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Morren MA, Fodstad H, Brems H, Bedoni N, Guenova E, Jacot-Guillarmod M, Busiah K, Giuliano F, Gilliet M, Atallah I. Mosaic RASopathies concept: different skin lesions, same systemic manifestations? J Med Genet 2024; 61:411-419. [PMID: 38290824 DOI: 10.1136/jmg-2023-109306] [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: 04/01/2023] [Accepted: 12/30/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Cutaneous epidermal nevi are genotypically diverse mosaic disorders. Pathogenic hotspot variants in HRAS, KRAS, and less frequently, NRAS and BRAF may cause isolated keratinocytic epidermal nevi and sebaceous nevi or several different syndromes when associated with extracutaneous anomalies. Therefore, some authors suggest the concept of mosaic RASopathies to group these different disorders. METHODS In this paper, we describe three new cases of syndromic epidermal nevi caused by mosaic HRAS variants: one associating an extensive keratinocytic epidermal nevus with hypomastia, another with extensive mucosal involvement and a third combining a small sebaceous nevus with seizures and intellectual deficiency. Moreover, we performed extensive literature of all cases of syndromic epidermal nevi and related disorders with confirmed pathogenic postzygotic variants in HRAS, KRAS, NRAS or BRAF. RESULTS Most patients presented with bone, ophthalmological or neurological anomalies. Rhabdomyosarcoma, urothelial cell carcinoma and pubertas praecox are also repeatedly reported. KRAS pathogenic variants are involved in 50% of the cases, especially in sebaceous nevi, oculoectodermal syndrome and encephalocraniocutaneous lipomatosis. They are frequently associated with eye and brain anomalies. Pathogenic variants in HRAS are rather present in syndromic keratinocytic epidermal nevi and phacomatosis pigmentokeratotica. CONCLUSION This review delineates genotype/phenotype correlations of syndromic epidermal nevi with somatic RAS and BRAF pathogenic variants and may help improve their follow-up.
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Affiliation(s)
- Marie-Anne Morren
- Pediatric Dermatology Unit, Department of Dermatology and Venereology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Heidi Fodstad
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Hilde Brems
- Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Nicola Bedoni
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology and Venereology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Martine Jacot-Guillarmod
- Pediatric Gynecology Unit, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Kanetee Busiah
- Pediatric Endocrinology, Diabetology, and Obesity Unit, Department of Mother-Woman-Child, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Michel Gilliet
- Dermatology and Venereology Department, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Isis Atallah
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Blanchard M, Morren MA, Busschots AM, Hauben E, Alberti-Violetti S, Berti E, Avallone G, Tavoletti G, Panzone M, Quaglino P, Colonna C, Melchers RC, Vermeer MH, Gniadecki R, Mitteldorf C, Gosmann J, Stadler R, Jonak C, Oren-Shabtai M, Hodak E, Friedland R, Gordon E, Geskin LJ, Scarisbrick JJ, Mayo Martínez F, Noguera Morel L, Pehr K, Amarov B, Faouzi M, Nicolay JP, Kempf W, Blanchard G, Guenova E. Paediatric onset lymphomatoid papulosis: results of a multicentre retrospective cohort study, on behalf of the EORTC Cutaneous Lymphoma Tumours Group (CLTG). Br J Dermatol 2024:ljae150. [PMID: 38595050 DOI: 10.1093/bjd/ljae150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Lymphomatoid Papulosis (LyP) is a rare cutaneous T-cell lymphoproliferative disorder. Comprehensive data on LyP in the paediatric population is scarce. OBJECTIVES To characterize epidemiological, clinical, histopathological, and prognostic features of paediatric LyP. METHODS This was a retrospective, multicentre international cohort study including 87 cases of children and adolescents with LyP diagnosed between 1998 and 2022. Patients aged ≤ 18 years old at disease onset were included. Diagnosis was made in each centre based on clinical-pathological correlation. RESULTS Eighty-seven patients from 12 centres were included. The mean age at onset was 7.0 years (range 3 months-18 years) with a male to female ratio of 2:1. The mean time between onset of first cutaneous lesions and diagnosis was 1.3 years (range 0-14 years). Initial misdiagnosis concerned 26.4% of patients. Initially, LyP was most often misdiagnosed as Pityriasis lichenoides et varioliformis acuta (PLEVA), insect bites, or mollusca contagiosa. Erythematous papules or papulonodules were the most frequent clinical presentation. Pruritus was specifically mentioned for 20.7% of patients. The main histological subtype was type A in 55.1% of the cases. If analysed, monoclonal TCR rearrangement was found in 76.5% of the skin biopsies. The overall survival rate was 100% with follow up at 5 years available for 33 patients and at 15 years for 8 patients. A development of associated haematological malignancy (HM) occurred in 9.6% of the cases (7/73), including four mycosis fungoides (MF) cases, one primary cutaneous anaplastic large cell lymphoma (pc-ALCL), one systemic ALCL and one case of acute myeloid leukaemia. If we compare incidence rates of cancer with the world 0-19 years old population from 2001-2010, we estimate a significantly higher risk of associated malignancy in general, occurring before the age of 19 years old with incidence rate ratio of 87.49 (CI 86.01-88.99). CONCLUSIONS We report epidemiological data from a large international cohort of children and adolescents with LyP. Overall the prognosis of the disease is good, with excellent survival rates for all patients. Due to increased risk of associated HM, a long-term follow-up should be recommended for LyP patients.
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Affiliation(s)
- Maël Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Anne Morren
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
| | | | | | - Silvia Alberti-Violetti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Emilio Berti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Avallone
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Gianluca Tavoletti
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Michele Panzone
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Pietro Quaglino
- Department of Medical Sciences, University of Turin, Dermatology Clinic, Turin, Italy
| | - Cristiana Colonna
- Pediatric Dermatology Unit, dept of clinical sciences and community health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Rutger C Melchers
- Department of Dermatology, Leiden University Medical Center, Leiden, Netherlands
| | - Maarten H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, Netherlands
| | - Robert Gniadecki
- Division of Dermatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany
| | - Janika Gosmann
- University Clinic for Dermatology, Johannes Wesling Medical Centre, UKRUB, University of Bochum, Minden, Germany
| | - Rudolf Stadler
- University Clinic for Dermatology, Johannes Wesling Medical Centre, UKRUB, University of Bochum, Minden, Germany
| | - Constanze Jonak
- Medical University of Vienna, Division of General Dermatology, Vienna, Austria
| | - Meital Oren-Shabtai
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, and Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Emmilia Hodak
- Division of Dermatology, Rabin Medical Center, Beilinson Hospital, and Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Rivka Friedland
- Pediatric Dermatology Unit, Schneider Children's Medical Center, and Sackler Faculty of medicine, Tel Aviv University Israel
| | - Emily Gordon
- Department of Dermatology, Columbia University, New York, NY, USA
| | - Larisa J Geskin
- Department of Dermatology, Columbia University, New York, NY, USA
| | - Julia J Scarisbrick
- Department of Dermatology, University Hospital Birmingham, Birmingham, United Kingdom
| | - Fatima Mayo Martínez
- Department of Dermatology, University Children's Hospital Niño Jesús, Madrid, Spain
| | - Lucero Noguera Morel
- Department of Dermatology, University Children's Hospital Niño Jesús, Madrid, Spain
| | - Kevin Pehr
- Division of Dermatology, Department of Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Boyko Amarov
- Institute of Statistics and Econometrics, Sofia University "St. Kliment Ohridski", Faculty of Economics and Business Administration, 1113 Sofia, Bulgaria
| | - Mohamed Faouzi
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland
| | - Jan P Nicolay
- Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Werner Kempf
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Gabriela Blanchard
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
- Division of Dermatology and Venereology, Geneva University Hospitals, Geneva, Switzerland
| | - Emmanuella Guenova
- Department of Dermatology, CHUV Lausanne, University of Lausanne, Switzerland
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Bruschi L, Minisini F, Nidegger A, Dubois J, Iselin C, Chang YT, Guenova E, Morren MA. [Autoimmune bullous diseases in children]. Rev Med Suisse 2024; 20:638-647. [PMID: 38563538 DOI: 10.53738/revmed.2024.20.867.638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Auto-immune bullous diseases (AIBD) are rare in children. Although their pathogenesis is similar to their adult counterpart, there are differences in the clinical presentation. Moreover certain AIBD prevail at certain ages. There are no guidelines for the treatment of AIBD specific for children. In this review the recent literature is summarised with attention to recent data including diagnostic criteria. We also propose a treatment algorithm.
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Affiliation(s)
- Laura Bruschi
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Frédéric Minisini
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Alessia Nidegger
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Jeanne Dubois
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Christoph Iselin
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Yun-Tsan Chang
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Emmanuella Guenova
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
| | - Marie-Anne Morren
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, Université de Lausanne, 1011 Lausanne
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4
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Messina F, Conrad C, Morren MA. [Treatment of childhood psoriasis: present and future]. Rev Med Suisse 2024; 20:631-635. [PMID: 38563537 DOI: 10.53738/revmed.2024.20.867.631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Psoriasis may present in childhood with skin, nail and scalp lesions but sometimes also articular involvement. It has an import impact on the quality of life of young patients. In this article we present an overview of the treatments that may be used in children according to skin area involved and severity of lesions with special interest for the biological treatments, already available and under investigation.
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Affiliation(s)
- Francesco Messina
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, Université de Lausanne, 1011 Lausanne
- Département de dermatologie, IRCCS Policlinico San Donato, Piazza Edmondo Malan 2, 20097 San Donato Milanese, Milan, Italie
| | - Curdin Conrad
- Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, Université de Lausanne, 1011 Lausanne
| | - Marie-Anne Morren
- Unité de dermatologie pédiatrique, Département de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois, Université de Lausanne, 1011 Lausanne
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5
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Bernard P, Blanchard M, Morren MA, Guenova E. [Clinical, therapeutic and pathophysiological aspects of Darier's disease]. Rev Med Suisse 2024; 20:659-663. [PMID: 38563541 DOI: 10.53738/revmed.2024.20.867.659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Darier Disease is a rare autosomal dominant inherited skin disorder classified as an acantholytic dermatosis. It manifests around puberty as brownish keratotic papules of skin folds and seborrheic areas, associated with onychopathy and mucosal involvementand have a chronic relapsing-remitting course with frequent exacerbations triggered by sun exposure, heat, friction, or infections. Darier patients have an increased risk of neuropsychiatric disorders, type 1 diabetes and heart failure. Short-term management relies on antibiotics/antiviral, topical corticosteroids and/or retinoids. Moisturizers, sun protection and avoiding triggers are essential for long-term management. Conventional long-term treatment is not standardized and many topical treatments, physical and surgical measures and systemic treatments are described in the literature.
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Affiliation(s)
- Pauline Bernard
- Département de dermatologie, Centre hospitalier universitaire vaudois et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - Maël Blanchard
- Département de dermatologie, Hôpitaux universitaires de Genève, 1211 Genève 14
| | - Marie-Anne Morren
- Unité de dermatologie pédiatrique, Service de dermatologie et vénérologie, Centre hospitalier universitaire vaudois et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - Emmanuella Guenova
- Département de dermatologie, Centre hospitalier universitaire vaudois et Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
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Wüthrich H, Yatim A, Di Lucca J, Walker A, Ventejou S, Morren MA, Goossens A, Dendooven E, Aerts O, Gilliet M, Seremet T. It is not always chlorhexidine: Identification of benzoxonium chloride and lauramine oxide as culprit allergens in a popular antiseptic in Switzerland. Contact Dermatitis 2023; 89:284-289. [PMID: 37286188 DOI: 10.1111/cod.14359] [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: 03/11/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND A popular antiseptic spray in Switzerland (Merfen spray), containing chlorhexidine digluconate, benzoxonium chloride and lauramine oxide, is frequently used to treat skin wounds. However, it is also increasingly reported as a major cause of adverse skin reactions, including allergic contact dermatitis (ACD). OBJECTIVES To investigate the contact allergens responsible for ACD from this antiseptic. PATIENTS/METHODS Patch tests were performed on seven patients with a clinical history compatible with contact dermatitis from this antiseptic mixture. RESULTS All patients presented with acute eczematous reactions following contact with either Merfen spray alone, or with multiple products including this spray. Patients showed positive reactions to this product in both patch tests and repeated open application tests (ROATs). Four patients showed dose-dependent reactions to both benzoxonium chloride and lauramine oxide. One patient showed a dose-dependent reaction to the former and a non-dose-dependent reaction to the latter. Finally, two subjects showed responses only to lauramine oxide. One patient reacted to chlorhexidine digluconate 0.5% aq. in addition to both other allergens. CONCLUSIONS Two commercially unavailable allergens, that is, benzoxonium chloride and/or lauramine oxide were identified as major causes of ACD from Merfen antiseptic spray, whereas chlorhexidine digluconate was a contributing culprit in only one patient.
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Affiliation(s)
- Héloïse Wüthrich
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Ahmad Yatim
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Julie Di Lucca
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Anna Walker
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Sarah Ventejou
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Marie-Anne Morren
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - An Goossens
- Department of Dermatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Ella Dendooven
- Department of Dermatology, University Hospital Antwerp (UZA), Antwerp, Belgium
- Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Olivier Aerts
- Department of Dermatology, University Hospital Antwerp (UZA), Antwerp, Belgium
- Research Group Immunology, University of Antwerp, Antwerp, Belgium
| | - Michel Gilliet
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Teofila Seremet
- Department of Dermatology and Venereology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Blanchard M, Norrenberg S, Monod M, Morren MA, Guenova E. [Tinea capitis: new insights into an old disease]. Rev Med Suisse 2023; 19:618-623. [PMID: 36988169 DOI: 10.53738/revmed.2023.19.820.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Tinea capitis is a superficial dermatophytic infection of the scalp. This common dermatosis occurs predominantly in children. The clinical manifestation of the disease is heterogeneous, and vary widely depending on the pathogenic fungal agent. Direct mycological examination and cultures are mandatory for an accurate diagnosis and species identification. Treatment should be both local and systemic, and ideally is tailored to the dermatophytic species identified by the laboratory diagnostic work up. Secondary prophylaxis through supplementary measures is crucial to avoid epidemic outbreak and patient reinfection.
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Affiliation(s)
- Maël Blanchard
- Département de dermatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, UNIL Lausanne
| | | | - Michel Monod
- Département de dermatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, UNIL Lausanne
| | - Marie-Anne Morren
- Département de dermatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Unité de dermatologie pédiatrique, Hôpital de l'enfance, 1004 Lausanne
| | - Emmanuella Guenova
- Département de dermatologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Faculté de biologie et médecine, UNIL Lausanne
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8
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Minisini F, Gilliet M, Morren MA. [Juvenile dermatomyositis, the dermatologist's point of view]. Rev Med Suisse 2023; 19:632-636. [PMID: 36988171 DOI: 10.53738/revmed.2023.19.820.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
Juvenile dermatomyositis is a rare multi-system auto-immune disease, particularly causing inflammation of skin and muscles of children. The diagnosis is based on the clinical picture with typical cutaneous lesions, which frequently are the first signs of the disease in contrast to muscle involvement. Muscular MRI is nowadays the first line investigation to diagnose myositis. Recently specific auto-antibodies have been detected allowing a better understanding of the disease and being important prognostic factors. An early diagnosis and aggressive treatment is crucial to induce remission of the disease, especially restore muscular function and to prevent severe complications such as calcinosis and lipodystrophy, which are difficult to treat as well as vital organ dysfunction.
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Affiliation(s)
- Frédéric Minisini
- Unité de dermatologie pédiatrie, Service de dermatologie et vénérologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Michel Gilliet
- Unité de dermatologie pédiatrie, Service de dermatologie et vénérologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Marie-Anne Morren
- Unité de dermatologie pédiatrie, Service de dermatologie et vénérologie, Centre hospitalier universitaire vaudois, 1011 Lausanne
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Morren MA, Legius E, Giuliano F, Hadj-Rabia S, Hohl D, Bodemer C. Challenges in Treating Genodermatoses: New Therapies at the Horizon. Front Pharmacol 2022; 12:746664. [PMID: 35069188 PMCID: PMC8766835 DOI: 10.3389/fphar.2021.746664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/29/2021] [Indexed: 01/28/2023] Open
Abstract
Genodermatoses are rare inherited skin diseases that frequently affect other organs. They often have marked effects on wellbeing and may cause early death. Progress in molecular genetics and translational research has unravelled many underlying pathological mechanisms, and in several disorders with high unmet need, has opened the way for the introduction of innovative treatments. One approach is to intervene where cell-signaling pathways are dysregulated, in the case of overactive pathways by the use of selective inhibitors, or when the activity of an essential factor is decreased by augmenting a molecular component to correct disequilibrium in the pathway. Where inflammatory reactions have been induced by a genetically altered protein, another possible approach is to suppress the inflammation directly. Depending on the nature of the genodermatosis, the implicated protein or even on the particular mutation, to correct the consequences or the genetic defect, may require a highly personalised stratagem. Repurposed drugs, can be used to bring about a "read through" strategy especially where the genetic defect induces premature termination codons. Sometimes the defective protein can be replaced by a normal functioning one. Cell therapies with allogeneic normal keratinocytes or fibroblasts may restore the integrity of diseased skin and allogeneic bone marrow or mesenchymal cells may additionally rescue other affected organs. Genetic engineering is expanding rapidly. The insertion of a normal functioning gene into cells of the recipient is since long explored. More recently, genome editing, allows reframing, insertion or deletion of exons or disruption of aberrantly functioning genes. There are now several examples where these stratagems are being explored in the (pre)clinical phase of therapeutic trial programmes. Another stratagem, designed to reduce the severity of a given disease involves the use of RNAi to attenuate expression of a harmful protein by decreasing abundance of the cognate transcript. Most of these strategies are short-lasting and will thus require intermittent life-long administration. In contrast, insertion of healthy copies of the relevant gene or editing the disease locus in the genome to correct harmful mutations in stem cells is more likely to induce a permanent cure. Here we discuss the potential advantages and drawbacks of applying these technologies in patients with these genetic conditions. Given the severity of many genodermatoses, prevention of transmission to future generations remains an important goal including offering reproductive choices, such as preimplantation genetic testing, which can allow selection of an unaffected embryo for transfer to the uterus.
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Affiliation(s)
- Marie-Anne Morren
- Pediatric Dermatology Unit, Departments of Dermatology and Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Eric Legius
- Department for Human Genetics, University Hospitals Leuven, KU Leuven, ERN Genturis and ERN Skin, Leuven, Belgium
| | - Fabienne Giuliano
- Department of Medical Genetics, University Hospital Lausanne, Lausanne, Switzerland
| | - Smail Hadj-Rabia
- Department of Pediatric Dermatology and Dermatology, National Reference Centre for Genodermatosis and Rare Diseases of the Skin (MAGEC), Hôpital Necker-Enfants Malades, and Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, ERN Skin, Paris, France
| | - Daniel Hohl
- Department of Dermatology and Venereology, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Christine Bodemer
- Department of Pediatric Dermatology and Dermatology, National Reference Centre for Genodermatosis and Rare Diseases of the Skin (MAGEC), Hôpital Necker-Enfants Malades, and Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, ERN Skin, Paris, France
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Noë E, Huygens S, Morren MA, Garmyn M, Goossens A, Gilissen L. Contact allergy in a paediatric population observed in a tertiary referral centre in Belgium. Contact Dermatitis 2021; 86:3-8. [PMID: 34537955 DOI: 10.1111/cod.13975] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 05/20/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Contact allergy is increasingly recognized as being important in children with eczema. OBJECTIVES To retrospectively analyse the patch test results in children over the past 10 years, aiming to (1) evaluate demographic characteristics and lesion locations, (2) describe frequencies of positive patch test reactions, and (3) investigate the relationship with atopic dermatitis (AD). METHODS A total of 329 children were patch tested between January 2010 and December 2019 with the European (children) baseline series and/or other series, and the personal product(s) used. RESULTS A total of 119 (36%) children presented with at least one positive reaction. Children with AD had a higher prevalence of positive reactions compared with the non-AD group (P = .002), but without statistically significant difference regarding sensitization to more than one hapten (P = .39). The face (20.2%), hands (19.3%), feet (16.8%), arms (12.6%), and body folds (10.9%) were the most common sites of primary localizations. The most frequent contact allergens were nickel sulfate and linalool hydroperoxide (both 16%), limonene hydroperoxide (13.5%), and para-phenylenediamine (10.9%). No statistically significant difference for nickel sulfate was found between the AD and non-AD group (P = .20). CONCLUSIONS Contact allergy in children with eczema was frequently observed in our tertiary referral centre in Belgium as well, confirming the need for patch testing.
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Affiliation(s)
- Esther Noë
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium
| | - Sara Huygens
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- Unité de Dermatologie Pediatrique, Hôpital des Enfants CHUV Lausanne, Lausanne, Switzerland
| | - Marjan Garmyn
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium.,Department of Oncology, Laboratory of Dermatology, KU Leuven, Leuven, Belgium
| | - An Goossens
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
| | - Liesbeth Gilissen
- Department of Dermatology, Contact Allergy Unit, University Hospitals of Leuven, Leuven, Belgium.,Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, KU Leuven, Leuven, Belgium
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11
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Ventéjou S, Schwieger-Briel A, Nicolai R, Christen-Zaech S, Schnider C, Hofer M, Bogiatzi S, Hohl D, De Benedetti F, Morren MA. Case Report: Pansclerotic Morphea-Clinical Features, Differential Diagnoses and Modern Treatment Concepts. Front Immunol 2021; 12:656407. [PMID: 33767715 PMCID: PMC7985437 DOI: 10.3389/fimmu.2021.656407] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/17/2021] [Indexed: 01/17/2023] Open
Abstract
Pansclerotic morphea (PSM) is a rare skin disease characterized by progressive stiffening of the skin with or without the typical superficial skin changes usually seen in morphea (localized scleroderma). Standard therapy, consisting of a combination of systemic glucocorticoids and methotrexate or mycophenolate mofetil, does rarely stop disease progression, which may lead to severe cutaneous sclerosis and secondary contractures. Little is known about the efficacy of newer biologicals such as abatacept, a fusion protein antibody against CTLA-4, or tocilizumab, a fully humanized IL-6R antibody, in the treatment of this pathology. We present the case of an 8 years old girl with an unusual, progressive stiffening of the skin, which was eventually diagnosed as pansclerotic morphea. A treatment with systemic glucocorticoids and methotrexate combined with tocilizumab led to a good clinical response within 2 months after initiation. In this paper, we discuss differential diagnoses to be considered and this new promising treatment option based on a case review of the literature.
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Affiliation(s)
- Sarah Ventéjou
- Pediatric Dermatology Unit, Department of Pediatrics and Dermatology and Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Agnes Schwieger-Briel
- Department of Dermatology, Pediatric Skin Center, University Children's Hospital Zurich, Zurich, Switzerland
| | - Rebecca Nicolai
- Division of Rheumatology, Istituto di Ricovero e Cura a Carattera Scientifico, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Stephanie Christen-Zaech
- Pediatric Dermatology Unit, Department of Pediatrics and Dermatology and Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Caroline Schnider
- Department of Pediatric Rheumatology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Michael Hofer
- Department of Pediatric Rheumatology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Sofia Bogiatzi
- Laboratory of Dermato-Histopathology, Department of Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Daniel Hohl
- Laboratory of Dermato-Histopathology, Department of Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Fabrizio De Benedetti
- Division of Rheumatology, Istituto di Ricovero e Cura a Carattera Scientifico, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Marie-Anne Morren
- Pediatric Dermatology Unit, Department of Pediatrics and Dermatology and Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
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12
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Frémond ML, Hadchouel A, Berteloot L, Melki I, Bresson V, Barnabei L, Jeremiah N, Belot A, Bondet V, Brocq O, Chan D, Dagher R, Dubus JC, Duffy D, Feuillet-Soummer S, Fusaro M, Gattorno M, Insalaco A, Jeziorski E, Kitabayashi N, Lopez-Corbeto M, Mazingue F, Morren MA, Rice GI, Rivière JG, Seabra L, Sirvente J, Soler-Palacin P, Stremler-Le Bel N, Thouvenin G, Thumerelle C, Van Aerde E, Volpi S, Willcocks S, Wouters C, Breton S, Molina T, Bader-Meunier B, Moshous D, Fischer A, Blanche S, Rieux-Laucat F, Crow YJ, Neven B. Overview of STING-Associated Vasculopathy with Onset in Infancy (SAVI) Among 21 Patients. J Allergy Clin Immunol Pract 2021. [PMID: 33217613 DOI: 10.1016/j.jaip.2020.11.007)] [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] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Gain-of-function mutations in STING1 underlie a type I interferonopathy termed SAVI (STING-associated vasculopathy with onset in infancy). This severe disease is variably characterized by early-onset systemic inflammation, skin vasculopathy, and interstitial lung disease (ILD). OBJECTIVE To describe a cohort of patients with SAVI. METHODS Assessment of clinical, radiological and immunological data from 21 patients (17 families) was carried out. RESULTS Patients carried heterozygous substitutions in STING1 previously described in SAVI, mainly the p.V155M. Most were symptomatic from infancy, but late onset in adulthood occurred in 1 patient. Systemic inflammation, skin vasculopathy, and ILD were observed in 19, 18, and 21 patients, respectively. Extensive tissue loss occurred in 4 patients. Severity of ILD was highly variable with insidious progression up to end-stage respiratory failure reached at teenage in 6 patients. Lung imaging revealed early fibrotic lesions. Failure to thrive was almost constant, with severe growth failure seen in 4 patients. Seven patients presented polyarthritis, and the phenotype in 1 infant mimicked a combined immunodeficiency. Extended features reminiscent of other interferonopathies were also found, including intracranial calcification, glaucoma and glomerular nephropathy. Increased expression of interferon-stimulated genes and interferon α protein was constant. Autoantibodies were frequently found, in particular rheumatoid factor. Most patients presented with a T-cell defect, with low counts of memory CD8+ cells and impaired T-cell proliferation in response to antigens. Long-term follow-up described in 8 children confirmed the clinical benefit of ruxolitinib in SAVI where the treatment was started early in the disease course, underlying the need for early diagnosis. Tolerance was reasonably good. CONCLUSION The largest worldwide cohort of SAVI patients yet described, illustrates the core features of the disease and extends the clinical and immunological phenotype to include overlap with other monogenic interferonopathies.
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Affiliation(s)
- Marie-Louise Frémond
- Université de Paris, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, Paris, France; Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France
| | - Alice Hadchouel
- Université de Paris, Paris, France; Pediatric Pulmonology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; INEM, INSERM U1151, Paris, France
| | - Laureline Berteloot
- Pediatric Radiology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France
| | - Isabelle Melki
- Université de Paris, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, Paris, France; Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; General Pediatrics-Infectious Diseases and Internal Medicine Department, Hôpital Robert Debré, AP-HP Nord-Université de Paris, Paris, France
| | - Violaine Bresson
- Pediatric Emergency Department, Hôpital de la Timone, AP-HM, Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - Laura Barnabei
- Université de Paris, Imagine Institute, Laboratory of Immunogenetics of Pediatric Autoimmunity, INSERM UMR 1163, Paris, France
| | - Nadia Jeremiah
- Immunity and Cancer Department, Institut Curie, PSL Research University, Institut National de la Santé et de la Recherche Médicale U932, Paris, France
| | - Alexandre Belot
- Pediatric Rheumatology, Nephrology and Dermatology Department, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, INSERM, U1111, CNRS UMR5308, Ecole Normale Supérieure de Lyon, Université Lyon 1, Lyon, France
| | - Vincent Bondet
- Translational Immunology Lab, Institut Pasteur, Paris, France
| | - Olivier Brocq
- Rheumatology Department, Centre Hospitalier Princesse Grace, Monaco, Monaco
| | - Damien Chan
- Pediatric Allergy and Immunology Department, Women's and Children's Hospital, Adelaide, South Australia, Australia
| | - Rawane Dagher
- Department of Pediatrics, Notre Dame des Secours University Hospital, Jbeil, Lebanon
| | - Jean-Christophe Dubus
- Pediatric Pulmonology Department, Hôpital de la Timone, AP-HM, Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - Darragh Duffy
- Translational Immunology Lab, Institut Pasteur, Paris, France
| | - Séverine Feuillet-Soummer
- Department of Thoracic and Vascular Surgery and Heart-Lung Transplantation, Marie-Lannelongue Hospital, Paris-Sud University, Le Plessis-Robinson, France
| | - Mathieu Fusaro
- Study Center for Primary Immunodeficiencies, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; Université de Paris, Imagine Institute, Laboratory of Lymphocyte Activation and Susceptibility to EBV Infection, INSERM UMR 1163, Paris, France
| | - Marco Gattorno
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Giannina Gaslini Institute, Genova, Italy
| | - Antonella Insalaco
- Pediatric Rheumatology Unit, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Eric Jeziorski
- Pediatrics Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Naoki Kitabayashi
- Université de Paris, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, Paris, France
| | - Mireia Lopez-Corbeto
- Pediatric Rheumatology Unit, Rheumatology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Catalonia, Spain
| | - Françoise Mazingue
- Pediatric Hematology Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Marie-Anne Morren
- Dermatology Department, University Hospitals Leuven, Leuven, Belgium; Department of Pediatrics and Dermatol-Venereology, University Hospital Lausanne and University of Lausanne Pediatric Dermatology Unit, Lausanne, Switzerland
| | - Gillian I Rice
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Jacques G Rivière
- Infection in Immunocompromised Pediatric Patients Research Group, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain
| | - Luis Seabra
- Université de Paris, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, Paris, France
| | - Jérôme Sirvente
- Internal Medicine Department, Hôpital Saint-Eloi, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Pere Soler-Palacin
- Infection in Immunocompromised Pediatric Patients Research Group, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra, Catalonia, Spain
| | - Nathalie Stremler-Le Bel
- Pediatric Pulmonology Department, Hôpital de la Timone, AP-HM, Centre Hospitalier Universitaire de Marseille, Marseille, France
| | - Guillaume Thouvenin
- Pediatric Pulmonology Department and Reference Center for Rare Lung Disease RespiRare, Trousseau University Hospital, AP-HP Sorbonne Université, Paris, France
| | - Caroline Thumerelle
- Pediatric Pneumology Department, Hôpital Jeanne de Flandre, CHRU Lille, Lille, France
| | - Eline Van Aerde
- Dermatology Department, University Hospitals Leuven, Leuven, Belgium
| | - Stefano Volpi
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Giannina Gaslini Institute, Genova, Italy
| | - Sophie Willcocks
- Pediatric Immunology and Allergy Service, Queensland Children's Hospital, Children's Health Queensland, Brisbane, Queensland, Australia
| | - Carine Wouters
- Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; Pediatrics Department, University Hospitals Leuven, Leuven, Belgium; Department of Immunology and Microbiology-Childhood Immunology University of Leuven, Leuven, Belgium
| | - Sylvain Breton
- Pediatric Radiology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France
| | - Thierry Molina
- Université de Paris, Paris, France; Pathology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France
| | - Brigitte Bader-Meunier
- Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; Université de Paris, Imagine Institute, Laboratory of Immunogenetics of Pediatric Autoimmunity, INSERM UMR 1163, Paris, France
| | - Despina Moshous
- Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; Université de Paris, Imagine Institute, Laboratory of Genome Dynamics in the Immune System, INSERM UMR 1163, Paris, France
| | - Alain Fischer
- Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; Université de Paris, Imagine Institute, INSERM UMR 1163, Paris, France; Collège de France, Paris, France
| | - Stéphane Blanche
- Université de Paris, Paris, France; Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France
| | - Frédéric Rieux-Laucat
- Université de Paris, Imagine Institute, Laboratory of Immunogenetics of Pediatric Autoimmunity, INSERM UMR 1163, Paris, France
| | - Yanick J Crow
- Université de Paris, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, Paris, France; Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom.
| | - Bénédicte Neven
- Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, AP-HP Centre Université de Paris, Paris, France; Université de Paris, Imagine Institute, Laboratory of Immunogenetics of Pediatric Autoimmunity, INSERM UMR 1163, Paris, France.
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13
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George K, Morren MA, Christen T, Letovanec I, Christen-Zaech S. Distal-type epitheloid sarcoma mimicking a wart in a child: A diagnosis not to be missed. Pediatr Dermatol 2021; 38:187-190. [PMID: 33247494 DOI: 10.1111/pde.14352] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/04/2020] [Accepted: 08/08/2020] [Indexed: 11/26/2022]
Abstract
Epithelioid sarcoma is a rare soft-tissue tumor that occurs mainly in children and young adults. It typically presents as a subcutaneous or deep dermal mass in distal extremities. Due to its benign-appearing clinical presentation, infrequent occurrence, and histologic similarities with other pathologies, the diagnosis of epithelioid sarcoma in its early stages can be extremely difficult and can be easily confused with benign lesions such as warts or foreign body granuloma. In this paper, we report the case of a 12-year-old boy with a distal-type epithelioid sarcoma of the hand and wish to emphasize the difficulties of diagnosing this potentially lethal tumor both clinically and histologically.
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Affiliation(s)
- Kimberley George
- Pediatric Dermatology Unit, Departments of Dermatology & Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Marie-Anne Morren
- Pediatric Dermatology Unit, Departments of Dermatology & Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Thierry Christen
- Hand Plastic Surgery Unit, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Igor Letovanec
- Institute of Pathology, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
| | - Stephanie Christen-Zaech
- Pediatric Dermatology Unit, Departments of Dermatology & Venereology and Pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
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14
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Goossens A, Morren MA. Contact Allergy in Children. Contact Dermatitis 2021. [DOI: 10.1007/978-3-030-36335-2_48] [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: 11/28/2022]
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15
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Cork MJ, Lockshin B, Morren MA, Etoh T, Chen Z, Rossi AB, Lu Y, Bansal A, Shabbir A. 15413 Dupilumab improves signs and symptoms in adult and adolescent patients with erythrodermic atopic dermatitis: A pooled subgroup analysis. J Am Acad Dermatol 2020. [DOI: 10.1016/j.jaad.2020.06.242] [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: 11/16/2022]
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16
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Andina D, Belloni-Fortina A, Bodemer C, Bonifazi E, Chiriac A, Colmenero I, Diociaiuti A, El-Hachem M, Fertitta L, van Gysel D, Hernández-Martín A, Hubiche T, Luca C, Martos-Cabrera L, Maruani A, Mazzotta F, Akkaya AD, Casals M, Ferrando J, Grimalt R, Grozdev I, Kinsler V, Morren MA, Munisami M, Nanda A, Novoa MP, Ott H, Pasmans S, Salavastru C, Zawar V, Torrelo A. Skin manifestations of COVID-19 in children: Part 3. Clin Exp Dermatol 2020; 46:462-472. [PMID: 33207021 PMCID: PMC7753282 DOI: 10.1111/ced.14483] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 12/13/2022]
Abstract
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial
recognized symptoms were respiratory, sometimes culminating in severe respiratory distress
requiring ventilation, and causing death in a percentage of those infected. As time has
passed, other symptoms have been recognized. The initial reports of cutaneous
manifestations were from Italian dermatologists, probably because Italy was the first
European country to be heavily affected by the pandemic. The overall clinical
presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in
adults as do the cutaneous manifestations of childhood. In this review, we summarize the
current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough
and critical review of articles published in the literature and from the personal
experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss
one of the first and most widespread cutaneous manifestations of COVID‐19, chilblain‐like
lesions, and in Part 2 we expanded to other manifestations, including erythema multiforme,
urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome. In this part of
the review, we discuss the histological findings of COVID‐19 manifestations, and the
testing and management of infected children for both COVID‐19 and any other pre‐existing
conditions. Click here for the corresponding questions to this CME article.
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Affiliation(s)
- D Andina
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Belloni-Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - C Bodemer
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - E Bonifazi
- Dermatologia Pediatrica Association, Bari, Italy
| | - A Chiriac
- Nicolina Medical Center, Iasi, Romania
| | - I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Fertitta
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - D van Gysel
- Department of Pediatrics, O. L. Vrouw Hospital, Aalst, Belgium
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - T Hubiche
- Department of Dermatology, Université Côte d'Azur, Nice, France
| | - C Luca
- Nicolina Medical Center, Iasi, Romania
| | - L Martos-Cabrera
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, SPHERE-INSERM1246, CHRU Tours, Tours, France
| | - F Mazzotta
- Dermatologia Pediatrica Association, Bari, Italy
| | - A D Akkaya
- Department of Dermatology, Ulus Liv Hospital, Istanbul, Turkey
| | - M Casals
- Department of Dermatology, Hospital Universitari de Sabadell, Barcelona, Spain
| | - J Ferrando
- Department of Dermatology, Hospital Clìnic, Barcelona, Spain
| | - R Grimalt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - I Grozdev
- Department of Dermatology, Children's University Hospital Queen Fabiola, Brussels, Belgium
| | - V Kinsler
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - M A Morren
- Pediatric Dermatology Unit, Department of Pediatrics and Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Munisami
- Department of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute Of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - M P Novoa
- Department of Dermatology, Hospital San Jose, Bogota, Colombia
| | - H Ott
- Division of Pediatric Dermatology, Children's Hospital Auf der Bult, Hannover, Germany
| | - S Pasmans
- Erasmus MC University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - V Zawar
- Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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17
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Andina D, Belloni-Fortina A, Bodemer C, Bonifazi E, Chiriac A, Colmenero I, Diociaiuti A, El-Hachem M, Fertitta L, van Gysel D, Hernández-Martín A, Hubiche T, Luca C, Martos-Cabrera L, Maruani A, Mazzotta F, Akkaya AD, Casals M, Ferrando J, Grimalt R, Grozdev I, Kinsler V, Morren MA, Munisami M, Nanda A, Novoa MP, Ott H, Pasmans S, Salavastru C, Zawar V, Torrelo A. Skin manifestations of COVID-19 in children: Part 1. Clin Exp Dermatol 2020; 46:444-450. [PMID: 33180982 PMCID: PMC9275402 DOI: 10.1111/ced.14481] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [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: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023]
Abstract
The current COVID‐19 pandemic is caused by the SARS‐CoV‐2 coronavirus. The initial
recognized symptoms were respiratory, sometimes culminating in severe respiratory distress
requiring ventilation, and causing death in a percentage of those infected. As time has
passed, other symptoms have been recognized. The initial reports of cutaneous
manifestations were from Italian dermatologists, probably because Italy was the first
European country to be heavily affected by the pandemic. The overall clinical
presentation, course and outcome of SARS‐CoV‐2 infection in children differ from those in
adults as do the cutaneous manifestations of childhood. In this review, we summarize the
current knowledge on the cutaneous manifestations of COVID‐19 in children after thorough
and critical review of articles published in the literature and from the personal
experience of a large panel of paediatric dermatologists in Europe. In Part 1, we discuss
one of the first and most widespread cutaneous manifestation of COVID‐19, chilblain‐like
lesions. In Part 2, we review other manifestations, including erythema multiforme,
urticaria and Kawasaki disease‐like inflammatory multisystemic syndrome, while in Part 3,
we discuss the histological findings of COVID‐19 manifestations, and the testing and
management of infected children, for both COVID‐19 and any other pre‐existing
conditions. Click here for the corresponding questions to this CME article.
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Affiliation(s)
- D Andina
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Belloni-Fortina
- Pediatric Dermatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
| | - C Bodemer
- Department of Dermatology, Hospital Necker Enfants Malades, Paris Centre University, Paris, France
| | - E Bonifazi
- Dermatologia Pediatrica Association, Bari, Italy
| | - A Chiriac
- Nicolina Medical Center, Iasi, Romania
| | - I Colmenero
- Department of Pathology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Diociaiuti
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - M El-Hachem
- Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - L Fertitta
- St Parascheva Infectious Diseases Hospital, Iasi, Romania
| | - D van Gysel
- Department of Pediatrics, O. L. Vrouw Hospital, Aalst, Belgium
| | - A Hernández-Martín
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - T Hubiche
- Department of Dermatology, Université Côte d'Azur, Nice, France
| | - C Luca
- Nicolina Medical Center, Iasi, Romania
| | - L Martos-Cabrera
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - A Maruani
- Department of Dermatology, Unit of Pediatric Dermatology, University of Tours, SPHERE-INSERM1246, CHRU Tours, Tours, France
| | - F Mazzotta
- Dermatologia Pediatrica Association, Bari, Italy
| | - A D Akkaya
- Department of Dermatology, Ulus Liv Hospital, Istanbul, Turkey
| | - M Casals
- Department of Dermatology, Hospital Universitari de Sabadell, Barcelona, Spain
| | - J Ferrando
- Department of Dermatology, Hospital Clìnic, Barcelona, Spain
| | - R Grimalt
- Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - I Grozdev
- Department of Dermatology, Children's University Hospital Queen Fabiola, Brussels, Belgium
| | - V Kinsler
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - M A Morren
- Pediatric Dermatology Unit, Department of Pediatrics and Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - M Munisami
- Department of Dermatology and Sexually Transmitted Diseases, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - A Nanda
- As'ad Al-Hamad Dermatology Center, Kuwait City, Kuwait
| | - M P Novoa
- Department of Dermatology, Hospital San Jose, Bogota, Colombia
| | - H Ott
- Division of Pediatric Dermatology, Children's Hospital Auf der Bult, Hannover, Germany
| | - S Pasmans
- Erasmus MC University Medical Center Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - C Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - V Zawar
- Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
| | - A Torrelo
- Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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18
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Bucciol G, Delafontaine S, Moens L, Corveleyn A, Morren MA, Meyts I. Pathogenic TLR3 Variant in a Patient with Recurrent Herpes Simplex Virus 1-Triggered Erythema Multiforme. J Clin Immunol 2020; 41:280-282. [PMID: 33174085 DOI: 10.1007/s10875-020-00907-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Giorgia Bucciol
- Laboratory of Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium
| | - Selket Delafontaine
- Laboratory of Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium
| | - Leen Moens
- Laboratory of Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Anniek Corveleyn
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Marie-Anne Morren
- Department of Dermatology, Leuven University Hospitals, Leuven, Belgium.,Pediatric Dermatology Unit, Department of Pediatrics and Dermato-Venereology, University Hospital Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Isabelle Meyts
- Laboratory of Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium. .,Department of Pediatrics, Leuven University Hospitals, Leuven, Belgium.
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19
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Abstract
Birt–Hogg–Dubé syndrome (BHD) is a rare inherited autosomal dominant disorder caused by germline mutations in the tumour suppressor gene FLCN, encoding the protein folliculin. Its clinical expression typically includes multiple pulmonary cysts, recurrent spontaneous pneumothoraces, cutaneous fibrofolliculomas and renal tumours of various histological types. BHD has no sex predilection and tends to manifest in the third or fourth decade of life. Multiple bilateral pulmonary cysts are found on chest computed tomography in >80% of patients and more than half experience one or more episodes of pneumothorax. A family history of pneumothorax is an important clue, which suggests the diagnosis of BHD. Unlike other cystic lung diseases such as lymphangioleiomyomatosis and pulmonary Langerhans cell histiocytosis, BHD does not lead to progressive loss of lung function and chronic respiratory insufficiency. Renal tumours affect about 30% of patients during their lifetime, and can be multiple and recurrent. The diagnosis of BHD is based on a combination of genetic, clinical and/or skin histopathological criteria. Management mainly consists of early pleurodesis in the case of pneumothorax, periodic renal imaging for tumour detection, and diagnostic work-up in search of BHD in relatives of the index patient. Birt–Hogg–Dubé syndrome is a rare genetic disorder characterised by multiple lung cysts, recurrent pneumothoraces, skin lesions and kidney tumours. As the presenting symptoms may be respiratory, chest physicians should be able to identify this disease.https://bit.ly/2xsOTuk
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Affiliation(s)
- Cécile Daccord
- Respiratory Medicine Dept, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean-Marc Good
- Division of Genetic Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie-Anne Morren
- Pediatric Dermatology Unit, Dept of Pediatrics and Dermatology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Bonny
- Service of Nephrology, Dept of Medicine, Lausanne University Hospital, Lausanne, Switzerland.,Dept of Biomedical Sciences, University of Lausanne, Lausanne, Switzerland
| | - Daniel Hohl
- Dermatology Dept, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Romain Lazor
- Respiratory Medicine Dept, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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20
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Mestach L, Polubothu S, Calder A, Denayer E, Gholam K, Legius E, Levtchenko E, Van Laethem A, Brems H, Kinsler VA, Morren MA. Keratinocytic epidermal nevi associated with localized fibro-osseous lesions without hypophosphatemia. Pediatr Dermatol 2020; 37:890-895. [PMID: 32662096 DOI: 10.1111/pde.14254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 11/23/2019] [Revised: 05/07/2020] [Accepted: 05/30/2020] [Indexed: 11/28/2022]
Abstract
Keratinocytic epidermal nevi (KEN) are characterized clinically by permanent hyperkeratosis in the distribution of Blaschko's lines and histologically by hyperplasia of epidermal keratinocytes. KEN with underlying RAS mutations have been associated with hypophosphatemic rickets and dysplastic bone lesions described as congenital cutaneous skeletal hypophosphatemia syndrome. Here, we describe two patients with keratinocytic epidermal nevi, in one associated with a papular nevus spilus, who presented with distinct localized congenital fibro-osseous lesions in the lower leg, diagnosed on both radiology and histology as osteofibrous dysplasia, in the absence of hypophosphatemia or rickets, or significantly raised FGF23 levels but with distinct mosaic HRAS mutations. This expands the spectrum of cutaneous/skeletal mosaic RASopathies and alerts clinicians to the importance of evaluating for bony disease even in the absence of bone profile abnormalities.
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Affiliation(s)
- Lien Mestach
- Department of Dermatology, University Hospitals of Leuven, Leuven, Belgium
| | - Satyamaanasa Polubothu
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK.,Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Alistair Calder
- Paediatric Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Ellen Denayer
- Center for Human Genetics, University Hospital Leuven, Leuven, Belgium
| | - Karolina Gholam
- Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Eric Legius
- Center for Human Genetics, University Hospital Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven - University of Leuven, Leuven, Belgium
| | - Elena Levtchenko
- Pediatric Nephrology, University Hospitals of Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - An Van Laethem
- Department of Dermatology, University Hospitals of Leuven, Leuven, Belgium
| | - Hilde Brems
- Center for Human Genetics, University Hospital Leuven, Leuven, Belgium.,Department of Human Genetics, KU Leuven - University of Leuven, Leuven, Belgium
| | - Veronica A Kinsler
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK.,Paediatric Dermatology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Marie-Anne Morren
- Department of Dermatology, University Hospitals of Leuven, Leuven, Belgium
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21
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Ventéjou S, Morren MA, George K, Vernez M, Hohl D, Christen-Zäch S. Bilateral Alopecia in a Six-year-old Boy: A Quiz. Acta Derm Venereol 2020; 100:adv00104. [PMID: 31690952 PMCID: PMC9128887 DOI: 10.2340/00015555-3364] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sarah Ventéjou
- Pediatric dermatology unit, Departments of dermatology and venerology and pediatrics, University Hospital Lausanne, University of Lausanne, Lausanne, Switzerland
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22
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Abstract
Corticophobia is a major problem in adherence to therapy. This study examined corticophobia among healthcare professionals using the Topical Corticosteroid Phobia (TOPICOP) questionnaire. The TOPICOP questionnaire was adapted for use with professionals (TOPICOP-P). Four groups of professionals: pharmacists, paediatricians, general practitioners and dermatologists were observed. The mean global TOPICOP score was 41.9 ± 14.9%. Pharmacists had the highest scores for corticophobia: a global score of 48.5 ± 13.9%, followed by general practitioners, 46.0 ± 13.5%, paediatricians 39.7 ± 14.5%, and dermatologists 32.3 ± 12.1%. Overall, there was a statistically significant difference in the mean score between the 4 groups (p < 0.05). In conclusion, there is prominent corticophobia among healthcare professionals, especially among pharmacists and general practitioners, which is probably based on insufficient knowledge of topical corticosteroids. In order to improve patient compliance, re-education of healthcare providers is suggested.
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Affiliation(s)
- Lies Lambrechts
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
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23
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Nguyen AL, Morren MA, van Doorn R. Severe Lipodystrophy Following Prolonged Subcutaneous Administration of Antisense Oligonucleotides. JAMA Dermatol 2019; 155:1084-1086. [PMID: 31241724 DOI: 10.1001/jamadermatol.2019.1404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Affiliation(s)
- Anh Ly Nguyen
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Marie-Anne Morren
- Department of Pediatrics and Dermatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Remco van Doorn
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
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24
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De Palma AM, Mazereeuw-Hautier J, Giehl K, Hernández-Martin A, Merlos M, Moons P, Morren MA. Burden of itch in ichthyosis: a multicentre study in 94 patients. J Eur Acad Dermatol Venereol 2019; 33:2095-2100. [PMID: 31062435 DOI: 10.1111/jdv.15613] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 04/01/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND From clinical experience, we know that itch is a major concern for many ichthyosis patients. Nonetheless, no previous studies specifically addressed the issue of itch in ichthyosis. OBJECTIVE The objective of this study was to specifically address the burden of itch and all its dimensions in ichthyosis patients. METHODS Ninety-four ichthyosis patients from four different centres were recruited to participate in this cross-sectional, questionnaire-based study. All participants completed the Leuven Itch Scale, a multidimensional self-report instrument that quantifies the frequency, duration, severity, distress, consequences and surface area of itch. RESULTS Participants included 18 keratinopathic types, 55 autosomal recessive congenital ichthyoses, 11 X-linked recessive ichthyoses (XLRIs), 6 Netherton's ichthyoses, 1 Sjögren-Larsson type, 1 Iocrin ichthyosis and 2 unknown subtypes. Itch occurred in 93% of all patients. In patients with itch, 63% reported that it was often or always present, although most itch episodes were short in duration. Itch, in all its dimensions, was worst in patients with Netherton syndrome. Patients with XLRI had in general a lower itch profile. About half of all ichthyosis patients reported to experience flares during a change in weather, in a hot environment or in stressful situations, whereas a cold environment led to itch in only 26% of patients. The most significant consequences of itching were lesions from scratching, difficulties in falling asleep, bad mood and loss of concentration. CONCLUSIONS Itch is a major concern in patients with ichthyosis, with significant impact on daily life. Research on future treatments should therefore take itch into consideration and itch should be evaluated in clinical studies. Among the studied subgroups, Netherton patients experienced the most severe consequences.
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Affiliation(s)
- A M De Palma
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - J Mazereeuw-Hautier
- Dermatology Department, Reference Centre for Rare Skin Diseases, Larrey Hospital, University P Sabatier, Toulouse, France
| | - K Giehl
- Zentrum für seltene und genetische Hautkrankheiten, Ludwig-Maximilians-Universität München, München, Germany
| | | | - M Merlos
- Dermatology Department, Reference Centre for Rare Skin Diseases, Larrey Hospital, University P Sabatier, Toulouse, France
| | - P Moons
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - M A Morren
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.,Pediatric dermatology unit, Dept of pediatrics and dermatology, University hospital CHUV Lausanne and University of Lausanne, Lausanne, Switzerland
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25
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Denorme P, Schrijvers R, Van Hoeyveld E, Verfaillie S, Bullens D, Morren MA, Breynaert C. Isotretinoin in Severe Peanut- and Soy-Allergic Patients: Is it Safe or Not? J Investig Allergol Clin Immunol 2019; 29:146-148. [PMID: 31017116 DOI: 10.18176/jiaci.0352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- P Denorme
- University Hospitals Leuven, Department of Dermatology, Leuven, Belgium
| | - R Schrijvers
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium.,University Hospitals Leuven, Department of General Internal Medicine, Allergy and Clinical Immunology, Leuven, Belgium
| | - E Van Hoeyveld
- University Hospitals Leuven, Laboratory Medicine, Leuven, Belgium
| | | | - D Bullens
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium.,University Hospitals Leuven, Department of Pediatrics, Pediatric Allergology, Leuven, Belgium
| | - M A Morren
- University Hospitals Leuven, Department of Dermatology, Leuven, Belgium
| | - C Breynaert
- KU Leuven Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Group, Leuven, Belgium.,University Hospitals Leuven, Department of General Internal Medicine, Allergy and Clinical Immunology, Leuven, Belgium
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26
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Ventéjou S, Lévy JL, Morren MA, Christen-Zaech S. [Telemedicine in pediatric dermatology:focus on current practices]. Rev Med Suisse 2019; 15:674-677. [PMID: 30916905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Pediatric teledermatology (PTD) allows offering long distance health care advice in pediatric dermatology trough telecommunication technologies. Due to the lack of pediatric dermatologists, the frequency of dermatological questions in general pediatrics, the visual nature of the specialty, and the rare occurrence of vital emergencies in dermatology, PTD appears to be a good option for giving long distance advice in a certain number of skin conditions. In this article, we will discuss benefits and limitations of PTD. We will also talk about diagnostic and therapeutic concordance between PTD and traditional consultations, as well as the most frequent advices asked.
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Affiliation(s)
- Sarah Ventéjou
- Unité de dermatologie pédiatrique, Services de pédiatrie et de dermatologie et vénéréologie, CHUV, 1011 Lausanne
| | - Jean-Luc Lévy
- Unité de dermatologie pédiatrique, Services de pédiatrie et de dermatologie et vénéréologie, CHUV, 1011 Lausanne
| | - Marie-Anne Morren
- Unité de dermatologie pédiatrique, Services de pédiatrie et de dermatologie et vénéréologie, CHUV, 1011 Lausanne
| | - Stéphanie Christen-Zaech
- Unité de dermatologie pédiatrique, Services de pédiatrie et de dermatologie et vénéréologie, CHUV, 1011 Lausanne
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27
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Hilhorst N, Spanoudi-Kitrimi I, Goemans N, Morren MA. Injection site reactions after long-term subcutaneous delivery of drisapersen: a retrospective study. Eur J Pediatr 2019; 178:253-258. [PMID: 30448867 DOI: 10.1007/s00431-018-3272-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 04/23/2018] [Revised: 10/13/2018] [Accepted: 10/17/2018] [Indexed: 01/13/2023]
Abstract
A retrospective study in which we reviewed the hospital files of a subset of 7 patients with Duchenne muscular dystrophy participating in the open-label phase I/II PRO051-02 study in Leuven. The objective of this study was to describe in detail the injection site reactions in these children treated with drisapersen (PRO-051), a 2'-O-methyl phosphorothioate RNA antisense oligonucleotide, that induces exon 51 skipping in Duchenne muscular dystrophy. Antisense oligonucleotides, restoring the reading frame by skipping of exons, have become a potential treatment of Duchenne muscular dystrophy and other monogenetic diseases. Erythema followed by hyperpigmentation, fibrosis, and calcification were seen at the injection sites in all children. Ulcerations, which were difficult to heal, occurred in 5 of 7 children. Progression still occurred after switching to intravenous administration of drisapersen or even after stopping therapy. Systemic reactions included a reversible proteinuria and α1-microglobulinuria. Moreover, hypotrichosis was a common feature.Conclusion: Subcutaneous administration of drisapersen causes severe and progressive injection site effects. What is known: • Antisense oligonucleotides offer the possibility to convert Duchenne muscular dystrophy to the less severe Becker type. This can potentially be achieved by targeting and skipping specific exons of the Duchenne muscular dystrophy gene to restore the disrupted reading frame and to induce the production of a semi functional dystrophin protein. • Drisapersen is such an antisense oligonucleotides which can be administered subcutaneously. Its use has been tested extensively in the escalating dose pilot study (PRO051-02). What is new: • This report describes the injection site reactions caused by this type of agent in detail which has never been done before. We therefore reviewed the hospital files of 7 patients with Duchenne muscular dystrophy participating in the phase I/II open-label, escalating dose pilot study (PRO051-02) with drisapersen. • Severe side effects starting with erythema, hyperpigmentation, and later fibrosis, calcification, and difficult to treat ulcerations developed in all patients, and these continued to progress even after cessation of drisapersen. We discuss some possible underlying mechanisms. The exact mechanism however is still not known.
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Affiliation(s)
- Niels Hilhorst
- Department of Dermatology, UZ Leuven Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium.
| | | | - Nathalie Goemans
- Department of Pediatrics, UZ Leuven Campus Gasthuisberg, Herestraat 49, Leuven, 3000, Belgium
| | - Marie-Anne Morren
- Department of Dermatology, UZ Leuven Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
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28
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Valent P, Oude Elberink JNG, Gorska A, Lange M, Zanotti R, van Anrooij B, Bonifacio M, Bonadonna P, Gleixner KV, Hadzijusufovic E, Perkins C, Hartmann K, Illerhaus A, Merante S, Elena C, Shoumariyeh K, von Bubnoff N, Parente R, Triggiani M, Schwaab J, Jawhar M, Caroppo F, Fortina AB, Brockow K, David Fuchs, Greul R, Yavuz AS, Doubek M, Mattsson M, Hagglund H, Panse J, Sabato V, Aberer E, Al-Ali HK, Morren MA, Varkonyi J, Zink A, Niedoszytko M, Niederwieser D, Malcovati L, Reiter A, Kennedy V, Gotlib J, Lortholary O, Hermine O, Arock M, Kluin-Nelemans H, Sperr WR. The Data Registry of the European Competence Network on Mastocytosis (ECNM): Set Up, Projects, and Perspectives. J Allergy Clin Immunol Pract 2019; 7:81-87. [PMID: 30416055 PMCID: PMC7115815 DOI: 10.1016/j.jaip.2018.09.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/18/2018] [Accepted: 09/20/2018] [Indexed: 01/08/2023]
Abstract
Mastocytosis is a unique hematologic neoplasm with complex biology and pathology and a variable clinical course. The disease can essentially be divided into cutaneous mastocytosis (CM) and systemic mastocytosis (SM). In adults, SM is diagnosed in most cases and manifests as either indolent or advanced disease. Patients with advanced SM have an unfavorable prognosis with reduced survival. However, so far, little is known about the prevalence of various categories of SM and about prognostic factors. In an attempt to learn more about the behavior and evolution of various forms of CM and SM, the European Competence Network on Mastocytosis (ECNM) initiated a mastocytosis registry in 2012. In this article, the set up and start phase of this registry are described. Until 2018, more than 3000 patients from 12 countries and 25 centers have been enrolled. In a majority of all patients, robust follow-up data and relevant clinical end points are available. Using this data set, a series of registry projects have been launched, with the aim to validate previously identified diagnostic and prognostic variables and to identify new disease-related and patient-related parameters in various forms of mastocytosis. Moreover, the core data set of the registry will be useful to establish multiparametric scoring systems through which prognostication and individualized management of patients with mastocytosis should improve in the foreseeable future.
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Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology & Oncology, Medical University of Vienna, Vienna, Austria.
| | - Joanna N G Oude Elberink
- Department of Allergology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Aleksandra Gorska
- Department of Allergology, Medical University of Gdansk, Gdańsk, Poland
| | - Magdalena Lange
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Roberta Zanotti
- Section of Hematology, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Björn van Anrooij
- Department of Allergology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Massimiliano Bonifacio
- Section of Hematology, Department of Medicine, Verona University Hospital, Verona, Italy
| | | | - Karoline V Gleixner
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology & Oncology, Medical University of Vienna, Vienna, Austria
| | - Emir Hadzijusufovic
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology & Oncology, Medical University of Vienna, Vienna, Austria; Department of Companion Animals and Horses, Clinic for Internal Medicine and Infectious Diseases, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Cecelia Perkins
- Division of Hematology, Department of Medicine, Stanford University School of Medicine/Stanford Cancer Institute, Stanford, Calif
| | - Karin Hartmann
- Department of Dermatology, University of Cologne, Cologne, Germany; Department of Dermatology, University of Luebeck, Luebeck, Germany
| | - Anja Illerhaus
- Department of Dermatology, University of Cologne, Cologne, Germany
| | - Serena Merante
- Department of Molecular Medicine and Department of Hematology Oncology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Chiara Elena
- Department of Molecular Medicine and Department of Hematology Oncology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Khalid Shoumariyeh
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nikolas von Bubnoff
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany; German Cancer Consortium (DKTK) partner site Freiburg, Freiburg, Germany
| | - Roberta Parente
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - Massimo Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - Juliana Schwaab
- Hämatologie und Onkologie, III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Mohamad Jawhar
- Hämatologie und Onkologie, III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Francesca Caroppo
- Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Anna Belloni Fortina
- Pediatric Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Knut Brockow
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
| | - David Fuchs
- Department of Internal Medicine 3, Hematology and Oncology, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Rosemarie Greul
- Department of Internal Medicine 3, Hematology and Oncology, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Akif Selim Yavuz
- Division of Hematology, Istanbul Medical School, University of Istanbul, Istanbul, Turkey
| | | | - Mattias Mattsson
- Department of Hematology, Uppsala University Hospital, and Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Hans Hagglund
- Division of Hematology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Jens Panse
- Department of Oncology, Haematology, Haemostaseology and Stem Cell Transplantation, University Hospital RWTH Aachen, Aachen, Germany
| | - Vito Sabato
- Faculty of Medicine and Health Sciences, Department of Immunology-Allergology-Rheumatology, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Elisabeth Aberer
- Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | | | - Marie-Anne Morren
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium
| | - Judit Varkonyi
- Department of Hematology, Semmelweis University, Budapest, Hungary
| | - Alexander Zink
- Department of Dermatology and Allergy Biederstein, Technische Universität München, Munich, Germany
| | - Marek Niedoszytko
- Department of Allergology, Medical University of Gdansk, Gdańsk, Poland
| | | | - Luca Malcovati
- Department of Molecular Medicine and Department of Hematology Oncology, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andreas Reiter
- Hämatologie und Onkologie, III. Medizinische Klinik, Universitätsmedizin Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Vanessa Kennedy
- Division of Hematology, Department of Medicine, Stanford University School of Medicine/Stanford Cancer Institute, Stanford, Calif
| | - Jason Gotlib
- Division of Hematology, Department of Medicine, Stanford University School of Medicine/Stanford Cancer Institute, Stanford, Calif
| | - Olivier Lortholary
- Necker Pasteur Center for Infectious Diseases & Tropical Medicine and Necker-Enfants malades, Institut Imagine, Centre National de Référence des Mastocytoses, Paris Descartes University, Paris, France
| | - Olivier Hermine
- Imagine Institute, INSERM U1123, Université Paris Descartes, Sorbonne, Paris Cité, Departement of Hematology, Centre national de référence des mastocytoses, Hôpital Necker, Assistance publique des hôpitaux de Paris (APHP), Paris, France
| | - Michel Arock
- Laboratory of Hematology, Pitié-Salpêtrière Hospital, Paris, France
| | - Hanneke Kluin-Nelemans
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Hematology & Oncology, Medical University of Vienna, Vienna, Austria
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Verhulst L, Noë E, Morren MA, Verslype C, Van Cutsem E, Van den Oord JJ, De Haes P. Scleroderma-like cutaneous lesions during treatment with paclitaxel and gemcitabine in a patient with pancreatic adenocarcinoma. Review of literature. Int J Dermatol 2018; 57:1075-1079. [PMID: 29938783 DOI: 10.1111/ijd.14067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 08/22/2017] [Revised: 04/11/2018] [Accepted: 05/03/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Chemotherapy-induced skin sclerosis is generally not associated with other manifestations of systemic sclerosis. It is featured by skin sclerosis without visceral involvement (i.e., Raynaud's phenomenon, esophageal dysmotility, and pulmonary fibrosis), temporal association with chemotherapy administration, and the absence of detectable autoantibodies. The clinical course of scleroderma-like changes induced by paclitaxel or gemcitabine are refractory to treatment and commonly progressive, even after discontinuation of the triggering drugs. OBJECTIVE Report a case of scleroderma-like cutaneous lesions during combination treatment with nab-paclitaxel and gemcitabine in a patient with pancreatic adenocarcinoma and determine other published cases of scleroderma-like skin changes following treatment with nab-paclitaxel, paclitaxel, or gemcitabine through the period from 2002 to 2018. METHODS Literature search from the year 2002 onwards using combinations of "Scleroderma" AND "paclitaxel," AND/OR "gemcitabine." RESULTS Additional to our case report we reviewed 14 other cases in the literature. Most of these cases share three prominent features: skin sclerosis without systemic involvement, temporal association with chemotherapy administration, and absence of detectable scleroderma-specific autoantibodies. CONCLUSION To our knowledge, this is the first case report of scleroderma-like cutaneous lesions during combination treatment with nab-paclitaxel and gemcitabine in a patient with pancreatic adenocarcinoma. However, given the current literature, these scleroderma-like lesions are most likely induced by nab-paclitaxel or paclitaxel, rather than by gemcitabine.
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Affiliation(s)
- Lien Verhulst
- Department of Dermatology, AZ Delta Hospital and private practice, Roeselare, Belgium
| | - Esther Noë
- Department of Dermatology, UZ Leuven, Leuven, Belgium
| | | | - Chris Verslype
- Department of Digestive Oncology, UZ Leuven and KULeuven, Leuven, Belgium
| | - Eric Van Cutsem
- Department of Digestive Oncology, UZ Leuven and KULeuven, Leuven, Belgium
| | | | - Petra De Haes
- Department of Dermatology, UZ Leuven, Leuven, Belgium
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Ngo J, Morren MA, Bodemer C, Heimann M, Fontaine J. Feline maculopapular cutaneous mastocytosis: a retrospective study of 13 cases and proposal for a new classification. J Feline Med Surg 2018; 21:394-404. [PMID: 29860905 DOI: 10.1177/1098612x18776141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
CASE SERIES SUMMARY Cutaneous mastocytosis is a disorder rarely reported in veterinary dermatology and usually described as 'urticaria pigmentosa'. This study aimed to evaluate the diagnosis, treatment and outcome of 13 affected cats, selected from the files of a private referral dermatology practice within a period of 14 years. Breeds of the affected individuals included Sphynx (n = 9), Devon Rex (n = 2) and Sphynx/Devon Rex crossbreeds (n = 2). Females (n = 9) were over-represented and the median duration of clinical signs prior to diagnosis was 8 months. The clinical presentation of these 13 cats was compared with cases reported in the veterinary literature and classified according to the current human consensus on cutaneous mastocytosis. Three clinical forms could be distinguished in cats: (1) large papular lesions and wheals, typically localised to the head, shoulders, ventral neck and axillae, and which may spontaneously resolve (termed polymorphic maculopapular cutaneous mastocytosis); (2) erythematous dermatitis, characterised by small maculopapular lesions often associated with crusts and with a poorer prognosis (termed monomorphic maculopapular cutaneous mastocytosis); and (3) more chronic dermatitis characterised by lichenification and hyperpigmentation, similar to the human condition 'urticaria pigmentosa' (termed pigmented maculopapular cutaneous mastocytosis). Histopathology was performed in eight cases and revealed a superficial-to-deep dermatitis characterised by infiltrates of mast cells and eosinophils. The response to various treatments, including antihistamines, steroids and ciclosporin, was variable. RELEVANCE AND NOVEL INFORMATION This article reports 13 new cases of feline cutaneous mastocytosis, confirming the clinical presentation and apparent breed predisposition. The feline maculopapular cutaneous mastocytosis seems to be clinically very close to the human form. This study proposes a new classification system for the feline disease based on the current human consensus, clinical presentation and prognosis, with three different subforms: polymorphic maculopapular cutaneous mastocytosis with eventual spontaneous regression; monomorphic maculopapular cutaneous mastocytosis with chronic evolution; and pigmented maculopapular cutaneous mastocytosis.
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Affiliation(s)
| | | | - Christine Bodemer
- 3 Dermatology Service, Necker Children's Hospital, APHP Paris, France
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Verduyn C, Morren MA, Stas M, Sinnaeve F, Segers K, Kiekens C. Successful forearm prosthesis fitting in a patient with epidermolysis bullosa dystrophica: Case report. Prosthet Orthot Int 2018; 42:254-257. [PMID: 28726572 DOI: 10.1177/0309364617718410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Indexed: 02/03/2023]
Abstract
BACKGROUND Epidermolysis bullosa dystrophica is a rare dermatological disease characterized by extreme skin fragility and elevated risk of developing a squamous cell carcinoma. In some cases, amputation of a limb is necessary. Case description and methods: A 37-year-old man with recessive, severe generalized epidermolysis bullosa dystrophica developed a squamous cell carcinoma on the right forearm requiring a below-elbow amputation. Preoperative advice concerning indication and level of amputation was given. Due to potential skin problems, a conventional prosthesis was not feasible. Findings and outcomes: A custom-designed adaptive prosthesis with an upper arm cuff was trialed and was well tolerated. Multiple working tools, attached with a rotation and inclination system, allowed independence and return to work. CONCLUSION Despite multiple potential skin problems of the stump, the patient was successfully fitted with a custom-designed adaptive prosthesis. Preparation for this fitting was done by a comprehensive multidisciplinary patient-centered approach. Clinical relevance Despite severe skin fragility, a patient with epidermolysis bullosa dystrophica was successfully fitted with a custom-designed adaptive upper limb prosthesis allowing good functional outcome. This required a multidisciplinary and patient-centered approach.
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Affiliation(s)
- Carl Verduyn
- 1 Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- 2 Department of Dermatology, University Hospitals Leuven, Leuven, Belgium.,3 Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - Marguerite Stas
- 4 Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Friedl Sinnaeve
- 5 Department of Orthopaedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Katarina Segers
- 6 Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Carlotte Kiekens
- 1 Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium
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Gilissen L, Mertens S, Goossens A, Bullens D, Morren MA. Delayed-type drug hypersensitivity caused by paracetamol in a 2-year-old boy, confirmed by a positive patch test reaction and oral provocation. Contact Dermatitis 2018; 78:362-363. [DOI: 10.1111/cod.12947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 11/24/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Liesbeth Gilissen
- Department of Dermatology; University Hospitals KU Leuven; 3000 Leuven Belgium
| | - Sarien Mertens
- Department of Dermatology; University Hospitals KU Leuven; 3000 Leuven Belgium
| | - An Goossens
- Department of Dermatology; University Hospitals KU Leuven; 3000 Leuven Belgium
| | - Dominique Bullens
- Department of Paediatrics; University Hospitals KU Leuven; 3000 Leuven Belgium
| | - Marie-Anne Morren
- Department of Dermatology; University Hospitals KU Leuven; 3000 Leuven Belgium
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Denorme P, Morren MA, Hollants S, Spaepen M, Suaer K, Zutterman N, Labarque V, Legius E, Brems H. Phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA)-related overgrowth spectrum: A brief report. Pediatr Dermatol 2018; 35:e186-e188. [PMID: 29493003 DOI: 10.1111/pde.13441] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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] [Indexed: 11/28/2022]
Abstract
A patient with extensive multisystem overgrowth caused by a somatic gain of function PIK3CA-mutation is described. This case is an example of the clinical diversity of the PIK3CA-Related Overgrowth Spectrum (PROS) as the patient had overlapping features of Congenital Lipomatous Overgrowth Vascular malformations Epidermal nevi and Skeletal abnormalities (CLOVES) syndrome and Megalencephaly-Capillary malformation Polymicrogyria (MCAP) syndrome and underlines the utility of this umbrella term.
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Affiliation(s)
- Pieter Denorme
- Department of Dermatology, Microbiology, and Immunology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- Department of Dermatology, Microbiology, and Immunology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Silke Hollants
- Department of Human Genetics, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Marijke Spaepen
- Department of Human Genetics, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Kate Suaer
- Department of Paediatric Medicine, AZ Sint-Jan, Brugge, Belgium
| | - Nele Zutterman
- Department of Dermatology, AZ Sint-Lucas, Brugge, Belgium
| | - Veerle Labarque
- Department of Paediatric Medicine, Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - Eric Legius
- Department of Human Genetics, Universitaire Ziekenhuizen Leuven, Leuven, Belgium.,Department of Human Genetics, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Hilde Brems
- Department of Human Genetics, Katholieke Universiteit Leuven, Leuven, Belgium
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De Palma A, Morren MA, Ged C, Pouvelle C, Taïeb A, Aoufouchi S, Sarasin A. Diagnosis of Xeroderma pigmentosum variant in a young patient with two novel mutations in the POLH gene. Am J Med Genet A 2017; 173:2511-2516. [PMID: 28688171 DOI: 10.1002/ajmg.a.38340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 02/24/2017] [Revised: 06/01/2017] [Accepted: 06/06/2017] [Indexed: 12/13/2022]
Abstract
We describe the characterization of Xeroderma Pigmentosum variant (XPV) in a young Caucasian patient with phototype I, who exhibited a high sensitivity to sunburn and multiple cutaneous tumors at the age of 15 years. Two novel mutations in the POLH gene, which encodes the translesion DNA polymerase η, with loss of function due to two independent exon skippings, are reported to be associated as a compound heterozygous state in the patient. Western blot analysis performed on proteins from dermal fibroblasts derived from the patient and analysis of the mutation spectrum on immunoglobulin genes produced during the somatic hypermutation process in his memory B cells, show the total absence of translesion polymerase η activity in the patient. The total lack of Polη activity, necessary to bypass in an error-free manner UVR-induced pyrimidine dimers following sun exposure, explains the early unusual clinical appearance of this patient.
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Affiliation(s)
- Armando De Palma
- Department of Dermatology, University hospitals Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- Department of Dermatology, University hospitals Leuven, Leuven, Belgium
| | - Cécile Ged
- Unité INSERM U1035 and Center de Référence pour les Maladies Rares de la Peau, CHU de Bordeaux, Bordeaux, France
| | - Caroline Pouvelle
- Laboratory of Genetic Instability and Oncogenesis, UMR8200 CNRS, Gustave Roussy, Université Paris-Sud, Villejuif, France
| | - Alain Taïeb
- Unité INSERM U1035 and Center de Référence pour les Maladies Rares de la Peau, CHU de Bordeaux, Bordeaux, France
| | - Said Aoufouchi
- Laboratory of Genetic Instability and Oncogenesis, UMR8200 CNRS, Gustave Roussy, Université Paris-Sud, Villejuif, France.,Université Pierre et Marie Curie, Paris, France
| | - Alain Sarasin
- Laboratory of Genetic Instability and Oncogenesis, UMR8200 CNRS, Gustave Roussy, Université Paris-Sud, Villejuif, France
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De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Caorsi R, Penco F, Grossi A, Insalaco A, Alessio M, Conti G, Marchetti F, Tommasini A, Martino S, Gallizzi R, Salis A, Schena F, Caroli F, Martini A, Damonte G, Ceccherini I, Gattorno M, Frémond ML, Uggenti C, Van Eyck L, Melki I, Duffy D, Bondet V, Rose Y, Neven B, Crow Y, Rodero MP, Kusche Y, Roth J, Barczyk-Kahlert K, Ferrara G, Chiocchetti A, Polizzi S, Vuch J, Vozzi D, Mondino A, Valencic E, Pastore S, Taddio A, Faletra F, Dianzani U, Ramenghi U, Tommasini A, Zhou Q, Yu X, Demirkaya E, Deuitch N, Stone D, Tsai W, Ombrello A, Romeo T, Remmers EF, Chae J, Gadina M, Welch S, Ozen S, Topaloglu R, Abinun M, Kastner DL, Aksentijevich I, Vairo D, Ferraro RM, Zani G, Galli J, De Simone M, Cattalini M, Fazzi E, Giliani S, Omoyinmi E, Standing A, Rowczenio D, Keylock A, Gomes SM, Price-Kuehne F, Nanthapisal S, Murphy C, Cullup T, Jenkins L, Gilmour K, Eleftheriou D, Lachmann H, Hawkins P, Klein N, Brogan P, Nikolayenko VB, Şahin K, Karaaslan Y, Civino A, Alighieri G, Davì S, Rondelli R, Martino S, Filocamo G, Magnolato A, Dhanrajani A, Ricci F, Gallizzi R, Olivieri A, Gerloni V, Lattanzi B, Soscia F, De Fanti A, Manzoni SM, Citiso S, Quartulli L, Chan M, La Torre F, Rigante D, Maggio MC, Marsili M, Pelagatti MA, Conter V, Fagioli F, Lepore L, Pession A, Ravelli A, Pau S, Consolaro A, Ruperto N, Garrone M, Rinaldi M, De Inocencio J, Demirkaya E, Garay S, Foell D, Lovell DJ, Lazar C, Ellsworth J, Nielsen S, Flato B, Martini A, Ravelli A, Marasco E, Aquilani A, Cascioli S, Caiello I, Moneta GM, Pires-Marafón D, Guzman J, Magni-Manzoni S, Carsetti R, De Benedetti F, Robinson E, Albani S, Beresford MW, de Jager W, de Roock S, Duong T, Ellis J, Aeschlimann FA, Hyrich K, Jervis L, Lovell D, Marshall L, Mellins ED, Minden K, Munro J, Nigrovic PA, Palman J, Roth J, Twilt M, Ruperto N, Sampath S, Schanberg LE, Thompson SD, Thomson W, Vesely R, Wallace C, Williams C, Wu Q, Wulffraat N, Eng SW, Yeung RSM, Prakken B, Wedderburn LR, Horneff G, Seyger MB, Arikan D, Kalabic J, Anderson JK, Lazar A, Williams DA, Sheikh S, Wang C, Tarzynski-Potempa R, Hymans JS, Simonini G, Scoccimarro E, Pontikaki I, Ferrara G, Giani T, Ventura A, Meroni PL, Laxer RM, Cimaz R, Minnone G, Soligo M, Caiello I, Prencipe G, Marafon DP, Magni-Manzoni S, Manni L, De Benedetti F, Laudiero LB, Hebert D, Groot N, Grein I, Wulffraat NM, Schepp R, Berbers G, de Souza CCBS, Ferriani VPL, Pileggi G, de Roock S, Grein IHR, Noone D, Scala S, Patrone E, Schoemaker C, Costello W, Wulffraat N, Parsons S, McDonagh J, Thomson W, Cohen JD, Bentayou D, Pagnoux C, Brunel MAB, Trope S, Klotsche J, Listing M, Niewerth M, Horneff G, Thon A, Huppertz HI, Mönkemöller K, Foeldvari I, Benseler SM, Föll D, Minden K, Marino A, Stagi S, Carli N, Bertini F, Giani T, Simonini G, Cimaz R, Díaz-Maldonado AS, Yeung RS, Pino S, Guarnizo P, Torres-Jimenez AR, Sanchez-Jara B, Solis-Vallejo E, Cespedes-Cruz AI, Zeferino-Cruz M, Ramirez-Miramontes JV, Kumar A, Gupta A, Kessel C, Suri D, Rawat A, Kakkar N, Singh S, Makay B, Gücenmez ÖA, Ünsal E, Magnusson B, Mördrup K, Vermé A, Lippitz K, Peterson C, Freychet C, Stephan JL, Hofer M, Belot A, Harkness CE, Rooney M, Foster L, Henry E, Taggart P, Weinhage T, Simsek D, Ozkececi CF, Kurt E, Basbozkurt G, Gok F, Demirkaya E, Gorczyca D, Postępski J, Czajkowska A, Szponar B, Hinze C, Paściak M, Gruenpeter A, Lachór-Motyka I, Augustyniak D, Olesińska E, Asuka ES, Golovko T, Aliejim SU, Clemente EI, Jimenez EI, Wittkowski H, Hernandez JC, Fernandez SB, Roca CG, Romo DM, Nieva NR, Angarita JMM, Lopez JA, Nuñez-Cuadros E, Diaz-Cordovés G, Galindo-Zavala R, Holzinger D, Urda-Cardona A, Fernández-Nebro A, Quesada-Masachs E, de la Sierra DÁ, Prat MG, Gallo MM, Borrell RP, Barril SM, Sánchez AMM, Caballero CM, Grün N, Merlin E, Breton S, Fraitag S, Stephan JL, Wouters C, Bodemer C, Bader-Meunier B, Baldo F, Annoni F, Di Landro G, Föll D, Torreggiani S, Torcoletti M, Petaccia A, Corona F, Filocamo G, Tiller G, Buckle J, Munro J, Cox A, Gowdie P, Van Dijkhuizen P, Allen RC, Akikusa JD, Hernández-Huirache HG, Rodea-Montero ER, Cohen JD, Belot A, Fahy W, Quartier P, Sordet C, Trope S, Del Chierico F, Berggren KB, Kembe JT, Bos J, Armbrust W, Wulffraat N, van Brussel M, Cappon J, Dijkstra P, Geertzen J, Legger E, Malattia C, van Rossum M, Sauer P, Lelieveld O, Ozturk K, Buluc L, Akansel G, Muezzinoglu B, Ekinci Z, Rychkova L, Knyazeva T, Russo A, Pogodina A, Belova T, Mandzyak T, Kulesh E, Cafarotti A, Marsili M, Giannini C, Salvatore R, Lapergola G, Di Battista C, Marafon DP, Marcovecchio ML, Basilico R, Pelliccia P, Chiarelli F, Breda L, Almeida B, Tansley S, Simou S, Gunawardena H, McHugh N, ter Haar NM, Wedderburn L, Aouizerate J, Bader-Meunier B, De Antonio M, Bodemer C, Barnerias C, Bassez G, Desguerre I, Quartier P, Gherardi R, Magni-Manzoni S, Charuel JL, Authier FJ, Gitiaux C, Spencer CH, Aziz RA, Yu CY, Adler B, Bout-Tabaku S, Lintner K, Moore-Clingenpeel M, Vastert SJ, Boros C, McCann L, Ambrose N, Cortina-Borja M, Simou S, Pilkington C, Wedderburn L, Hinze C, Oommen PT, Speth F, Dallapiccola B, Haas JP, Hinze C, Oommen PT, Speth F, Haas JP, Speth F, Haas JP, Hinze C, Lavarello C, Giancane G, Prakken B, Pistorio A, Rider L, Aggarwal R, Oliveira SK, Cuttica R, Fischbach M, Sterba G, Brochard K, Dressler F, Barone P, Martini A, Burgos-Vargas R, Chalom EC, Desjonqueres M, Espada G, Fasth A, Garay SM, Herbigneaux RM, Hoyoux C, Deslandre CJ, Miller FW, De Benedetti F, Vencovsky J, Ravelli A, Martini A, Ruperto N, Sag E, Ozen S, Kale G, Topaloglu H, Talim B, Giancane G, Putignani L, Lavarello C, Pistorio A, Zulian F, Magnusson B, Avcin T, Corona F, Gerloni V, Pastore S, Marini R, Martino S, Fidanci BE, Pagnier A, Rodiere M, Soler C, Stanevicha V, Ten Cate R, Uziel Y, Vojinovic J, Ravelli A, Martini A, Ruperto N, Barut K, Villarreal AV, Acevedo N, Diaz T, Ramirez Y, Faugier E, Maldonado R, Arabshahi B, Lee JH, Leibowitz I, Okong’o LO, Arıcı S, Wilmshurst J, Esser M, Scott C, Batu ED, Emiroglu N, Sonmez HE, Tugcu GD, Arici ZS, Yalcin E, Dogru D, Simsek D, Ozcelik U, Bilginer Y, Haliloglu M, Kiper N, Ozen S, Yashiro M, Yamada M, Yabuuchi T, Kikkawa T, Nosaka N, Cakan M, Fujii Y, Saito Y, Tsukahara H, Al-Mayouf SM, AlMutiari N, Muzaffer M, shehata R, Al-Wahadneh A, Abdwani R, Al-Abrawi S, Batu ED, Abu-shukair M, El-Habahbeh Z, Alsonbul A, Szabat A, Chęć M, Opoka-Winiarska V, Kumar A, Gupta A, Rawat A, Saikia B, Şahin S, Minz RW, Suri D, Singh S, Arango C, Malagon C, Gomez MDP, Mosquera AC, Yepez R, Gonzalez T, Vargas C, Kısaarslan A, Zulian F, Balzarin M, Castaldi B, Reffo E, Sperotto F, Martini G, Meneghel A, Milanesi O, Foeldvari I, Klotsche J, Yilmaz E, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sifuentes-Giraldo WA, Basaran Ö, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Kallinich T, Demir F, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Foeldvari I, Baildem E, Blakley M, Boros C, Ozturk K, Fligelstone K, Kienast A, Nemcova D, Pain C, Saracino A, Simoni G, Torok K, Weibel L, Helmus N, Foeldvari I, Gunduz Z, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Sozeri B, Sifuentes-Giraldo WA, Smith V, Sztajnbok F, Avcin T, Santos MJ, Nemcova D, Battagliotti C, Eleftheriou D, Harel L, Janarthanan M, Makay B, Kallinich T, Lopez JA, Minden K, Nielsen S, Torok K, Uziel Y, Helmus N, Osminina MK, Geppe NA, Niconorova OV, Ayaz N, Karashtina OV, Abbyasova OV, Shpitonkova OV, Adrovic A, Sahin S, Barut K, Durmus S, Uzun H, Kasapcopur O, Foeldvari I, Yavascan O, Klotsche J, Kasapçopur O, Adrovic A, Stanevicha V, Terreri MT, Alexeeva E, Katsicas M, Cimaz R, Kostik M, Lehman T, Aydog O, Sifuentes-Giraldo WA, Smith V, 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Arthur V, Remmers EF, Hinks A, Marzan K, Kastner DL, Woo P, Thomson W, Stanimirovic B, Djurdjevic-Banjac B, Ljuboja O, Hugle B, Speth F, Haas JP, Maritsi D, Wulffraat N, Onoufriou MA, Vougiouka O, Eleftheriou D, Horneff G, Peitz J, Kekow J, Foell D, Bouayed K, El Hani S, Hafid I, Schneider R, Mikou N, Ioseliani M, Lekishvili M, Shelia N, Tvalabeishvili S, Kajrishvili A, Laan M, Ilisson J, Pruunsild C, Padeh S, Chasnyk V, Wouters C, Kuemmerle-Deschner JB, Kallinich T, Lauwerys B, Haddad E, Nasonov E, Trachana M, Vougiouka O, Leon K, Vritzali E, Lheritier K, Martini A, Lovell D, Schena F, Volpi S, Caorsi R, Penco F, Pastorino C, Kalli F, Omenetti A, Chiesa S, Bertoni A, Picco P, Filaci G, Aksentijevich I, Grossi A, Ceccherini I, Martini A, Traggiai E, Gattorno M, Melki I, Rose Y, Uggenti C, Fremond ML, Van Eyck L, Kitabayashi N, Gattorno M, Volpi S, Sacco O, Meyts I, Morren MA, Wouters C, Legius E, Callebaut I, Bodemer C, Rieux-Laucat F, Rodero M, Crow Y, Frémond ML, Rodero MP, Jeremiah N, Belot A, Jeziorski E, Duffy D, Bessis D, Cros G, Rice GI, Charbit B, Hulin A, Khoudour N, Caballero CM, Bodemer C, Fabre M, Berteloot L, Le Bourgeois M, Reix P, Walzer T, Moshous D, Blanche S, Fischer A, Bader-Meunier B, Rieux-Laucat F, Crow Y, Neven B, Annink K, ter Haar N, Al-Mayouf S, Amaryan G, Anton J, Barron K, Benseler S, Brogan P, Cantarini L, Cattalini M, Cochino A, De Benedetti F, Dedeoglu F, De Jesus A, Dellacasa O, Demirkaya E, Dolezalova P, Durrant K, Fabio G, Gallizzi R, Goldbach-Mansky R, Hachulla E, Hentgen V, Herlin T, Hofer M, Hoffman H, Insalaco A, Jansson A, Kallinich T, Koné-Paut I, Kozlova A, Kuemmerle-Deschner J, Lachmann H, Laxer R, Martini A, Nielsen S, Nikishina I, Ombrello A, Ozen S, Papadopoulou-Alataki E, Quartier P, Ravelli A, Rigante D, Russo R, Simon A, Trachana M, Uziel Y, Gattorno M, Frenkel J, ter Haar N, Jeyaratnam J, Lachmann H, Simon A, Brogan P, Doglio M, Cattalini M, Anton J, Modesto C, Quartier P, Hoppenreijs E, Martino S, Insalaco A, Cantarini L, Lepore L, Alessio M, Penades IC, Boros C, Consolini R, Rigante D, Russo R, Schmid JP, Lane T, Martini A, Ruperto N, Frenkel J, Gattorno M, Passarelli C, Pisaneschi E, Messia V, Pardeo M, Novelli A, Debenedetti F, Insalaco A, Brogan PA, Hofer M, Kuemmerle-Deschner JB, Lauwerys B, Speziale A, Wei X, Laxer R, Insalaco A, Marafon DP, Finetti M, Pardeo M, Martino S, Cattalini M, Alessio M, Orlando F, Taddio A, Pastore S, Cortis E, Miniaci A, Ruperto N, Martini A, De Benedetti F, Gattorno M, Eijkelboom C, ter Haar N, Cantarini L, Finetti M, Brogan P, Dolezalova P, Koné-Paut I, Insalaco A, Jelusic-Drazic M, Bezrodnik L, Pinedo MC, Stanevicha V, van Gijn M, Federici S, Ruperto N, Frenkel J, Gattorno M, Girschick H, Finetti M, Orlando F, Insalaco A, Ganser G, Nielsen S, Herlin T, Koné-Paut I, Martino S, Cattalini M, Anton J, Al-Mayouf SM, Hofer M, Quartier P, Boros C, Kuemmerle-Deschner J, Schalm S, Alessio M, Ruperto N, Martini A, Jansson A, Gattorno M, Finetti M, Marchi M, Marini C, Doglio M, Malattia C, Ravelli A, Martini A, Garaventa A, Gattorno M, Bertoni A, Carta S, Balza E, Castellani P, Pellecchia C, Penco F, Schena F, Borghini S, Trotta ML, Pastorino C, Ceccherini I, Martini A, Gattorno M, Rubartelli A, Chiesa S, Guzman J, Henrey A, Loughin T, Berard R, Shiff N, Jurencak R, Benseler S, Tucker L, Papadopoulou C, Hong Y, Krol P, Ioannou Y, Pilkington C, Chaplin H, Simou S, Charakida M, Wedderburn L, Brogan P, Eleftheriou D, Spiegel LR, Kohut SA, Stinson J, Forgeron P, Kaufman M, Luca N, Amaria K, Bell M, Swart J, Boris F, Castagnola E, Groll A, Giancane G, Horneff G, Huppertz HI, Lovell D, Wolfs T, Hofer M, Alekseeva E, Panaviene V, Nielsen S, Anton J, Uettwiller F, Stanevicha V, Trachana M, De Benedetti F, Ailioaie LM, Tsitami E, Kamphuis S, Herlin T, Dolezalova P, Susic G, Sztajnbok F, Flato B, Pistorio A, Martini A, Wulffraat N, Ruperto N, Shoop SJW, Verstappen SMM, McDonagh JE, Thomson W, Hyrich KL, Tarkiainen M, Tynjala P, Lahdenne P, Martikainen J, Wilkinson M, Piper C, Otto G, Deakin CT, Dowle S, Simou S, Kelberman D, Ioannou Y, Mauri C, Jury E, Isenberg D, Wedderburn LR, Nistala K, Foeldvari I, Ruperto N, Lovell DJ, Horneff G, Huppertz HI, Quartier P, Simonini G, Bereswill M, Kalabic J, Martini A, Brunner HI, Oen K, Guzman J, Feldman BM, Dufault B, Lee J, Shiff N, Duffy KW, Tucker L, Duffy C, Ruperto N, Lovell DJ, Tzaribachev N, Vega-Cornejo G, Louw I, Berman A, Calvo I, Cuttica R, Horneff G, Avila-Zapata F, Anton J, Cimaz R, Solau-Gervais E, Joos R, Espada G, Li X, Nys M, Wong R, Banerjee S, Martini A, Brunner HI, Nicolai R, Marafon DP, Verardo M, D’Amico A, Bracci-Laudiero L, De Benedetti F, Moneta GM, Belot A, Rice G, Mathieu AL, Omarjee SO, Bader-Meunier B, Walzer T, Briggs TA, O’Sullivan J, Williams S, Cimaz R, Smith E, Beresford MW, Crow YJ, Rooney M, Bishop N, davidson J, pilkington C, Beresford M, Clinch J, Satyapal R, Foster H, Medwin JG, McDonagh J, Wyatt S, Modignani VL, Baldo F, Lanni S, Consolaro A, Ravelli A, Filocamo G, Omenetti A, Frenkel J, Lachmann HJ, Ozen S, Ruperto N, Gattorno M, Insalaco A, Moneta G, Pardeo M, Passarelli C, Celani C, Messia V, De Benedetti F, Cherqaoui B, Rossi-Semerano L, Dusser P, Hentgen V, Koné-Paut I, Grimwood C, Dusser P, Rossi L, Paut IK, Hentgen V, Lasigliè D, Ferrera D, Amico G, Di Duca M, Caorsi R, Lepore L, Insalaco A, Cattalini M, Obici L, Consolini R, Ravazzolo R, Martini A, Ceccherini I, Nishikomori R, Arostegui J, Gattorno M, Borghini S, Penco F, Petretto A, Lavarello C, Inglese E, Omenetti A, Finetti M, Pastorino C, Bertoni A, Gattorno M, Vanoni F, Federici S, Ozen S, Frenkel J, Lachmann H, Martini A, Ruperto N, Gattorno M, Hofer M, Kuemmerle-Deschner JB, Hoffman HM, Hawkins PN, van der Poll T, Walker UA, Speziale A, Joubert Y, Tilson HH, Kuemmerle-Deschner J, Ozen S, Tyrrell PN, Koné-Paut I, Goldbach-Mansky R, Lachmann H, Blank N, Hoffman HM, Weissbarth-Riedel E, Huegle B, Kallinich T, Gattorno M, Gul A, ter Haar NM, Oswald M, Dedeoglu F, Benseler SM, Hanaya A, Miyamae T, Kawamoto M, Tani Y, Hara T, Kawaguchi Y, Nagata S, Yamanaka H, Ćosićkić A, Skokić F, Čolić B, Suljendić S, Kozlova A, Mersiyanova I, Panina M, Hachtryan L, Burlakov V, Raikina E, Maschan A, Shcherbina A, Acar B, Albayrak M, Sozeri B, Sahin S, Barut K, Adrovic A, Inan N, Sevgi S, Kasapcopur O, Andreasen CM, Jurik AG, Glerup MB, Høst C, Mahler BT, Hauge EM, Herlin T, Lazea C, Damian L, Lazar C, Manasia R, Stephenson CM, Prajapati V, Miettunen PM, Yılmaz D, Tokgöz Y, Bulut Y, Çakmak H, Sönmez F, Comak E, Aksoy GK, Koyun M, Akman S, Arıkan Y, Terzioğlu E, Özdeş ON, Keser İ, Koçak H, Bingöl A, Yılmaz A, Artan R, De Benedetti F, Anton J, Gattorno M, Lachmann H, Kone-Paut I, Ozen S, Frenkel J, Simon A, Zeft A, Ben-Chetrit E, Hoffman HM, Joubert Y, Lheritier K, Speziale A, Guido J, Xu X, Mehregan FF, Ziaee V, Moradinejad MH, Ferrara G, Pastore S, Insalaco A, Pardeo M, Tommasini A, La Torre F, Alizzi C, Cimaz R, Finetti M, Gattorno M, D’Adamo P, Taddio A, Lachmann H, Simon A, Anton J, Gattorno M, Kone-Paut I, Ozen S, Frenkel J, Ben-Chetrit E, Hoffman H, Zeft A, Joubert Y, Lheritier K, Speziale A, Junge G, Gregson J, De Benedetti F, Sargsyan H, Sargsyan H, Zengin H, Fidanci BE, Kaymakamgil C, Konukbay D, Simsek D, Batu ED, Yildiz D, Gok F, Ozen S, Demirkaya E, Stoler I, Freytag J, Orak B, Seib C, Esmann L, Seipelt E, Gohar F, Foell D, Wittkowski H, Kallinich T, Dursun I, Tulpar S, Yel S, Kartal D, Borlu M, Bastug F, Poyrazoglu H, Gunduz Z, Kose K, Yuksel ME, Calıskan A, Cekgeloglu AB, Dusunsel R, Bouchalova K, Franova J, Schuller M, Macku M, Theodoropoulou K, Carlomagno R, von Scheven-Gête A, Poloni C, Hofer M, Damian LO, Cosma D, Radulescu A, Vasilescu D, Rogojan L, Lazar C, Rednic S, Lupse M, De Somer L, Moens P, Wouters C, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Zavala RG, Pedraz LM, Cuadros EN, Rego GDC, Cardona ALU, Forno ID, Pieropan S, Viapiana O, Gatti D, Dallagiacoma G, Caramaschi P, Biasi D, Windschall D, Trauzeddel R, Lehmann H, Ganser G, Berendes R, Haller M, Krumrey-Langkammerer M, Nimtz-Talaska A, Schoof P, Trauzeddel RF, Nirschl C, Quesada-Masachs E, Blancafort CA, Barril SM, Caballero CM, Aguiar F, Fonseca R, Alves D, Vieira A, Vieira A, Dias JA, Brito I, Susic G, Milic V, Radunovic G, Boricic I, Marteau P, Adamsbaum C, Rossi-Semerano L, De Bandt M, Lemelle I, Deslandre C, Tran TA, Lohse A, Solau-Gervais E, Pillet P, Bader-Meunier B, Wipff J, Gaujoux-Viala C, Breton S, Devauchelle-Pensec V, Gran S, Fehler O, Zenker S, Schäfers M, Roth J, Vogl T, Czitrom SG, Foell D, Holzinger D, Lanni S, Van Dijkhuizen EHP, Manzoni SM, Marafon DP, Magnaguagno F, de Horatio LT, Ter Haar NM, Littooij AS, Vastert SJ, De Benedetti F, Ravelli A, Martini A, Malattia C, Teixeira VA, Campanilho-Marques R, Mourão AF, Ramos FO, Costa M, Madan WA, Killeen OG, Vidal AR, Delgado DS, Fernandez MIG, Montesinos BL, Penades IC, Kozhevnikov A, Pozdeeva N, Konev M, Melchenko E, Kenis V, Novik G, Sozeri B, Kısaarslan AP, Gunduz Z, Poyrazoglu H, Dusunsel R, Lerkvaleekul B, Jaovisidha S, Sungkarat W, Chitrapazt N, Fuangfa P, Ruangchaijatuporn T, Vilaiyuk S, Pradsgaard DØ, Hørlyck A, Spannow AH, Heuck CW, Herlin T, Diaz T, Garcia F, De La Cruz L, Rubio N, Świdrowska-Jaros J, Smolewska E, Lamot M, Lamot L, Vidovic M, Bosak EP, Rados I, Harjacek M, Tzaribachev N, Louka P, Hagoug R, Trentin C, Kubassova O, Hinton M, Boesen M, Oshlianska OA, Chaikovsky IA, Mjasnikov G, Kazmirchyk A, Garagiola U, Borzani I, Cressoni P, Corona F, Dzsida E, Farronato G, Garagiola U, Cressoni P, Corona F, Petaccia A, Dzsida E, Farronato G, Gagro A, Pasini AM, Roic G, Vrdoljak O, Lujic L, Zutelija-Fattorini M, Esser MM, Abraham DR, Kinnear C, Durrheim G, Urban M, Hoal E, Crow Y, Oshlianska OA. Proceedings of the 23rd Paediatric Rheumatology European Society Congress: part one. Pediatr Rheumatol Online J 2017. [PMCID: PMC5461530 DOI: 10.1186/s12969-017-0141-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Marasigan V, Morren MA, Lambert J, Medaer K, Fieuws S, Nijsten T, Garmyn M. Inverse Association Between Atopy and Melanoma: A Case-control Study. Acta Derm Venereol 2017; 97:54-57. [PMID: 27276655 DOI: 10.2340/00015555-2476] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Heightened cutaneous immune surveillance in atopic patients may inhibit development of melanoma. The aim of this study was to analyse the association between atopy and melanoma (development and outcome). A total of 188 cases of melanoma and 596 healthy controls were interviewed by telephone with a standardized questionnaire on atopic, demographic and melanoma characteristics. Cases were matched with controls on important confounders (age, sex, sunburn sensitivity, hair colour, number of moles, sunburn as juvenile, ever solarium, familial melanoma). Melanoma outcome data (disease relapse and death) within cases were retrieved. Analysis showed a general inverse association between atopy and melanoma development, but this was statistically significant only for a history of personal atopy (odds ratio 0.53, 95% confidence interval: 0.30-0.96, p-value = 0.04). Among melanoma patients, atopy did not affect survival or progression. In conclusion, this study suggests an inverse association between a history of atopy and melanoma development, but not with disease progression.
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Affiliation(s)
- Vivien Marasigan
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
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De Beule T, Vranckx J, Verhamme P, Labarque V, Morren MA, Fourneau I, Maleux G. Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes. VASA 2016; 45:497-504. [DOI: 10.1024/0301-1526/a000571] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract. Background: The technical and clinical outcomes of catheter-directed embolization for peripheral arteriovenous malformations (AVM) using Onyx® (ethylene-vinyl alcohol copolymer) are not well documented. The purpose of this study was to retrospectively assess the safety, technical outcomes and clinical outcomes of catheter-directed Onyx® embolisation for the treatment of symptomatic peripheral AVMs. Patients and methods: Demographics, (pre-)interventional clinical and radiological data were assessed. Follow-up was based on hospital medical records and telephone calls to the patients’ general practitioners. Radiological success was defined as complete angiographic eradication of the peripheral AVM nidus. Clinical success was defined as major clinical improvement or complete disappearance of the initial symptoms. Results: 25 procedures were performed in 22 patients. The principal indications for treatment were pain (n = 10), limb swelling (n = 6), recurrent bleeding (n = 2), tinnitus (n = 3), and exertional dyspnoea (n = 1). Complete radiological success was obtained in eight patients (36 %); near-complete eradication of the nidus was achieved in the remaining 14 patients. Adjunctive embolic agents were used in nine patients (41 %). Clinical success was observed in 18 patients (82%). Major complications were reported in two patients (9 %). During follow-up, seven patients (32 %) presented with symptom recurrence, which required additional therapy in three patients. Conclusions: Catheter-directed embolisation of peripheral AVMs with Onyx® resulted in major clinical improvement or complete disappearance of symptoms in the vast majority of patients, although complete angiographic exclusion of the AVMs occurred in only a minority of patients.
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Affiliation(s)
| | - Jan Vranckx
- University Hospitals Leuven, Leuven, Belgium
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Morren MA, Vanden Broecke K, Vangeebergen L, Sillevis-Smitt JH, Van Den Berghe P, Hauben E, Jacobs S, Van Gool SW. Diverse Cutaneous Presentations of Langerhans Cell Histiocytosis in Children: A Retrospective Cohort Study. Pediatr Blood Cancer 2016; 63:486-92. [PMID: 26586230 DOI: 10.1002/pbc.25834] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [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: 06/12/2015] [Accepted: 10/12/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Langerhans cell histiocytosis (LCH) is a rare disease, frequently affecting young children. PROCEDURE We performed a retrospective study in patients younger than 16 years old manifesting with skin symptoms, and documented their different cutaneous lesions and systemic symptoms. We compared subgroups of children with single-system, skin-only, and multisystem disease and sought signs predictive for multisystem disease. In a small sample of patients, BRAF mutations were analyzed in archived biopsies. RESULTS A wide spectrum of cutaneous presentations varying from crusted nodules and papules, blisters, vascular tumor-like lesions, scaling orange to red macules (frequently in seborrheic regions) to purpuric macules, and papules was documented in our cohort of 32 children. Otitis externa was a common manifestation and mucosal lesions were seen in three patients. A novel manifestation was a red-blue nodule that appeared in a patient after a vaccination. None of the cutaneous lesions was predictive for the classification or final outcome as a single-system or multisystem disease. However, later onset and a more protracted course of skin lesions were more frequent findings in multisystem LCH. Mucosal lesions and otitis externa were almost exclusively seen in patients with multisystem disease, a finding that warrants further investigation. Both wild-type (WT) and mutated BRAF were found not only in multisystem LCH, but also in skin-only LCH. Two cases with rapidly resolving congenital lesions had WT BRAF. CONCLUSIONS Late onset and a protracted course of skin lesions are associated with MS-LCH, whereas WT BRAF is found in rapidly resolving skin lesions.
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Affiliation(s)
- Marie-Anne Morren
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium and Department of Microbiology and Immunolgy KU Leuven, Belgium
| | - Katrien Vanden Broecke
- Department of Dermatology, University Hospitals Leuven, Leuven, Belgium and Department of Microbiology and Immunolgy KU Leuven, Belgium
| | - Leen Vangeebergen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Esther Hauben
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Sandra Jacobs
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
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Marasigan V, Morren MA, Lambert J, Medaer K, Fieuws S, Garmyn M. Atopic dermatitis and melanoma: A case-control study. Arch Public Health 2015. [PMCID: PMC4582243 DOI: 10.1186/2049-3258-73-s1-p1] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
Frey's syndrome is characterized by sweating and flushing in the temporal and preauricular areas after a salivary stimulus. It is caused by damage to the auriculotemporal nerve, hence the alternative name of auriculotemporal syndrome. We report the case of a 2-year-old girl presenting with postprandial unilateral flushing that developed after a herpes zoster infection.
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Affiliation(s)
- Pieter Bourgeois
- Department of Dermatology, University Hospital of Leuven, Leuven, Belgium
| | - Marie-Anne Morren
- Department of Dermatology, University Hospital of Leuven, Leuven, Belgium
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Vandevenne A, Morren MA, Goossens A. Immunological contact urticaria caused by a silk shirt in an atopic patient. Contact Dermatitis 2015; 72:240-1. [DOI: 10.1111/cod.12360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 12/30/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Alix Vandevenne
- Department of Dermatology; University Hospitals, K.U. Leuven; B-3000 Leuven Belgium
| | - Marie-Anne Morren
- Department of Dermatology; University Hospitals, K.U. Leuven; B-3000 Leuven Belgium
| | - An Goossens
- Department of Dermatology; University Hospitals, K.U. Leuven; B-3000 Leuven Belgium
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Lambrecht C, Wouters C, Van Esch H, Moens P, Casteels I, Morren MA. Conradi-Hünermann-Happle syndrome: a novel heterozygous missense mutation, c.204G>T (p.W68C). Pediatr Dermatol 2014; 31:493-6. [PMID: 24915996 DOI: 10.1111/pde.12336] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Conradi-Hünermann-Happle syndrome (X-linked dominant chondrodysplasia punctata, CDPX2 [Online Mendelian Inheritance in Man 302960]) is a rare genodermatosis that presents with blaschkolinear ichthyosis, cicatricial alopecia, chondrodysplasia punctata, asymmetric shortening of the bones, and cataracts. In this case report we describe a child presenting with a patterned alopecia in which supplementary signs and clinical examination of the mother led to the suspicion of Conradi-Hünermann-Happle syndrome. Mutation analysis revealed a heterozygous novel missense mutation, c.204G>T (p.W68C), in exon 2.
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Snauwaert JJL, Yuen WY, Jonkman MF, Moons P, Naulaers G, Morren MA. Burden of itch in epidermolysis bullosa. Br J Dermatol 2014; 171:73-8. [PMID: 24506095 DOI: 10.1111/bjd.12885] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Itch is an unpleasant feeling that leads to scratching. It is a common, but understudied, problem in patients with epidermolysis bullosa (EB). OBJECTIVES We measured the prevalence and characteristics of itch in the three major forms of EB: generalized EB simplex (EBS), junctional EB (JEB) and dystrophic EB (DEB). METHODS Forty patients with EB were recruited from two tertiary care centres and one patient organization. The sample included 19 patients with EBS, seven with JEB and 14 with DEB. Patients completed the Leuven Itch Scale (LIS), a multidimensional self-report instrument that quantifies the frequency, duration, severity, distress, consequences and surface area of itch. This instrument has good clinimetric properties. RESULTS Itch occurred in 85% of the patients, with substantial differences across the subtypes (EBS 74%, JEB 100%, DEB 93%). Itch, in all its dimensions, was most pronounced in patients with JEB and DEB, and less prominent in patients with EBS. The scores were significantly different for itch frequency, severity, distress and surface area, and the overall itch scores were comparable with those of atopic dermatitis. Itch mainly occurred in a hot environment (65%) and when sweating (62%). The most prevalent consequences were difficulty in falling asleep (88%) and lesions from scratching (85%). Differences between the three major subtypes were also observed in terms of circumstances, consequences and sensory characteristics. CONCLUSIONS As expected, itch is common among patients with EB. All aspects of itch measured by the LIS were more severe in JEB and DEB than in EBS.
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Affiliation(s)
- J J L Snauwaert
- Department of Dermatology, UZ Leuven, University of Leuven, Leuven, Belgium; Department of Microbiology and Immunology, KU Leuven, University of Leuven, Leuven, Belgium
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De Cock J, Snauwaert J, Van Rompaey W, Morren MA, Demaerel P. A newborn with neurocutaneous melanocytosis and Dandy-Walker malformation. Pediatr Neurol 2014; 50:276-8. [PMID: 24321541 DOI: 10.1016/j.pediatrneurol.2013.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 01/22/2013] [Revised: 04/01/2013] [Accepted: 04/08/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Neurocutaneous melanocytosis is a rare congenital dysplasia of the neuroectodermal melanocyte precursor cells that leads to proliferation of melanin-producing cells in the skin and leptomeninges. PATIENT We describe a newborn with a giant congenital melanocytic nevus on his back, buttocks, and thighs. His brain magnetic resonance imaging study revealed bilateral T1 hyperintense lesions in the cerebellum and in the amygdala, hydrocephalus, and a Blake's pouch cyst, consistent with neurocutaneous melanocytosis and Dandy-Walker malformation. CONCLUSION Neurocutaneous melanocytosis has a wide clinical spectrum that includes hydrocephalus, epilepsy, cranial nerve palsy, increased intracranial pressure, and sensorimotor deficits.
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Affiliation(s)
- Jens De Cock
- Radiology, University Hospitals Leuven, and Department of Imaging and Pathology, KU Leuven, Belgium
| | - Julie Snauwaert
- Dermatology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Belgium
| | | | - Marie-Anne Morren
- Dermatology, University Hospitals Leuven, and Department of Oncology, KU Leuven, Belgium
| | - Philippe Demaerel
- Radiology, University Hospitals Leuven, and Department of Imaging and Pathology, KU Leuven, Belgium.
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Danso-Abeam D, Zhang J, Dooley J, Staats KA, Van Eyck L, Van Brussel T, Zaman S, Hauben E, Van de Velde M, Morren MA, Renard M, Van Geet C, Schaballie H, Lambrechts D, Tao J, Franckaert D, Humblet-Baron S, Meyts I, Liston A. Olmsted syndrome: exploration of the immunological phenotype. Orphanet J Rare Dis 2013; 8:79. [PMID: 23692804 PMCID: PMC3662572 DOI: 10.1186/1750-1172-8-79] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [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: 04/05/2013] [Accepted: 05/08/2013] [Indexed: 02/07/2023] Open
Abstract
Background Olmsted syndrome is a rare congenital skin disorder presenting with periorifical hyperkeratotic lesions and mutilating palmoplantar keratoderma, which is often associated with infections of the keratotic area. A recent study identified de novo mutations causing constitutive activation of TRPV3 as a cause of the keratotic manifestations of Olmsted syndrome. Methods Genetic, clinical and immunological profiling was performed on a case study patient with the clinical diagnosis of Olmsted syndrome. Results The patient was found to harbour a previously undescribed 1718G-C transversion in TRPV3, causing a G573A point mutation. In depth clinical and immunological analysis found multiple indicators of immune dysregulation, including frequent dermal infections, inflammatory infiltrate in the affected skin, hyper IgE production and elevated follicular T cells and eosinophils in the peripheral blood. Conclusions These results provide the first comprehensive assessment of the immunological features of Olmsted syndrome. The systemic phenotype of hyper IgE and persistent eosinophilia suggest a primary or secondary role of immunological processes in the pathogenesis of Olmsted syndrome, and have important clinical consequences with regard to the treatment of Olmsted syndrome patients.
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Barbarot S, Bernier C, Deleuran M, De Raeve L, Eichenfield L, El Hachem M, Gelmetti C, Gieler U, Lio P, Marcoux D, Morren MA, Torrelo A, Stalder JF. Therapeutic patient education in children with atopic dermatitis: position paper on objectives and recommendations. Pediatr Dermatol 2013; 30:199-206. [PMID: 23461685 DOI: 10.1111/pde.12045] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Poor adherence is frequent in patients with atopic dermatitis (AD), leading to therapeutic failure. Therapeutic patient education (TPE) helps patients with chronic disease to acquire or maintain the skills they need to manage their chronic disease. After a review of the literature, a group of multispecialty physicians, nurses, psychologists, and patients worked together during two international workshops to develop common recommendations for TPE in AD. These recommendations were structured as answers to nine frequently asked questions about TPE in AD: What is TPE and what are its underlying principles? Why use TPE in the management of AD? Who should benefit from TPE in AD? How can TPE be organized for AD? What is the assessment process for TPE in AD? What is the evidence of the benefit of TPE in AD? Who are the people involved in TPE? How should TPE be funded in dermatology? What are the limits of the TPE process?
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Morren MA, Bruwiere I, Lemmens M, Goossens A, Garmyn M. [Lack of compliance to topical corticosteroid therapy: possible cause and solutions]. J Pharm Belg 2013:20-27. [PMID: 23638609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Adherence to therapy is low for topical therapy used in dermatological disorders. particularly in chronic diseases like atopic dermatitis and psoriasis. One of the reasons is that patients do not trust their therapy and fear side effects, particularly with topical corticosteroids. In order to make patients more confident, it is it important to provide correct and detailed information about the prescribed products and the amount to apply, to involve them in the implementation of therapy and to harmonize the information given by various care providers (physicians, nurses, pharmacists). The message needs to be clear and consistent between caregivers and not lead to unjustified worries. Poor adherence may result in the use of stronger preparations or switch to systemic treatment, which eventually will result in more severe side effects.
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Affiliation(s)
- M A Morren
- Service de Dermatologie, UZ Leuven, Louvain.
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Morren MA, Hoppé A, Renard M, Debiec Rychter M, Uyttebroeck A, Dubreuil P, Martin L. Imatinib mesylate in the treatment of diffuse cutaneous mastocytosis. J Pediatr 2013; 162:205-7. [PMID: 23069194 DOI: 10.1016/j.jpeds.2012.08.035] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2012] [Revised: 06/15/2012] [Accepted: 08/23/2012] [Indexed: 11/24/2022]
Abstract
Diffuse cutaneous mastocytosis is a less common but potentially life-threatening variant of childhood mastocytosis. Here we report 2 children with diffuse cutaneous mastocytosis in whom an activating somatic KIT mutation was detected. Treatment with imatinib, a KIT inhibitor, resulted in resolution of the lesions and were well tolerated by the patients.
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Affiliation(s)
- Marie-Anne Morren
- Department of Dermatology, Catholic University of Leuven and University Hospitals Leuven, Leuven, Belgium.
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Slavotinek AM, Mehrotra P, Nazarenko I, Tang PLF, Lao R, Cameron D, Li B, Chu C, Chou C, Marqueling AL, Yahyavi M, Cordoro K, Frieden I, Glaser T, Prescott T, Morren MA, Devriendt K, Kwok PY, Petkovich M, Desnick RJ. Focal facial dermal dysplasia, type IV, is caused by mutations in CYP26C1. Hum Mol Genet 2012; 22:696-703. [PMID: 23161670 DOI: 10.1093/hmg/dds477] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Focal facial dermal dysplasia (FFDD) Type IV is a rare syndrome characterized by facial lesions resembling aplasia cutis in a preauricular distribution along the line of fusion of the maxillary and mandibular prominences. To identify the causative gene(s), exome sequencing was performed in a family with two affected siblings. Assuming autosomal recessive inheritance, two novel sequence variants were identified in both siblings in CYP26C1-a duplication of seven base pairs, which was maternally inherited, c.844_851dupCCATGCA, predicting p.Glu284fsX128 and a missense mutation, c.1433G>A, predicting p.Arg478His, that was paternally inherited. The duplication predicted a frameshift mutation that led to a premature stop codon and premature chain termination, whereas the missense mutation was not functional based on its in vitro expression in mammalian cells. The FFDD skin lesions arise along the sites of fusion of the maxillary and mandibular prominences early in facial development, and Cyp26c1 was expressed exactly along the fusion line for these facial prominences in the first branchial arch in mice. Sequencing of four additional, unrelated Type IV FFDD patients and eight Type II or III TWIST2-negative FFDD patients revealed that three of the Type IV patients were homozygous for the duplication, whereas none of the Type II or III patients had CYP26C1 mutations. The seven base pairs duplication was present in 0.3% of healthy controls and 0.3% of patients with other birth defects. These findings suggest that the phenotypic manifestations of FFDD Type IV can be non-penetrant or underascertained. Thus, FFDD Type IV results from the loss of function mutations in CYP26C1.
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Affiliation(s)
- Anne M Slavotinek
- Division of Genetics, Department of Pediatrics, University of California, San Francisco, San Francisco, CA 94143-0316, USA.
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Haest C, Casaer MP, Daems A, De Vos B, Vermeersch E, Morren MA, Van Steenbergen W, Ceuppens JL, Moons P. Measurement of itching: Validation of the Leuven Itch Scale. Burns 2011; 37:939-50. [DOI: 10.1016/j.burns.2011.04.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 04/13/2011] [Accepted: 04/15/2011] [Indexed: 11/24/2022]
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