The article discusses the development and validation of a new scoring system called the Atopic Dermatitis Activity Score 7 (ADAS7) for assessing disease activity in patients with atopic dermatitis (AD). The ADAS7 score combines clinical signs, patient-reported symptoms, and quality of life measures. The study found that ADAS7 correlated well with the existing scoring system, SCORing Atopic Dermatitis (SCORAD), and was able to identify patients with controlled AD, non-controlled AD with continuously severe disease, and non-controlled AD with active (fluctuating) disease. The limitations of the study include a small sample size and potential selection bias due to loss-to-follow-up. The authors suggest that ADAS7 can be a useful tool for discussing long-term disease control and treatment strategies with patients. [Extracted from the article]
LANGERHANS-cell histiocytosis, MITOGEN-activated protein kinases, PROTEIN kinase inhibitors, DISEASE remission
Abstract
We report a case of congenital multisystem Langerhans cell histiocytosis with cutaneous and hematopoietic involvement. After the failure of first‐line (vinblastine and prednisolone) and second‐line (vincristine and cytarabine) therapies, treatment with cobimetinib, a mitogen‐activated protein kinase (MEK) inhibitor, led to the remission of disease and a sustained response after 11 months of ongoing treatment. Protein kinase inhibitors targeting BRAF or MEK could represent a promising future therapeutic option, also in children with LCH. [ABSTRACT FROM AUTHOR]
A real-life observational study was conducted to evaluate the effectiveness and safety of tralokinumab, a monoclonal antibody, in adolescents with severe atopic dermatitis (AD). The study included 14 adolescents who had failed previous treatments and were treated with tralokinumab for 12 to 16 weeks. The primary outcome was improvement in clinical scores, specifically the Eczema Area and Severity Index (EASI) and the Peak Pruritus Numerical Rating Scale (PP-NRS). The study found that tralokinumab was effective in improving EASI and PP-NRS scores in most patients, with 28.6% achieving an EASI 75 and 42.8% experiencing a four-point or higher reduction in PP-NRS. The most common adverse events were flare of AD and injection-site reactions. The study concluded that tralokinumab is effective and well-tolerated in adolescents with severe AD, but longer-term studies are needed. [Extracted from the article]
De Greef, Axel, Baeck, Marie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, UCL - (SLuc) Centre de l'allergie, and UCL - (SLuc) Centre de malformations vasculaires congénitales
L’arrivée des inhibiteurs de Janus-Kinase (JAKi) dans l’arsenal thérapeutique en dermatologie permet une évolution considérable de la prise en charge de certaines pathologies inflammatoires comme la dermatite atopique, ou les maladies auto-immunes comme la pelade (alopecia areata) ou le vitiligo. Le profil d’action large des JAKi au niveau du blocage des cytokines, bénéfique en termes d’efficacité, implique toutefois une certaine prudence au niveau du profil de sécurité de ce groupe de molécules. Cet article se veut faire le point sur les dernières données de sécurité des JAKi. Il en ressort qu’il est fondamental de distinguer le risque en fonction des populations traitées et des pathologies ciblées par ces molécules. La prudence reste de mise chez les patients âgés, les patients présentant des facteurs de risque cardiovasculaires incluant un tabagisme actif ou ancien conséquent, et les patients présentant des antécédents oncologiques.
UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, Terrasson, Julie, Baeck, Marie, Gutermuth, Jan, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, Terrasson, Julie, Baeck, Marie, and Gutermuth, Jan
UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service de dermatologie, Terrasson, Julie, Baeck, Marie, Gutermuth, Jan, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - (SLuc) Service de dermatologie, Terrasson, Julie, Baeck, Marie, and Gutermuth, Jan
UCL - (SLuc) Service de dermatologie, UCL - SSS/DDUV/GECE - Génétique cellulaire, De Greef, Axel, Coulie, Pierre G., Baeck, Marie, UCL - (SLuc) Service de dermatologie, UCL - SSS/DDUV/GECE - Génétique cellulaire, De Greef, Axel, Coulie, Pierre G., and Baeck, Marie
Abstract
The exact etiopathology of chilblains observed during the Coronavirus Disease 2019 (COVID-19) pandemic is still unclear. Initially, SARS-CoV-2 appeared as the obvious causing agent, but two years of various investigations have failed to convincingly support its direct implication. Most affected individuals have no detectable virus, no anti-SARS-CoV-2 antibodies and no symptoms of COVID-19. Analyses of skin biopsies similarly failed to unambiguously demonstrate presence of the virus or its genome. In a recent hypothesis, SARS-CoV-2 would cause the lesions before being promptly eliminated by unusually strong type I interferon responses. With others, we feel that environmental factors have not been sufficiently considered, in particular cold exposure related to unprecedented containment measures. The cause of pandemic chilblains remains a stimulating puzzle which warrants further investigation.
UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Centre de l'allergie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC/CTMA - Centre de technologies moléculaires appliquées (plate-forme technologique), UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de médecine interne générale, Mengeot, Laura, Yombi, Jean Cyr, Baeck, Marie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Centre de l'allergie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC/CTMA - Centre de technologies moléculaires appliquées (plate-forme technologique), UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service de médecine interne générale, Mengeot, Laura, Yombi, Jean Cyr, and Baeck, Marie
Abstract
Cutaneous leishmaniasis (CL) is a chronic infectious skin disease caused by a group of protozoan parasites of the Leishmania genus. Parasites are transmitted to humans via the bite of sandflies. Leishmania aethiopica, one of the most neglected species, is the main causative agent of CL in Ethiopia, with infection characterized by reduced sensitivity to conventional drugs. Although the incidence of imported cases of CL is increasing in nonendemic areas, L aethiopica is rarely reported in travelers. We report a case of localized CL due to L aethiopica in a Belgian traveler. [...]
UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Centre de malformations vasculaires congénitales, UCL - (SLuc) Service d'anatomie pathologique, UCL - (SLuc) Centre de l'allergie, Nielens, Nina, Marot, Liliane, Baeck, Marie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Centre de malformations vasculaires congénitales, UCL - (SLuc) Service d'anatomie pathologique, UCL - (SLuc) Centre de l'allergie, Nielens, Nina, Marot, Liliane, and Baeck, Marie
Abstract
An 82-year-old man presented with unilateral oedema of the right lower limb overlaid with multiple sporotrichoid distributed panniculitis lesions. These symptoms appeared in a context of immunodepression and were associated with significant weight loss and a deterioration in general condition. The patient's medical history, the histological findings, PCR testing, and bacterial culture led to a diagnosis of cutaneous tuberculosis due to Mycobacterium bovis. This infection occurred as a late complication of intravesical bacillus Calmette-Guérin (BCG) instillations that the patient had received as an adjunctive immunotherapy for bladder cancer. This is an unusual clinical presentation and aetiology of cutaneous tuberculosis. Indeed, the observed sporotrichoid pattern is uncommon for tuberculous mycobacteria. Moreover, the occurrence of tuberculous skin lesions after intravesical BCG instillations is extremely rare, with only a few cases described, and, to the authors' knowledge, none with such a clinical presentation. This case report suggests that a medical history of BCG immunotherapy should always be considered when assessing any infectious-type cutaneous lesions and that skin should be regarded as a possible late localization of infectious complications of this treatment.
UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre de l'allergie, UCL - (SLuc) Centre de malformations vasculaires congénitales, de Montjoye, Laurence, De Greef, Axel, Degraeuwe, Alexia, Harkemanne, Evelyne, Thirion, Romane, Nobile, Laura, Ghislain, Pierre-Dominique, Baeck, Marie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre de l'allergie, UCL - (SLuc) Centre de malformations vasculaires congénitales, de Montjoye, Laurence, De Greef, Axel, Degraeuwe, Alexia, Harkemanne, Evelyne, Thirion, Romane, Nobile, Laura, Ghislain, Pierre-Dominique, and Baeck, Marie
UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, Herman, Anne, de Montjoye, Laurence, Baeck, Marie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, Herman, Anne, de Montjoye, Laurence, and Baeck, Marie
Abstract
Only a few cases of allergic contact dermatitis (ACD) from chlorphenesin have been reported and since 2015 no new cases have been published. We describe two additional cases of ACD from this preservative in cosmetics observed during late 2021. [...]
Terrasson, Julie, Baeck, Marie, Gutermuth, Jan, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, and UCL - (SLuc) Service de dermatologie
Mengeot, Laura, Yombi, Jean Cyr, Baeck, Marie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Centre de l'allergie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC/CTMA - Centre de technologies moléculaires appliquées (plate-forme technologique), UCL - SSS/IREC/SLUC - Pôle St.-Luc, and UCL - (SLuc) Service de médecine interne générale
Cutaneous leishmaniasis (CL) is a chronic infectious skin disease caused by a group of protozoan parasites of the Leishmania genus. Parasites are transmitted to humans via the bite of sandflies. Leishmania aethiopica, one of the most neglected species, is the main causative agent of CL in Ethiopia, with infection characterized by reduced sensitivity to conventional drugs. Although the incidence of imported cases of CL is increasing in nonendemic areas, L aethiopica is rarely reported in travelers. We report a case of localized CL due to L aethiopica in a Belgian traveler. [...]
Terrasson, Julie, Baeck, Marie, Gutermuth, Jan, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, and UCL - (SLuc) Service de dermatologie
de Montjoye, Laurence, De Greef, Axel, Degraeuwe, Alexia, Harkemanne, Evelyne, Thirion, Romane, Nobile, Laura, Ghislain, Pierre-Dominique, Baeck, Marie, UCL - SSS/IREC/PNEU - Pôle de Pneumologie, ORL et Dermatologie, UCL - (SLuc) Service de dermatologie, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Centre de l'allergie, and UCL - (SLuc) Centre de malformations vasculaires congénitales
Fouarge, Anne‐Laure, Cuvelier, Marie, Roquet‐Gravy, Charlotte, de Montjoye, Laurence, and Baeck, Marie
Subjects
PITYRIASIS rubra, TREATMENT effectiveness
Abstract
Pityriasis rubra pilaris (PRP) is an uncommon keratinization disorder typically presenting as a generalized papulo-squamous pruritic eruption and a palmo-plantar keratoderma (PPK).[[1]] The understanding of the underlying pathophysiology of PRP remains incomplete and the condition frequently fails to respond to conventional therapies such as oral retinoids, phototherapy, methotrexate and ciclosporin.[[1]] However, the use of biotherapies such as anti-TNF, anti-IL-12/IL-23, anti-IL-23/p19 and anti-IL-17 has been put forward.[[1], [3], [5], [7]] We report five patients with confirmed PRP who were treated with risankizumab, a IL-23/p19 antagonist. Erythema and pruritus decreased after 4 to 8 weeks for all patients and resolution of erythroderma was achieved in all patients within 3 to 10 months after initiation of treatment (Figure 1c,f,i,m). Response was incomplete in patient 1 and patient 3 with notably persistent residual PPK (Figure 1d) while PPK in patient 5 improved slower than erythroderma but eventually resolved after 13 months (Figure 1n). [Extracted from the article]
Unlike AdrU wheals, CholU lesions are more commonly encircled by red flares.[3] Nevertheless, the distinction can be insidious and a case with combined CholU and AdrU has been described.[4] 1 TABLE Differential diagnosis of adrenergic urticaria HT
Differential diagnosis
Main characteristics
Cholinergic urticaria
Small red papules encircled by large red flares. Intradermal test with epinephrine (1 mg/mL) which reproduced the typical lesion of adrenergic urticaria (AdrU) with a 4-mm erythematous papule, a 2-mm white halo of vasoconstriction and a 35-mm surrounding erythema (right). Adrenergic urticaria (AdrU) is a rare sub-type of chronic urticaria characterized by pruritic erythematous wheals surrounded by a pale halo of vasoconstriction. [Extracted from the article]
Herman, Anne, Aerts, Olivier, Jacobs, Marie‐Claude, Scheers, Christel, Gilissen, Liesbeth, Goossens, An, and Baeck, Marie
Subjects
CONTACT dermatitis, COSMETICS, DETERGENTS
Abstract
Background: In the 2010s an epidemic of allergic contact dermatitis to methylisothiazolinone (MI) occurred in Europe. European authorities banned the use of methylisothiazolinone in leave‐on cosmetics in 2017 and limited its use in rinse‐off products in 2018. Objectives: To investigate the sensitization rate to MI in Belgium between January 2014 and December 2019, and to assess cosensitizations to octylisothiazolinone (OIT) and benzisothiazolinone (BIT) in MI‐sensitized patients. Methods: A retrospective study of patch test results with MI, OIT, and BIT observed in patients attending five Belgian hospitals. Results: Overall, 560 of 10 029 patients (5.58%) had a positive patch test reaction to MI, and its sensitization rate decreased from 7.9% in 2014 to 3.1% in 2019. Rinse‐off cosmetics, paints, and detergents were the most prevalent sensitization sources in recent years. Simultaneous reactions readily occurred to OIT, and, surprisingly, and increasingly, also to BIT. Conclusions: Contact allergy to MI in Belgium has reached a pre‐epidemic level, reflecting the impact of recent regulatory measures. Leave‐on cosmetics, in contrast to rinse‐off products, have almost disappeared as sensitization sources in Europe. Paints and detergents also remain problematic. The remarkably high number of patients (co)sensitized to BIT should be a focus of future research. [ABSTRACT FROM AUTHOR]
SKIN inflammation, ALLERGENS, CONTACT dermatitis, TRANSCRIPTOMES, T cells
Abstract
Background: Skin exposure to chemicals may induce an inflammatory disease known as contact dermatitis (CD). Distinguishing the allergic and irritant forms of CD often proves challenging in the clinic. Methods: To characterize the molecular signatures of chemical‐induced skin inflammation, we conducted a comprehensive transcriptomic analysis on the skin lesions of 47 patients with positive patch tests to reference contact allergens and nonallergenic irritants. Results: A clear segregation was observed between allergen‐ and irritant‐induced gene profiles. Distinct modules pertaining to the epidermal compartment, metabolism, and proliferation were induced by both contact allergens and irritants; whereas only contact allergens prompted strong activation of adaptive immunity, notably of cytotoxic T‐cell responses. Our results also confirmed that: (a) unique pathways characterize allergen‐ and irritant‐induced dermatitis; (b) the intensity of the clinical reaction correlates with the magnitude of immune activation. Finally, using a machine‐learning approach, we identified and validated several minimal combinations of biomarkers to distinguish contact allergy from irritation. Conclusion: These results highlight the value of molecular profiling of chemical‐induced skin inflammation for improving the diagnosis of allergic versus irritant contact dermatitis. [ABSTRACT FROM AUTHOR]