Trinh Hermanns-Lê

Pathology, Dermatology

35.20

Publications

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    ABSTRACT: Wound healing following partial thickness thermal burns is commonly hampered by the risk of hypertrophic scarring. Skin myofibroblast (MF) density is commonly increased in postburn healing. The transition between fibroblast-like cells and α-smooth muscle actin (SMA)+ MF possibly begins with CD14+ monocytes, evolving to CD14+ CD34+ fibrocytes, followed by β-SMA+ protomyofibroblast (PMF) maturation. Skin biopsies from 25 burn patients were collected about 1 and 4 weeks after injury. Immunohistochemistry was performed using monoclonal antibodies to α-SMA, β-SMA, factor XIIIa, lysozyme, Mac 387, CD14, CD117 and Ulex europaeus agglutinin-1 (UEA-1). The set of Mac 387+ and CD14+ monocytes was accompanied by both CD34+ fibrocytes and factor XIIIa+ dendrocytes. By contrast, β-SMA+ PMF were rare. Of note, α-SMA+ MF were more abundant at week 4 than at week 1 (p < 0.01). The UEA-1+ endothelial cells showed marked variations in their dermal distribution, irrespective of the densities in the other scrutinized cells. In conclusion, healing of partial thickness thermal burns involves a diversity of cell types including PMF. In the present samples, the PMF density remained low. © 2015 S. Karger AG, Basel.
    Skin pharmacology and physiology 05/2015; 28(5):250-254. DOI:10.1159/000430102 · 1.96 Impact Factor
  • T Hermanns-Lê · G E Piérard · C Piérard-Franchimont
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    ABSTRACT: Ehlers-Danlos syndrome (EDS) represents a heterogeneous group of disorders of the connective tissue structure. Currently, several types are distinguished following a limited set of clinical signs and genetic mutations. However, there is a lack of specificity of most recognized genetic alterations with the current clinical typing. In addition, the criteria from dermatopathology, ultrastructure and biomechanics are not considered. In addition, the established EDS frontiers are hazardous because a series of anatomo-clinical signs are not considered in the classical EDS concept. The hypermobile type EDS represents an example of the diagnostic uncertainties. It results that guidelines based on evidence-based medicine cannot be established. Only an individual management can be offered to the concerned patients.
    Revue médicale de Liège 05/2015; 70(5-6):325-30.
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    ABSTRACT: The melanotic facial pigmentation of each individual is frequently heterogeneous, even when this condition remains imperceptible under natural ambient light. However, with aging, this aspect may appear to everybody. The melanin heterochromia has various origins including ethnicity, the hormonal impact, the influence of various inflammatory, toxic and drug-induced disorders, as well as the impact of photoaging. The cheetah-look aspect is thus established and well identified under ultraviolet light or using an ingenious trick selecting some wavelengths of visible light.
    Revue médicale de Liège 04/2015; 70(4):204-6.
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    ABSTRACT: Bi-allelic variants in CHST14, encoding dermatan-4-O-sulfotransferase-1 (D4ST1), cause musculocontractural EDS (MC-EDS), a recessive disorder characterized by connective tissue fragility, craniofacial abnormalities, congenital contractures and developmental anomalies. Recently, the identification of bi-allelic variants in DSE, encoding dermatan sulfate epimerase-1 (DS-epi1), in a child with MC-EDS features, suggested locus heterogeneity for this condition. DS-epi1 and D4ST1 are crucial for biosynthesis of dermatan sulfate (DS) moieties in the hybrid chondroitin sulfate (CS)/DS glycosaminoglycans (GAGs). Here we report four novel families with severe MC-EDS caused by unique homozygous CHST14 variants and the second family with a homozygous DSE missense variant, presenting a somewhat milder MC-EDS phenotype. The glycanation of the dermal DS proteoglycan decorin is impaired in fibroblasts from D4ST1- as well as DS-epi1-deficient patients. However, in D4ST1-deficieny the decorin GAG is completely replaced by CS, whereas in DS-epi1-deficiency still some DS moieties are present. The multisystemic abnormalities observed in our patients support a tight spatiotemporal control of the balance between CS and DS, which is crucial for multiple processes including cell differentiation, organ development, cell migration, coagulation and connective tissue integrity. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Human Mutation 02/2015; DOI:10.1002/humu.22774 · 5.05 Impact Factor
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    ABSTRACT: Whereas the vast majority of osteogenesis imperfecta (OI) is caused by autosomal dominant defects in the genes encoding type I procollagen, mutations in a myriad of genes affecting type I procollagen biosynthesis or bone formation and homeostasis have now been associated with rare autosomal recessive OI forms. Recently, homozygous or compound heterozygous mutations in BMP1, encoding the metalloproteases bone morphogenetic protein-1 (BMP1) and its longer isoform mammalian Tolloid (mTLD), were identified in five children with a severe autosomal recessive form of OI and in four individuals with mild-to-moderate bone fragility. BMP1/mTLD functions as the procollagen carboxy-(C)-proteinase for types I-III procollagen, but was also suggested to participate in amino-(N)-propeptide cleavage of types V and XI procollagens, and in proteolytic trimming of other extracellular matrix (ECM) substrates. We report the phenotypic characteristics and natural history of four adults with severe, progressive OI characterized by numerous fractures, short stature with rhizomelic shortening and deformity of the limbs and variable kyphoscoliosis, in whom we identified novel bi-allelic missense and frameshift mutations in BMP1. We show that BMP1/mTLD-deficiency in humans not only results in delayed cleavage of the type I procollagen C-propeptide, but also hampers the processing of the small leucine-rich proteoglycan prodecorin, a regulator of collagen fibrillogenesis. Immunofluorescent staining of types I and V collagen and transmission electron microscopy of the dermis show impaired assembly of heterotypic type I/V collagen fibrils in the ECM. Our study thus highlights the severe and progressive nature of BMP1-associated OI in adults, and broadens insights into the functional consequences of BMP1/mTLD-deficiency on ECM organization. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 02/2015; DOI:10.1002/jbmr.2473 · 6.59 Impact Factor
  • G.-E. Piérard · C. Piérard-Franchimont · T. Hermanns-Lê
    12/2014; 48(4). DOI:10.1016/S1761-2896(14)69292-X
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    ABSTRACT: The stratum corneum materializes the interface between the body and its environment. Such a structure is influenced by the climate and seasons. A series of physicochemical parameters are involved in this relationship. Among them, the relative humidity, the dew point, the insensible loss of water and the concepts of water-as-ice and the higgledy-piggledy-water.
    Revue médicale de Liège 11/2014; 69(11):618-21.
  • 10/2014; 4. DOI:10.13070/mm.en.4.1097
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    ABSTRACT: The recognition of a complex disorder associating skin psoriasis and its comorbidities has considerably progressed over recent years. Beyond the skin lesions, psoriatic arthritis, the metabolic syndrome, type II diabetes, cardiovascular disease, inflammatory bowel diseases, and some cancers represent a group of chronic systemic disorders. The process is initiated and sustained by an immunological pathway involving Th1, Th17 and Th22 lymphocytes. The recognition of this complex disorder indicates that the clinical impact of psoriasis is not exclusively limited to the skin only.
    Revue médicale de Liège 10/2014; 69(10):555-8.
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    ABSTRACT: The presentations of primary and metastatic cutaneous malignant melanoma (CMM) are very diverse. Evidence increasingly indicates that single CMM cells spread to distant sites quite early during cancer progression and are soon eliminated before they become clinically detectable. However bulky metastases which appear at a later stage might derive from some of these early neoplastic cells. It seems that local CMM single cell micro-metastases commonly predict sentinel lymph node involvement without overtly reflecting CMM progression to bulky visceral metastases. This study is intended to review the current understanding of the mechanisms underlying two CMM presentations. The first is the long interval, apparently disease-free, with persistent CMM dormancy, which may precede overt metastatic growth. Immunosurveillance may induce dormancy in single CMM cells disseminated in the body by blocking their proliferation cycle. The second is the so-called CMM smoldering phenomenon, which is marked by an alternate progression and regression of CMM locally with metastases that wax and wane for long periods of time over restricted skin areas. These very diverse patterns of CMM progression are likely to be ascribable to a number of biological factors, including the activation of CMM stem cells, and the combined phenotypic heterogeneity and variability in proliferative amplification in CMM cell clusters. Furthermore an adequate stimulation of CMM immune-surveillance and the induction of a specific stromal structure and vascular response are required. In this context, most early CMM tumors are in part controlled by lymphocyte-mediated responses before they become clinically detectable. However both the role of immune-surveillance and the mechanisms underlying both persistent and smoldering CMM dormancy remain unclear.
    Oncology Reviews 09/2014; 8(2):252. DOI:10.4081/oncol.2014.252
  • G E Piérard · C Piérard-Franchimont · T Hermanns-Lê · P Paquet
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    ABSTRACT: α-Hydroxy acid (AHA) formulations are commonly used for skin chemical peelings. The primary target is the stratum corneum (SC). The aim of this study was to assess the effects of various glycolic acid concentrations and commercial phenolic acid formulations on the SC. Quantitative colorimetry of a corneoxenometry bioassay was used. The test procedure involved glycolic acid concentrations ranging from 3% to 70% in alcoholic solution. Exposure times were set for 1 min and 3 min. The bioassay showed consistent reactivity with a dose-effect relationship when using the selected low exposure times. In a similar procedure the aggressiveness of commercially available phenolic acid formulations was identified not using hazardous in vivo testing. Corneoxenometry appears useful for in vitro testing of AHA peeling agents during short exposure times.
    British Journal of Dermatology 09/2014; 171 Suppl 3(s3):34-7. DOI:10.1111/bjd.13244 · 4.10 Impact Factor
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    ABSTRACT: Keloid is a protruding hypertrophic fibrous formation of the dermis. It corresponds to a tough lesion at palpation. Two clinical types are distinguished. They correspond either to a peculiar evolution of a scar, or to a seemingly spontaneous event. Such lesion is characterized by massive deposits of collagen bundles. This aspect is distinct from hypertrophic scars primarily representing an accumulation of fibroblasts and small vessels.
    Revue médicale de Liège 09/2014; 69(9):518-21.
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    ABSTRACT: Background Human cutaneous malignant melanoma (CMM) is an aggressive cancer showing a dramatic worldwide increase in incidence over the past few decades. The most prominent relative epidemiological increase has been disclosed in young women. The aim of the study was to assess the effects of chronic sun exposures in order to rate the extend of melanocytic stimulations in the vicinity of CMM. Methods The study was designed to evaluate the melanin distribution and density using ultraviolet light illumination. The present study was performed on surgical excision specimens of thin CMM lesion removed from the upper limbs of 55 Caucasian adults (37 women and 18 men). Two control groups comprised 23 men and 21 women of similar ages who had medium-size congenital melanocytic nevi, also present on the upper limbs. The peritumoral skin was scrutinized using a Visioscan® VC98 device, revealing the faint mosaic melanoderma (FMM) pattern that grossly indicates early signs of chronic photodamage in epidermal melanin units. Results The median extent of relative FMM was significantly higher in the CMM male group. By contrast, the CMM female group showed a reverse bimodal distribution in FMM size. Only 12/37 (32.5%) of the CMM female group had an increased FMM size, whereas 25/37 (67.5%) of females with CMM had a global FMM extent in the normal range, relative to the controls. Conclusion Thin CMM supervening in young women appear unrelated to repeat photoexposure. Other mechanisms are possibly involved.
    Clinical, Cosmetic and Investigational Dermatology 08/2014; 7:225-30. DOI:10.2147/CCID.S66929
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    ABSTRACT: In the dermatopathology field, some simple available laboratory tests require minimum equipment for establishing a diagnosis. Among them, the cyanoacrylate skin surface stripping (CSSS), formerly named skin surface biopsy or follicular biopsy, represents a convenient low cost procedure. It is a minimally invasive method collecting a continuous sheet of stratum corneum and horny follicular casts. In the vast majority of cases, it is painless and is unassociated with adverse events. CSSS can be performed in subjects of any age. The method has a number of applications in diagnostic dermatopathology and cosmetology, as well as in experimental dermatology settings. A series of derived analytic procedures include xerosis grading, comedometry, corneofungimetry, corneodynamics of stratum corneum renewal, corneomelametry, corneosurfametry, and corneoxenometry.
    08/2014; 2014:462634. DOI:10.1155/2014/462634
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    C Piérard-Franchimont · T Hermanns-Lê · G E Piérard
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    ABSTRACT: Human scabies is an ectoparasitosis affecting any individual at any age. The level of infestation by Sarcoptes scabiei var. hominis is influenced by any defect in immune response. Several clinical types of scabies are described including baby scabies, profuse scabies of immunodepression, norvegian scabies and sarcoptic mange. Onchocerciasis dermatitis is a tropical microfilariosis completely distinct by its parasitic nature.
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    ABSTRACT: Climacteric skin aging affects certain biophysical characteristics of facial skin. The purpose of the present study was to assess the symmetric involvement of the cheeks in this stage of the aging process. Skin viscoelasticity was compared on both cheeks in premenopausal and post-menopausal women with indoor occupational activities somewhat limiting the influence of chronic sun exposure. Eighty-four healthy women comprising 36 premenopausal women and 48 early post-menopausal women off hormone replacement therapy were enrolled in two groups. The tensile characteristics of both cheeks were tested and compared in each group. A computerized suction device equipped with a 2 mm diameter hollow probe was used to derive viscoelasticity parameters during a five-cycle procedure of 2 seconds each. Skin unfolding, intrinsic distensibility, biological elasticity, and creep extension were measured. Both biological elasticity and creep extension were asymmetric on the cheeks of the post-menopausal women. In contrast, these differences were more discrete in the premenopausal women. Facial skin viscoelasticity appeared to be asymmetric following menopause. The possibility of asymmetry should be taken into account in future studies of the effects of hormone replacement therapy and any antiaging procedure on the face in menopausal women.
    Clinical, Cosmetic and Investigational Dermatology 04/2014; 7:111-8. DOI:10.2147/CCID.S60313
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    ABSTRACT: Skin ageing occasionally manifests itself at long-term by severe atrophoderma. Systemic or topical corticotherapy exerts an atrophic impact mimicking the effects of old age. Such atrophoderma condition has been described as transparent skin about 40 years ago, and it received more recently the new denomination of dermatoporosis. Such condition stands out in the medical history to induce clinical consequences. They are sometimes prominent introducing diverse lesions such as Bateman purpura, stellate scars and wounds following minor trauma.
    Revue médicale de Liège 04/2014; 69(4):210-3.
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    Trinh Hermanns-Lê · Sébastien Piérard
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    ABSTRACT: Sporadic cutaneous melanoma (SCM) has shown a dramatic increase in incidence in Caucasian populations over the past few decades. A particular epidemiological increase was reported in women during their childbearing age. In the Belgian Mosan region, a progressive unremitting increase in SCM incidence was noticed in young women for the past 35 years. The vast majority of these SCMs were of the superficial type without any obvious relationship with a large number of melanocytic nevi or with signs of frequent and intense sunlight exposures as disclosed by the extent in the mosaic subclinical melanoderma. A series of investigations pointed to a possible relationship linking the development of some SCM to the women hormonal status including the effect of hormonal disruptors. These aspects remain, however, unsettled and controversial. It is possible to differentiate and clearly quantify the SCM shape, size, scalloped border, and variegated pigmentation using computerized morphometry as well as fractal and multifractal methods.
    02/2014; 2014:320767. DOI:10.1155/2014/320767
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    ABSTRACT: In recent years, clinical dermoscopy has yielded improvement in the early disclosure of various atypical melanocytic neoplasms (AMN). Beyond this approach, histopathology of AMN remains mandatory in the establishment of their precise diagnosis and proper management. Of note, panels of expert pathologists in AMN diagnosis report only moderate agreement in a variety of puzzling cases. The risk for divergence in opinion and microscopic misdiagnosis is probably increased when histopathologic criteria are not fine-tuned and when the number of AMN entities is increasing. In addition, some of the AMN have been differently designated in the literature including atypical Spitz tumor, metastasizing Spitz tumor, borderline and intermediate melanocytic tumor, malignant Spitz nevus and pigmented epithelioid melanocytoma or animal-type melanoma. Some acronyms have been further proposed such as MELTUMP (after ‘melanocytic tumor of uncertain malignant potential’) and STUMP (after ‘Spitzoid melanocytic tumor of uncertain malignant potential’). In this review, such AMN at the exclusion of cutaneous malignant melanoma variants are grouped under the tentative broad heading ‘cutaneous melanocytoma’. These lesions typically follow an indolent course, although they exhibit atypical and sometimes worrisome patterns or cytologic aspects. Rare cases of cutaneous melanocytomas progress to locoregional clusters of lesions (agminate lesions), and even to regional lymph nodes. At times, the distinction between a cutaneous melanocytoma and malignant melanoma remains problematic and even proves to be merely impossible. However, multipronged immunohistochemistry helps to assess the malignancy risk.
    Expert Review of Dermatology 01/2014; 8(2). DOI:10.1586/edm.13.11
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    ABSTRACT: Menopause is a key point moment in the specific aging process of women. It represents a universal evolution in life. Its initiation is defined by a 12-month amenorrhea following the ultimate menstrual period. It encompasses a series of different biologic and physiologic characteristics. This period of life appears to spot a decline in a series of skin functional performances initiating tissue atrophy, withering, and slackness. Any part of the skin is possibly altered, including the epidermis, dermis, hypodermis, and hair follicles. Hormone replacement therapy (oral and nonoral) and transdermal estrogen therapy represent possible specific managements for women engaged in the climacteric phase. All the current reports indicate that chronologic aging, climacteric estrogen deficiency, and adequate hormone therapy exert profound effects on various parts of the skin.
    12/2013; 2013:971760. DOI:10.1155/2013/971760

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