<i>In vivo</i> assessment of optical properties of basal cell carcinoma and differentiation of BCC subtypes by high-definition optical coherence tomography

High-definition optical coherence tomography (HD-OCT) features of basal cell carcinoma (BCC) have recently been defined. We assessed in vivo optical properties (IV-OP) of BCC, by HD-OCT. Moreover their critical values for BCC subtype differentiation were determined. The technique of semi-log plot whereby an exponential function becomes linear has been implemented on HD-OCT signals. The relative attenuation factor (µ(raf)) at different skin layers could be assessed.(.) IV-OP of superficial BCC with high diagnostic accuracy (DA) and high negative predictive values (NPV) were (i) decreased µ(raf) in lower part of epidermis and (ii) increased epidermal thickness (E-T). IV-OP of nodular BCC with good to high DA and NPV were (i) less negative µ(raf) in papillary dermis compared to normal adjacent skin and (ii) significantly decreased E-T and papillary dermal thickness (PD-T). In infiltrative BCC (i) high µ(raf) in reticular dermis compared to normal adjacent skin and (ii) presence of peaks and falls in reticular dermis had good DA and high NPV. HD-OCT seems to enable the combination of in vivo morphological analysis of cellular and 3-D micro-architectural structures with IV-OP analysis of BCC. This permits BCC sub-differentiation with higher accuracy than in vivo HD-OCT analysis of morphology alone

Acute Erythroderma in a Patient Receiving TNF-α-Blocking Therapy for Hidradenitis Suppurativa

Tumor necrosis factor-α (TNF-α) normally binds to TNF-α receptors, leading to the inflammatory response of autoimmune diseases. Adalimumab is a TNF-inhibiting, anti-inflammatory, biological medication which binds to TNF-α, thus reducing this inflammatory response. The use of TNF-α-inhibiting medication, such as adalimumab, being the first FDA-approved treatment for hidradenitis suppurativa, has drastically changed the management of dermatological diseases. One rarely reported manifestation that occurs as a side effect associated with the use of TNF-α-blocking agents is erythroderma. This study, for the first time, reports the case of a patient suffering from hidradenitis suppurativa with concomitant psoriasis, who developed a severe and acute erythrodermic rash after the start of adalimumab therapy

Overview and comparison of the clinical scores in hidradenitis suppurativa: A real-life clinical data

IntroductionPartly due to its clinical heterogeneity, hidradenitis suppurativa (HS) is difficult to score accurately; illustrated by the large number of disease scores. In 2016, a systematic review by Ingram et al. reported the use of about thirty scores, and since then, this number has increased further. Our aim is twofold: to provide a succinct but detailed narrative review of the scores used to date, and to compare these scores with each other for individual patients.Materials and methodsThe review of the literature was done among articles in English and French, on Google, Google scholar, Pubmed, ScienceDirect and Cochrane. To illustrate the differences between scores, data from some Belgian patients included in the European Registry for HS were selected. A first series of patients compares the severity of the following scores: Hurley, Hurley Staging refined, three versions of Sartorius score (2003, 2007, 2009), Hidradenitis Suppurativa Physician Global Assessment (HS-PGA), International Hidradenitis Suppurativa Severity Scoring System (IHS4), Severity Assessment of Hidradenitis Suppurativa (SAHS), Hidradenitis Suppurativa Severity Index (HSSI), Acne Inversa Severity Index (AISI), the Static Metascore, and one score that is not specific to HS: Dermatology Life Quality Index (DLQI). A second set of patients illustrates how some scores change over time and with treatment: Hurley, Hurley Staging refined, Sartorius 2003, Sartorius 2007, HS-PGA, IHS4, SAHS, AISI, Hidradenitis Suppurativa Clinical Response (HiSCR), the very new iHS4-55, the Dynamic Metascore, and DLQI.ResultsNineteen scores are detailed in this overview. We illustrate that for some patients, the scores do not predictably and consistently correlate with each other, either in an evaluation of the severity at a time-point t, or in the evaluation of the response to a treatment. Some patients in this cohort may be considered responders according to some scores, but non-responders according to others. The clinical heterogeneity of the disease, represented by its many phenotypes, seems partly to explain this difference.ConclusionThese examples illustrate how the choice of a score can lead to different interpretations of the response to a treatment, or even potentially change the results of a randomized clinical trial

Aggressive Squamous Cell Carcinoma in Organ Transplant Recipients

Importance: Squamous cell carcinoma (SCC) is the most frequent malignant neoplasm found in solid organ transplant recipients and is associated with a more aggressive disease course and higher risk of metastasis and death than in the general population. Objectives: To report the clinicopathologic features of and identify factors associated with aggressive SCC in solid organ transplant recipients. Methods: This retrospective multicentric case series included 51 patients who underwent solid organ transplantation and were found to have aggressive SCC, defined by nodal or distant metastasis or death by local progression of primary SCC. Standard questionnaires were completed by the researchers between July 18, 2005, and January 1, 2015. Data were analyzed between February 22, 2016, and July 12, 2016. Results: Of the 51 participants, 43 were men and 8 were women, with a median age of 51 years (range, 19-71 years) at time of transplantation and 62 years (range, 36-77 years) at time of diagnosis of aggressive SCC. The distribution of aggressive SCC was preferentially on the face (34 [67%]) and scalp (6 [12%]), followed by the upper extremities (6 [12%]). A total of 21 tumors (41%) were poorly differentiated, with a median tumor diameter of 18.0 mm (range, 4.0-64.0 mm) and median tumor depth of 6.2 mm (range, 1.0-20.0 mm). Perineural invasion was present in 20 patients (39%), while 23 (45%) showed a local recurrence. The 5-year overall survival rate was 23%, while 5-year disease-specific survival was 30.5%. Conclusions and Relevance: Results of this case series suggest that anatomical site, differentiation, tumor diameter, tumor depth, and perineural invasion are important risk factors in aggressive SCC in solid organ transplant recipients

La campaña del euromelanoma

SCOPUS: ed.jSCOPUS: ed.jinfo:eu-repo/semantics/publishe

Contribution à l'étude de la régulation de la mélanogenèse chez l'homme

Doctorat en sciences médicalesinfo:eu-repo/semantics/nonPublishe

Abcès cutanés multiples et récidivants: Approche diagnostique

Introduction: The cutaneous abscess commonly occurs in the medical practice, its management being well known. However, atypical cases-multiple occurrence, recurrence and/or resistance to classical treatment can be very challenging for the physician. These cases can be addressed for consultation in several medical specialties depending the age of the patient and the site of the lesions. The systematization of the diagnostic approach would have a great impact for the clinical practice. Method: We used the PubMed search engine to perform a literature review on the different aspects to consider in case of atypical abscess. This has been conducted in order to offer an updated diagnostic approach. Conclusions: The multiple and recurrent cutaneous abscesses can be caused in general by community-acquired or family transmitted infections. However they can also be the manifestation of an underlying chronic disorder as an acquired or innate immunodeficiency, chronic dermatoses, or other systemic diseases. Thus different diagnostic conditions are to be considered.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

The Female Pattern Hair Loss: Review of Etiopathogenesis and Diagnosis

Female pattern hair loss (FPHL) is the most common hair loss disorder in women. Initial signs may develop during teenage years leading to a progressive hair loss with a characteristic pattern distribution. The condition is characterized by progressive replacement of terminal hair follicles over the frontal and vertex regions by miniaturized follicles, that leads progressively to a visible reduction in hair density. Women diagnosed with FPHL may undergo significant impairment of quality of life. FPHL diagnosis is mostly clinical. Depending on patient history and clinical evaluation, further diagnostic testing may be useful. The purpose of the paper is to review the current knowledge about epidemiology, pathogenesis, clinical manifestations, and diagnosis of FPHL

Calciphylaxis

The complete physiopathology is still unclear. Two separate processes have been described: a progressive calcification of medium and small vessels of the subcutaneous and fat tissues related to an abnormal phosphate/calcium ratio occurring in the presence of predisposing factors (chronic vasculopathy, diabetes mellitus, obesity, renal insufficiency, etc.) and an acute phase caused by a decreased blood flow (hypotension, hemostatis perturbations and coagulopathy, infection, injury, etc.) causing the infarction of the tissues. The main risk factor for calciphylaxis is the chronic renal insufficiency with or without a hyperparathyroidy. It mostly occurs on a dialysed patient but may be also associated with other conditions (corticosteroids or antivitamin K therapy, neoplasia, chronic inflammation, etc.).SCOPUS: ch.binfo:eu-repo/semantics/publishe

La mise au point d'une alopécie

SCOPUS: re.jinfo:eu-repo/semantics/publishe