http://hdl.handle.net/2268/97 Chercher dans ce canal chercher http://orbi.ulg.ac.be/simple-search http://hdl.handle.net/2268/148971 Titre: La vignette diagnostique de l'etudiant. Le spectre des toxidermies. <br/> <br/>Auteur, co-auteur: Hermanns-Le, T.; Franchimont, Claudine; PIERARD, Gérald <br/> <br/>Résumé: Drug eruptions are frequently encountered and they represent "diseases of medical progress". They are expected in about 2% of treated patients. Their putative diagnosis is based on a set of imputability factors. Several distinct drug-induced skin disorders are identified. They are initially recognized from personal experience, but the implication to a specific drug derives from the collective experience of published evidence. Their histopathological aspect is often evocative or demonstrative for the nature of the dermatosis. Some drug eruptions follow an indolent course, while others are life-threatening. http://hdl.handle.net/2268/146705 Titre: Fibromyalgie: un syndrome d'Ehlers-Danlos de type hypermobile qui s'ignore? <br/> <br/>Auteur, co-auteur: Hermanns-Le, T.; PIERARD, Gérald; Angenot, Ph <br/> <br/>Résumé: Some patients suffering from fibromyalgia present with clinical signs and alterations in the histopathology, immunohistochemistry and ultrastructure of the dermis similar to the Ehlers-Danlos syndrome, hypermobile type (EDSH). Some types of fibromyalgia possibly represent an undiagnosed EDSH. http://hdl.handle.net/2268/146689 Titre: Scleroderma: skin stiffness assessment using the stress-strain relationship under progressive suction. <br/> <br/>Auteur, co-auteur: PIERARD, Gérald; HERMANNS, Trinh; Franchimont, Claudine <br/> <br/>Résumé: Introduction: A few non-invasive biometrological methods are available for monitoring skin stiffening in systemic scleroderma. Among them, the Cutometer(R) is used for years by several clinical teams. Objectives: To revisit the microscopic structure of the dermal fibrous networks in scleroderma and the relationship with changes in viscoelasticity. Methods: The suction method delivered by the Cutometer(R) was applied following the progressive stress-vs-strain modality. Results: The test procedure was sensitive enough to document the initial progression steps of acroscleroderma. Four stages were thus identified including i) the incipient, ii) the progressive, iii) the overt, and iv) the regressive acroscleroderma. Conclusion: The non-invasive determination of skin biomechanical functions is relevant both in routine clinical practice and in antisclerotic drug development. It is complementary although not a substitute for the determination of selected serum biomarkers. http://hdl.handle.net/2268/146688 Titre: Critical assessment of diabetic xerosis. <br/> <br/>Auteur, co-auteur: PIERARD, Gérald; Franchimont, Claudine; Scheen, André <br/> <br/>Résumé: Introduction: Diabetes mellitus is commonly responsible for skin changes including discrete to mild xerosis. Areas covered: This review focuses on some selected relevant bioinstrumental methods assessing diabetes xerosis. Peer-reviewed articles on objective non-invasive methods were scrutinized. The reviewed methods address i) the xerosis severity grading scale, ii) corneodynamics referring to the desquamation rate, iii) electrometric assessment of skin hydration including skin capacitance mapping and iv) implication of the imperceptible perspiration. The subjective clinical assessment often fails to disclose diabetic xerosis with confidence and precision. By contrast, a multipronged biometrological approach identifies a cluster of diabetic patients who experience alterations in the structural and functional maturation of the stratum corneum. Expert opinion: A multipronged biometrological approach helps identifying the changes in the stratum corneum of diabetic xerosis. There is a continuum between the 'dry skin' feeling, xerosis and ichthyosiform presentations, particularly on the shins and feet of diabetic patients. http://hdl.handle.net/2268/146687 Titre: Characterization of spontaneous collagen fibrillogenesis in a cell-free and tension-free environment. <br/> <br/>Auteur, co-auteur: PIERARD, Gérald; Hermanns-Lê, Trinh; Delvenne, Philippe; Franchimont, Claudine <br/> <br/>Résumé: The collagen fibril packing that forms threads and bundles is poorly defined, despite the fact that it is important for distinct aspects of the adventitial and reticular dermis. The present study explored an in vitro fibrillogenesis model using the property of heat polymerization. The process was performed on glass slides with mixtures of collagen I and III, and the material was viewed by scanning electron microscopy. In all instances, collagen I and III formed fibrils with regular sizes. The formation of threads was influenced by the relative proportions of collagen I and III; increasing the relative proportion of collagen I resulted in the formation of threads showing increasing variations in thickness. These findings are in line with the differential presentation and compositions of the different parts of the dermis. The possible interventions of stromal cells and of other macromoleules of the extracellular matrix were not considered in this study. <br/> <br/>Commentaires: (c) The Author(s) CED (c) 2013 British Association of Dermatologists. http://hdl.handle.net/2268/146685 Titre: Et si j'avais une boule de cristal... je prédirais le devenir d'un mycosis fongoïde. <br/> <br/>Auteur, co-auteur: Franchimont, Claudine; HERMANNS, Trinh; PIERARD, Gérald http://hdl.handle.net/2268/144061 Titre: Deciphering supportive treatment strategies for toxic epidermal necrolysis. <br/> <br/>Auteur, co-auteur: Jennes, Serge; PIERARD, Gérald; Paquet, Philippe <br/> <br/>Résumé: Toxic epidermal necrolysis (TEN) is a dreadful life-threatening syndrome typically induced by an adverse drug reaction. This condition is characterized by the sudden and extensive destruction of the epidermis. The patient should be promptly addressed to a burn unit where three types of treatment should be administered, namely, (a) specific topical care of the bullous/eroded skin areas, (b) systemic anti-apoptotic/necrotic treatments, and (c) supportive care preventing secondary internal organ failures. This latter aspect is covered by the present review and focuses on (a) early withdrawal of the causative drug, (b) airway management, (c) hydro-electrolytic control, (d) nutritional support, (e) antibiotherapy, (f) prevention of venous thrombosis and gastroduodenal ulcers, and (g) analgesia and anesthesia. http://hdl.handle.net/2268/144058 Titre: Toxic epidermal necrolysis and antifolate drugs in cancer chemotherapy. <br/> <br/>Auteur, co-auteur: Franchimont, Claudine; Lesuisse, Marianne; Humbert, Philippe; Delvenne, Philippe; PIERARD, Gérald <br/> <br/>Résumé: Folates are one-carbon donors essential for synthesizing purines, pyrimidines, serine, and methionine. They correspond to anionic hydrophilic molecules essential for DNA synthesis in mammalian cells. The latter cells lack the capacity to synthesize folates. In some patients, high dosages of antifolate drugs (eg: methotrexate, pemetrexed) used in cancer chemotherapy alter the keratinocytes, endothelial cells and Factor XIIIa+ dermal dendrocytes in a range of various severities. Such conditions clinically designed under the heading antifolate cytotoxic skin reaction (ACSR) occasionally resemble the toxic epidermal necrolysis (TEN) / Stevens-Johnson syndrome (SJS) spectrum. Whether or not the TEN/SJS presentation of ACSR is a regular condition similar to that induced by other drugs or a variant condition supported by a unique pathomechanism is unsettled. http://hdl.handle.net/2268/144056 Titre: Drug Interactions with Normal and TEN Epidermal Keratinocytes. <br/> <br/>Auteur, co-auteur: Paquet, Philippe; Delvenne, Philippe; PIERARD, Gérald <br/> <br/>Résumé: Human epidermal keratinocytes (EKs) are metabolically involved in various drug transport mechanisms, as well as in detoxification or activation processes. The overall cell mechanisms of drug metabolization, and more specifically drug processing are reviewed in normal EKs. The overall drug metabolism involves different phases corresponding to the uptake, biotransformation and anti-transport steps. In EKs, both the enzymes and transportassociated proteins are different from those involved in the hepatocyte metabolism. Some cytochrome P450 enzymes and the flavin-containing mono-oxygenases are particularly involved in EKs. Basically, EKs represent key cells likely involved during the initial stage of drug-induced toxic epidermal necrolysis (TEN). Only limited advances have been made so far in this field. Nevertheless, mitigating EKs metabolic disturbances in TEN probably represent a promising specific treatment of the disease. http://hdl.handle.net/2268/144053 Titre: Proteomic kinetic analysis of blister fluid and serum in a patient with drug-induced toxic epidermal necrolysis. A comparison with skin immunohistochemistry. <br/> <br/>Auteur, co-auteur: Paquet, Philippe; Meuwis, Marie-Alice; Mazzucchelli, Gabriel; Delvenne, Philippe; PIERARD, Gérald <br/> <br/>Résumé: Drug-induced toxic epidermal necrolysis (TEN) is a rare but potentially lethal bullous disease whose complex pathomechanisms remain uncertain. The aim of the study was an exploratory attempt to assess TEN pathobiology using a combination of immunohistochemistry and proteomics. Skin blister fluid (BF) and serum were collected in a patient in the early TEN stage at day (D) +4 of evolution and three days later (D +7). Intravenous cyclosporine A (CsA) treatment was initiated since D +4. Immunohistochemistry was performed on skin blister biopsies. In addition, proteomic analyses compared the BF protein content before and at the issue of the 3-day CsA treatment. Proteins were selected according to their prominent differential abundance in BF between D+4 and D+7, when influenced by lesional skin cells, but not in serum. Among 300 proteins, four were considered. Glutathione transferase pi was related to oxidative stress in TEN epidermis. The monocyte differentiation antigen CD14 and myeloperoxidase indicated macrophage activation. The proinflammatory S100-A8 protein probably originated from activated keratinocytes and/or macrophages. These proteomic findings were in line with immunohistochemistry and supported the prominent involvement of keratinocytes and macrophages in TEN pathomechanism. As opposed to CD14, other proteins were mainly present in BF at D+7, confirming that CsA expressed little effect, if any, on the activity of keratinocytes and macrophages in the present TEN patient. Of note, the present exploratory study using proteomic analyses in a single TEN case supports a pathogenic hypothesis without establishing any firm conclusion. http://hdl.handle.net/2268/144051 Titre: Editorial: toxic epidermal necrolysis. <br/> <br/>Auteur, co-auteur: PIERARD, Gérald http://hdl.handle.net/2268/144047 Titre: How to manage hair changes in cancer patients. <br/> <br/>Auteur, co-auteur: FRANCHIMONT, Claudine; QUATRESOOZ, Pascale; RORIVE, Andrée; PIERARD, Gérald http://hdl.handle.net/2268/144045 Titre: Trancking and treating malignant melanoma metastases. <br/> <br/>Auteur, co-auteur: PIERARD, Gérald; HUMBERT, Philippe; QUATRESOOZ, Pascale http://hdl.handle.net/2268/143658 Titre: Journée mondiale du Psoriasis <br/> <br/>Auteur, co-auteur: FAILLA, Valérie; AIRO, Mara; NIKKELS, Arjen <br/> <br/>Résumé: La journée mondiale du Psoriasis a eu lieu le 29/10/2011, une bonne occasion de rappeler l'importance de considérer le patient psoriasique dans sa globalité, tant sur le plan cutané que physique et psychique. Une interaction positive entre les différents acteurs comme le dermatologue, le psychologue et le pharmacien, permet une prise en charge efficace et globale du patient psoriasique. C'est sur ces trois axes que la Journée mondiale du Psoriasis s'est focalisée au CHU de Liège, avec l'intervention des services de Dermatologie, de Psychologie médicale et de Pharmacie galénique. http://hdl.handle.net/2268/143621 Titre: Ipilimumab induces simultaneous regression of melanocytic naevi and melanoma metastases <br/> <br/>Auteur, co-auteur: LIBON, Florence; ARRESE ESTRADA, Jorge; RORIVET, A.; NIKKELS, Arjen <br/> <br/>Résumé: 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. http://hdl.handle.net/2268/143428 Titre: Fractal Quantification of the Microvasculature Heterogeneity in Cutaneous Melanoma <br/> <br/>Auteur, co-auteur: Heymans, O.; Blacher, Silvia; Brouers, François; Pierard, Gérald <br/> <br/>Résumé: BACKGROUND: Recent advances in angiogenesis research have led to the introduction of new prognosis factors. Although the vessel count is effective in breast cancer, the prognosis of primary cutaneous melanoma (PCM) does not seems to be directly influenced by this parameter. However, the microscopic examination of PCM suggests variability in the repartition of the microvasculature. OBJECTIVE AND METHOD: To explore the possibility of extracting information about the vessel distribution by performing a textural analysis on the grey level of histological sections by means of fractal characterization by both Fourier spectrum and multifractal analysis. RESULTS: Three different patterns of vasculature were identified according to the vessel density and distribution. CONCLUSION: It is possible to differentiate and quantify clearly the differences in the microvessel profile organization using the fractal and multifractal methods. http://hdl.handle.net/2268/142671 Titre: La vignette diagnostique de l'étudiant. Le phénomène de Raynaud. <br/> <br/>Auteur, co-auteur: FRANCHIMONT, Claudine; PIERARD, Gérald; Hermanns-Le, Trinh http://hdl.handle.net/2268/142669 Titre: Impact climatique sur les ulcères veineux de jambe. <br/> <br/>Auteur, co-auteur: FRANCHIMONT, Claudine; Hermanns-Le, Trinh; LESUISSE, Marianne; PIERARD, Gérald http://hdl.handle.net/2268/142668 Titre: Deux bacteries et une kyrielle d'infections cutanees communes. <br/> <br/>Auteur, co-auteur: Franchimont, Claudine; Lesuisse, M.; PIERARD, Gérald <br/> <br/>Résumé: Common bacterial skin infections represent frequent disorders encountered in general practice and in dermatology as well. They encompass a series of infections affecting the epidermis, dermis, hypodermis and subcutaneous tissues. The two main bacteria involved in these processes are Streptococcus pyogenes and Staphylococcus aureus. The resulting infections show various clinical presentations. Their management must be adapted to their gravity and to the putative or proven nature of the causal microorganism. Searching for any skin ingress possibility and any favouring factor is always of importance in order to stimulate healing and avoid recurrences. Of note, skin possibly allows the ingress way for a secondary septicemic dissemination. Conversely, skin is possibly involved in tissue localisation of septicemia. http://hdl.handle.net/2268/142667 Titre: Le melanome cutane: une seule maladie? <br/> <br/>Auteur, co-auteur: PIERARD, Gérald; Franchimont, Claudine; Hermanns-Le, Trinh; Delvenne, Philippe <br/> <br/>Résumé: For the media and the public at large, malignant melanoma is the most dreadful cancer of the skin. This statement is obvious. However, some nuances merit to be considered. The clinical presentations, histopathology and molecular genetics point to the fact that malignant melanoma is not a single monolithic pathological condition. Different types of melanomas are distinguished based on distinct origins and contrasted prognoses. The management and information for the patient should be handled individually.