What was new in 2021?

Laurence de Montjoye, Axel De Greef, Alexia Degraeuwe, Evelyne Harkemanne, Romane Thirion, Laura Nobile, Pierre-Dominique Ghislain, Marie Baeck Published in the journal : February 2022 Category : Dermatology

Several innovations in dermatology in 2021 should be mentioned, particularly in the field of inflammatory and immunological diseases, such as atopic dermatitis, chronic urticaria, alopecia areata or Behçet's disease, but also in oncodermatology.

For the past few years, advances have been made in atopic dermatitis leading to a better understanding of the pathogenesis, identification of comorbidities, and emergence of new biological treatments.

In the course of the year 2021, international guidelines for chronic urticaria clarified the classification and therapeutic management of this disease.

Treatment of patients with alopecia areata became more promising through the advent of Janus kinases inhibitors, leading to encouraging results.

Apremilast became a new treatment option being reimbursed for oral ulcers in Behçet's disease.

In onco-dermatology, several new developments in both diagnosis and management were made:

- Reflectance confocal microscopy is a non-invasive optical imaging technique that was made available for managing patients with suspected malignant skin lesions;

- Chlormethine, a local chemotherapy gel, was shown to be effective and is thus being reimbursed for treating cutaneous T-cell lymphoma mycosis fungoides type in adult patients;

- Simulated daylight-mediated photodynamic therapy is a new technique, which was made available for the therapeutic arsenal designed to manage transplant patients with actinic keratoses.

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Epidermal hamartoma type PENS («papular epidermal nevus with « skyline » basal cell layer»)

Marie Cuvelier (1*), Josette André (2), Didier Bessis (3), Pierre-Paul Roquet-Gravy (1), Audrey Bulinckx (1) Published in the journal : January 2021 Category : Dermatology

PENS hamartoma or “papular epidermal nevus with "skyline" basal cell layer” is a congenital epidermal hamartoma, which is characterized by specific histopathological features. We report a diagnosis of PENS hamartoma that was made in an 18-month-old girl.

Initially described by Torrelo et al. in 2011 (1), PENS hamartoma exhibits particular clinical features consisting of coalescent, verrucous, and light brown polygonal papules (2). The diagnosis is confirmed by histological examination, which, in the majority of cases, shows an alignment of epidermal basal cells and palissadic disposition of nuclei evoking a "skyline". In 2012, the term PENS Syndrome was retained, owing to new clinical descriptions associating light neurological abnormalities with these cutaneous lesions (2). PENS syndrome is a rare neuro-cutaneous syndrome, which involves one or more congenital epidermal hamartomas of PENS type, as well as non-specific neurological abnormalities (1-3). Neurological manifestations begin to occur during the first two years of life (1). A review of the literature identified 27 reported cases of PENS hamartomas (1-12), including some familial cases and other cases associated with neurological abnormalities (PENS syndrome). The physiopathology of PENS hamartoma and PENS syndrome remains unclear, whereas several hypotheses have been advanced (7).

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Cutaneous manifestations associated with COVID-19

Marie Baeck, Caroline Peeters, Marie Cuvelier, Laetitia Fameree, Evelyne Harkemanne, Fanny Ickx, Margaux Mairlot, Marine Matthews, Nina Nielens, Laura Nobile, Romane Thirion, Anne Herman Published in the journal : May 2020 Category : Dermatology

Skin manifestations are considered uncommon presentations of COVID-19. Despite reported cases in the literature, no causal link has been formally demonstrated to date. Skin lesions associated with COVID-19 are: 1) rashes that are classically viral or paraviral in nature like exanthemas, urticaria, and erythema multiforme; 2) eruptions that are secondary to the systemic consequences of COVID-19 like vasculitis or thrombotic vasculopathy; 3) rashes induced by drugs prescribed as part of COVID-19; 4) skin lesions like chilblains that are likely to be an indirect consequences of COVID-19 and containment measures.

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Staphylococcal scalded skin syndrome in a 13-year-old teenager

Marylou Lefèvre, Audrey Bulinck, Pierre-Paul Roquet-Gravy Published in the journal : January 2020 Category : Dermatology

Staphylococcal scaled skin syndrome (SSSS) is an exfoliating skin disease that predominantly affects newborns and young children. This infectious exanthema, characterized by superficial epidermis detachment, is due to Staphylococcus aureus infection excreting exfoliative toxins A and/or B. This case report illustrates the clinical signs of SSSS characterized by an erythrodermic and blistering skin rash with erythematous and oozing lesions in friction areas. The diagnosis of SSSS was clinically established. A positive evolution was observed under intravenous antibiotic treatment with flucloxacillin and clindamycin associated with movicol®, local care, and hydro-electric re-equilibration. We have addressed the physiopathology and differential diagnosis of SSSS, highlighting the relevance of early diagnosis.

Then, we have discussed guidelines about the treatment/management, and particularly the benefits of combining clindamycin and an osmotic laxative, infusion of fresh frozen plasma, or intravenous immunoglobulins in case of antibiotic resistance.

Key Words

Staphylococcal scaled skin syndrome (SSSS), exfoliative skin disease, adolescent, bullous, exfoliative toxins, clindamycin

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Internal medicine and dermatology

Evelyne Harkemanne (1), Mathieu Ziraldo (1), Camille Francès (2), Marie Baeck (1) Published in the journal : December 2019 Category : Dermatology

We herein report on the “Peau’se dermatologique” meeting held on June 3rd, 2019 in the Cliniques universitaires Saint-Luc, Brussels, and focused on dermatological manifestations of systemic diseases. Professor Camille Francès, member of the Dermatology department at Hôpital Tenon in Paris, presented eight interesting clinical cases of systemic diseases with associated dermatological features.

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Endocrine disruptors

Corentine Vanlier (1), Marie Baeck (1), Anne-Simone Parent (2), Christine Lafforgue (3), Caroline Peeters (1), Anne Herman (1) Published in the journal : October 2019 Category : Dermatology

We herein report on the “PEAU’se dermatologique” meeting focused on endocrine disruptors, which was held on October 22, 2018 and organised by the Department of dermatology of the Cliniques universitaires Saint-Luc. Doctor AS. Parent first described the interactions taking place between endocrine disruptors and child development. Next, Doctor CH. Laforge presented the legislation on endocrine disruptors and talked about absorption mechanisms. Finally, the experts provided us with advice on how to limit exposure to and, thus, avoid the undesirable effects of these products.

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Dermatology and internal medicine

Marine Beeckman (1), Deborah Debois (1), Didier Bessis (2), Marie Baeck (1) Published in the journal : September 2019 Category : Dermatology

We herein report on the «PEAUse dermatologique» meeting of the Cliniques universitaires Saint-Luc held on May 14, 2018, which was focused on the topic “dermatology and internal medicine”.

For this occasion, Professor Didier Bessis, head of the Dermatology department of the CHU Montpellier and specialist in the care of rare dermatological diseases, presented us some clinical cases and four examples of new clinical entities in dermatology.

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Dermatology and immuno-allergology

Diane Declaye (1), Olivier Aerts (2), Alexia Kervyn (3), Laurence de Montjoye (1), Laura Nobile (1), Didier Ebo (4), Marie Baeck (1) Published in the journal : July 2019 Category : Dermatology

We report on the “PEAU’se dermatologique” meeting held on June 18, 2018, organized by the Dermatology department of the Cliniques universitaires Saint-Luc, which was focused on immuno-allergology. The first part of the meeting, presented by Professor Didier Ebo, Head of the Department of Immunology and Allergology at UZA (Universitair Ziekenhuis Antwerpen), addressed the problem of “Perioperative hypersensitivity reactions”. The second part, presented by Professor Olivier Aerts (UZA), was dedicated to "Atypical aspects of contact dermatitis".

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Hematology & dermatology

Déborah Debois (1), Liliane Marot (1), Eric Van Den Neste (2), Alessandra Camboni (3), Isabelle Tromme (1) Published in the journal : January 2019 Category : Dermatology

We here briefly summarize the “PEAUse dermatologique” meeting organized in February 2018 by the Department of Dermatology of the Saint-Luc University Clinics and dedicated to cutaneous lymphomas. Professor E. Van Den Neste presented the most frequent cutaneous lymphomas, their treatments, as well as several clinical cases from the Department of Hematology. Professor A. Camboni focused on the histological aspects.

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Bullous skin disease

Pamela El Nemnom (1), Marie Baeck (1), Claire Dachelet (2), Liliane Marot (1) Published in the journal : December 2018 Category : Dermatology

We have herein reported on the “PEAU’se dermatologique” meeting conducted at the Cliniques universitaires Saint- Luc on November 13, 2017, while being focused on bullous skin disease. After a brief reminder of the clinical lesions for each condition, the anatomopathological characteristics were specified, with the latest updates about their treatment provided. The newest update concerned rituximab that will now be reimbursed in the context of complicated bullous skin disease.

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