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Biomedical subjects

A F Nikkels

Publications and source records attributed to A F Nikkels.

68 records · Page 4Linked to original sources
PubMed1993

Comparative immunohistochemical study of herpes simplex and varicella-zoster infections.

Herpes simplex (HSV) and varicella-zoster (VZV) skin infections share so many histological similarities that distinguishing between them may prove to be impossible. We developed and characterized a new monoclonal antibody, VL8, IgG kappa isotype, directed to the VZV envelope glycoprotein gpI. Immunohistochemistry with VL8 appeared highly sensitive and specific on formalin-fixed paraffin-embedded biopsies and a clear-cut distinction between HSV and VZV infections was possible. The pattern of VL8 immunolabelling in VZV infections was strikingly different from that found in HSV infections studied with polyclonal antibodies to HSV I and II. Double immunolabelling revealed the VL8 positivity of sebaceous cells, endothelial cells, Mac 387- and CD68-positive monocyte-macrophages, and factor XIIIa-positive perivascular, perineural and interstitial dendrocytes. Intracytoplasmic VL8 labelling of endothelial cells and perivascular dendrocytes was found at the site of leukocytoclastic vasculitis.

Adult↗
PubMed1993

Neutrophilic eccrine hidradenitis. A case report.

Neutrophilic eccrine hidradenitis (NEH) is a rare neutrophilic dermatosis occurring most frequently during induction chemotherapy for a variety of malignancies. We report a case of NEH in a 41-year-old woman with acute myeloblastic leukemia under daunorubicin, cytarabine and etoposide chemotherapy. She developed red, tender and painful nodules on a shoulder. The lesions resolved spontaneously. Histological examination is mandatory as the clinical presentation of this dermatosis is highly polymorphic. Leukemia cutis, sepsis, deep fungal infection and Sweet's syndrome must be excluded as these implicate different therapies.

Adult↗
PubMed1993

CD68 and factor XIIIa expressions in granular-cell tumor of the skin.

Immunohistochemical and electron microscopic studies support a Schwann cell origin for most of the granular-cell tumors of the skin. We studied 9 granular-cell tumors by immunohistochemistry, using antibodies to CD68, S-100 proteins, factor XIIIa, L1 antigen, desmin and vimentin. The CD68 monocyte-macrophage-associated lysosomal antigen was expressed in granular cells which however had no Mac 387 reactivity. The 'satellite fibroblasts' were factor XIIIa-positive similarly to dendrocytes and perineurial cells. Our study reveals the lack of specificity of CD68 antibody to identify macrophages. It also presents granular cell tumor of the skin as an exception in the group of schwannomas by the presence of factor XIIIa-positive cells inside the neoplasm.

Adult↗
PubMedDate not supplied

Skin cancer screening campaign in the German speaking Community of Belgium.

The incidence of primary malignant melanoma (MM) and skin carcinomas, including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), is progressively raising. As long as their diagnosis and therapeutic managements are initiated early, their prognosis remains favorable. This underlines the importance of early recognition of skin cancers. Furthermore, it has been demonstrated that skin cancer screening programs are efficacious in increasing the population awareness of the early signs of skin cancer and of the dangers of UV - exposure. A skin cancer screening campaign was organised by dermatologists of the German-speaking Community of Belgium in cooperation with the Department of Family, Health, and Social Affairs of the Regional Ministry of the German-speaking Community of Belgium. In order to increase the screening selectivity, two risk populations were targeted; patients presenting 30 or more moles, and patients over 50 years of age presenting recent skin changes of the head and neck area. A media campaign using radio, television and daily press was started to increase the population awareness of the dangers of UV exposure and of the early signs of skin cancer. During 2 screening days, three-hour sessions were organised in 2 health centers located in Eupen and St Vith. A total of 148 patients were examined. A total of 124/148 patients met the selection criteria predefined during the media announcement. The simultaneous presence of 4 dermatologists during the screening sessions allowed a second opinion for warning lesions. Four BBCs as well as 23 patients pesenting dysplastic nevi were clinically diagnosed. During the 2 months following the screening campaign 5 MMs were identified by the same dermatologists in their routine practice. In conclusion, this skin cancer screening campaign led to the diagnosis of 4 carcinomas. The campaign furthermore increased the patient awareness, permitting the diagnosis of 5 MMs during the 2 following months. This figure represents about 30% of all MMs diagnosed yearly in this region of Belgium.

Adolescent↗
PubMedDate not supplied

Photodynamic therapy and imiquimod immunotherapy for basal cell carcinomas.

Photodynamic therapy (PDT) and topical imiquimod immunotherapy (TII) are two recently introduced treatment modalities for certain types of basal cell carcinomas (BCC). We present a review of the relevant literature and report our own findings regarding the efficacy and tolerance of PDT and TII in the treatment of BCCs. According to published studies, the cure rates range from 75-95% for PDT and 42-100% for TII, depending on treatment modalities and BCC type. In our observations, 13 patients with nodular or superficial BCCs were treated by PDT using two courses of 3-hour topical application of methyl aminolevulinate, followed by 8 minutes illumination (lambda = 634 nm, e = 37J/cm2). Biopsies were taken before and one month after PDT. Side effects including pain and crusting were assessed. Eight patients with superficial BCC were treated by TII using 3 monthly courses each consisting of 3 weekly applications for 3 weeks followed by one week out of treatment. Biopsies were taken before and after 3 months of TII. Adverse reactions including erythema, oozing, ulceration, and crusting were recorded. Clinico-histological cure was obtained in 12/13 PDT cases as assessed after 1 month, and in 6/8 TII cases after 3 months. Minimal pain during illumination and crust formation were observed in 7/13 and 3/13 PDT cases, respectively. Variable erythema, oozing, ulceration, and crusting were observed in all TII-treated lesions. It is concluded that PDT represents an active and well tolerated alternative treatment for both nodular and superficial BCCs. TII also shows activity, although the tolerance may be poor and cure needs a longer time to be obtained. The final cosmetic appearance was fine following both PDT and TII procedures. Both PDT and TII may leave intact neoplastic aggregates inside the skin. They cannot be clinically perceived, leading to unexpected recurrences. It is stressed that the currently available efficacy information about PDT and TII deals with short term follow-up periods. A 5-year follow-up must be awaited before drawing firm conclusions.

Adjuvants, Immunologic↗
PubMedDate not supplied

Fatal herpes simplex virus infection in Darier disease under corticotherapy.

A 67-year-old man is presented with longstanding and severe Darier disease treated by topical antiseptics and potent corticosteroids, in combination with oral glucocorticoids and etretinate. After cardiac bypass surgery in 1997, the patient experienced herpes simplex virus (HSV type-1) infection of the skin that was treated by intravenous aciclovir. In 2003, he presented a widespread atypical exacerbation of his Darier disease, involving the face, trunk, buttocks, intertriginous areas and arms. Initial clinical signs and bacteriological findings suggested a bacterial involvement by multiresistant Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Proteus mirabilis. Despite antibiotherapy, the clinical presentation progressively worsened. A skin biopsy was performed and immunohistochemical examination identified a type-2 HSV infection. Although intravenous aciclovir was administered, the widespread cutaneous HSV infection was followed by systemic dissemination. A severe acute respiratory distress syndrome (ARDS) developed, leading to a fatal issue. At autopsy, a severe interstitial type-2 HSV pneumonitis with extensive necrotic areas was found, in association with gastro-intestinal involvement. This case represents, to the best of our knowledge, the first case of Darier disease presenting a fatal type-2 HSV infection. It underlines the importance of rapidly recognizing HSV infection in Darier disease and stresses the risk of lethal outcome. The different risk factors for HSV infection in this patient are reviewed.

Acyclovir↗
PubMedDate not supplied

[Herpesvirus 6. What attention does it deserve in general practice?].

The human herpesvirus 6 (HHV6) is a member of the beta-herpes viridae family. The primary infection is usually asymptomatic and commonly occurs during childhood. The clinical form is called exanthema subitum, or roseala infantum or the 6th disease. This biphasic disorder usually runs a benign course and requires no antiviral treatment. However, the HHV6 reactivation can lead to serious systemic diseases, especially encephalopathy, that may be fatal in the immunocompromised or grafted patient. In seronegative pregnant women, a primary HHV6 infection contracted from a child with roseola infantum can lead, in rare instances, to spontaneous abortion during the first trimester, or produce neurological complications in the newborn after HHV6 transplacental infection. Aciclovir, ganciclovir (GCV), foscarnet and cidofovir show anti-HHV6 in vitro efficacy, but GCV is currently the first line agent when of HHV6 infection is diagnosed in the immunocompromised patient.

Family Practice↗
PubMedDate not supplied

[Recurrent labial herpes. How to treat and prevent it best].

Labial herpes is a recurrent muco-cutaneous disorder caused by the herpes simplex virus (HSV), particularly the HSV type I. It affects 10 to 30% of the adult population. The recurrence rate varies from episodic events to monthly recurrences. Several triggering factors have been identified. They include physical factors such as ultraviolet radiations and any local traumatism such as dental and neurosurgical interventions, and dermo-cosmetic procedures of the face. Hormonal factors are also involved including those related to menses and pregnancy. Psychogenic factors, particularly severe stress are also involved. Any other intercurrent infection may also be complicated by recurrent labial herpes. The management of recurrent labial herpes currently relies on the identification and possible avoidance of triggering factors, and on the use of antiviral agents. There is no curative treatment available so far.

Herpes Labialis↗
PubMedDate not supplied

[How I prevent...exacerbation of atopic dermatitis].

Atopic dermatitis is under the influence of series of environmental factors. The contact with unsuited cleaning agents and rough textiles can exacerbate pruritus and inflammation. Preventive and adjuvant measures can thus help the care procedures of the disease. Appropriate hygiene measures and the use of emollients are particularly helpful. Clothing measures are also in place. Undergarments and pyjamas made of knitted natural silk are available. Other measures, sometimes corresponding to anecdotal claims--antihistamines, thermal cures, unconventional medicine, probiotics, chinese herbals, essential fatty acids--have not proven their preventive efficacy in atopic dermatitis.

Clothing↗