[A pin-point pattern of rapid occurrence on the skin of adolescents]. / Un semis ponctué d'apparition rapide sur la peau d'un adolescent.

In some instances, a dermatosis exhibits a rapid and focal surge of seemingly similar tiny lesions. We report a few typical exemples occurring in adolescents.

[How I explore ... the diagnosis of syphilis]. / Comment j'explore ... l'hypothèse diagnostique d'une syphilis.

The versatility of the clinical presentations of syphilis is large. A laboratory diagnosis is required in any case where a clinical assumption is raised. Two main diagnostic methods are available according to the lesion aspects and the staging of the disease. They rely on the recognition of the spirochete or on the identification of the immune response using specific and non specific serology tests.

[Behind the scenes of breast cancer]. / Les coulisses du cancer mammaire.

A 55 year-old women presented with lesions simulating cysts of the scalp. The dermatopathological examination revealed a metastasis of a breast adenocarcinoma. At the diagnosis disclosure, the patient recognized having concealed for 7 years a neoplastic wound replacing one of her breasts. About this case report, we report the astonishing clinical diversity of skin metastases of breast adenocarcinomas.

[Pruritus, a frequent worry]. / Le prurit, un "méhin" frequent.

Pruritus is a frequent symptom expressed locally or generalized. Its origin may be found locally in the skin or may prove to be systemic. The clinical examination and history are important in the establishment of the etiologic diagnosis which governs the treatment.

[About the reticence to specific immunotherapy in alergic subjects]. / A propos de la réticence a l'immunothérapie spécifique chez les personnes allergiques: les nouvelles données de la littérature.

The increasing number of allergic subjects and the alteration of their quality of life are major concerns of public health. Symptomatic treatments of allergic diseases are not always able to improve the patient's complaints. Allergic exploration aims to identify IgE-dependant mechanisms and subsequently to prove the responsibility of the detected allergen in the allergic disease. The efficacy of the specific immunotherapy (SIT) using allergens in either subcutaneous or sublingual forms has been proven in rhinitis, conjunctivitis, asthma and IgE-induced reactions to hymenoptera venom. The lack of training in allergology is an important reticence of general practitioners and specialists to prescribe SIT. Furthermore, the duration of the treatment and its important cost in Belgium (where, only venom SIT is reimbursed by the Social Security) interfere significantly with the compliance of the patients.

[When creams turn into a burden]. / Le crémage a du plomb dans l'aile.

Topical treatment is the cornerstone of therapy for patients suffering from psoriasis. Its efficacy and safety have been demonstrated in a large number of publications. However, in daily life, the treatment outcome is often less satisfactory than the results published in the literature. This phenomenon is clearly linked to non-adherence. Indeed, patients with psoriasis frequently consider the topical therapies frequently as a heavy burden. The successful management of psoriasis with topical agents requires a perfect understanding between the patient and the practionner, which provides regular renewal of the patient's motivation.

[Chilblains, differential diagnosis and risk factors]. / Les engelures, stigmates des affres climatiques.

Chilblain results from environmental nonfreezing cold exposure. It is a localized inflammatory lesion most frequently localized on the toes and fingers. Chilblains are often idiopathic, but they may be part of lupus erythematosus.

Efficiency of photodynamic therapy in the treatment of diffuse facial viral warts in an immunosuppressed patient: towards a gold standard?

A 64-year-old man with a pulmonary transplant developed diffuse verrucae vulgares of the neck. After the failure of multiple cryotherapy treatments, 3 sessions of photodynamic therapy resulted in rapid therapeutic clinical success. This moderately painful and well-tolerated treatment is reproducible and can be very useful in treating papillomavirus infections in the immunosuppressed patient.