine (PVP-I), silver sulfadiazine or chlorhexidine digluconate. Histological examinations were made at inclusion and after the 6-week therapy. Time to healing was also recorded. RESULTS: At entry in the study, fibroblasts, macrophages, neutrophils and vessels were abundant in the ulcers. In addition, focal necrotizing vasculitis was related to the microbiological load. Compared to the control lesions, both the healing rate and time to healing of the leg ulcers showed a modest improvement at the sites receiving silver sulfadiazine (2-7%) or chlorhexidine digluconate (-1 to 5%). By contrast, PVP-I increased significantly the healing rate (4-18%, p < 0.01), and time to healing was reduced by 2-9 weeks (p < 0.01). The 3 antimicrobials decreased the bacterial density, and the vascular margination and migration of inflammatory cells, thus abating the vasculitic changes. PVP-I applications did not alter the microvessels and did not significantly reduce the density in dendrocytes and fibroblasts. By contrast, both silver sulfadiazine and chorhexidine digluconate appeared to alter the superficial microsvasculature including the dendrocyte population. CONCLUSION: Although topical antimicrobials may apparently achieve almost similar activity on the bacterial load inside chronic leg ulcers, the toxicity upon host cells was different among these agents. PVP-I appeared to be an efficient compound in these respects exhibiting a positive and relevant clinical effect. [less ▲]

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See detailEuclidean and fractal computer-assisted corneofungimetry: a comparison of 2% ketoconazole and 1% terbinafine topical formulations.
Arrese Estrada, Jorge ULg; Fogouang, L.; Pierard, Claudine ULg et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(3), 222-7

BACKGROUND: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. OBJECTIVE: In this 2-step study performed in two groups ... [more ▼]

BACKGROUND: The corneofungimetry bioassay was designed as a unique model predicting the efficacy of topical and oral antifungals in dermatomycoses. OBJECTIVE: In this 2-step study performed in two groups of 15 volunteers, corneofungimetry was used to compare the effect of 5-day b.i.d. treatments with 2% ketoconazole and 1% terbinafine creams. METHODS: The bioassay was performed using 10 isolates of each of the 3 fungi Trichophyton rubrum, T. mentagrophytes var. interdigitale and Candida albicans put to grow on human stratum corneum. Controls were stratum corneum either untreated or enriched in propylene glycol contained in an unmedicated vehicle. Quantitative assessments were made using both Euclidean and fractal geometry parameters. RESULTS: In comparison with untreated stratum corneum, the fungitoxic activity of the 2% ketoconazole and 1% terbinafine formulations was obvious and similar against dermatophytes. By contrast, 2% ketoconazole was significantly more active against C. albicans than 1% terbinafine. The propylene-glycol-containing vehicle did not exhibit a significant effect upon the dermatophyte growth. Positive linear correlations were yielded between the extent area and the fractal dimension D of dermatophyte mycelia. By contrast, D appeared unrelated to the relative area of dermatophyte growth compared to controls. CONCLUSION: The combination of Euclidean and fractal analyses improves the information provided by the corneofungimetry bioassay. Creams containing 2% ketoconazole and 1% terbinafine appear equally effective against dermatophytes while the former is more potent against Candida albicans. [less ▲]

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See detailProteus syndrome of the hand.
Fraiture, Anne Laure; Ihou, E David; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 318-20

Proteus syndrome exhibits an expanded phenotype. We report a case with restricted macrodactyly and cerebriform hypertrophy of one palm. The differential diagnosis with macrodactyly and other hamartomatous ... [more ▼]

Proteus syndrome exhibits an expanded phenotype. We report a case with restricted macrodactyly and cerebriform hypertrophy of one palm. The differential diagnosis with macrodactyly and other hamartomatous overgrowth syndromes is discussed. [less ▲]

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See detailA double-blind placebo-controlled study of ketoconazole + desonide gel combination in the treatment of facial seborrheic dermatitis.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2002), 204(4), 344-7

BACKGROUND: The pathobiology of seborrheic dermatitis is rooted in a peculiar inflammatory reaction to Malassezia spp. Both topical corticosteroids and antifungals are routinely used with success, either ... [more ▼]

BACKGROUND: The pathobiology of seborrheic dermatitis is rooted in a peculiar inflammatory reaction to Malassezia spp. Both topical corticosteroids and antifungals are routinely used with success, either singly or in combination. OBJECTIVE: To assess the effect of a new combination therapy in this condition. METHODS: Eighteen patients with facial seborrheic dermatitis were treated in a pilot double-blind trial with an anhydrous gel containing the combination of 2% ketoconazole and 0.05% desonide (n = 9) or the unmedicated gel (n = 9). The products were applied once daily for 3 consecutive weeks. Disease severity was assessed at the start and weekly during treatment, as well as 2, 4 and 8 weeks after the end of treatment or at the time of recurrence. The overall clinical assessments were performed using a visual analogue scale. Objective measurements included squamometry X after harvesting the stratum corneum and the erythema index yielded by narrow-band reflectance spectrophotometry. Data were evaluated in an intent-to-treat analysis. RESULTS: The combination therapy yielded reductions in the overall clinical symptom severity of 49, 84 and 92% after 1, 2 and 3 weeks of treatment, respectively. The corresponding improvements with the placebo gel were significantly smaller (p < 0.01), reaching 23, 29 and 42% at successive 1-week intervals. At the end of the 3-week treatment, the clinical signs had completely subsided in 6/9 patients treated with the medicated gel and in only 1/9 patients using the placebo gel. Thus, the clinical response rate was significantly faster (p < 0.01) with the combination therapy than with the vehicle. Differences between the treatment groups using objective noninvasive assessments were also significantly (p < 0.01) in favor of the combination therapy. The squamometry X measurements showed 47, 67 and 74% improvements with the combination gel after 1, 2 and 3 weeks, respectively. The corresponding values with the placebo gel were 34, 46 and 53%, respectively. The erythema index was almost completely reduced to normal at week 2 of treatment in contrast with about 50% reduction with the unmedicated vehicle. None of the patients reported any side effects. CONCLUSION: The combination of ketoconazole with desonide in an anhydrous gel is well tolerated and proves to be significantly more effective than the vehicle for treating facial seborrheic dermatitis. The fast response to treatment and the limited additional improvement between weeks 2 and 3 of the treatment suggest that this combination product may be efficacious with once daily applications for 2 weeks. These data call for expanded studies comparing each single compound, the vehicle and the combination therapy. [less ▲]

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See detailEffect of Ketoconazole 1% and 2% Shampoos on Severe Dandruff and Seborrhoeic Dermatitis: Clinical, Squamometric and Mycological Assessments
Pierard-Franchimont, Claudine ULg; Pierard, Gérald ULg; Arrese, J. E. et al

in Dermatology : International Journal for Clinical & Investigative Dermatology (2001), 202(2), 171-6

Ketoconazole (KET) is active to control dandruff and seborrhoeic dermatitis. Objective assessments comparing the 1% and 2% shampoo formulations are scant. This open, randomized parallel-group trial was ... [more ▼]

Ketoconazole (KET) is active to control dandruff and seborrhoeic dermatitis. Objective assessments comparing the 1% and 2% shampoo formulations are scant. This open, randomized parallel-group trial was carried out to differentiate the effectiveness of KET 1% and 2% in severe dandruff and seborrhoeic dermatitis. A total of 66 patients with severe dandruff or seborrhoeic dermatitis were randomized to each of the two groups. A 2-week run-in phase was followed by a 4-week treatment phase, in turn followed by a 4-week follow-up. The efficacy of treatments was evaluated by combining squamometry X, Malassezia spp. counts and clinical assessments. After 2 and 4 weeks of treatment, KET 2% was significantly superior over KET 1% (p < 0.001) for decreasing both in flakiness and Malassezia density from baseline. The same trend was observed in the mean change from baseline in the overall dandruff severity score. Only 6 mild adverse events were reported. During follow-up KET 2% showed a trend to fewer relapses than KET 1%. KET 2% had superior efficacy compared to KET 1% in the treatment of severe dandruff and scalp seborrhoeic dermatitis. Biometrological evaluations were correlated with the clinical improvements and therefore useful to incorporate in future dandruff studies. [less ▲]

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See detailMicrowave Corneosurfametry and the Short-Duration Dansyl Chloride Extraction Test for Rating Concentrated Irritant Surfactants
Goffin, Véronique ULg; Pierard, Gérald ULg

in Dermatology : International Journal for Clinical & Investigative Dermatology (2001), 202(1), 46-8

BACKGROUND: There are ethical concerns to conduct in vivo tests in the animal and human to provide evidence that cosmetics and other topical products are safe. OBJECTIVE: To compare two methods, namely ... [more ▼]

BACKGROUND: There are ethical concerns to conduct in vivo tests in the animal and human to provide evidence that cosmetics and other topical products are safe. OBJECTIVE: To compare two methods, namely the short-duration dansyl chloride extraction test and the microwave corneosurfametry bioassay, to test the irritation potential of concentrated surfactant systems. METHODS: Five surfactants and water were tested using the in vivo test and the bioassay. RESULTS: A significant linear correlation was found between data yielded by the two procedures. CONCLUSION: The short-duration dansyl chloride extraction test and the microwave corneosurfametry bioassay provide similar information. The latter has the advantage of being safe. [less ▲]

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