Publications of Arjen NIKKELS
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See detailL’image du mois. Pseudo-hernie abdominale post-zostérienne.
Absil, Gilles ULiege; BOUQUIAUX, Olivier ULiege; WANG, François-Charles ULiege et al

in Revue medicale de Liege (2021), 76(11), 773-775

Postherpetic neuralgia is the most feared complication of herpes zoster (HZ). The incidence increases with age. Nevertheless, around 5 % of HZ patients will experience a motor deficiency known as ... [more ▼]

Postherpetic neuralgia is the most feared complication of herpes zoster (HZ). The incidence increases with age. Nevertheless, around 5 % of HZ patients will experience a motor deficiency known as segmental zoster paresis (SZP) according to the affected dermatome. Abdominal pseudohernia is an exceptional clinical presentation of SZP, involving the T6-L1 dermatomas. The recognition of this rare complication of HZ prevents unnecessary explorations and interventions. There is no specific treatment but in general the evolution is favorable and spontaneous healing is observed within several months. [less ▲]

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See detailA Comprehensive Update of the Atypical, Rare and Mimicking Presentations of Mycosis Fungoides
LEBAS, Eve ULiege; COLLINS, Patrick ULiege; SOMJA, Joan ULiege et al

in Dermatology and Therapy (2021)

Introduction: Mycosis fungoides (MF) is the most frequent subtype of primary cutaneous T cell lymphomas (pCTCL). The diagnosis may be particularly difficult in the early stages as well as in atypical and ... [more ▼]

Introduction: Mycosis fungoides (MF) is the most frequent subtype of primary cutaneous T cell lymphomas (pCTCL). The diagnosis may be particularly difficult in the early stages as well as in atypical and rare clinical presentations. Furthermore, MF may simulate a large variety of common dermatologic disorders and patterns, both histopathologically and clinically. Methods: A literature search was performed to provide a comprehensive update on the rare and atypical MF manifestations as well as the dermatoses and dermatological patterns that could be imitated by MF. Results: A total of 114 publications were found describing a series of different dermatoses and dermatological patterns mimicked by MF, as well as some particular localizations of MF lesions and dermatoses that occur in preexisting MF lesions. Conclusions: The number of dermatoses that can be imitated by MF is ever-increasing. Patients with common dermatologic conditions that prove to be treatment refractory should be biopsied without delay, and sequentially as necessary, to prevent delay in diagnosis and progression of disease. Clinicopathologic correlation is the best way of diagnosis. [less ▲]

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See detailA rare malignant skin infiltrate
Bailleux, Sophie ULiege; Cao, Sandrine; DEZFOULIAN, Bita ULiege et al

Conference (2021, October)

A 9-month-old boy presented with urticaria-like cutaneous lesions. They appeared, for the first time, at the age of 5 months. The first clinical diagnosis was a mast cell disorder or urticaria pigmentosa ... [more ▼]

A 9-month-old boy presented with urticaria-like cutaneous lesions. They appeared, for the first time, at the age of 5 months. The first clinical diagnosis was a mast cell disorder or urticaria pigmentosa although antihistamines were not efficacious. Previously, the child was treated for thrombocytopenic purpura. A complete work up and systemic evaluation revealed severe thrombopenia. The bone marrow biopsy revealed no dyspoiesis in any of the cell lines. The final diagnosis was severe thrombocytopenic purpura in the context of an influenza-like syndrome. The treatment included systemic corticosteroids, sirolimus, rituximab, intravenous immunoglobulins and romiplostim. This immunosuppressive treatment led to a complete resolution of the skin lesions although recurrence was observed at treatment withdrawal. The clinical examination evidenced brownish and erythematous granulomatous plaques of the back, shoulders, face and thighs. A skin biopsy revealed a lymphoblastic infiltrate with blast cells sparing the dermis. Immunohistochemistry revealed a positivity for CD45, PAX5n CD79a, CD43 and CD34. The morphology and immunohistochemical profile were in favor of a cutaneous localization of an acute B-type lymphoblastic leukemia versus a B-type lymphoblastic lymphoma. The systemic workup showed no immunophenotyping abnormalities in the bone marrow and no malignant cells in the central nervous system but a tumefaction of both testicles. The testicular biopsy revealed an infiltration by a blastoid population expressing CD45, CD19 and CD34 whereas the cytogenetic revealed the presence of a partial 19p deletion and a MLL-AF10 rearrangement in 62% of nuclei. The child was treated by chemotherapy following the diagnosis of aleukemic leukemia cutis CD19+CD10-CD34+ CD20- with a testicular involvement and showed a good response. Aleukemic leukemia cutis is defined as a cutaneous infiltration of leukemic cells in the absence of both blood and bone marrow involvement. It is still not clear whether the malignant cells originate from the skin or spread from the bone marrow. The immature blast cells in the dermis and hypodermis clinically present as unspecific papules, nodules and plaques. Although rare and poorly characterized, recognition of this disease is important for early treatment. The management remains controversial. A diagnostic workup should include a blood test, bone marrow studies, FISH and cytogenetics. The treatment is similar as that for acute leukemia consisting in an induction and consolidation chemotherapy. [less ▲]

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See detailNecrobiosis lipoidica following breast reduction
Absil, Gilles ULiege; COLLINS, Patrick ULiege; EL HAYDERI, Lara ULiege et al

Conference (2021, September 29)

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See detailPooled Safety Analysis from Phase 3 Studies of Secukinumab in Paediatric Patients with Moderate to Severe Plaque Psoriasis
Sticherling, M.; NIKKELS, Arjen ULiege; Hamza, AM. et al

Conference (2021, September 29)

Psoriasis affects approximately 1% of the paediatric population1-3, negatively impacts the quality of life and affects long-term psychological well-being4. Secukinumab is efficacious in children 6 to <18 ... [more ▼]

Psoriasis affects approximately 1% of the paediatric population1-3, negatively impacts the quality of life and affects long-term psychological well-being4. Secukinumab is efficacious in children 6 to <18 years of age with severe and moderate to severe chronic plaque psoriasis5,6. The EMA and USFDA have approved secukinumab for the treatment of moderate to severe plaque psoriasis in children aged ≥6 years of age 7,8. Long-term pooled safety data for secukinumab in adults with moderate to severe plaque psoriasis have been reported earlier9 ; however, its safety profile in a large pool of paediatric patients is yet to be investigated. Here, we report a pooled safety analysis from two Phase 3 (NCT02471144 and NCT03668613) studies up to 52 weeks in paediatric patients with moderate to severe chronic plaque psoriasis. Data from four pivotal studies (NCT01365455, NCT01358578, NCT01555125 and NCT01636687) in the adult population were also pooled to present alongside the results from the pooled paediatric safety dataset. [less ▲]

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See detailNecrobiosis Lipoidica following Breast Reduction
Absil, Gilles ULiege; COLLINS, Patrick ULiege; EL HAYDERI, Lara ULiege et al

in Plastic and Reconstructive Surgery, Global Open (2021)

Necrobiosis lipoidica (NL) is a rare granulomatous skin disorder of unknown physiopathology that is frequently associated with diabetes mellitus. The typical skin lesions of NL present as chronic ... [more ▼]

Necrobiosis lipoidica (NL) is a rare granulomatous skin disorder of unknown physiopathology that is frequently associated with diabetes mellitus. The typical skin lesions of NL present as chronic, bilateral, well-defined red to yellow-brown plaques with telangectasias, a violaceous border and a waxy atrophic center. The lower legs are the most often involved areas, but NL may exceptionally develop on scar tissue following surgery. The treatment is very challenging and notoriously difficult. We report a 60-year-old diabetic woman who developed NL all along the surgical scars following breast reduction, without presenting NL on the lower legs. NL should be considered among the rare but possible skin healing complications of surgery. [less ▲]

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See detailHEREDITARY LEIOMYOMATOSIS AND ACUTE LYMPHOBLASTIC LEUKEMIA: a LINK THROUGH FUMARATE DYSHYDRATASE MUTATION?
Bailleux, Sophie ULiege; SOMJA, Joan ULiege; MARTIN, Marie ULiege et al

in Acta Clinica Belgica (2021)

Background: Hereditary leiomyomatosis (HL) is an autosomal dominant condition due to a variety of fumarate hydratase (FH) mutations in which individuals tend to develop cutaneous leiomyomas, multiple ... [more ▼]

Background: Hereditary leiomyomatosis (HL) is an autosomal dominant condition due to a variety of fumarate hydratase (FH) mutations in which individuals tend to develop cutaneous leiomyomas, multiple uterine leiomyomas and are at risk for developing aggressive papillary renal cell carcinoma. Case presentation: A 26-year-old man with a past history of acute lymphoblastic leukemia (T-ALL) presented with numerous painful light brown papules and nodules spread all over his body except for the head, appearing since infancy. Similar lesions were present in his mother’s family. A cutaneous biopsy revealed a cutaneous leiomyoma. His mother died from metastatic uterine neoplasia and his sister suffered from leiomyoma of the uterus. No renal cancer was reported in his family. A heterozygous pathogenic variant was detected in the FH gene. Conclusion: To our knowledge, this is the first case possibly linking HL and T-ALL through FH deficiency. [less ▲]

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See detailLe phénomène de Köbner en Dermatologie
GIET, Gabrielle ULiege; SENTERRE, Yseult ULiege; LEBAS, Eve ULiege et al

in Revue Médicale de Liège (2021), 76(9), 651-656

Köbner's phenomenon and its related phenomena are dermatological curiosities that are still partially misunderstood. The Köbner phenomenon is by far the best known and the most studied. It is ... [more ▼]

Köbner's phenomenon and its related phenomena are dermatological curiosities that are still partially misunderstood. The Köbner phenomenon is by far the best known and the most studied. It is characterized as the appearance of an inflammatory or infectious dermatosis in an area of healthy skin after skin trauma. The dermatoses most frequently concerned are psoriasis, lichen planus and vitiligo. The inverse Köbner phenomenon and the Renbök phenomenon are two very similar phenomena. The first represents the disappearance of a skin lesion after skin trauma. The second is characterized by a skin trauma that is more specifically induced by another dermatosis. Finally, the Wolf's isotopic phenomenon corresponds to the appearance of a new dermatosis on an area of the skin that was previously the site of another healed dermatosis. [less ▲]

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See detailBiologicals for moderate-to-severe plaque type psoriasis in pediatric patients
Libon, Florence ULiege; LEBAS, Eve ULiege; DE SCHAETZEN VAN BRIENEN, Virginie ULiege et al

in Expert Review of Clinical Immunology (2021), 17

Introduction Psoriasis affects around 2% of children in Europe. The majority of cases is readily managed with topical treatments using corticosteroids without or with calcipotriol. More resistant and ... [more ▼]

Introduction Psoriasis affects around 2% of children in Europe. The majority of cases is readily managed with topical treatments using corticosteroids without or with calcipotriol. More resistant and extensive moderate-to-severe cases require UVA or UVB phototherapies or conventional systemic treatment including ciclosporin, acitretin and methotrexate. However, these therapies are associated with a low tolerability and potential cumulative long-term adverse effects and toxicities. Areas covered About 15 years ago, the first biological appeared for the treatment of moderate-to-severe plaque type psoriasis in adult patients. Several years later, the first biologic treatment to be approved in children was etanercept, a soluble receptor that binds both tumor necrosis factor (TNF)-α and β followed by adalimumab, a monoclonal antibody against TNF-α, and currently by ustekinumab, a monoclonal IL12/23 p40 antagonist and, very recently, secukinumab and ixekizumab, both IL17 antagonists. All these biologic treatments brought significantly improved treatment results compared to light-based therapies and conventional treatments and present very good tolerance and safety profiles. Expert opinion Due to their excellent efficacy and safety profiles ustekinumab, secukinumab and ixekizumab could currently be considered as a first-line treatment options for moderate-to-severe childhood and adolescent psoriasis requiring a systemic treatment. [less ▲]

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See detailThe impact of COVID-19 on the new diagnoses of melanoma
GEDEAH, Christophe ULiege; DAMSIN, Thomas ULiege; Absil, Gilles ULiege et al

in European Journal of Dermatology (2021), 31(4), 565-567

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See detailLe dupilumab diminue la fréquence et la sévérité des infections herpétiques chez les patients atteints de dermatite atopique
Libon, Florence ULiege; DEZFOULIAN, Bita ULiege; NIKKELS, Arjen ULiege

Conference (2021, May 27)

L'anticorps monoclonal dupilumab est un antagoniste de l'IL 4 et de l'IL 13, approuvé pour la dermatite atopique (DA) modérée à sévère. La DA est caractérisée, via les altérations structurelles de la ... [more ▼]

L'anticorps monoclonal dupilumab est un antagoniste de l'IL 4 et de l'IL 13, approuvé pour la dermatite atopique (DA) modérée à sévère. La DA est caractérisée, via les altérations structurelles de la barrière épidermique, par une susceptibilité accrue pour les infections cutanées virales et bactériennes. La littérature est cependant controversée au sujet de l'incidence des infections herpétiques récurrentes chez les patients ayant une DA traités par dupilumab. [less ▲]

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See detailShingrix offre un nouvel espoir de prévenir le zona et les névralgies post-zostériennes
NIKKELS, Arjen ULiege

in La référence médicale (2021)

Le Professeur Arjen Nikkels est chef du service Dermatologie à l'Hôpital Universitaire de Liège et il possède une expertise spécifique dans le domaine du zona. A l'occasion du 44ième Wintermeeting de la ... [more ▼]

Le Professeur Arjen Nikkels est chef du service Dermatologie à l'Hôpital Universitaire de Liège et il possède une expertise spécifique dans le domaine du zona. A l'occasion du 44ième Wintermeeting de la Société Belge de Gérontologie et de Gériatrie et des Belgian Dermatology Days, il a tenu une conférence sur la présentation clinique du zona. [less ▲]

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See detailUn nouveau traitement de l’alopécie androgéno-génétique : les injections dans le cuir chevelu de plasma riche en plaquettes (PRP) autologue
MOREAU, Thomas; CASTRONOVO, Charlotte ULiege; Kaux, Jean-François ULiege et al

in Revue Médicale de Liège (2021), 76(2), 117-121

Androgenic alopecia is a genetically determined and leads to a progressive hair loss of the vertex, affecting both men and women. It is related to an important psychological and social distress. Medical ... [more ▼]

Androgenic alopecia is a genetically determined and leads to a progressive hair loss of the vertex, affecting both men and women. It is related to an important psychological and social distress. Medical therapies include topical minoxidil, oral 5α-reductase inhibitors and oestroprogestative drugs with anti-androgen effects for women. The surgical option is autograft hair transplantation. Recently, phototherapy with low-level energy lasers became available. All these treatments may present adverse effects and their effectiveness is questionable. Subcutaneous injections of autologous platelet-rich plasma into the scalp represent an interesting alternative treatment for androgenetic alopecia, as monotherapy or as an adjuvant treatment. The methodology, the possible mechanisms of action and some initial clinical results of this treatment are presented. [less ▲]

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See detailA phalanx abnormality in a newborn
Jouret, Gaëlle ULiege; CAO, Sandrine ULiege; NIKKELS, Arjen ULiege et al

Conference (2021, January 23)

Case report : A two-month-old boy was referred to the dermatology outpatients for a nail disorder since birth. Surgical correction of a pyloric stenosis was his only medical history. Her mother had been ... [more ▼]

Case report : A two-month-old boy was referred to the dermatology outpatients for a nail disorder since birth. Surgical correction of a pyloric stenosis was his only medical history. Her mother had been treated with Metformin for a hyperinsulinism before the conception and during the pregnancy. The parents are not consanguineous. The clinical examination revealed anonychia of the right second toenail and micronychia of the left one. Left finger index showed micronychia and seemed shorter. Hai and eyebrows were normal. Patellas were palpated. X-ray was made and highlighted an insufficient development of the extremities of second fingers and toes. [less ▲]

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See detailComment je traite… le mycosis fongoïde : à propos du brentuximab védotine, une nouvelle arme thérapeutique
LEBAS, Eve ULiege; COLLINS, Patrick ULiege; BONNET, Christophe ULiege et al

in Revue Médicale de Liège (2021), 76(4), 224-231

Récemment, le brentuximab védotine (BV) (Adcetris®) a obtenu le remboursement en Belgique pour le traitement du lymphome cutané primitif de type mycosis fongoïde (MF), du lymphome anaplasique à larges ... [more ▼]

Récemment, le brentuximab védotine (BV) (Adcetris®) a obtenu le remboursement en Belgique pour le traitement du lymphome cutané primitif de type mycosis fongoïde (MF), du lymphome anaplasique à larges cellules et de la papulose lymphomatoïde de type A. Le BV est un anticorps monoclonal dirigé contre le CD30 exprimé par les cellules T tumorales. L’inhibition de cette voie de signalisation induit un processus d’apoptose et conduit à la mort cellulaire. Le BV est remboursé après l’échec d’un autre traitement systémique et lorsque le nombre de cellules T atypiques exprimant le CD30 en immunohistochimie excède 10 % de la population totale sur une biopsie cutanée. Le BV est administré par voie intraveineuse toutes les 3 semaines à la posologie de 1,8 mg/kg, avec un maximum de 16 cures. Les taux de réponse globale excèdent 75 %. Certains patients négatifs pour le CD30 ont également montré une réponse thérapeutique intéressante. Les principaux effets indésirables du BV sont la neutropénie et la neuropathie périphérique. Les cas de deux patients avec un MF de longue date et multi-résistant, ayant répondu favorablement au BV, sont présentés dans cet article. [less ▲]

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See detailA2310 and A2311 Padiatrics Post-Hoc Safety Analysis Abstract
NIKKELS, Arjen ULiege; Hamza, Ashraf; Pearl, Kwong et al

Conference (2021)

Plaque psoriasis affects adults and children. Secukinumab, a fully human monoclonal anti-interleukin-17A antibody, has proven efficacious in adults in the long-term treatment of multiple manifestations of ... [more ▼]

Plaque psoriasis affects adults and children. Secukinumab, a fully human monoclonal anti-interleukin-17A antibody, has proven efficacious in adults in the long-term treatment of multiple manifestations of psoriatic disease, with a favorable safety profile. Long-term pooled safety data for secukinumab in adult patients with moderate to severe plaque psoriasis have been reported earlier. Here, we report a pooled safety analysis from two phase 3 studies up to 52 weeks in pediatric patients with moderate to severe plaque psoriasis. [less ▲]

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See detailFixed Drug Eruption to Piroxicam : About two cases
Absil, Gilles ULiege; Libon, Florence ULiege; NIKKELS, Arjen ULiege et al

Conference (2020, October 24)

Clinical case 5: Erythème pigmenté fixe à propos de 2 cas.

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See detailAvant-propos - Le carcinome spinocellulaire
Suys, Erwin; NIKKELS, Arjen ULiege

in Skin (2020), 23(4), 3

Le thème principal de ce numéro est les carcinomes spinocellulaires. Actuellement, on les appelle cSCC (cutaneous squamous cell carcinoma) en opposition avec les formes survenant au niveau des muqueuses.

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See detailLe carcinome spinocellulaire en 2020 : manuel pour le praticien
Suys, Erwin; NIKKELS, Arjen ULiege

in Skin (2020), 23(4), 8-13

Les cancers cutanés non-mélanome sont les cancers les plus répandus dans le monde occidental. Ainsi, 2% de la population d'Australie en est affectée. L'incidence augmente de 7% par an. En Belgique ... [more ▼]

Les cancers cutanés non-mélanome sont les cancers les plus répandus dans le monde occidental. Ainsi, 2% de la population d'Australie en est affectée. L'incidence augmente de 7% par an. En Belgique, environ 18.000 à 34.000 nouveaux cas annuels de carcinome basocellulaire et de carcinome spinocellulaire sont observés, dont environ 80 à 90% sont des carcinomes basocellulaires. [less ▲]

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See detailCutaneous Breast Cancer Metastases Successfully Treated Using an Oxygen Flow Assisted Topical Administration of Methotrexate (OFAMTX)
Jouret, Gaëlle ULiege; GONNE, Elodie ULiege; QUATRESOOZ, Pascale ULiege et al

in Dermatology and Therapy (2020)

Cutaneous metastases of breast cancer remain a therapeutic challenge. Oxygen flow-assisted topical administration of methotrexate 5% (OFAMTX, 5% methotrexate in a carrier solution) has recently been ... [more ▼]

Cutaneous metastases of breast cancer remain a therapeutic challenge. Oxygen flow-assisted topical administration of methotrexate 5% (OFAMTX, 5% methotrexate in a carrier solution) has recently been proven to be an efficacious alternative treatment for extramammary Paget’s disease, which is considered to be an in situ mammary adenocarcinoma of the epidermis. [less ▲]

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