[How I treat ... the athlete's foot and its non-mycotic cutaneous pathology]. / Comment je traite ... le pied du sportif et sa pathologie cutanée non mycosique.

Skin and nails of the foot of sport practitioners of various disciplines are subjected to the effects of benign but invalidating pathologies. Microtraumatisms are frequently involved. Beside dermatomycoses and onychomycoses, a dozen of typical disorders are identified.

[How I treat...pityriasis rubra pilaris]. / Comment je traite.... Un pityriasis rubra pilaire.

Pityriasis rubra pilaris is a syndrome of unknown etiology. Six distinct clinical types have been described in infancy and adulthood. Oral retinoids have proven their efficacy. Emollients and topical calcipotriol may improve the clinical presentation.

["Banal dermatomycoses" that cannot be overlooked]. / Des "dermatomycoses banales" qui ne pardonnent pas.

Two young adults presented an interdigital intertrigo and a dyschromic nail alteration, respectively. They were adept of intense sport swimming in pools. Lesions had been misdiagnosed as athlete's foot and onychomycosis, respectively. Several antifungal treatments had been tried without success. After many months of inadequate management, the dermatological examination revealed the presence of two malignant melanomas corresponding to the eroded acrolentiginous and nodular subungueal types, respectively.

[A conjugally exacerbated allergy: procuration dermatosis]. / Une allergie conjugale exacerbée: les dermatoses par procuration.

A young woman presented two distinct vesiculobullous dermatoses sharing in common her husband's imputability. She suffered from contact dermatitis due to colophony used by her husband who was violinist. During her second pregnancy, pemphigoid gestationis was diagnosed. This autoimmune disease is directed to the father's HLA class II present on the placenta. The same antibodies also interact with the dermo-epidermal junction in the mother where they induce blisters.

[How I explore ... A cutaneous scleroderma using noninvasive methods]. / Comment j'explore.... Une sclérodermie cutanée d'une manière non invasive.

There exists several clinical types of scleroderma. Most of them show cutaneous manifestations. Skin involvement may be isolated (morphea) or be part of a multi-organ systemic disease. Objective non-invasive functional methods are useful in order to better assess the severity and evolution of the disease and the effects of treatments. Measurements of the thickness and mechanical properties of the skin as well as the visualization of the cutaneous blood flow prove to be informative.

[Image of the month. A hidden melanoma hidden in a tennis player]. / L'image du mois. Un mélanome masqué chez un joueur de tennis.

A man presented with a malignant melanoma of the scalp. The lesion reached a large size before being disclosed. Repetitive sunburns during tennis matches could be responsible for this cancer. Indeed, hair protects only partially the skin from ultraviolet damages.

[How I explore ... a lichenoid drug reaction]. / Comment j'explore ... une toxidermie lichénoïde.

Lichenoid drug reactions are specific unwanted cutaneous side-effects related to some drugs. The clinical presentation of the lesions often suggests the diagnosis, but the distinction with idiopathic lichen planus remains difficult. The diagnosis is firmly established by the dermatopathological assessment of a cutaneous biopsy. The anamnestic search is focused on drug imputability based on well defined criteria. Biologic evaluations and various in vitro tests are little contributive and even may prove to be irrelevant.

[Eruptive tropical viroses]. / Viroses tropicales éruptives.

Eruptive tropical virosis are severe diseases which may prove to be sometimes fatal diseases. They are characterized by erythemato-purpuric cutaneous lesions associated with hyperthermia. Polyarthralgia or severe haemorrhage can also be part of the clinical presentation. Rapid diagnosis and preventive measures are mandatory, particularly when human transmission is possible.

[Towards obsolete senescence. Everything wanes ... Old age no longer exists!]. / Vers l'obsolescence de la sénescence. Tout se déglingue ... Il n'y a plus de vieillesse!

Skin ageing is the global result of the influence of numerous factors. Oxidative stress through the intervention of free radicals is one of the most important biological mechanisms solicited by ageing promotors. Prevention of skin senescence relies on several approaches. The main ones are sun protection, tobacco avoidance and limitation of sustained mechanical stress to the skin. Free radical scavengers in adequate combinations might slow down the ageing process. In cosmetology, retinol fulfills its claims. Vitamins E and C, as well as selenium and some plant extracts also show some interest. In the search for increased efficacy, tretinoin is the single topical drug available. Its biologic activity boosts the epidermal growth and the collagen synthesis while inhibiting some metalloproteinases responsible for dermal degradation. Clinical proofs of its efficacy are beyond doubt.

Squamometry in seborrheic dermatitis.

BACKGROUND: Seborrheic dermatitis is a corticosteroid-responsive condition. Topical corticosteroids exhibit distinct activities according to the type and cellular site of action of the hormone and its vehicle. The latter influences not only drug penetration, but also the structure and function of the horny layer. OBJECTIVE: The present study compared the early response of seborrheic dermatitis to two topical corticosteroids using objective quantifications of the stratum corneum alterations. METHOD: Squamometry was used to supplement the clinical assessment of the therapeutic activity of 0.1% hydrocortisone butyrate in an oil-in-water emulsion (Locoid Crelo) and 0.05% betamethasone 17-21 dipropionate lotion (Diprosone lotion). RESULTS: The hydrocortisone butyrate formulation had a faster onset of efficacy as documented by a greater improvement of lesions after a 1-week twice-daily treatment. Clearance or marked improvement was observed in the two treatment groups at completion of the 2-week trial. CONCLUSIONS: As the ranking of the clinical efficacy was not predicted by the intrinsic anti-inflammatory potency of the steroids, it is suggested that the vehicle contributed itself to the global in vivo efficacy. The anti-inflammatory action of hydrocortisone butyrate appears to be synergistically implemented by the emollient effect of the specially designed oil-in-water emulsion.

[Cutaneous melanomas, a spectrum of emerging cancers in women of Wallonia. Outlook by the Mosan Study Group of Pigmented Neoplasms]. / Les mélanomes cutanés, un spectre de cancers émergents chez la femme en région Wallonne. Un regard porté par le Groupe Mosan d'Etude des Tumeurs Pigmentaires.

The Mosan Study Group of Pigmented Neoplasms was founded about 15 years ago. It has collected more than 20,000 cutaneous malignancies including melanomas and basal and squamous cell carcinomas. The incidence of these cancers is on the rise in Wallonia. In particular, malignant melanomas represent a spectrum of emerging cancers characterized by a proteiform biological outcome. They mostly affect young women. The major risk factor appears to be iterative and unwise ultraviolet exposures. The prevention of melanomas is basically founded on such a dogma and accordingly relies on sunscreens. However, controversies about their beneficial effects are rife and fueled by axiomas and contradictory sophisms. At the exception of surgery, the therapeutic options for the diverse types of melanomas do not yet fulfill the scope of evidence-based medicine.

[Dermatologic diseases of the nipple and areola]. / Maladies dermatologiques du mamelon et de son aréole.

Several diseases of the nipple and areola have a specific dermatological presentation. They may be classified into five main categories including dysembryoplasias, mastalgia, inflammatory dermatoses, hyperkeratoses and neoplasms.

[Perimenstrual dermatoses: a comment fact of chronobiology]. / Les dermatoses cataméniales: une facette fréquente de la chronobiologie.

More than 15 common or specific dermatoses may be worsened during the premenstrual phase. Acne, herpes simplex and the autoimmune progesterone dermatitis represent typical examples.

Split-face clinical and bio-instrumental comparison of 0.1% adapalene and 0.05% tretinoin in facial acne.

BACKGROUND: Adapalene and tretinoin are topical compounds active for treating acne. OBJECTIVE: To compare the efficacity and safety of adapalene 0.1% gel and tretinoin 0.05% gel in moderately severe facial acne using clinical and objective biometrological assessments. Such information is currently lacking in the literature. METHODS: The split-face method was used in 25 acne volunteers for a 6-week treatment. In addition to clinical counts of lesions, the amount of comedones was assessed using computer-assisted morphometry of cyanoacrylate follicular biopsies. The erythema index and squamometry values were used to quantitate skin irritation. RESULTS: The tretinoin formulation brought better comedolysis and clinical improvement than the adapalene formulation. Erythema was transiently more pronounced on the tretinoin-treated side. Squamometry yielded no significant difference between both products. CONCLUSION: Tretinoin 0.05% gel exhibits a greater anti-acne efficacy than adapalene 0.1% gel, although with temperate tolerability.

[The cutaneous neurosensory axis and the neuro-immuno-cutaneous system]. / L'axe neuro-sensoriel cutané et le système neuro-immuno-cutané.

Since a few years the concept of a neuro-immuno-cutaneous system complementary to the neuro-sensorial cutaneous axis is emerging. It opens new ways to interpret the physiopathologic response of skin to a nociceptive stress, particularly the modulation of inflammation and immunity.