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Benjelloun G, Roquet-Gravy C, Marot L, Secco LP, Roquet-Gravy PP, Baeck M, Bulinckx A. Treatment of congenital Langerhans cell histiocytosis with cobimetinib. Pediatr Dermatol 2024; 41:515-517. [PMID: 38387093 DOI: 10.1111/pde.15512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 12/16/2023] [Indexed: 02/24/2024]
Abstract
We report a case of congenital multisystem Langerhans cell histiocytosis with cutaneous and hematopoietic involvement. After the failure of first-line (vinblastine and prednisolone) and second-line (vincristine and cytarabine) therapies, treatment with cobimetinib, a mitogen-activated protein kinase (MEK) inhibitor, led to the remission of disease and a sustained response after 11 months of ongoing treatment. Protein kinase inhibitors targeting BRAF or MEK could represent a promising future therapeutic option, also in children with LCH.
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Affiliation(s)
- Ghita Benjelloun
- Department of Dermatology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - Liliane Marot
- Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Léo-Paul Secco
- Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Audrey Bulinckx
- Department of Dermatology, Grand Hôpital de Charleroi, Charleroi, Belgium
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2
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De Greef A, Ghislain PD, de Montjoye L, Adriaenssens K, Bulinckx A, Colmant C, Cuvelier M, Deleu H, Goeteyn M, Janssens P, Kul A, Roquet-Gravy C, Stragier I, Baeck M. Tralokinumab improves clinical scores in adolescents with severe atopic dermatitis: A real-life multicentric observational study. J Eur Acad Dermatol Venereol 2024; 38:e288-e290. [PMID: 37909058 DOI: 10.1111/jdv.19605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Pierre-Dominique Ghislain
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Laurence de Montjoye
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | | | - Audrey Bulinckx
- Department of Dermatology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | | | - Marie Cuvelier
- Department of Dermatology, Clinique Notre-Dame de Grâce, Gosselies, Belgium
| | | | | | | | - Anouschka Kul
- Department of Dermatology, CHU Saint-Pierre, Brussels, Belgium
| | | | | | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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De Greef A, Benjelloun G, Harkemanne E, Baeck M. Successful Treatment of Disseminated Granuloma Annulare with Upadacitinib. Dermatol Ther (Heidelb) 2024; 14:813-817. [PMID: 38438785 DOI: 10.1007/s13555-024-01117-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 03/06/2024] Open
Abstract
Disseminated granuloma annulare (DGA) is an inflammatory skin disorder characterized by more than 10 erythematous, raised, ring-shaped plaques. Its treatment remains challenging, with conventional therapies showing variable efficacy. We report the case of a woman in her 50s with a 2-year history of DGA refractory to multiple treatments. Given the recent evidence of the role of the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway in the granuloma annulare pathophysiology, treatment with upadacitinib 30 mg per day was started with rapid effectiveness and good tolerance. This case underscores the potential of JAK inhibitors as promising therapeutic options for recalcitrant granuloma annulare.
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Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - Ghita Benjelloun
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Evelyne Harkemanne
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
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Lapeere H, Speeckaert R, Baeck M, Dezfoulian B, Lambert J, Roquet-Gravy PP, Stockman A, White J, Castelijns F, Gutermuth J. Belgian atopic dermatitis guidelines. Acta Clin Belg 2024; 79:62-74. [PMID: 37997950 DOI: 10.1080/17843286.2023.2285576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/13/2023] [Indexed: 11/25/2023]
Abstract
Atopic dermatitis (AD) is one of the most common, bothersome and difficult to treat skin disorders. Recent introduction of new systemic treatments has revolutionized the management of AD. The goal of this guideline is to provide evidence-based recommendations for the management of patients suffering from atopic dermatitis that easily can be implemented in clinical practice. These recommendations were developed by 11 Belgian AD experts. Comments of all experts on the proposed statements were gathered, followed by an online voting session. The most relevant strategies for the management and treatment of AD in the context of the Belgian health care landscape are discussed. General measures, patient education and adequate topical treatment remain the cornerstones of AD management. For moderate to severe AD, the introduction of biologics and JAK inhibitors show unprecedented efficacy, although currently access is limited to a subgroup of patients meeting the reimbursement criteria.
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Affiliation(s)
- Hilde Lapeere
- Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | | | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Bita Dezfoulian
- Department of Dermatology, Liège University Hospital, Liège, Belgium
| | - Julien Lambert
- Department of Dermatology, University Hospital Antwerp (UZA), Edegem, Belgium
| | | | - Annelies Stockman
- Department of Dermatology, AZ Delta campus Rembert Torhout, Torhout, Belgium
| | - Jonathan White
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Jan Gutermuth
- Vrije Universiteit Brussel (VUB), Department of Dermatology, Universitair Ziekenhuis Brussel, Brussels, Belgium
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De Greef A, Ghislain PD, Baeck M. Prolonged real-life experience with baricitinib in patients with moderate-to-severe atopic dermatitis. Eur J Dermatol 2023; 33:707-709. [PMID: 38465563 DOI: 10.1684/ejd.2023.4618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
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De Greef A, de Montjoye L, Bieber T, Baeck M. Atopic dermatitis: a need to define the disease activity. Front Med (Lausanne) 2023; 10:1293185. [PMID: 38020127 PMCID: PMC10654964 DOI: 10.3389/fmed.2023.1293185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Laurence de Montjoye
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Thomas Bieber
- Christine Kühne-Center for Allergy Research and Education, Davos, Switzerland
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Harkemanne E, Thomas L, Braun R, Baeck M, Tromme I. A new TADA-inspired decision algorithm for training primary care practitioners in dermoscopy. J Eur Acad Dermatol Venereol 2023; 37:e1295-e1297. [PMID: 37328925 DOI: 10.1111/jdv.19277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- E Harkemanne
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
- King Albert II Cancer and Hematology Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - L Thomas
- Dermatology Department, Lyon Cancer Research Center INSERM, Université Lyon 1, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - R Braun
- Dermatology Department, University Hospital Zürich, Zürich, Switzerland
| | - M Baeck
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
| | - I Tromme
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- King Albert II Cancer and Hematology Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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De Greef A, Thirion R, Ghislain PD, Baeck M. Real-Life Effectiveness and Tolerance of Baricitinib for the Treatment of Severe Alopecia Areata with 1-Year Follow-Up Data. Dermatol Ther (Heidelb) 2023; 13:2869-2877. [PMID: 37717224 PMCID: PMC10613164 DOI: 10.1007/s13555-023-01030-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/05/2023] [Indexed: 09/19/2023] Open
Abstract
INTRODUCTION The efficacy of conventional treatments for alopecia areata (AA) has been extremely variable and disappointing, with a high rate of relapse. Recent clinical trials and real-life studies have demonstrated efficacy and safety of baricitinib (an oral Janus kinase 1 and 2 inhibitor) in alopecia areata. METHODS We retrospectively evaluated the effectiveness and tolerance of baricitinib in alopecia areata in a real-life Belgian monocentric adult cohort. The primary outcome was evaluated by the percentage of patients who achieved a Severity of Alopecia Tool (SALT) score of ≤ 20 at the end of the follow-up. All treatment-emergent adverse events were collected. RESULTS In this 19-patient series, with a median ± interquartile range (IQR) follow-up duration of 13 ± 16.2 months, we demonstrated that: (i) hair regrowth was observed in nearly 90% of patients between 4 and 16 weeks after initiation of baricitinib; (ii) at the end of the follow-up, more than 70% and, in particular, 100% of patients with patchy AA, reached the primary outcome (SALT score ≤ 20); (iii) almost half of the patients, mostly with patchy AA, showed a complete hair regrowth (SALT score = 0), within a median ± IQR treatment time of 8.5 ± 10 months; (iv) baricitinib was discontinued in three patients with total hair regrowth, two of whom relapsed; and (v) no serious adverse events were reported. CONCLUSION Baricitinib is effective in treating patients with alopecia areata, particularly for the patchy phenotype, but with a risk of relapse after discontinuation. Safety data are reassuring, with lipid changes being the most frequent adverse event.
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Affiliation(s)
- Axel De Greef
- Dermatology Department, Cliniques universitaires Saint-Luc, UCLouvain, Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - Romane Thirion
- Dermatology Department, Cliniques universitaires Saint-Luc, UCLouvain, Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Pierre-Dominique Ghislain
- Dermatology Department, Cliniques universitaires Saint-Luc, UCLouvain, Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Dermatology Department, Cliniques universitaires Saint-Luc, UCLouvain, Avenue Hippocrate 10, 1200, Brussels, Belgium
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De Greef A, Mairlot M, Baeck M. Pseudo-Quincke's sign caused by Sweet syndrome. J Eur Acad Dermatol Venereol 2023; 37:e1290-e1291. [PMID: 37328928 DOI: 10.1111/jdv.19273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Margaux Mairlot
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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De Greef A, Ghislain PD, de Montjoye L, Baeck M. Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults. Adv Ther 2023; 40:2509-2514. [PMID: 36944819 PMCID: PMC10129949 DOI: 10.1007/s12325-023-02490-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/07/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION The efficacy and safety of upadacitinib in atopic dermatitis have been defined in clinical trials, but long-term real-life experience, essential for clinical decision-making, is still limited. We aimed to assess the effectiveness and tolerance of upadacitinib in a real-life cohort of adults and adolescents with severe atopic dermatitis in whom previous systemic therapies largely failed. METHODS Retrospective cohort study collecting data from adults and adolescents treated with upadacitinib 15 or 30 mg per day between July 2021 to August 2022. The outcomes for effectiveness were evaluated by the percentage of patients who achieved a validated Investigator's Global Assessment for atopic dermatitis (vIGA-AD) of 0 (clear) or 1 (almost clear) and/or an improvement of at least 75% on the Eczema Area and Severity Index (EASI 75) at the end of the follow-up. All treatment-emergent adverse events were collected. RESULTS A total of 29 patients were included (22 adults and 7 adolescents), with a median follow-up of 54.4 weeks. At the end of the follow-up, 23 patients (79.3%) reached a vIGA-AD of 0/1, and 24 patients (82.7%) achieved EASI 75. Among patients treated with upadacitinib after initial failure of first- and/or second-line treatment with biologics or baricitinib, 5/7 patients (71.4%) reached a vIGA-AD score of 0/1. Disease control was slightly better in adults than in adolescents (81.8% vs 71.4% reached the efficacy endpoint, respectively). Response rate in patients with upadacitinib 15 mg seemed better than in clinical trials or network meta-analysis. Safety data were reassuring; lipid changes were the most frequent adverse event. CONCLUSION This real-life study confirms the effectiveness of upadacitinib, particularly for the treatment of atopic dermatitis recalcitrant to conventional systemic agents, biologics or baricitinib. Induced lipid changes require close follow-up.
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Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques Universitaires Saint-Luc (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - Pierre-Dominique Ghislain
- Department of Dermatology, Cliniques Universitaires Saint-Luc (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Laurence de Montjoye
- Department of Dermatology, Cliniques Universitaires Saint-Luc (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
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Herman A, Marot L, Baeck M. Sofa dermatitis: Value of patch test with 2-(thiocyanomethylthio)benzothiazole. Contact Dermatitis 2023. [PMID: 37037196 DOI: 10.1111/cod.14320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND In 2008, numerous cases of allergic contact dermatitis caused by leather chairs (sofa dermatitis) were reported, with dimethylfumarate being the culprit allergen. However, octylisothiazolinone, methylisothiazolinone and cobalt have also been associated with cases of sofa dermatitis. An antifungal agent, 2-(thiocyanomethylthio)benzothiazole (TCMTB), has also previously been described as a contact allergen in leather. MATERIALS AND METHODS Seven patients were referred to the Department of Dermatology of the Cliniques universitaires Saint-Luc, Brussels, Belgium with suspicion of allergic contact dermatitis caused by leather sofas. They were patch tested with the European Baseline Series, additional series (according to the patients' history and clinical aspect of the eruption), dimethylfumarate (4/7 patients) and with TCMTB. RESULTS All seven patients presented a positive reaction to TCMTB and only one presented a concomitant positive reaction to dimethylfumarate. All patients showed clinical improvement after avoiding contact with their leather sofa. CONCLUSION 2-(Thiocyanomethylthio)benzothiazole (TCMTB) is probably an underestimated allergen present in leather chairs (responsible for the so-called 'sofa dermatitis'), and more generally in leather objects. It is, therefore, important to test with TCMTB 0.1% petrolatum in case of contact dermatitis related with leather products.
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Affiliation(s)
- Anne Herman
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Liliane Marot
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Harkemanne E, Legrand C, Sawadogo K, van Maanen A, Vossaert K, Argenziano G, Braun R, Thomas L, Baeck M, Tromme I. Evaluation of primary care physicians' competence in selective skin tumor triage after short versus long dermoscopy training A randomized non-inferiority trial. J Eur Acad Dermatol Venereol 2023. [PMID: 37013726 DOI: 10.1111/jdv.19087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 03/08/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Although primary care physicians (PCPs) play a key role in skin cancer screening, their skills in detecting malignant tumors is suboptimal. OBJECTIVES To determine whether a short dermoscopy e-learning course (4 hours) in skin tumor diagnosis for PCPs is non-inferior to a long course (12 hours) in selective triage of skin lesions. Secondly, to evaluate whether regular refresher training sessions are necessary to maintain the PCPs' skills in the medium term. METHODS A randomized 2x2 factorial non-inferiority trial was conducted online over an 8-month period among 233 PCPs including 126 certified general practitioners, 94 PCPs in training, and 13 occupational physicians, all without prior advanced dermoscopy training. Participants were randomized 1:1:1:1 to receive short training and mandatory refreshers (n=58), short training and optional refreshers (n=59), long training and mandatory refreshers (n=58), or long training and optional refreshers (n=58). PCPs' skills were evaluated before training (T0), immediately after training (T1) to test the non-inferiority, and after five months (T2) to evaluate the impact of the refreshers. The primary endpoint was the difference in the change of score after short and long training. The non-inferiority margin was set at -28%. RESULTS Among the 233 randomized participants, 216 (93%) completed T1 and 197 (84.5%) completed T2. For short vs. long training, the primary endpoint was 1.392 (95% CI: 0.138; 2.645) in the per-protocol population (P<.001) and 1.016 (95% CI: -0.224; 2.256) in the modified intention-to-treat population (P<.001). After training, the type of refresher showed no impact on the score (P=.840). However, PCPs who completed all refreshers showed the best mean overall score at T2 (P<.001). CONCLUSIONS These findings confirm that short dermoscopy e-learning is non-inferior in training PCPs to triage skin lesions compared to long training. After training, regular refreshers are important to maintain the PCPs' acquired skills over time.
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Affiliation(s)
- E Harkemanne
- Dermatology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
- King Albert II Cancer and Hematology Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C Legrand
- Institute of Statistics, Biostatistics and Actuarial Sciences (ISBA/LIDAM), UCLouvain, Louvain-la-Neuve, Belgium
| | - K Sawadogo
- Statistical Support Unit, King Albert II Cancer and Hematology Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A van Maanen
- Statistical Support Unit, King Albert II Cancer and Hematology Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - K Vossaert
- Dermatologie Maldegem, private practice, Maldegem, Belgium
| | - G Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - R Braun
- Dermatology department, University Hospital Zürich, Switzerland
| | - L Thomas
- Dermatology Department, Lyon Cancer Research Center INSERM, Université Lyon 1, Centre Hospitalier Lyon Sud, Pierre, Bénite, France
| | - M Baeck
- Dermatology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
| | - I Tromme
- Dermatology Department, Cliniques universitaires Saint-Luc, Brussels, Belgium
- King Albert II Cancer and Hematology Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium
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De Greef A, Ghislain PD, Bulinckx A, Coster A, de Halleux C, Damsin T, Jacobs MC, Suys E, Zoghaib S, Baeck M. Real-Life Experience of Tralokinumab for the Treatment of Adult Patients with Severe Atopic Dermatitis: A Multicentric Prospective Study. Clin Drug Investig 2023; 43:299-306. [PMID: 37012527 PMCID: PMC10097792 DOI: 10.1007/s40261-023-01258-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Tralokinumab, the first fully human monoclonal antibody that binds specifically to interleukin-13, was safe and effective for treating atopic dermatitis (AD) in clinical trials, but real-life experience is still limited. OBJECTIVES The objective of this study was to evaluate the effectiveness and safety of tralokinumab in severe AD in a real-life multicenter prospective cohort. METHODS Adult patients with severe AD were enrolled between January 2022 and July 2022 and received tralokinumab subcutaneously for 16 weeks. Objective and subjective scores were collected at baseline, weeks 6 and 16. Adverse events were reported throughout the study. RESULTS Twenty-one patients were included. An improvement of at least 75% on the Eczema Area and Severity Index (EASI 75) was achieved in 66.7% of patients at week 16. The median objective and subjective scores at week 16 were significantly (p < 0.001) lower than those at baseline. Combination with cyclosporine was sometimes necessary at the beginning of treatment, and addition of upadacitinib was required for some patients with very severe disease during the treatment. The most frequent adverse events were flares of eczema (23.8%) and reactions at injection site (19.0%). No cases of conjunctivitis were reported. Four patients (19.0%) discontinued treatment. CONCLUSIONS Tralokinumab is an effective first-line biotherapy for severe AD. However, therapeutic response may be progressive. Safety data were reassuring. Atopic dermatitis flares or reactions at the injection site may lead to discontinuation of treatment. A history of conjunctivitis on dupilumab is not a contraindication to the initiation of tralokinumab.
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Affiliation(s)
- Axel De Greef
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - Pierre-Dominique Ghislain
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Audrey Bulinckx
- Department of Dermatology, Grand Hôpital de Charleroi, Charleroi, Belgium
| | - Alison Coster
- Department of Dermatology, CHU UCL Namur Sainte-Elisabeth, Namur, Belgium
| | | | - Thomas Damsin
- Department of Dermatology, University Hospital Centre, CHU du Sart-Tilman, Liège, Belgium
| | | | - Erwin Suys
- Private Dermatology Practice, Kortrijk, Belgium
| | - Samer Zoghaib
- Department of Dermatology, CHU Ambroise Paré, Mons, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
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Schnebert B, de Montjoye L, Baeck M. A rare case of adrenergic urticaria in a child. J Eur Acad Dermatol Venereol 2023; 37:e226-e228. [PMID: 35951465 DOI: 10.1111/jdv.18497] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/27/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Benjamin Schnebert
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Laurence de Montjoye
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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15
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Fouarge AL, Cuvelier M, Roquet-Gravy C, de Montjoye L, Baeck M. Successful treatment of pityriasis rubra pilaris with risankizumab, a IL-23/p19 antagonist. J Eur Acad Dermatol Venereol 2023; 37:e106-e109. [PMID: 35972816 DOI: 10.1111/jdv.18516] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Anne-Laure Fouarge
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marie Cuvelier
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Charlotte Roquet-Gravy
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Laurence de Montjoye
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marie Baeck
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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16
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Harkemanne E, Duyver C, Leconte S, Sawadogo K, Baeck M, Tromme I. Short- and Long-Term Evaluation of General Practitioners' Competences After a Training in Melanoma Diagnosis: Refresher Training Sessions May Be Needed. J Cancer Educ 2022; 37:1928-1941. [PMID: 34704171 PMCID: PMC8547729 DOI: 10.1007/s13187-021-02063-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/27/2021] [Indexed: 06/13/2023]
Abstract
General practitioners (GPs) are first-line clinicians in melanoma diagnosis. It is, therefore, important to ensure that they maintain their melanoma diagnostic accuracy over time. The objective of this study was to assess the short- and long-term competences of GPs after a training session in naked-eye melanoma diagnosis. An interventional prospective study was conducted whereby, over a 6-month period, GPs attended a 1-h melanoma diagnostic training session. To assess their acquired competences, GPs were asked to fill in a questionnaire on basic melanoma knowledge and to evaluate 10 clinical images of pigmented skin lesions prior to training, immediately after and 1 year later. In total, 89 GPs completed the questionnaire prior and immediately after training. As expected, the number of GPs who appropriately managed [Formula: see text] 50% of the melanoma cases increased after training (P < 0.001). One year after training, only 27 (30%) of the 89 GPs completed the questionnaire. This number of participants was too low to obtain significant figures but the GPs' mean overall score of appropriately managed clinical cases was much lower than in the immediate post-test. In conclusion, although this short training improved the GPs' diagnostic accuracy and management of melanoma in the short-term, participating GPs do not seem to have maintained these competences in the long-term. Further studies are needed to assess whether refresher training sessions are able to sustain acquired diagnostic and management skills.
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Affiliation(s)
- Evelyne Harkemanne
- Dermatology Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200, Brussels, Belgium.
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium.
| | - Corentin Duyver
- Centre Académique de Médecine Générale (CAMG), UCLouvain, Brussels, Belgium
| | - Sophie Leconte
- Centre Académique de Médecine Générale (CAMG), UCLouvain, Brussels, Belgium
| | - Kiswendsida Sawadogo
- Statistical Support Unit, King Albert II Cancer and Hematology Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marie Baeck
- Dermatology Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
| | - Isabelle Tromme
- Dermatology Department, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200, Brussels, Belgium
- King Albert II Cancer and Hematology Institute, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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17
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Mengeot L, Marot L, Baeck M. Rapidly evolving necrotic skin lesions of the face. JAAD Case Rep 2022; 28:149-151. [PMID: 36274788 PMCID: PMC9579697 DOI: 10.1016/j.jdcr.2022.01.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Herman A, Montjoye LD, Baeck M. Re-emergence of allergic contact dermatitis from chlorphenesin. Contact Dermatitis 2022; 87:464-465. [PMID: 35916838 DOI: 10.1111/cod.14196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Laurence de Montjoye
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
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19
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de Montjoye L, Herman A, Baeck M. Case series (Journal of The American Academy of Dermatology Cases Reports) Chronic spontaneous urticaria following COVID-19 vaccination. JAAD Case Rep 2022; 25:35-38. [PMID: 35615160 PMCID: PMC9123822 DOI: 10.1016/j.jdcr.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Laurence de Montjoye
- Correspondence to: Laurence de Montjoye, MD, PhD, Department of Dermatology, Cliniques universitaires Saint-Luc (UCLouvain), Avenue Hippocrate 10, B-1200 Brussels, Belgium.
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20
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Harkemanne E, Duyver C, Leconte S, Bugli C, Thomas L, Baeck M, Tromme I. Melanoma Diagnostic Practices of French-Speaking Belgian General Practitioners and the Prospective Study of Their Pigmented Skin Lesion Diagnostic Accuracy and Management. J Cancer Educ 2021; 36:1316-1324. [PMID: 32448923 DOI: 10.1007/s13187-020-01770-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
General practitioners (GPs) are among the main actors involved in early melanoma diagnosis. However, melanoma diagnostic accuracy and management are reported to be insufficient among GPs in Europe. The primary aim of this observational prospective study was to shed light on melanoma diagnostic practices among French-speaking Belgian GPs. The second aim was to specifically analyse these GPs' pigmented skin lesion diagnostic accuracy and management. GPs from the five French-speaking districts of Belgium were asked to complete a questionnaire, before taking part in a melanoma diagnostic training session. First, we assessed the GPs' current melanoma diagnostic practices. Then, their pigmented skin lesion diagnostic accuracy and management were evaluated, through basic theoretical questions and clinical images. These results were subsequently analysed, according to the GPs' sociodemographic characteristics and medical practice type. In total, 89 GPs completed the questionnaire. Almost half of the GPs (43%; CI = [33;54]) were confronted with a suspicious skin lesion as the main reason for consultation once every 3 months, while 33% (CI = [24;43]) were consulted for a suspicious lesion as a secondary reason once a month. Prior to training, one-third of the GPs exhibited suboptimal diagnostic accuracy in at least one of six "life-threatening" clinical cases among two sets of 10 clinical images of pigmented skin lesions, which can lead to inadequate patient management (i.e. incorrect treatment and/or inappropriate reinsurance). This study underlines the need to train GPs in melanoma diagnosis. GPs' pigmented skin lesion diagnostic accuracy and management should be improved to increase early melanoma detection.
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Affiliation(s)
- E Harkemanne
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium.
| | - C Duyver
- Centre Académique de Médecine Générale (CAMG), UCLouvain, Brussels, Belgium
| | - S Leconte
- Centre Académique de Médecine Générale (CAMG), UCLouvain, Brussels, Belgium
| | - C Bugli
- Statistical Methodology and Computing Service (SMCS), Louvain-la-Neuve, Belgium
| | - L Thomas
- Dermatology Department, Lyon Cancer Research Center INSERM, Université Lyon 1, Centre Hospitalier Lyon Sud, Pierre Bénite, France
| | - M Baeck
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
| | - I Tromme
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of Experimental and Clinical Research (IREC), UCLouvain, Brussels, Belgium
- King Albert II Cancer and Hematology Institute, Cliniques universitaires Saint-Luc, Brussels, Belgium
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21
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Lefevre M, Nosbaum A, Rozieres A, Lenief V, Mosnier A, Cortial A, Prieux M, De Bernard S, Nourikyan J, Jouve P, Buffat L, Hacard F, Ferrier‐Lebouedec M, Pralong P, Dzviga C, Herman A, Baeck M, Nicolas J, Vocanson M. Unique molecular signatures typify skin inflammation induced by chemical allergens and irritants. Allergy 2021; 76:3697-3712. [PMID: 34174113 DOI: 10.1111/all.14989] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/26/2021] [Accepted: 06/09/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Skin exposure to chemicals may induce an inflammatory disease known as contact dermatitis (CD). Distinguishing the allergic and irritant forms of CD often proves challenging in the clinic. METHODS To characterize the molecular signatures of chemical-induced skin inflammation, we conducted a comprehensive transcriptomic analysis on the skin lesions of 47 patients with positive patch tests to reference contact allergens and nonallergenic irritants. RESULTS A clear segregation was observed between allergen- and irritant-induced gene profiles. Distinct modules pertaining to the epidermal compartment, metabolism, and proliferation were induced by both contact allergens and irritants; whereas only contact allergens prompted strong activation of adaptive immunity, notably of cytotoxic T-cell responses. Our results also confirmed that: (a) unique pathways characterize allergen- and irritant-induced dermatitis; (b) the intensity of the clinical reaction correlates with the magnitude of immune activation. Finally, using a machine-learning approach, we identified and validated several minimal combinations of biomarkers to distinguish contact allergy from irritation. CONCLUSION These results highlight the value of molecular profiling of chemical-induced skin inflammation for improving the diagnosis of allergic versus irritant contact dermatitis.
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Affiliation(s)
- Marine‐Alexia Lefevre
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
- Department of Dermatology and Allergology Centre Hospitalier Universitaire de Saint‐Etienne Saint‐Priest‐en‐Jarez France
| | - Audrey Nosbaum
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
- Department of Allergy and Clinical Immunology Centre Hospitalier Lyon‐Sud Pierre‐Benite France
| | - Aurore Rozieres
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Vanina Lenief
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Amandine Mosnier
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Angèle Cortial
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | - Margaux Prieux
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
| | | | | | | | | | - Florence Hacard
- Department of Allergy and Clinical Immunology Centre Hospitalier Lyon‐Sud Pierre‐Benite France
| | | | - Pauline Pralong
- Department of Dermatology, Allergology and Photobiology Centre Hospitalier Universitaire Grenoble Alpes La Tronche France
| | - Charles Dzviga
- Department of Dermatology and Allergology Centre Hospitalier Universitaire de Saint‐Etienne Saint‐Priest‐en‐Jarez France
| | - Anne Herman
- Department of Dermatology Cliniques universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
| | - Marie Baeck
- Department of Dermatology Cliniques universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
| | - Jean‐François Nicolas
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
- Department of Allergy and Clinical Immunology Centre Hospitalier Lyon‐Sud Pierre‐Benite France
| | - Marc Vocanson
- CIRI, Centre International de Recherche en Infectiologie, (Team Epidermal Immunity and Allergy) INSERM, U1111 Univ LyonUniversité de Lyon 1Ecole Normale Supérieure de LyonCNRS, UMR 5308 Lyon France
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22
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de Montjoye L, Marot L, Baeck M. Eosinophilic cellulitis after BNT162b2 mRNA Covid-19 vaccine. J Eur Acad Dermatol Venereol 2021; 36:e26-e28. [PMID: 34547138 DOI: 10.1111/jdv.17685] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/16/2021] [Indexed: 12/16/2022]
Affiliation(s)
- L de Montjoye
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - L Marot
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium.,Department of Anatomopathology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - M Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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23
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De Greef A, Dachelet C, Marot L, Baeck M. Acute haemorrhagic oedema-like eruption in an adult. J Eur Acad Dermatol Venereol 2021; 36:e48-e50. [PMID: 34418184 DOI: 10.1111/jdv.17617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
- A De Greef
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - C Dachelet
- Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - L Marot
- Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - M Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Herman A, Aerts O, Jacobs MC, Scheers C, Gilissen L, Goossens A, Baeck M. Evolution of methylisothiazolinone sensitization: a Belgian multicentric study from 2014 to 2019. Contact Dermatitis 2021; 85:643-649. [PMID: 34387868 DOI: 10.1111/cod.13956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/29/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the 2010s an epidemic of allergic contact dermatitis to methylisothiazolinone occurred in Europe. European authorities banned the use of methylisothiazolinone in leave-on cosmetics in 2017 and limited its use in rinse-off products in 2018. OBJECTIVES To investigate the sensitization rate to methylisothiazolinone in Belgium between January 2014 and December 2019, and to assess co-sensitizations to octylisothiazolinone and benzisothiazolinone in methylisothiazolinone -sensitized patients. METHODS A retrospective study of patch test results with methylisothiazolinone, octylisothiazolinone and benzisothiazolinone observed in patients attending five Belgian hospitals. RESULTS Overall, 560 of 10.029 patients (5.58%) had a positive patch test reaction to methylisothiazolinone, and its sensitization rate decreased from 7.9% in 2014 to 3.1% in 2019. Rinse-off cosmetics, paints and detergents were the most prevalent sensitization sources in recent years. Simultaneous reactions readily occurred to octylisothiazolinone, and, surprisingly, and increasingly, also to benzisothiazolinone. CONCLUSIONS Contact allergy to methylisothiazolinone in Belgium has reached a pre-epidemic level, reflecting the impact of recent regulatory measures. Leave-on cosmetics, in contrast to rinse-off products, have almost disappeared as sensitization sources in Europe. Paints and detergents also remain problematic. The remarkably high number of patients (co-) sensitized to benzisothiazolinone should be a focus of future research. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), and Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology pole, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA), and Infla-Med Centre of Excellence, Research group Immunology, University of Antwerp, Antwerp, Belgium
| | - Marie Claude Jacobs
- Department of Dermatology, Cliniques Saint Jean, 1000 Brussels, and Private Dermatologist, Brussels, Belgium
| | - Christel Scheers
- Department of Dermatology, Cliniques Saint- Pierre, Brussels, Belgium
| | - Liesbeth Gilissen
- Department of Dermatology, University Hospitals Leuven, and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, 3000 KU Leuven, 3000, Leuven, Belgium
| | - An Goossens
- Department of Dermatology, University Hospitals Leuven, and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, 3000 KU Leuven, 3000, Leuven, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), and Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology pole, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Affiliation(s)
- Marie Baeck
- Cliniques Universitaires Saint-Luc Université Catholique de Louvain, Brussels, Belgium
| | - Liliane Marot
- Cliniques Universitaires Saint-Luc Université Catholique de Louvain, Brussels, Belgium
| | - Leila Belkhir
- Cliniques Universitaires Saint-Luc Université Catholique de Louvain, Brussels, Belgium
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26
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Nielens N, Marot L, Baeck M. Sporotrichoid distributed tuberculous panniculitis as a late complication of intravesical Bacillus Calmette-Guérin (BCG) immunotherapy. Int J Infect Dis 2021; 117:247-250. [PMID: 33984512 DOI: 10.1016/j.ijid.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/01/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022] Open
Abstract
An 82-year-old man presented with unilateral oedema of the right lower limb overlaid with multiple, sporotrichoid distributed, panniculitis lesions. These symptoms appeared in a context of immunodepression and were associated with significant weight loss and deteriorated general condition. Patient's medical history, the histological findings, PCR testing and bacterial culture led to a diagnosis of cutaneous tuberculosis due to Mycobacterium bovis. This infection occurred as a late complication of intravesical Bacillus Calmette-Guérin (BCG) instillations that the patient had received as an adjunctive immunotherapy for bladder cancer. This is an unusual clinical presentation and aetiology of cutaneous tuberculosis. Indeed, the observed sporotrichoid pattern is uncommon for tuberculous mycobacteria. Moreover, the occurrence of tuberculous skin lesions after intravesical BCG instillations is extremely rare, with only a few cases described, and, to our knowledge, none with such clinical presentation. This case report suggests that a medical history of BCG immunotherapy should always be considered when assessing any infectious-type cutaneous lesions and that skin should be regarded as a possible late localization of infectious complications of this treatment.
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Affiliation(s)
- Nina Nielens
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Liliane Marot
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
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Abstract
BACKGROUND General practitioners (GPs) play a key role in early melanoma detection. To help GPs deal with suspicious skin lesions, melanoma diagnostic training programmes have been developed. However, it is unclear whether these programmes guarantee the acquisition of skills that will be applied by GPs in their daily clinical practice and maintained over time. OBJECTIVES This scoping review aimed to examine and compare educational programmes designed to train GPs in melanoma diagnosis using clinical (naked eye) examination alone or dermoscopy±clinical examination, and sought to inform on the long-term sustainability of the GPs' acquired skills. ELIGIBILITY CRITERIA Studies eligible for inclusion evaluated educational programmes for teaching diagnosis of melanoma to GPs. MEDLINE, EMBASE and Cochrane databases were searched for relevant articles from 1995 to May 2020. RESULTS Forty-five relevant articles were found assessing 31 educational programmes. Most programmes that improved the diagnostic accuracy and long-term performances of the GPs, that is, increase in confidence, decrease in dermatologist referral for benign skin lesions and improvement in the benign/malignant ratio of excised skin lesions, trained the GPs in clinical diagnosis, followed by dermoscopy. To maintain long-term performances, these programmes provided refresher training material. CONCLUSION This review shows that studies generally report positive outcomes from the training of GPs in melanoma diagnosis. However, refresher training material seemed necessary to maintain the acquired skills. The optimal form and ideal frequency for these updates have yet to be defined.
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Affiliation(s)
- Evelyne Harkemanne
- Service de dermatologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
- Pôle de pneumologie et dermatologie, Institut de Recherche Expérimentale et Clinique, UCLouvain, Bruxelles, Belgique
| | - Marie Baeck
- Service de dermatologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
- Pôle de pneumologie et dermatologie, Institut de Recherche Expérimentale et Clinique, UCLouvain, Bruxelles, Belgique
| | - Isabelle Tromme
- Service de dermatologie, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
- Clinique du mélanome, Institut Roi Albert II, Cliniques universitaires Saint-Luc, Bruxelles, Belgique
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Baeck M, Herman A. Chilblains and COVID-19: can recent epidemiological data shed light on the aetiological debate? Clin Exp Dermatol 2021; 46:759-762. [PMID: 33522016 PMCID: PMC8014263 DOI: 10.1111/ced.14586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 01/11/2023]
Affiliation(s)
- M Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Herman
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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de Montjoye L, Darrigade AS, Giménez-Arnau A, Herman A, Dumoutier L, Baeck M. Correlations between disease activity, autoimmunity and biological parameters in patients with chronic spontaneous urticaria. Eur Ann Allergy Clin Immunol 2021; 53:55-66. [PMID: 31965967 DOI: 10.23822/eurannaci.1764-1489.132] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary Background. Biomarkers of disease activity/severity and criteria of autoimmune chronic spontaneous urticaria (CSU) are still a matter of debate. Objective. To investigate possible correlations between clinical and biological markers and their associations with: 1) disease activity, 2) resistance to H1-antihistamines, 3) autoimmunity and 4) autologous serum skin test (ASST) in patients with CSU. To also analyze biological parameter modifications in patients with CSU treated with omalizumab. Materials and methods. Disease activity, H1-antihistamines response and presence of concomitant autoimmune disease were prospectively recorded in 95 patients with CSU. For 60 of them, ASST was performed. Broad biological analysis were performed. Results. C-reactive protein (CRP) serum levels were higher in H1-antihistamines unresponders (p less-than 0.0001) and in more active diseases (p = 0.033). D-dimer plasma levels were higher in H1-antihistamines unresponders (p = 0.008) and in patients with autoimmune status (concomitant autoimmune disease and/or with autoantibodies) (p = 0.016). Total immunoglobuline E (IgE) serum level was lower in patients with positive ASST. Blood basophil counts were lower in patients with CSU and especially in H1-antihistamines unresponders (p = 0.023), in patients with more active disease (p = 0.023), with positive ASST (p = 0.001), and with autoimmune status (p = 0.057). Conversely, under omalizumab, a decrease of CRP (p = 0.0038) and D-dimer serum/plasma levels (p = 0.0002) and an increase of blood basophil counts (p = 0.0023) and total IgE serum levels (p = 0.0007) were observed. Conclusions. This study brings additional evidences of interest to investigate IgE, D-dimer serum/plasma levels and basophil blood counts in patients with CSU as they could be correlated to disease activity, response to treatment and/or autoimmunity.
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Affiliation(s)
- L de Montjoye
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.,Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology Pole, Université catholique de Louvain, Brussels, Belgium
| | - A S Darrigade
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - A Giménez-Arnau
- Department of Dermatology, Hospital del Mar, Institut Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - A Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.,Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology Pole, Université catholique de Louvain, Brussels, Belgium
| | - L Dumoutier
- de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - M Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.,Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology Pole, Université catholique de Louvain, Brussels, Belgium
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Affiliation(s)
- Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Anne Herman
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Herman A, Baeck M. Sensitization to isobornyl acrylate in a tertiary Belgian hospital. Contact Dermatitis 2021; 85:105-106. [PMID: 33527358 DOI: 10.1111/cod.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/12/2021] [Accepted: 01/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Abstract
BACKGROUND Numerous of cases of chilblains have been observed, mainly in young subjects with no or mild symptoms compatible with COVID-19. The pathophysiology of these lesions is still widely debated and an association with SARS-CoV-2 infection remains unconfirmed. OBJECTIVES This paper focus on the unresolved issues about these COVID toes and in particular whether or not they are associated with COVID-19. ARGUMENTS The temporal link between the outbreak of chilblains and the COVID-19 pandemic is a first suggests a link between the two events. Positive anti-SARS-CoV/SARS-CoV-2 immunostaining on skin biopsy of chilblains seem to confirm the presence of the virus in the lesions, but lack specificity and must be interpreted with caution. Conversely, RT-PCR and anti-SARS-CoV-2 serology were negative in the majority of patients with chilblains. Therefore, SARS-CoV-2 infection can be excluded, with relative certainty, even after accounting for possible lower immunization in mild/asymptomatic patients and for some differences in sensitivity/specificity between the tests used. Some authors hypothesize that chilblains could be the cutaneous expression of a strong type I interferon (IFN-I) response. High production of IFN-I is suggested to be associated with early viral control and may suppress antibody response. However, the absence of other cutaneous or extracutaneous symptoms as observed in other interferonopathies raises unanswered questions. To date, a direct link between chilblains and COVID-19 still seems impossible to confirm. A more indirect association due to lifestyle changes induced by lockdown is a possible explanation. Improvement of chilblains when protective measures were adopted and after lifting of lockdown, support this hypothesis. CONCLUSION Conflicting current evidence highlights the need for systematic and repeated testing of larger numbers of patients and the need for valid follow-up data that take into consideration epidemic curves and evolution of lockdown measures.
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Affiliation(s)
- Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
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Herman A, Peeters C, Verroken A, Tromme I, Tennstedt D, Marot L, Dachelet C, Gruson D, Hermans C, Baeck M. Evaluation of Chilblains as a Manifestation of the COVID-19 Pandemic. JAMA Dermatol 2020; 156:998-1003. [PMID: 32584377 DOI: 10.1001/jamadermatol.2020.2368] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Importance During the coronavirus disease 2019 (COVID-19) pandemic, several cases of chilblains have been reported. Objective To determine if chilblains are associated with COVID-19. Design, Setting, and Participants This monocentric case series was conducted at the Department of Dermatology at Cliniques universitaires Saint-Luc, a tertiary care hospital in Brussels, Belgium, between April 10 and April 17, 2020. We evaluated a total of 31 referred patients who had recently developed chilblains. Main Outcomes and Measures Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA on nasopharyngeal swabs for all patients and in skin biopsy specimens for 22 patients. Blood samples from all patients were tested for specific anti-SARS-CoV-2 immunoglobulin (Ig) M and IgG antibodies. All patients had extended blood analyses. Histologic (22 patients) and immunofluorescence examinations (15 patients) were performed on the skin biopsy specimens. Results The 31 patients were generally in good health; most were teenagers or young adults, and 19 were women. Histopathologic analysis of skin biopsy specimens (22 patients) confirmed the diagnosis of chilblains and showed occasional lymphocytic or microthrombotic phenomena. Immunofluorescence analyses showed vasculitis of small-diameter vessels in 7 patients. In all patients, SARS-CoV-2 RNA remained undetected by RT-PCR on nasopharyngeal swabs and in biopsy samples of the skin lesions. The IgM and IgG antibody titers were negative for SARS-CoV-2 in all patients (<1.0 arbitrary unit/mL). No significant abnormalities in blood test results were suggestive of systemic disease. Antinuclear antibody titers were low in 7 patients and higher in 1 patient. Conclusions and Relevance Chilblains appeared not to be directly associated with COVID-19 in this case series. Lifestyle changes associated with community containment and lockdown measures are a possible explanation for these lesions.
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Affiliation(s)
- Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Pneumology, ENT, and Dermatology Pole, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
| | - Caroline Peeters
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Alexia Verroken
- Department of Laboratory Medicine, Division of Microbiology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Isabelle Tromme
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Dominique Tennstedt
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Liliane Marot
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Department of Anatomopathology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Claire Dachelet
- Department of Anatomopathology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Damien Gruson
- Department of Laboratory Medicine, Division of Clinical Biochemistry, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Cedric Hermans
- Department of Internal Medicine, Division of Hematology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.,Pneumology, ENT, and Dermatology Pole, Institute of Experimental and Clinical Research, Université Catholique de Louvain, Brussels, Belgium
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Matthews M, Vanlier C, de Montjoye L, Baeck M. A creeping holiday souvenir: about a misleading case of hookworm folliculitis†. J Travel Med 2020; 27:5862545. [PMID: 32584381 DOI: 10.1093/jtm/taaa101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/09/2020] [Accepted: 06/14/2020] [Indexed: 11/12/2022]
Abstract
Hookworm-related cutaneous larva migrans occurs in endemic areas but also amongst travelers. Although this disease usually presents as a single pruritic raised erythematous track, misleading clinical presentations are not uncommon. This particularly extensive, follicular presentation of larva migrans should warn clinicians about atypical forms of this emerging tropical disease.
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Affiliation(s)
- Marine Matthews
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Corentine Vanlier
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Laurence de Montjoye
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200 Brussels, Belgium
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Baeck M, Hoton D, Marot L, Herman A. Chilblains and COVID-19: why SARS-CoV-2 endothelial infection is questioned. Br J Dermatol 2020; 183:1152-1153. [PMID: 32798309 PMCID: PMC7461534 DOI: 10.1111/bjd.19489] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/10/2020] [Accepted: 08/13/2020] [Indexed: 01/24/2023]
Abstract
Linked Article: Colmenero et al. Br J Dermatol 2020; 183:729–737.
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Affiliation(s)
- M Baeck
- Division of Dermatology, Cliniques, Université, Avenue, 1200, Brussels, Belgium
| | - D Hoton
- Division of Anatomopathology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - L Marot
- Division of Dermatology, Cliniques, Université, Avenue, 1200, Brussels, Belgium.,Division of Anatomopathology, Cliniques universitaires Saint-Luc, Université catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - A Herman
- Division of Dermatology, Cliniques, Université, Avenue, 1200, Brussels, Belgium
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36
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Baeck M, Peeters C, Herman A. Chilblains and COVID-19: further evidence against a causal association. J Eur Acad Dermatol Venereol 2020; 35:e2-e3. [PMID: 32866323 DOI: 10.1111/jdv.16901] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/15/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022]
Affiliation(s)
- M Baeck
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - C Peeters
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - A Herman
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Vanlier C, Marot L, Laranaga E, D'abadie P, Yombi JC, Yildiz H, Baeck M. A case report of cutaneous leishmaniasis: a misleading clinical presentation. Infection 2020; 49:177-180. [PMID: 32876896 DOI: 10.1007/s15010-020-01517-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/25/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The diagnosis of cutaneous leishmaniasis (CL) is often difficult because of the diversity of clinical presentations, its often-misleading appearance and the very long incubation period (time between the endemic stay and the onset of skin lesions). CASE We report the case of an otherwise healthy 67-year-old man who presented with inflammatory skin lesions on the scalp and face for the past 7 years. The lesions were first mistaken as cutaneous sarcoidosis, mycobacterial infection, and cutaneous lymphoma. Finally, the diagnosis was made by RT-PCR analysis on a punch-biopsy specimen, which was positive for Leishmania infantum. DISCUSSION AND CONCLUSION: To date, the choice of treatment for complex cutaneous leishmaniases is based on the Leishmania species. Our patient successfully responded to liposomal amphotericin B.
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Affiliation(s)
- Corentine Vanlier
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Liliane Marot
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.,Department of Anatomopathology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Eva Laranaga
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Philippe D'abadie
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Jean-Cyr Yombi
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Halil Yildiz
- Department of Internal Medicine and Infectious Diseases, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Avenue Hippocrate 10, 1200, Brussels, Belgium.
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Baeck M, Herman A, Peeters C, Marot L, Hermans C. Are chilblains a skin expression of COVID-19 microangiopathy? J Thromb Haemost 2020; 18:2414-2415. [PMID: 32657464 PMCID: PMC7405401 DOI: 10.1111/jth.15008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/10/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Marie Baeck
- Division of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Anne Herman
- Division of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Caroline Peeters
- Division of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Liliane Marot
- Division of Dermatology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
- Division of Anatomopathology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Cedric Hermans
- Division of Hematology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Herman A, Matthews M, Mairlot M, Nobile L, Fameree L, Jacquet LM, Baeck M. Drug reaction with eosinophilia and systemic symptoms syndrome in a patient with COVID-19. J Eur Acad Dermatol Venereol 2020; 34:e768-e700. [PMID: 32735713 PMCID: PMC7436859 DOI: 10.1111/jdv.16838] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 12/17/2022]
Affiliation(s)
- A Herman
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - M Matthews
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - M Mairlot
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - L Nobile
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - L Fameree
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - L-M Jacquet
- Cardiac ICU Department, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - M Baeck
- Division of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Lefevre MA, Nosbaum A, Hacard F, Berard F, Baeck M, Herman A, Bruze M, Svedman C, Nicolas JF, Vocanson M. Molecular diagnosis of skin allergy. World Allergy Organ J 2020. [DOI: 10.1016/j.waojou.2020.100357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Herman A, Montjoye L, Baeck M. Adverse cutaneous reaction to diabetic glucose sensors and insulin pumps: Irritant contact dermatitis or allergic contact dermatitis? Contact Dermatitis 2020; 83:25-30. [DOI: 10.1111/cod.13529] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 01/18/2023]
Affiliation(s)
| | - Laurence Montjoye
- Department of DermatologyCliniques universitaires Saint‐Luc Brussels Belgium
| | - Marie Baeck
- Department of DermatologyCliniques universitaires Saint‐Luc Brussels Belgium
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Darrigade A, Colmant C, Montjoye L, Herman A, Bugli C, Tromme I, Baeck M. Atopic Dermatitis Score 7 (ADS7): A promising tool for daily clinical assessment of atopic dermatitis. Allergy 2020; 75:1264-1266. [PMID: 31725914 DOI: 10.1111/all.14104] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Caroline Colmant
- Dermatology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Laurence Montjoye
- Dermatology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Anne Herman
- Dermatology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Céline Bugli
- Plateforme Technologique de Support en Méthodologie et Support Statistique (SMCS) Université Catholique de Louvain Louvain‐la‐Neuve Belgium
| | - Isabelle Tromme
- Dermatology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Marie Baeck
- Dermatology Department Cliniques Universitaires Saint‐Luc Brussels Belgium
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Montjoye L, Choteau M, Herman A, Hendrickx E, Chéou P, Baeck M, Dumoutier L. IL-6 and IL-1β expression is increased in autologous serum skin test of patients with chronic spontaneous urticaria. Allergy 2019; 74:2522-2524. [PMID: 31125442 DOI: 10.1111/all.13928] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Laurence Montjoye
- Department of Dermatology Cliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
- Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology Pole Université Catholique de Louvain Brussels Belgium
| | - Mathilde Choteau
- de Duve Institute Université catholique de Louvain Brussels Belgium
| | - Anne Herman
- Department of Dermatology Cliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
- Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology Pole Université Catholique de Louvain Brussels Belgium
| | - Emilie Hendrickx
- de Duve Institute Université catholique de Louvain Brussels Belgium
| | - Paméla Chéou
- de Duve Institute Université catholique de Louvain Brussels Belgium
| | - Marie Baeck
- Department of Dermatology Cliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
- Institute of Experimental and Clinical Research, Pneumology, ENT and Dermatology Pole Université Catholique de Louvain Brussels Belgium
| | - Laure Dumoutier
- de Duve Institute Université catholique de Louvain Brussels Belgium
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Herman A, Darrigade A, Montjoye L, Baeck M. Contact dermatitis caused by glucose sensors in diabetic children. Contact Dermatitis 2019; 82:105-111. [DOI: 10.1111/cod.13429] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/22/2019] [Accepted: 10/25/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Anne Herman
- Department of DermatologyCliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
| | - Anne‐Sophie Darrigade
- Department of DermatologyCliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
| | - Laurence Montjoye
- Department of DermatologyCliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
| | - Marie Baeck
- Department of DermatologyCliniques Universitaires Saint‐Luc, Université Catholique de Louvain Brussels Belgium
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Colmant C, Camboni A, Dekeuleneer V, Marot L, Dachelet C, Baeck M. Linear IgA dermatosis in association with angioimmunoblastic T-cell lymphoma infiltrating the skin: A case report with literature review. J Cutan Pathol 2019; 47:251-256. [PMID: 31482600 DOI: 10.1111/cup.13576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 08/09/2019] [Accepted: 08/14/2019] [Indexed: 11/26/2022]
Abstract
Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive form of peripheral T-cell lymphoma, characterized by systemic symptoms, diffuse lymphadenopathy, hepatosplenomegaly and immunodysregulation. Half of AITL is associated with cutaneous symptoms, but only few cases with bullous eruption have been described. Association with a linear IgA dermatosis is extremely rare. Linear IgA dermatosis can be idiopathic, or linked with drug intake or neoplastic disorders. Some cases of linear IgA dermatosis presenting as toxic epidermal necrolysis (TEN) have been described, most of them being drug induced. We here present the case of a 72-year-old man recently diagnosed with AITL who developed a bullous eruption, presenting as TEN. Histopathology showed deep cutaneous involvement of the lymphoma with a sub-epidermal blistering and direct immunofluorescence revealed a heavy IgA linear deposit on the dermal-epidermal junction. A diagnosis of linear IgA dermatosis associated with cutaneous involvement of an angioimmunoblastic T-cell lymphoma was made. Chemotherapy and corticosteroids allowed cutaneous improvement but the patient died of his lymphoma shortly after.
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Affiliation(s)
- Caroline Colmant
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Alessandra Camboni
- Anatomopathology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Valérie Dekeuleneer
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Liliane Marot
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.,Anatomopathology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Claire Dachelet
- Anatomopathology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Marie Baeck
- Dermatology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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46
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Dejonckheere G, Herman A, Baeck M. Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3-diphenylguanidine is common. Contact Dermatitis 2019; 81:167-173. [PMID: 30891769 DOI: 10.1111/cod.13269] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/12/2019] [Accepted: 03/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND The frequency of allergic contact dermatitis has significantly increased in healthcare workers since the transition from latex to synthetic rubber gloves, with 1,3-diphenylguanidine being identified as the most frequently implicated allergen. OBJECTIVES To highlight the role of 1,3-diphenylguanidine as the culprit allergen in contact allergies to synthetic rubber gloves, to propose recommendations for patch testing, and to discuss alternatives for sensitized subjects. MATERIALS AND METHODS Patch test data from healthcare workers who developed hand dermatitis after wearing rubber gloves and who reacted positively to glove samples and rubber additives were collected from September 2010 to December 2017 in a Belgian hospital. RESULTS A total of 44 caregivers were included in this study. Patch tests showed that: (a) 84% of the study population reacted positively to carba mix; (b) 86% reacted positively to 1,3-diphenylguanidine; and (c) 13 (30%) reacted positively to thiuram mix. Half of the subjects reacted positively to gloves containing 1,3-diphenylguanidine, whereas none reacted to accelerator-free gloves. CONCLUSION The most commonly identified allergen was 1,3-diphenylguanidine, far ahead of thiurams, which were previously described as the most sensitizing accelerators. The use of 1,3-diphenylguanidine-free gloves is recommended. No subject reacted to gloves without accelerators, thus confirming their efficiency among accelerator-sensitized patients. We recommend that 1,3-diphenylguanidine be added to the European baseline series.
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Affiliation(s)
- Guillaume Dejonckheere
- Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium and IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Anne Herman
- Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium and IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Marie Baeck
- Department of Dermatology, Cliniques universitaires Saint-Luc, Brussels, Belgium and IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, Dermatologie, Université Catholique de Louvain, Brussels, Belgium
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47
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Lefevre M, Nosbaum A, Hacard F, Berard F, Baeck M, Herman A, Bruze M, Svedman C, Nicolas J, Vocanson M. 056 Molecular diagnosis of skin allergy. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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48
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Montjoye L, Herman A, Hendrickx E, Chéou P, Blanchetot C, Hofman E, Baeck M, Dumoutier L. Increased expression of IL-24 in chronic spontaneous urticaria. Allergy 2019; 74:1811-1813. [PMID: 31006117 DOI: 10.1111/all.13832] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/01/2019] [Accepted: 04/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Laurence Montjoye
- Department of Dermatology, Cliniques Universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
- Pneumology, ENT and Dermatology Pole Institute of Experimental and Clinical Research, Université catholique de Louvain Brussels Belgium
| | - Anne Herman
- Department of Dermatology, Cliniques Universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
- Pneumology, ENT and Dermatology Pole Institute of Experimental and Clinical Research, Université catholique de Louvain Brussels Belgium
| | - Emilie Hendrickx
- de Duve Institute Université catholique de Louvain Brussels Belgium
| | - Paméla Chéou
- de Duve Institute Université catholique de Louvain Brussels Belgium
| | | | | | - Marie Baeck
- Department of Dermatology, Cliniques Universitaires Saint‐Luc Université Catholique de Louvain Brussels Belgium
- Pneumology, ENT and Dermatology Pole Institute of Experimental and Clinical Research, Université catholique de Louvain Brussels Belgium
| | - Laure Dumoutier
- de Duve Institute Université catholique de Louvain Brussels Belgium
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49
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Herman A, Baeck M, Montjoye L, Bruze M, Giertz E, Goossens A, Mowitz M. Allergic contact dermatitis caused by isobornyl acrylate in the Enlite glucose sensor and the Paradigm MiniMed Quick‐set insulin infusion set. Contact Dermatitis 2019; 81:432-437. [DOI: 10.1111/cod.13374] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/01/2019] [Accepted: 08/04/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Anne Herman
- Department of DermatologyCliniques universitaires Saint‐Luc Brussels Belgium
- IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, DermatologieUniversité Catholique de Louvain Brussels Belgium
| | - Marie Baeck
- Department of DermatologyCliniques universitaires Saint‐Luc Brussels Belgium
- IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, DermatologieUniversité Catholique de Louvain Brussels Belgium
| | - Laurence Montjoye
- Department of DermatologyCliniques universitaires Saint‐Luc Brussels Belgium
- IREC (Institut de Recherche Experimentale et Clinique) Pôle Pneumologie, ORL, DermatologieUniversité Catholique de Louvain Brussels Belgium
| | - Magnus Bruze
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Malmö Sweden
| | - Emil Giertz
- Department of DermatologyBlekinge Hospital Karlskrona Sweden
| | - An Goossens
- Department of DermatologyUniversity Hospitals KU Leuven Leuven Belgium
| | - Martin Mowitz
- Department of Occupational and Environmental DermatologyLund University, Skåne University Hospital Malmö Sweden
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50
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Lapeere H, Baeck M, Stockman A, Sabato V, Grosber M, Moutschen M, Lambert J, Vandebuerie L, de Montjoye L, Rabijns H, Allewaert K, Schrijvers R. A retrospective analysis omalizumab treatment patterns in patients with chronic spontaneous urticaria: a real-world study in Belgium. J Eur Acad Dermatol Venereol 2019; 34:127-134. [PMID: 31099916 PMCID: PMC7003755 DOI: 10.1111/jdv.15684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/23/2019] [Indexed: 01/17/2023]
Abstract
Background Chronic spontaneous urticaria (CSU) is characterized by the repeated occurrence of persistent hives and/or angioedema for ≥6 weeks, without specific external stimuli. H1‐antihistamines have long been the standard of care of CSU, but many patients remain uncontrolled even at 4× the approved dose. Add‐on therapy with omalizumab has proven effective in clinical trials, but little is known about omalizumab treatment in Belgium. Objective To collect real‐world clinical data on omalizumab treatment in adults with CSU in Belgium. Methods This was an observational, retrospective chart review of adults with CSU, who initiated omalizumab treatment between August 2014 and December 2016 (maximum 28 months follow‐up). Results In total, 235 patients were included (median time from symptom onset to diagnosis, 5.4 months; median time from diagnosis to commencing omalizumab, 6.7 months). Treatments used before/after commencing omalizumab did not always adhere to guidelines; many patients (26.4%/11.1%) received first‐generation H1‐antihistamines, while 20.4% used omalizumab monotherapy after initiating treatment. The mean interval between omalizumab administrations was 4.8 (SD 1.7) weeks; 67.8% of patients had ≥1 interval prolongation and/or shortening. Mean baseline 7‐day Urticaria Activity Score (UAS7) was 32.0 (SD 6.05); this improved to 12.6 (SD 11.2) after 1 month of omalizumab. About 67.2% of patients reached UAS7 ≤ 6 (well controlled) during the study. A total of 87 patients stopped omalizumab and never restarted before the end of the observation period; the most prevalent reason was remission of symptoms (49.4% of patients), followed by lack of effect (12.6%), lost to follow‐up (6.9%) and adverse events (3.4%). Headache was the most common adverse event (n = 8/82). No anaphylaxis was reported. Conclusions This study revealed that patients initiated on omalizumab in Belgium had severe CSU at baseline, and showed substantial improvements after 1 month of treatment. Greater adherence to the prescription of guideline‐recommended medications is needed for the treatment of CSU.
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Affiliation(s)
- H Lapeere
- Department of Dermatology, Ghent University Hospital, Gent, Belgium
| | - M Baeck
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - A Stockman
- Department of Dermatology, AZ Delta Campus Rembert Torhout, Torhout, Belgium
| | - V Sabato
- Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - M Grosber
- Department of Dermatology, Universitair Ziekenhuis Brussel, Brussels, Belgium.,Vrije Universiteit Brussel, Brussels, Belgium
| | - M Moutschen
- Service Infectious Diseases and General Internal Medicine, CHU Liège, Liège, Belgium
| | - J Lambert
- Department of Dermatology University Hospital Antwerp, University of Antwerp, Antwerp, Belgium
| | - L Vandebuerie
- Groepspraktijk Dermatologie Roeselare, Roeselare, Belgium
| | - L de Montjoye
- Department of Dermatology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - H Rabijns
- N.V. Novartis Pharma S.A., Vilvoorde, Belgium
| | - K Allewaert
- N.V. Novartis Pharma S.A., Vilvoorde, Belgium
| | - R Schrijvers
- Laboratory of Clinical Immunology, KU Leuven Department of Microbiology and Immunology, Leuven, Belgium
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