Publications of Florence Libon
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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 detailDUPIXENT (dupilumab) A New Era in the Treatment of Severe Atopic Dermatitis
DEZFOULIAN, Bita ULiege; Libon, Florence ULiege

Scientific conference (2020, February 20)

Program : Practical Management of Severe AD with Dupilumab ; Workshop : Diagnosis and Assessment of Atopic Dermatitis Using scoring Systems.

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See detailTables rondes "AbbVie en dermatologie"
Libon, Florence ULiege; NIKKELS, Arjen ULiege; DEZFOULIAN, Bita ULiege

Conference (2019, November 14)

Physiopathologie du psoriasis ; Nouvelles données cliniques ; Dermatite atopique et les options de traitement.

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See detailLe dosage sérique des IgE en dermatologie
DEZFOULIAN, Bita ULiege; Libon, Florence ULiege; NIKKELS, Arjen ULiege

in Skin (2019), 22(1), 10-13

L'immunoglobuline E (IgE) est le principal anticorps impliqué dans les réactions allergiques de type immédiat (réaction d'hypersensibilité de type 1 de la classification de Gell et Coombs). Comme les ... [more ▼]

L'immunoglobuline E (IgE) est le principal anticorps impliqué dans les réactions allergiques de type immédiat (réaction d'hypersensibilité de type 1 de la classification de Gell et Coombs). Comme les autres anticorps, les IgE ont 2 régions fonctionnelles : la région Fc, qui sert d'attache aux cellules effectrices, et la région Fab, sur laquelle se situe l'interaction avec l'allergène. Il existe 2 types de récepteurs spécifiques sur les membranes cellulaires pour le Fc des IgE. Les mastocytes et les basophiles portent des récepteurs de haute affinité pour l'IgE, appelés FcεR1, qui permettent la sensibilisation de ces cellules et la libération d'histamine et des cytokines. Le second récepteur pour les IgE, FcεR2, est présent sur les cellules inflammatoires, y compris sur les cellules NK (natural killer), les macrophages, les éosinophiles, les plaquettes, les lymphocytes B et T, les cellules de Langerhans et les cellules dendritiques folliculaires. Le FcεR2 a une affinité plus basse pour les IgE et intervient dans la cytotoxicité cellulaire anticorps-dépendante et dans l'inflammation allergique. Ce récepteur induit également la prolifération et la différenciation des lymphocytes B activés, et agit comme cofacteur de l'IL4 lors de la commutation de la chaîne lourde en IgE. La liaison du complexe IgE-antigène aux FcεR2 des lymphocytes B puis l'internalisation de ce complexe contribuent à la fonction de présentation de l'antigène. L'IgE est la moins abondante des diverses classes d'anticorps, et sa concentration sérique n'est que de 0.1 à 0.3 µg/l contre 5 à 15g/l pour les IgG. Cependant, après stimulation antigénique, suite à la nouvelle synthèse d'anticorps IgE, sa concentration augmente. Cela correspond à la demi-vie courte dans le sérum. Les anticorps IgE spécifiques sont plus compétitifs que les IgE non spécifiques pour la liaison aux récepteurs cellulaires et sont plus adaptés que les anticorps IgG pour provoquer la dégranulation des mastocytes et des basophiles. le système IgE est très sensible et est susceptible de provoquer une réaction d'hypersensibilité. [less ▲]

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See detailComment je traite... Les toxicités mucocutanées des thérapies ciblées en oncologie
DAMSIN, Thomas ULiege; COLLIGNON, Joëlle ULiege; LEBAS, Eve ULiege et al

in Revue Médicale de Liège (2019), 01

Le spectre des effets indésirables mucocutanés des thérapies ciblées (hors immunothérapies), comme les anti-EGFR, anti-VEGF, anti-TK et anti-BRAF, présente des similarités avec celui des traitements ... [more ▼]

Le spectre des effets indésirables mucocutanés des thérapies ciblées (hors immunothérapies), comme les anti-EGFR, anti-VEGF, anti-TK et anti-BRAF, présente des similarités avec celui des traitements chimiothérapeutiques classiques, mais également des lésions plus spécifiques. Cet article abordera les toxicités dermatologiques des thérapies ciblées, à l'aide de 11 illustrations cliniques : les mucites et toxicités endobuccales, les éruptions acnéiformes, les modifications et complications unguéales, le syndrome main/pied, la radiosensibilisation, les alopécies, la xérose et les fissures cutanées. Après une brève description clinique et quelques notions théoriques, la prise en charge dermatologique est détaillée. [less ▲]

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See detailPatient avec un carcinome spinocellulaire cutané localement avancé et métastatique traité par Cemiplimab
Vanhakendover, Louise ULiege; LEBAS, Eve ULiege; Libon, Florence ULiege et al

in Revue Médicale de Liège (2019), (74), 1-5

Le traitement du carcinome spinocellulaire cutané (cSCC) localement avancé et/ou métastasique repose essentiellement sur la chirurgie et, éventuellement, une radiothérapie de la zone chirurgicale et de ... [more ▼]

Le traitement du carcinome spinocellulaire cutané (cSCC) localement avancé et/ou métastasique repose essentiellement sur la chirurgie et, éventuellement, une radiothérapie de la zone chirurgicale et de l’aire ganglionnaire afférente. Malheureusement, certains cas ne sont plus opérables ou accessibles à la radiothérapie et un traitement systémique est alors indiqué. Les chimiothérapies sont peu efficaces et potentiellement toxiques. Une étude récente évaluant l’efficacité et la tolérance du cemiplimab, un antagoniste PD1, dans les cSCC localement avancés et métastasiques démontre une réponse objective confirmée de 49 % et de 47 %, respectivement, avec un maintien de la réponse d’au moins 6 mois de 63 % et de 60 %, respectivement. Nous présentons le cas d’un patient avec un cSCC localement avancé au niveau du front, avec effraction osseuse et adénopathies cervicales, ayant eu de multiples chirurgies et radiothérapies. Il a présenté une réponse partielle au cemiplimab avec un profil de tolérance satisfaisant. [less ▲]

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See detailCarcinome spinocellulaire cutané localement avancé et métastatique traité par cemiplimab.
Vanhakendover, Louise ULiege; LEBAS, Eve ULiege; Libon, Florence ULiege et al

in Revue medicale de Liege (2019), 74(7-8), 436-440

The treatment of locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) essentially relies on surgery and eventually radiotherapy of the treated site and afferent lymph nodes ... [more ▼]

The treatment of locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) essentially relies on surgery and eventually radiotherapy of the treated site and afferent lymph nodes. Unfortunately, some cases are no candidates for surgery or radiotherapy and a systemic treatment may be indicated. Chemotherapies are only partially efficacious and associated with potential toxicities. A recent study evaluating the efficacy and tolerance of cemiplimab, a PD1 antagonist for locally advanced and metastatic cSCC demonstrated an objective response rate of 49 % and 47 % for locally advanced and metastatic cSCC, while maintaining a response of at least 6 months of 63 % and 60 %, respectively. We present a clinical case of a patient with a locally advanced cSCC of the forehead with bone resorption and cervical lymphadenopathies. After failure of multiple surgical interventions and radiotherapies, he responded partially to cemiplimab immunotherapy with a good safety profile. [less ▲]

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See detailPrecautions when reading the drug skin tests
DAMSIN, Thomas ULiege; NIKKELS, Arjen ULiege; Libon, Florence ULiege et al

Conference (2018, October 13)

Adverse drug reactions due to an allergy are a frequent problem in clinical practice. The application of skin tests and their interpretation for the diagnosis of immediate and delayed type allergies are ... [more ▼]

Adverse drug reactions due to an allergy are a frequent problem in clinical practice. The application of skin tests and their interpretation for the diagnosis of immediate and delayed type allergies are well known. [less ▲]

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See detailPolymorphous light eruption: Phototherapy-based desensitization versus intramuscular steroids - Who is right, who is wrong?
Libon, Florence ULiege; Nikkels, Arjen ULiege

in Dermatology (2018), 234(5-6), 192-193

Polymorphous light eruption (PLE) is an immunological mediated photo-dermatosis occurring in temperate regions that affects around 10–20% of the population, particularly between the second and third ... [more ▼]

Polymorphous light eruption (PLE) is an immunological mediated photo-dermatosis occurring in temperate regions that affects around 10–20% of the population, particularly between the second and third decades of life. Women are more often affected than men. The photo-distributed maculopapular eruption appears relatively rapidly after exposure to UV radiation and lasts for several days. Severe pruritus and general malaise may be observed. PLE has a serious impact on quality of life and patients are often afraid of being severely bothered during their holidays or leisure activities. [less ▲]

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See detailQuoi de neuf dans le traitement de l'hidradénite suppurative en 2018?
GIET, Gabrielle ULiege; LEBAS, Eve ULiege; Libon, Florence ULiege et al

in Revue Médicale de Liège (2018)

Hidradenitis suppurativa (HS), also known as Verneuil’s disease and acne inversa, is a chronic inflammatory skin disease characterized by a dysfunction of the pilosebaceous structures resulting in ... [more ▼]

Hidradenitis suppurativa (HS), also known as Verneuil’s disease and acne inversa, is a chronic inflammatory skin disease characterized by a dysfunction of the pilosebaceous structures resulting in occlusion and inflammation. The disease usually starts after puberty, on average between twenty and thirty years, with subcutaneous painful inflammatory nodules, abscess collections, fistulization and scars mainly in the axillary, inguinal, sub-mammary, perineal and perianal regions. It is a multifactorial disease with the most commonly cited risk factors or aggravating factors being smoking, obesity, and HS family history. The first line of treatment relies on antibiotics, including tetracyclins, clindamycin and rifampycin. In case of non-response, TNFα antagonists, more specifically adalimumab, may be considered. [less ▲]

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See detailSunscreens block cutaneous vitamin D production with only a minimal effect on circulating 25-hydroxyvitamin D
Libon, Florence ULiege; Courtois, Justine; LE GOFF, Caroline ULiege et al

in Archives of Osteoporosis (2017)

Summary A 50+ SPF sunscreen decreased significantly cutaneous vitamin D production following a single narrow-band (nb)UVB exposure, independently from the body surface area exposed. In contrast, the ... [more ▼]

Summary A 50+ SPF sunscreen decreased significantly cutaneous vitamin D production following a single narrow-band (nb)UVB exposure, independently from the body surface area exposed. In contrast, the circulating 25(OH)D3 levels were only minimally affected. It is probable that another endogenous source of precursors is selected when skin-originated precursors are lacking. Purpose Sunscreen use, highly advocated for preventing cutaneous carcinogenesis, is potentially leading to an aggravation of vitamin D deficiency with its consequences on bone health. The effect of sunscreens on circulating vitamin D levels remains debated. This study investigated the effect of sunscreen on cutaneous vitamin D production and circulating 25(OH)D3 levels, according to different body surface areas (BSA). Methods Vitamin D and 25(OH)D3 levels were measured in four groups exposed to a single nbUVB exposure on 9% (group I: head and hands), 23% (group II: head, hands and arms), 50% (group III: head, hands, arms and legs) and 96% (group IV: total body) of the body surface without and with a 50+ sun protection factor sunscreen. Results Sunscreen use decreased by 83, 88.3, 75.7 and 92.5% the cutaneous vitamin D production in groups I to IV, respectively, but only by 13.2, 10.5, 7.7 and 10.4% the values of circulating 25(OH)D3, correspondingly. Conclusions Although a 50+ sunscreen decreases significantly cutaneous vitamin D production following a single nbUVB exposure, and independently from the BSA, the circulating 25(OH)D3 levels were only minimally affected. This could be explained by a switch to another endogenous source of precursors. Short-term sunscreen use probably does not affect circulating vitamin D levels and hence does not increase the risk for osteoporosis. The effect of long-term sunscreen use remains however to be determined. [less ▲]

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See detailNon-dermatophyte Dermatoses Mimicking Dermatophytoses in Humans
Libon, Florence ULiege; TASSOUDJI, Nazli ULiege; NIKKELS, Arjen ULiege et al

in Mycopathologia (2017), 182(1-2), 101-111

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the ... [more ▼]

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the intertriginous regions (feet, inguinal, axillar, submammary), dermatophytic colonisations and infections manifest as whitish, slightly hyperkeratotic, pruritic and sometimes fissurated lesions. On the scalp, dermatophytic infections commonly lead to single or multiple more or less inflammatory and alopecic lesions. On the plantar and palmar aspects of the feet and hand, dermatophytosis presents as an eczema-like chronic dermatosis. Abscess-like lesions may occur due to zoophilic dermatomycosis. Dermatophytic infections of the nails reveal ill-defined whitish-yellowish colorations of the distal end or the lateral aspects of the nails, sometimes combined with partial nail embrittlement or even complete destruction. Despite the ubiquity of dermatophytic skin infections and their usually highly typical clinical features, a differential diagnosis has to be considered, in particular when treatment is not efficient or when treatment resistance occurs. This review presents the differential diagnosis in terms of frequency as well as the diagnostic methods permitting the distinction of annular, intertriginous, alopecic, palmoplantar, abscess-like and onychodystrophic lesions. [less ▲]

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See detailProspective pilot evaluation of the efficacy and safety of topical ingenol mebutate gel for localized patch/plaque stage mycosis fungoides
CASTRONOVO, Charlotte ULiege; ARRESE ESTRADA, Jorge ULiege; Libon, Florence ULiege et al

in Open Dermatology Journal (2017), 11

Background: Mycosis Fungoides (MF) is the most frequent type of the primary cutaneous NK/T-cell lymphomas. Ingenol mebutate (IM) displays in vitro pro-apoptotic properties on neoplastic lymphocytes ... [more ▼]

Background: Mycosis Fungoides (MF) is the most frequent type of the primary cutaneous NK/T-cell lymphomas. Ingenol mebutate (IM) displays in vitro pro-apoptotic properties on neoplastic lymphocytes. Objectives: To evaluate the efficacy and safety of IM gel as topical treatment for MF. Materials and Methods: Ten male patients with longstanding classic type MF (n=9) and follicular MF (FMF; n=1), T2bN0M0B0, stage Ib, resistant to systemic methotrexate or acitretin therapies for at least 3 months, were included in this pilot study. In these patients, 11 target patch/plaque stage lesions with an area ≤ 25 cm2 were selected for IM therapy (0,05%, 2 weekly applications). The primary endpoint was the improvement of the CAILS scores. Biopsies were performed before and after treatment from 10 target lesions. Relapse rates were evaluated at 6 months. Results: The mean CAILS score of treated target lesions was reduced by 58.2%. The mean erythema, scaling and plaque elevation scores were improved by 73.6%, 93.9% and 97.9% (p<0.0001), respectively, while the lesion size remained unchanged (p=0.34). A complete or partial clearance of histological and immunohistochemical features was observed in 6/10 (60%) and 4/10 (40%) of the MF or FMF target lesions, respectively. Monoclonal TCR rearrangement was evidenced in 100% (7/7) of the patients and in 3/7 (43%) after treatment. The relapse rate at 6 months was 18%. All the patients experienced burning sensations, oozing and crusting. Conclusion: IM gel warrants further investigation and development as a potential topical treatment for localized patch/plaque stage MF and FMF. © 2017 Lebas et al. [less ▲]

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See detailEffect of Body Site and Surface on Vitamin D and 25-Hydroxyvitamin D Production after a Single Narrowband UVB Exposure
Libon, Florence ULiege; COURTOIS, Jessica ULiege; Le Goff, Caroline ULiege et al

in Journal of Investigative Dermatology (2017), 137(6), 1391-1393

[No abstract available]

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See detailNON-DERMATOPHYTE DERMATOSES MIMICKING DERMATOPHYTOSES IN HUMANS
Libon, Florence ULiege; TASSOUDJI, Nazli ULiege; DEZFOULIAN, Bita ULiege et al

in Mycopathologia (2016)

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the ... [more ▼]

Human dermatophytic cutaneous infections usually present as single or multiple slowly progressing annular erythemato-squamous lesions with a tendency to central healing on the hairless skin. In the intertriginous regions (feet, inguinal, axillar, submammary), dermatophytic colonisations and infections manifest as whitish, slightly hyperkeratotic, pruritic and sometimes fissurated lesions. On the scalp, dermatophytic infections commonly lead to single or multiple more or less inflammatory and alopecic lesions. On the plantar and palmar aspects of the feet and hand, dermatophytosis presents as an eczema-like chronic dermatosis. Abscess-like lesions may occur due to zoophilic dermatomycosis. Dermatophytic infections of the nails reveal ill-defined whitish-yellowish colorations of the distal end or the lateral aspects of the nails, sometimes combined with partial nail embrittlement or even complete destruction. Despite the ubiquity of dermatophytic skin infections and their usually highly typical clinical features, a differential diagnosis has to be considered, in particular when treatment is not efficient or when treatment resistance occurs. This review presents the differential diagnosis in terms of frequency as well as the diagnostic methods permitting the distinction of annular, intertriginous, alopecic, palmoplantar, abscess-like and onychodystrophic lesions. [less ▲]

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See detailMelanoma masquerading as nomelanocytic lesions
DETRIXHE, Audrey ULiege; Libon, Florence ULiege; MANSUY, Marion ULiege et al

in Melanoma Research (2016)

Increased awareness among dermatologists as well as the development of dermoscopy and sequential dermoscopy have contributed significantly toward an increase in the diagnostic accuracy of pigmented ... [more ▼]

Increased awareness among dermatologists as well as the development of dermoscopy and sequential dermoscopy have contributed significantly toward an increase in the diagnostic accuracy of pigmented melanoma and even of amelanotic melanoma. However, the dermatologist's nightmare is the small group of melanomas that present as common skin diseases, often associated with a significant delay in diagnosis and hence a poor prognosis. The study was carried out to prospectively assess the number of melanomas lacking any clinical suspicion of melanoma and to describe their clinical and histological features over a 6-year observation period in an University Tertiary Skin Cancer Center. Out of 502 cases of newly diagnosed cases of melanoma, seven (1.4%) nonpigmented and nonamelanotic cases of melanoma were identified. The mean age of the patients was 69 years (two females/five males). All cases were discovered by chance on a punch biopsy. The clinical diagnostic suspicions were basal cell carcinoma, fungal intertrigo, keratoacanthoma, lichenoid keratoma, diabetic foot ulcer, eczema, and necrotic pressure ulcer. Dermoscopy, performed after the punch biopsies, was only partially contributive. The mean histological thickness was 2.7 mm, the mean number of mitoses was 7/mm, local micrometastases were present in 5/7 (71%), the mean Ki67 count was 18.9%, and a positive sentinel lymph node was observed in 4/6 (66%) cases. Nonpigmented and nonamelanotic melanomas are rare, are at high risk, and have a poor prognosis because of a delayed diagnosis. Dermoscopy is only of partial diagnostic aid. Treatment resistance or atypical behavior of the above-mentioned lesions should lead to biopsy. [less ▲]

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See detailPartie 1 : Les maladies bactériennes cutanées
Libon, Florence ULiege; LEBAS, Eglantine ULiege; ABDALLAH Rhim et al

in Skin (2016), 19(6), 6-13

Les lignes de conduite thérapeutiques sont habituellement établies sur la base des données de la littérature internationale de la médecine basée sur des faits (evidence-based medecine, EBM) ainsi que sur ... [more ▼]

Les lignes de conduite thérapeutiques sont habituellement établies sur la base des données de la littérature internationale de la médecine basée sur des faits (evidence-based medecine, EBM) ainsi que sur les avis exprimés par des experts reconnus dans le domaine. Néanmoins, ces lignes de conduite sont souvent difficile à traduire vers la pratique quotidienne d'un pays donné vu les conditions de remboursement spécifiques et l'organisation des soins médicaux. En matière de maladies infectieuses de la peau, il n'y a que peu de littérature publiée de type EBM. Cette initiative, émanant des assistants en formation en dermatologie et vénérologie en Wallonie/Bruxelles et coordonnée par Florence Libon, Eglantine Lebas et Arjen Nikkels de l'ULg, vise à revoir les différentes recommandations nationales et internationales existantes afin de les adapter pour al situation actuellen en Wallonie/Bruxelles. Elle vise également à unifier les habitudes de prescription sur une base logique et sur les données de la littérature tout en créant des lignes de conduite pratiques. Comme toutes les recommandations diagnostiques et thérapeutiques, une adaptation individuelle devra être réalisée en fonction de chaque patient et le médecin reste in fine le seul décideur et responsable du plan thérapeutique. Ces recommandations n'ont pas pour prétention d'être exhaustives sur toutes les pathologies cutanées bactériennes mais concernent les situations cliniques les plus souvent rencontrées. Dans cette première partie, seront abordés les consensus thérapeutiques pour les maladies cutanées d'origine bactérienne, à partir des cas cliniques [less ▲]

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See detailKoebner Phenomenon and Mycosis Fungoides
LEBAS, Eve ULiege; Libon, Florence ULiege; NIKKELS, Arjen ULiege

in Case Reports in Dermatology (2015)

Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin ... [more ▼]

Mycosis fungoides (MF) is the most frequent type of primary cutaneous T-cell/NK-cell lymphoma. The Koebner phenomenon is defined as the appearance of cutaneous lesions on previously noninvolved skin following trauma and is observed in a series of cutaneous diseases including psoriasis, lichen planus, viral warts, molluscum contagiosum, etc. In this case report, 3 patients with longstanding MF are presented, the 1st with the appearance of a circumscribed early-stage type MF lesion rapidly following a surgical excision of an infundibular cyst, the 2nd with the appearance of a unique unilateral palmar tumoral MF lesion at the pressure site of a crutch, and the 3rd presented localized MF early stage lesions at the friction site of a belt. This report suggests that some MF patients may experience Koebner phenomenon-induced MF lesions and that MF should be added to the long list of skin diseases potentially exhibiting the Koebner phenomenon. [less ▲]

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See detailEffect of body surface, body site and sunscreen application on production of vitamin D and 25-hydroxyvitamin D after a single narrowband-UVB exposure
Libon, Florence ULiege; Courtois, Justine ULiege; LUKAS, Pierre ULiege et al

Conference (2015, October)

The major source of vitamin D results from cutaneous synthesis and is ultraviolet B (UVB) radiation dependant, implying that the sun-exposed body surface area would play a determining role. The precise ... [more ▼]

The major source of vitamin D results from cutaneous synthesis and is ultraviolet B (UVB) radiation dependant, implying that the sun-exposed body surface area would play a determining role. The precise link between the cutaneous surface exposed to UVB and the formation of vitamin D remains unclear. The aim of our research was to study the influence of the body surface area exposed to an UVB-source on the production of cholecalciferol and calcidiol. [less ▲]

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