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See detailSunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin D
Libon, Florence ULiege; Courtois, Justine; LE GOFF, Caroline ULiege et al

in Archives of Osteoporosis (2017)

Summary A 50+ SPF sunscreen decreased significantly cutaneous vitamin D production following a single narrow-band (nb)UVB exposure, independently from the body surface area exposed. In contrast, the ... [more ▼]

Summary A 50+ SPF sunscreen decreased significantly cutaneous vitamin D production following a single narrow-band (nb)UVB exposure, independently from the body surface area exposed. In contrast, the circulating 25(OH)D3 levels were only minimally affected. It is probable that another endogenous source of precursors is selected when skin-originated precursors are lacking. Purpose Sunscreen use, highly advocated for preventing cutaneous carcinogenesis, is potentially leading to an aggravation of vitamin D deficiency with its consequences on bone health. The effect of sunscreens on circulating vitamin D levels remains debated. This study investigated the effect of sunscreen on cutaneous vitamin D production and circulating 25(OH)D3 levels, according to different body surface areas (BSA). Methods Vitamin D and 25(OH)D3 levels were measured in four groups exposed to a single nbUVB exposure on 9% (group I: head and hands), 23% (group II: head, hands and arms), 50% (group III: head, hands, arms and legs) and 96% (group IV: total body) of the body surface without and with a 50+ sun protection factor sunscreen. Results Sunscreen use decreased by 83, 88.3, 75.7 and 92.5% the cutaneous vitamin D production in groups I to IV, respectively, but only by 13.2, 10.5, 7.7 and 10.4% the values of circulating 25(OH)D3, correspondingly. Conclusions Although a 50+ sunscreen decreases significantly cutaneous vitamin D production following a single nbUVB exposure, and independently from the BSA, the circulating 25(OH)D3 levels were only minimally affected. This could be explained by a switch to another endogenous source of precursors. Short-term sunscreen use probably does not affect circulating vitamin D levels and hence does not increase the risk for osteoporosis. The effect of long-term sunscreen use remains however to be determined. [less ▲]

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See detailNON-DERMATOPHYTE DERMATOSES MIMICKING DERMATOPHYTOSES IN HUMANS
Libon, Florence ULiege; TASSOUDJI, Nazli ULiege; DEZFOULIAN, Bita ULiege et al

in Mycopathologia (2016)

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the ... [more ▼]

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the intertriginous regions (feet, inguinal, axillar, submammary), dermatophytic colonisations and infections manifest as whitish, slightly hyperkeratotic, pruritic and sometimes fissurated lesions. On the scalp, dermatophytic infections commonly lead to single or multiple more or less inflammatory and alopecic lesions. On the plantar and palmar aspects of the feet and hand, dermatophytosis presents as an eczema-like chronic dermatosis. Abscess-like lesions may occur due to zoophilic dermatomycosis. Dermatophytic infections of the nails reveal ill-defined whitish-yellowish colorations of the distal end or the lateral aspects of the nails, sometimes combined with partial nail embrittlement or even complete destruction. Despite the ubiquity of dermatophytic skin infections and their usually highly typical clinical features, a differential diagnosis has to be considered, in particular when treatment is not efficient or when treatment resistance occurs. This review presents the differential diagnosis in terms of frequency as well as the diagnostic methods permitting the distinction of annular, intertriginous, alopecic, palmoplantar, abscess-like and onychodystrophic lesions. [less ▲]

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See detailMelanoma masquerading as nomelanocytic lesions
DETRIXHE, Audrey ULiege; Libon, Florence ULiege; MANSUY, Marion ULiege et al

in Melanoma Research (2016)

Increased awareness among dermatologists as well as the development of dermoscopy and sequential dermoscopy have contributed significantly toward an increase in the diagnostic accuracy of pigmented ... [more ▼]

Increased awareness among dermatologists as well as the development of dermoscopy and sequential dermoscopy have contributed significantly toward an increase in the diagnostic accuracy of pigmented melanoma and even of amelanotic melanoma. However, the dermatologist's nightmare is the small group of melanomas that present as common skin diseases, often associated with a significant delay in diagnosis and hence a poor prognosis. The study was carried out to prospectively assess the number of melanomas lacking any clinical suspicion of melanoma and to describe their clinical and histological features over a 6-year observation period in an University Tertiary Skin Cancer Center. Out of 502 cases of newly diagnosed cases of melanoma, seven (1.4%) nonpigmented and nonamelanotic cases of melanoma were identified. The mean age of the patients was 69 years (two females/five males). All cases were discovered by chance on a punch biopsy. The clinical diagnostic suspicions were basal cell carcinoma, fungal intertrigo, keratoacanthoma, lichenoid keratoma, diabetic foot ulcer, eczema, and necrotic pressure ulcer. Dermoscopy, performed after the punch biopsies, was only partially contributive. The mean histological thickness was 2.7 mm, the mean number of mitoses was 7/mm, local micrometastases were present in 5/7 (71%), the mean Ki67 count was 18.9%, and a positive sentinel lymph node was observed in 4/6 (66%) cases. Nonpigmented and nonamelanotic melanomas are rare, are at high risk, and have a poor prognosis because of a delayed diagnosis. Dermoscopy is only of partial diagnostic aid. Treatment resistance or atypical behavior of the above-mentioned lesions should lead to biopsy. [less ▲]

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See detailPartie 1 : Les maladies bactériennes cutanées
Libon, Florence ULiege; LEBAS, Eglantine ULiege; ABDALLAH Rhim et al

in SKIN (2016), 19(6), 6-13

Les lignes de conduite thérapeutiques sont habituellement établies sur la base des données de la littérature internationale de la médecine basée sur des faits (evidence-based medecine, EBM) ainsi que sur ... [more ▼]

Les lignes de conduite thérapeutiques sont habituellement établies sur la base des données de la littérature internationale de la médecine basée sur des faits (evidence-based medecine, EBM) ainsi que sur les avis exprimés par des experts reconnus dans le domaine. Néanmoins, ces lignes de conduite sont souvent difficile à traduire vers la pratique quotidienne d'un pays donné vu les conditions de remboursement spécifiques et l'organisation des soins médicaux. En matière de maladies infectieuses de la peau, il n'y a que peu de littérature publiée de type EBM. Cette initiative, émanant des assistants en formation en dermatologie et vénérologie en Wallonie/Bruxelles et coordonnée par Florence Libon, Eglantine Lebas et Arjen Nikkels de l'ULg, vise à revoir les différentes recommandations nationales et internationales existantes afin de les adapter pour al situation actuellen en Wallonie/Bruxelles. Elle vise également à unifier les habitudes de prescription sur une base logique et sur les données de la littérature tout en créant des lignes de conduite pratiques. Comme toutes les recommandations diagnostiques et thérapeutiques, une adaptation individuelle devra être réalisée en fonction de chaque patient et le médecin reste in fine le seul décideur et responsable du plan thérapeutique. Ces recommandations n'ont pas pour prétention d'être exhaustives sur toutes les pathologies cutanées bactériennes mais concernent les situations cliniques les plus souvent rencontrées. Dans cette première partie, seront abordés les consensus thérapeutiques pour les maladies cutanées d'origine bactérienne, à partir des cas cliniques [less ▲]

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See detailKoebner Phenomenon and Mycosis Fungoides
LEBAS, Eve ULiege; Libon, Florence ULiege; NIKKELS, Arjen ULiege

in Case Reports in Dermatology (2015)

Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin ... [more ▼]

Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc. In this case report, 3 patients with longstanding MF are presented, the 1st with the appearance of a circumscribed early-stage type MF lesion rapidly following a surgical excision of an infundibular cyst, the 2nd with the appearance of a unique unilateral palmar tumoral MF lesion at the pressure site of a crutch, and the 3rd presented localized MF early stage lesions at the friction site of a belt. This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon. [less ▲]

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See detailZosteriform dermatoses-A review
EL HAYDERI, Lara ULiege; LIBON, Florence ULiege; TASSOUDJI, Nazli ULiege et al

in Global Dermatology (2015), 2 (4)

The zosteriform distribution of cutaneous lesions is a common disease pattern in dermatology. It describes a unilateral girdle-like distribution restricted to the sensitive nerve territory of a dermatome ... [more ▼]

The zosteriform distribution of cutaneous lesions is a common disease pattern in dermatology. It describes a unilateral girdle-like distribution restricted to the sensitive nerve territory of a dermatome. Three different pathogenic pathways can lead to a zosteriform pattern. The neural pathway uses the axons of a nerve ganglion for viral transport to a specific dermatome. The arche type is Herpes Zoster (HZ) followed by Zosteriform Herpes Simplex Virus Type (HSV) I infection. The Blaschkoid pathway uses the Blaschko lines that represent embryonic migration patterns, often mimicking a dermatomal distribution, particularly on the trunk. The isotopic pathway defines a dermatosis that exclusively develops on the site of a previously healed HZ eruption. Before a zosteriform eruption, a history of prior HZ guides the diagnosis to the isotopic pathway, mainly represented by granulomatous reactions followed by, among others, lichen planus, vasculitis and basal cell carcinoma. With no prior history of HZ recent eruptions orientate towards HZ and zosteriform HSV, whereas chronic eruptions should primarily evoke cutaneous metastases, principally from breast, ovary and lung carcinoma. This review summarizes the relevant literature and presents a clinical algorithm for the differential diagnosis of zosteriform dermatoses. [less ▲]

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See detailVISMODEGIB ET CARCINOMES BASOCELLULAIRES LOCALEMENT AVANCES
LEBAS, Eglantine ULiege; RORIVE, Andrée ULiege; EL HAYDERI, Lara ULiege et al

in Revue Médicale de Liège (2015)

Basal cell carcinoma is the most frequent skin cancer. Even though metastases are exceptional, these cancers may be locally highly aggressive. The Hedgehog signaling pathway plays a significant role in ... [more ▼]

Basal cell carcinoma is the most frequent skin cancer. Even though metastases are exceptional, these cancers may be locally highly aggressive. The Hedgehog signaling pathway plays a significant role in the pathogenesis of basal cell carcinoma. Vismodegib is a selective inhibitor of this pathway and may be administered orally. Its main indication is locally advanced basal cell carcinoma, when other therapeutic options have failed or are contra-indicated. Vismodegib can also be used as prophylactic therapy in the Gorlin syndrome or basal cell nevomatosis. Its principal adverse effects are muscle spasms, alopecia and altered taste. They are frequent, but often moderate in intensity; they sometimes restrict continuation of treatment. Two clinical cases are presented, relating the efficacity and tolerance of this new therapeutic option. [less ▲]

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See detailLa rosacée
LIBON, Florence ULiege; EL HAYDERI, Lara ULiege; TASSOUDJI, Nazli ULiege et al

in Revue Médicale de Liège (2015)

Rosacea is a common centro-facial dermatosis with a high socio-esthétic impact. Ocular involvement is not uncommon. Different stypes are distinguished, classified into grades according to their severity ... [more ▼]

Rosacea is a common centro-facial dermatosis with a high socio-esthétic impact. Ocular involvement is not uncommon. Different stypes are distinguished, classified into grades according to their severity. This classification is essential for therapeutic management. In general, rosacea remains difficult to treat as its pathophysiology is still not entirely understood. Future research is needed for a better understanding of this disease and the development of targeted treatments. [less ▲]

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See detailRéaction immédiate à l'alcool
LIBON, Florence ULiege; DEZFOULIAN, Bita ULiege; NIKKELS, Arjen ULiege

Poster (2014, April 17)

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See detailTwo spondylodiscitis due to a contamination by Brucella melitensis in a mother and daughter back from holidays
MALAISE, Olivier ULiege; LIBON, Florence ULiege; BRICMAAN J et al

in Revue Médicale de la Suisse Romande (2014), 10(404), 197-200

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See detailEffect of N-acetylcysteine combined with infliximab on toxic epidermal necrolysis. A proof-of-concept study.
PAQUET, Philippe ULiege; JENNES, Serge; ROUSSEAU, Anne-Françoise ULiege et al

in Burns : Journal of the International Society for Burn Injuries (2014)

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See detailSkin color is relevant to vitamin D synthesis
LIBON, Florence ULiege; CAVALIER, Etienne ULiege; NIKKELS, Arjen ULiege

in Dermatology (2013), 227(3), 250-4

BACKGROUND: Whether dark skin produces less vitamin D after UVB radiation than fair skin remains controversial. OBJECTIVE: To compare 25-hydroxyvitamin D [25-(OH)-D] levels after a single UVB exposure in ... [more ▼]

BACKGROUND: Whether dark skin produces less vitamin D after UVB radiation than fair skin remains controversial. OBJECTIVE: To compare 25-hydroxyvitamin D [25-(OH)-D] levels after a single UVB exposure in fair (phototype II-III) and black-skinned (phototype VI) volunteers. METHODS: Fair-skinned volunteers (n = 20, 4 males/16 females, mean age: 23.2 years) and black-skinned (n = 11, 6 males/5 females, mean age: 23.8 years) received a single total body UVB exposure (0.022 J/cm(2)). The 25-(OH)-D levels were measured on days 0, 2 and 6. RESULTS: On day 0, all volunteers were severely vitamin D deficient. On day 2, 25-(OH)-D levels of fair-skinned volunteers increased significantly (median: 11.9-13.3 ng/ml, p < 0.0001), but not in black-skinned people (median: 8.60-8.55 ng/ml, p = 0.843). Again, on day 6, 25-(OH)-D levels of fair-skinned volunteers increased significantly (median: 11.9-14.3 ng/ml, p < 0.0001), but not in black-skinned people (median: 8.60-9.57 ng/ml, p = 0.375). CONCLUSION: This study suggests that skin pigmentation negatively influences vitamin D synthesis. [less ▲]

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

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 dermoscopie digitalisée séquentielle dans la dermatologie d'aujourd'hui
LIBON, Florence ULiege; COLSON, Fany ULiege; CAO, Sandrine ULiege 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 detailIpilimumab induces simultaneous regression of melanocytic naevi and melanoma metastases
LIBON, Florence ULiege; ARRESE ESTRADA, Jorge ULiege; 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 detailLa photoprotection en 2012
LIBON, Florence ULiege; DEZFOULIAN, Bita ULiege; NIKKELS, Arjen ULiege

in Skin Inc (2012)

La photoprotection est essentielle dans la prévention du processus de photovieillissement et de la carcinogenèse cutanée. Elle peut être comportementale, naturelle, induite, vestimentaire, topique et ... [more ▼]

La photoprotection est essentielle dans la prévention du processus de photovieillissement et de la carcinogenèse cutanée. Elle peut être comportementale, naturelle, induite, vestimentaire, topique et systémique. La photoprotection vestimentaire inclut le port de vêtements protecteurs, de lunettes solaires et de chapeau. La photoprotection externe topique repose sur l'utilisation de différents véhicules contenant siot des filtres minéraux, ayant pour but une réflexion de la radiation ultraviolette incidente, soit des agents chimiques qui absorbent une partie de la radiation incidente. La photoprotection systémique consiste en l'administration, par voie orale, de substances photoprotectrices. D'autres nouvelles voies de photoprotection sont les stimulations chimique ou hormonale de la mélanogenèse. Cet article revoit les dernières évolutions dans ce domaine. [less ▲]

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