Anne Herman

Cliniques Universitaires Saint-Luc · Division of of Dermatology

Background: Most diabetic patients sensitized to FreeStyle Libre react to isobornyl acrylate, with a considerable number of them also showing unexpected positive patch test reactions to sesquiterpene lactone mix (SLM) tested in the baseline series. Objectives: To compile patch test results of subjects affected, and provide potential explanations...

Allergic contact dermatitis (ACD) from isothiazolinones has frequently been described in the literature. Following an epidemic of sensitization to methylchloroisothiazolinone/ methylisothiazolinone (MCI/MI) in the 1980′s, and more recently to MI, the Scientific Committee on Consumer Safety of the European Commission banned their use in leave‐on pro...

Background In recent years, skin reactions secondary to the use of medical devices (MD), such as allergic contact dermatitis have increasingly been observed (e.g. to continuous blood sugar monitoring systems, insulin pumps, wound dressings, medical gloves, etc.): this is regarded as a developing epidemic. Lack of labelling of the composition of MD,...

Background: Type 1 interferon (IFN-I) response induced by SARS-CoV-2 has been hypothesized to explain the association between chilblain lesions (CL) and SARS-CoV-2 infection. Objective: To explore direct cytopathogenicity of SARS-CoV-2 in CL and to focus on IFN-I expression in patients with chilblains. Materials & methods: A monocentric cohort...

Résumé La dermatite allergique de contact, encore appelée eczéma de contact, est une réaction retardée de type IV selon la classification de Gell et Coombs. Les réactions de type immédiat ne sont pas abordées dans cet article. Idéalement, le bilan d’une dermatite allergique de contact nécessite la réalisation de tests épicutanés. Ceux-ci permettent...

Background In the 2010s an epidemic of allergic contact dermatitis to methylisothiazolinone occurred in Europe. European authorities banned the use of methylisothiazolinone in leave-on cosmetics in 2017 and limited its use in rinse-off products in 2018. Objectives To investigate the sensitization rate to methylisothiazolinone in Belgium between Ja...

Background Skin exposure to chemicals may induce an inflammatory disease known as contact dermatitis (CD). Distinguishing the allergic and irritant forms of CD often proves challenging in clinic. Methods To characterize the molecular signatures of chemical-induced skin inflammation, we conducted a comprehensive transcriptomic analysis on the skin...

Introduction L’eczéma de contact est une dermatose inflammatoire fréquente, induite par l’exposition répétée de la peau à des produits chimiques, allergènes et/ou irritants, présents dans notre environnement. Il peut donc être d’origine allergique (ECA) ou non. Les outils diagnostiques actuels permettant d’identifier de façon fiable un ECA sont lim...

In March and April 2020, at the peak of the COVID‐19 pandemic, several countries imposed lockdown measures. Concurrently, a significant number of chilblains were observed in otherwise healthy adolescents and young adults. The physiopathology of these chilblains has not been completely elucidated and their direct link to COVID‐19 remains unconfirmed...

Highlights • The sensitization rate to isobornyl acrylate in a patch‐tested population was evaluated at 0.6%. • In this study, among patients sensitized to isobornyl acrylate, apart from glucose sensors and insulin pumps, no other sources of sensitization were identified.

Background Numerous cases of chilblains have been observed, mainly in young subjects with no or mild symptoms compatible with COVID-19. The pathophysiology of these lesions is still widely debated, and an association with SARS-CoV-2 infection remains unconfirmed. Objectives This paper focuses on the unresolved issues about these COVID toes and, in...

Recently, Colmenero et al (1) demonstrated, by immunohistochemistry, the presence of SARS‐CoV‐2 in endothelial cells of skin biopsy specimens of chilblains in seven patients. These results raise some questions: The presence of the virus at cutaneous and vascular levels in otherwise asymptomatic patients with negative RT‐PCR is unexpected. Vascular...

Acro‐ischemic lesions have been observed both in adults with severe forms of COVID‐19 and in younger patients with no or mild symptoms of COVID‐19. In severe COVID‐19, peripheral cyanotic lesions are secondary to thrombotic vasculopathy and systemic procoagulant state. The pathophysiology of chilblains in asymptomatic or mildly symptomatic patients...

The unexpected outbreak of chilblains during the current coronavirus disease 2019 (COVID‐19) pandemic has been causally linked to severe acute respiratory syndrome coronavirus 2 (SARSCoV‐2) infection (1). The pathophysiology of these chilblains observed in otherwise healthy patients is widely discussed.

Skin rashes associated with COVID‐19 include eruptions induced by drugs prescribed for management of this infection. We report a case of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in a patient with COVID‐19. A 50‐year‐old man was admitted to the intensive care unit for pneumonia with acute respiratory distress syndrome....

Importance During the coronavirus disease 2019 (COVID-19) pandemic, several cases of chilblains have been reported. Objective To determine if chilblains are associated with COVID-19. Design, Setting, and Participants This monocentric case series was conducted at the Department of Dermatology at Cliniques universitaires Saint-Luc, a tertiary care...

Skin manifestations are considered uncommon presentations of COVID-19. Despite reported cases in the literature, no causal link has been formally demonstrated to date. Skin lesions associated with COVID-19 are: 1) rashes that are classically viral or paraviral in nature like exanthemas, urticaria, and erythema multiforme; 2) eruptions that are seco...

Background Adverse cutaneous reaction to diabetes medical devices (glucose sensors and insulin pumps) are described, notably allergic contact dermatitis with isobornyl acrylate and N,N dimethylacrylamide as the main allergen. Objectives To determine if all adverse cutaneous reaction observed with diabetes medical devices ie Freestyle Libre, Enlite...

Background.Biomarkers of disease activity/severity and criteria of autoimmune chronic spontaneous urticaria (CSU) are still a matter of debate. Objective. To investigate possible correlations between clinical and biological markers and their associations with: (i) disease activity; (ii) resistance to H1-antihistamines; (iii) autoimmunity; and (iiii...

Multidisciplinary collaboration between several European dermatology departments has identified isobornyl acrylate (IBOA; CAS 5888-33-5), once deemed a low-risk sensitizer, as a major culprit contact allergen in glucose sensors and insulin pumps, medical devices used by diabetes patients worldwide. Although the patch test modalities of IBOA have be...

Background: Allergic contact dermatitis caused by glucose sensors has been recently described in diabetes, mostly in adult patients. Isobornyl acrylate and N-N dimethylacrylamide are the potent causative agents. Objectives: To describe a children population with contact dermatitis caused by glucose sensors, determine the causative allergen, and...

Background: The FreeStyle Libre glucose sensor has caused many cases of allergic contact dermatitis, and isobornyl acrylate (IBOA) was identified as one of the culprit allergens. Objectives: To report on the presence of IBOA in devices produced by Medtronic, i.e., Enlite sensor and insulin infusion set Paradigm MiniMed Quick-Set. Patients and m...

Isobornyl acrylate (IBOA) is a potent contact sensitizer contained in the glucose sensor FreeStyle Libre (1). Many cases of allergic contact dermatitis (ACD) have already been described in this regard. We have herein described a case of ACD caused by IBOA and followed by hypopigmentation in the application areas of this sensor. This article is prot...

La dermatitis alérgica de contacto, también conocida como eccema de contacto, es una reacción tardía de tipo IV según la clasificación de Gell y Coombs. Las reacciones de tipo inmediato no se describen en este artículo. La evaluación ideal de una dermatitis alérgica de contacto requiere la realización de pruebas epicutáneas que permiten reproducir...

Background Patients suffering from drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome caused by first‐line antituberculous drugs often need to be re‐treated rapidly. Patch tests prior to the re‐introduction of antituberculosis drugs are rarely performed. Objectives We aim to highlight those drugs most often involved in DRESS fr...

Background Allergic contact dermatitis (ACD) from leather is common, and several responsible allergens, such as tanning agents, glues, mercaptobenzothiazole‐ derivatives, dyes, but also antimicrobials and antifungals are involved. Material and methods Three female patients were referred to the Departments of Dermatology in a Belgian university hos...

Background Allergic contact dermatitis has significantly increased in healthcare workers since the transition from latex to synthetic rubber gloves, with 1,3‐diphenylguanidine identified as the most frequently implicated allergen. Objectives We aimed to highlight the role of 1,3 diphenylguanidine as culprit allergen in contact allergies to synthet...

Background Isobornyl acrylate (IBOA) has recently been identified as one sensitizer in the FreeStyle Libre glucose sensor. Analyses by gas chromatography‐mass spectrometry (GC‐MS) have indicated the presence of N,N‐dimethylacrylamide (DMAA) in the sensor. Material and methods Seven patients were referred for patch testing after developing skin rea...

Allergic contact dermatitis caused by medical devices for diabetes patients has been increasingly described in the literature in the last few years. This article reviews the cases of allergic contact dermatitis caused by insulin pumps and glucose sensors reported since the 1970s, the culprit allergen(s), the results of patch tests and/or chromatogr...

Background Allergic contact dermatitis has been described as a type IV reaction caused by antigen‐specific T cells. Central roles for CD8⁺ cytotoxic T cells as effector cells and CD4⁺ T cells as regulatory cells have been suggested. T helper (Th) 2 and Th1 cytokines have been implicated; however, the nature of the allergen influences the Th respons...

The panoply of products used by hair care professionals to wash, dye, shape and beautify hair is not entirely free from adverse events. Such effects consist mainly of irritation dermatitis and allergic contact eczema affecting the scalp, as well as the back and front of the neck, the forehead and periorbital areas, and the cheeks. The most frequent...

This paper summarizes and reviews the mechanisms of action and data concerning efficacy of recommended treatments as well as other treatments that have been tested, independently of the outcomes, in the management of chronic spontaneous urticaria. Due to the central role of mast cells and histamine in the pathophysiology of this disease, H1-antihis...

We report the contents of the “PEAU’se dermatologique” meeting of the Cliniques Universitaires Saint-Luc of the 21th of November 2016 concerning the topographic dermatosis. Professor D. Tennstedt, consultant at the department of Dermatology at the Cliniques Universitaires Saint-Luc, presented cases of cheilitis and detailed the contact dermatitis o...

A 25 years-old woman, with a history of personal atopic dermatitis, allergic asthma and hay fever, experienced a facial angioedema 5 minutes after consuming fresh donkey's milk for the first time (Fig. 1). She developed dyspnea and collapsed after a few minutes. The patient required administration of adrenaline and corticosteroids. During her child...

Introduction La pustulose sous cornée de Sneddon-Wilkinson est une pathologie rare dont la clinique reste parfois surprenante. Elle a été décrite pour la première fois en 1956. Observation Une femme de 37 ans est hospitalisée dans le service de revalidation suite à un HELLP syndrome (Hemolysis elevated liver enzymes low platelet count), secondaire...

La gamma di prodotti utilizzati dai professionisti per lavare o impreziosire la capigliatura e per modificarne il colore o la forma non è priva di effetti collaterali. Questi effetti sono principalmente dermatiti da irritazione ed eczemi allergici da contatto, che possono influire sul cuoio capelluto, ma anche su nuca, faccia anteriore del collo, f...

Within their first days of life, newborns' skin undergoes various adaptation processes needed to accommodate the transition from the wet uterine environment to the dry atmosphere. The skin of newborns and infants is considered as a physiological fragile skin, a skin with lower resistance to aggressions. Fragile skin is divided into four categories...

2015 was an important year in dermatology, especially in the therapeutic area. New treatments are available for chronic urticaria, psoriasis and angiofibromas of the face in the tubrous sclerosis complex context. In dermato-oncology, treatments of advanced cases of basal cell carcinomas and metastatic melanomas have significally improved. Finally,...

Observation : Nous rapportons le cas d'une patiente caucasienne de 28 ans qui présente un tableau clinique associant de multiples symptômes. Dans le décours de sa grossesse, la patiente perd environ 7 Kg de plus que son poids habituel, se sent particulièrement fatiguée et présente des sudations nocturnes. Elle constate des arthralgies répondant aux...