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See detailComment je traite ... un psoriasis en plaques par l'association calcipotriol-dipropionate de betamethasone.
Henry, Frédérique ULg; Flagothier, Caroline ULg; Franchimont, Claudine ULg et al

in Revue Médicale de Liège (2006), 61(3), 139-41

The combination of calcipotriol and betamethasone dipropionate in a single topical formulation is a recent advance in treatment of plaque type psoriasis. Studies rooted on evidence-based medicine have ... [more ▼]

The combination of calcipotriol and betamethasone dipropionate in a single topical formulation is a recent advance in treatment of plaque type psoriasis. Studies rooted on evidence-based medicine have been recently published. We report a synthesis and a critical analysis, critical analysis of these investigations, and translate their data with a view to apply them in daily practice. [less ▲]

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See detailLe médicament du mois. L'étanercept (Enbrel) pour le traitement du psoriasis en plaques modéré a sévère.
Franchimont, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(3), 201-5

Etanercept (Enbrel) is a soluble tumour necrosis factor (TNF) receptor drug. By this mechanism, it inhibits the effects of TNF-alpha involved in the pathogenesis of psoriasis. Enbrel is approved for the ... [more ▼]

Etanercept (Enbrel) is a soluble tumour necrosis factor (TNF) receptor drug. By this mechanism, it inhibits the effects of TNF-alpha involved in the pathogenesis of psoriasis. Enbrel is approved for the treatment of moderate to severe chronic plaque psoriasis, and also for psoriatic arthritis. [less ▲]

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See detailL'image du mois. Lésions cutanées révélatrices d'une dermatomyosite.
Franchimont, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(4), 209-10

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See detailComment je traite...une dermite des langes.
Henry, Frédérique ULg; Thirion, Laurence; Franchimont, Claudine ULg et al

in Revue Médicale de Liège (2006), 61(4), 212-6

Diaper dermatitis is the most frequent skin disorder of the newborn. Several clinical types are distinguished. The most frequent type results from increased fragility of the newborn buttock skin when ... [more ▼]

Diaper dermatitis is the most frequent skin disorder of the newborn. Several clinical types are distinguished. The most frequent type results from increased fragility of the newborn buttock skin when covered by diapers. According to the mechanisms involved and the severity of the dermatitis, one can distinguish the intertrigo of the chubby baby, and the so-called "W", "Y" and "red panties" types of diaper dermatitis. When the effects of occlusion are not controlled by adequate absorption by the diapers maceration of the stratum corneum occurs. As a result, degradation of the skin barrier function takes place. In addition, the value of the coefficient of friction of the skin increases with epidermal weakening to rubbing. In addition, fecal enzymes alter urines and skin. Judicious hygiene measures and a correct choice of care and diapers are mandatory. Cutaneous colonisation by microorganisms, in particular the yeasts Candida spp, is the main complication. Adequate preventive and curative measures can combat diaper dermatitis with confidence. A miconazole paste allows to improve the tribological properties of the interface between diapers and the skin. It also corrects the degradation of the skin barrier function, reduces inflammation and abates the impact of Candida spp. in the pathogenesis of the skin disorder. [less ▲]

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See detailQualite de vie, emollients et agents hydratants.
Xhauflaire, Emmanuelle ULg; Haubrechts, C.; Pierard, Claudine ULg et al

in Revue Médicale de Liège (2006), 61(4), 233-6

So-called dry skin is a quite common and annoying condition. This skin may affect individuals that are otherwise healthy. It may be particularly severe and unpleasant in cases of ichthyosis, atopic ... [more ▼]

So-called dry skin is a quite common and annoying condition. This skin may affect individuals that are otherwise healthy. It may be particularly severe and unpleasant in cases of ichthyosis, atopic dermatitis or psoriasis. The inductive effects of the environment must not be ignored. Emollients and hydrating agents for the stratum corneum can help relieve the clinical manifestations. [less ▲]

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See detailHighlighting the rim of the perifollicular epidermal unit.
Xhauflaire, Emmanuelle ULg; Hermanns, Jean-Francois; Pierard, Claudine ULg et al

in European Journal of Dermatology (2006), 16(3), 225-9

The perifollicular and interfollicular areas of normal skin may look similar. However, some physiological and pathological processes may specifically involve a thin perifollicular rim. This review ... [more ▼]

The perifollicular and interfollicular areas of normal skin may look similar. However, some physiological and pathological processes may specifically involve a thin perifollicular rim. This review illustrates some of the methods available for highlighting the rim of the perifollicular epidermal unit. Non invasive methods rely on dermoscopy, ultraviolet light enhanced visualization (ULEV), skin capacitance imaging and cyanoacrylate skin surface strippings (CSSS). Conventional histology and immunohistochemistry may also show specific perifollicular features without, however, revealing the aspects highlighted by the specific non invasive methods. The clinically relevant modifications consist of pigmentary and hyperkeratotic perifollicular changes. [less ▲]

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See detailL'herpes virus de type 6. Quelle attention mérite-t'il en medecine générale?
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(5-6), 317-21

The human herpesvirus 6 (HHV6) is a member of the beta-herpes viridae family. The primary infection is usually asymptomatic and commonly occurs during childhood. The clinical form is called exanthema ... [more ▼]

The human herpesvirus 6 (HHV6) is a member of the beta-herpes viridae family. The primary infection is usually asymptomatic and commonly occurs during childhood. The clinical form is called exanthema subitum, or roseala infantum or the 6th disease. This biphasic disorder usually runs a benign course and requires no antiviral treatment. However, the HHV6 reactivation can lead to serious systemic diseases, especially encephalopathy, that may be fatal in the immunocompromised or grafted patient. In seronegative pregnant women, a primary HHV6 infection contracted from a child with roseola infantum can lead, in rare instances, to spontaneous abortion during the first trimester, or produce neurological complications in the newborn after HHV6 transplacental infection. Aciclovir, ganciclovir (GCV), foscarnet and cidofovir show anti-HHV6 in vitro efficacy, but GCV is currently the first line agent when of HHV6 infection is diagnosed in the immunocompromised patient. [less ▲]

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See detailL'herpes labial récidivant. Comment traiter et prévenir au mieux.
Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(5-6), 442-7

Labial herpes is a recurrent muco-cutaneous disorder caused by the herpes simplex virus (HSV), particularly the HSV type I. It affects 10 to 30% of the adult population. The recurrence rate varies from ... [more ▼]

Labial herpes is a recurrent muco-cutaneous disorder caused by the herpes simplex virus (HSV), particularly the HSV type I. It affects 10 to 30% of the adult population. The recurrence rate varies from episodic events to monthly recurrences. Several triggering factors have been identified. They include physical factors such as ultraviolet radiations and any local traumatism such as dental and neurosurgical interventions, and dermo-cosmetic procedures of the face. Hormonal factors are also involved including those related to menses and pregnancy. Psychogenic factors, particularly severe stress are also involved. Any other intercurrent infection may also be complicated by recurrent labial herpes. The management of recurrent labial herpes currently relies on the identification and possible avoidance of triggering factors, and on the use of antiviral agents. There is no curative treatment available so far. [less ▲]

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See detailL'image du mois. Ecthyma de l'adulte révélateur d'un diabète.
Thirion, L.; Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(7-8), 543-4

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See detailComment je previens...une exacerbation de la dermatite atopique.
Xhauflaire, Emmanuelle ULg; Pierard, Claudine ULg; Nikkels, Arjen ULg et al

in Revue Médicale de Liège (2006), 61(7-8), 600-3

Atopic dermatitis is under the influence of series of environmental factors. The contact with unsuited cleaning agents and rough textiles can exacerbate pruritus and inflammation. Preventive and adjuvant ... [more ▼]

Atopic dermatitis is under the influence of series of environmental factors. The contact with unsuited cleaning agents and rough textiles can exacerbate pruritus and inflammation. Preventive and adjuvant measures can thus help the care procedures of the disease. Appropriate hygiene measures and the use of emollients are particularly helpful. Clothing measures are also in place. Undergarments and pyjamas made of knitted natural silk are available. Other measures, sometimes corresponding to anecdotal claims--antihistamines, thermal cures, unconventional medicine, probiotics, chinese herbals, essential fatty acids--have not proven their preventive efficacy in atopic dermatitis. [less ▲]

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See detailL'image du mois: Maladie de Kaposi chez un sidéen africain.
Thirion, L.; Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(9), 609-10

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See detailLe cas clinique du mois. Carcinome basocellulaire pédicule et pigmenté: une présentation inhabituelle.
Azzam, C.; Arrese Estrada, Jorge ULg; Jacquemin, Denise ULg et al

in Revue Médicale de Liège (2006), 61(9), 614-6

Basal cell carcinomas (BCC) are the most common malignant neoplasms in humans. Clinical misdiagnoses are not uncommon. These cancers are classified according to their histological and clinical ... [more ▼]

Basal cell carcinomas (BCC) are the most common malignant neoplasms in humans. Clinical misdiagnoses are not uncommon. These cancers are classified according to their histological and clinical characteristics which exhibit distinct malignant behaviours. It is important to be aware of the different clinical presentations both for the accurate diagnosis and tumour management. We report the case of a 78-year-old man, who presented an unusual pedunculated and pigmented BCC. This combined aspect is rarely encountered. [less ▲]

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See detailSyndrome DRESS à la sulfasalazine.
Bourguignon, Raphaël; Pierard, Claudine ULg; Paquet, Philippe ULg et al

in Revue Médicale de Liège (2006), 61(9), 643-8

We report a case of drug hypersensibility syndrome (DRESS syndrome) developed one month after initiation of a treatment by sulfasalazine. Due to the severity of the cytolytic hepatic damages as observed ... [more ▼]

We report a case of drug hypersensibility syndrome (DRESS syndrome) developed one month after initiation of a treatment by sulfasalazine. Due to the severity of the cytolytic hepatic damages as observed in this case, we emphasize the importance of suggesting this diagnosis in any patient developing a cutaneous rash and an alteration of the general health status after initiation of a new treatment. The hematologic alterations which represent a key feature for the diagnosis may rash. develop only a few days after the cutaneous rash. [less ▲]

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See detailComment je traite...l'acné de l'adolescent: un algorithme stratégique sans antibiotique.
Xhauflaire, Emmanuelle ULg; Goffin, Véronique ULg; Pierard, Claudine ULg et al

in Revue Médicale de Liège (2006), 61(10), 667-70

Acne is a multifaceted disorder. Its clinical presentation differs according to the age and gender of the subjects. Acne of the adolescent is a frequent disorder. Some topical and oral antibiotics have ... [more ▼]

Acne is a multifaceted disorder. Its clinical presentation differs according to the age and gender of the subjects. Acne of the adolescent is a frequent disorder. Some topical and oral antibiotics have proven their efficacy. However, the risk of bacterial resistance may be a concern for the clinicians and their patients. Hence, a therapeutic strategy without antibiotics merits to be considered. Retinoids have a place of choice in this therapeutic strategy. Benzoyl peroxide and miconazole are also active and valuable agents in this therapeutic algorithm. [less ▲]

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See detailLes dermatoses linéaires.
Thirion, L.; Nikkels, Arjen ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(10), 719-23

Some typical distributions of skin lesions represent a helpful sign for the differential diagnosis in dermatology. Indeed, some dermatoses, affecting the skin, nails or mucosae, display an annular or ... [more ▼]

Some typical distributions of skin lesions represent a helpful sign for the differential diagnosis in dermatology. Indeed, some dermatoses, affecting the skin, nails or mucosae, display an annular or linear disposition. The linear pattern can be explained by several factors. The dermatosis can follow either a nerve traject, vascular or lymphatic vessels, or embryological lines. Exogenous factors, including traumatisms or automutilations, can also contribute to this particular distribution. In this review, the principal linear dermatoses are discussed together with their pathogenesis. [less ▲]

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See detailLe caractère relatif des indicateurs de tendance
Monseur, Christian ULg; Lafontaine, Dominique ULg

in Schweizerische Zeitschrift für Bildungswissenschaften = Rivista Svizzera di Scienze dell' Educazione = Revue Suisse des Sciences de l'Education (2006), 3(28), 353-371

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See detailComment je traite...un patient atteint de mycosis fongoide.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(11), 740-6

Primary lymphomas of the skin exhibit singular clinical, histological and prognostic features that are not shared by lymphomas originating from the lymphoid tissues. This review is an update of the ... [more ▼]

Primary lymphomas of the skin exhibit singular clinical, histological and prognostic features that are not shared by lymphomas originating from the lymphoid tissues. This review is an update of the current concepts about the diagnosis and treatment of mycosis fungoides, the most frequent entity among the primary cutaneous lymphomas. [less ▲]

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See detailComment j'explore ... un patient atteint de mélanome: actualisation d'un algorithme.
Pierard, Claudine ULg; Pierard, Gérald ULg

in Revue Médicale de Liège (2006), 61(12), 837-43

Cutaneous melanoma is a cancer affecting an ever growing proportion of young adults. Currently, the best approach for a prolonged remission or cure relies on early detection of the primary neoplasm and of ... [more ▼]

Cutaneous melanoma is a cancer affecting an ever growing proportion of young adults. Currently, the best approach for a prolonged remission or cure relies on early detection of the primary neoplasm and of its first possible metastases. Some therapies can bring much hope at this stage of the disease. The early detection of lymph node metastases is therefore essential in the global management strategy. The excision and the microscopic examination of the sentinel lymph node are important in this evaluation. Echography of the draining lymph nodes is a non invasive procedure which may also prove to be informative. PET-scan brings additional information, particularly when the dissemination risk is beyond the first group of lymph nodes. [less ▲]

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See detailSkin capacitance imaging for the dermatologists
Pierard, Gérald ULg

in European Dermatology Review (2006), 1

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