Photodynamic therapy for multi-resistant cutaneous Langerhans cell histiocytosis

Langerhans cell histiocytosis is a rare group of proliferative disorders. Beside cutaneous involvement, other internal organs can be affected. The treatment of cutaneous lesions is difficult and relies on topical corticosteroids, carmustine, nitrogen mustard, and photochemotherapy. Systemic steroids and vinblastine are used for recalcitrant skin lesions. However, some cases fail to respond. An 18-month old boy presented a CD1a+, S100a+ Langerhans cell histocytosis with cutaneous and severe scalp involvement. Topical corticosteroids and nitrogen mustard failed to improve the skin lesions. Systemic corticosteroids and vinblastine improved the truncal involvement but had no effect on the scalp lesions. Methylaminolevulinate (MAL) based photodynamic therapy (PDT) resulted in a significant regression of the scalp lesions. Control histology revealed an almost complete clearance of the tumor infiltrate. Clinical follow-up after six months showed no recurrence

In Vitro and In Vivo Human Herpesvirus 8 Infection of Placenta

Herpesvirus infection of placenta may be harmful in pregnancy leading to disorders in fetal growth, premature delivery, miscarriage, or major congenital abnormalities. Although a correlation between human herpesvirus 8 (HHV-8) infection and abortion or low birth weight in children has been suggested, and rare cases of in utero or perinatal HHV-8 transmission have been documented, no direct evidence of HHV-8 infection of placenta has yet been reported. The aim of this study was to evaluate the in vitro and in vivo susceptibility of placental cells to HHV-8 infection. Short-term infection assays were performed on placental chorionic villi isolated from term placentae. Qualitative and quantitative HHV-8 detection were performed by PCR and real-time PCR, and HHV-8 proteins were analyzed by immunohistochemistry. Term placenta samples from HHV-8-seropositive women were analyzed for the presence of HHV-8 DNA and antigens. In vitro infected histocultures showed increasing amounts of HHV-8 DNA in tissues and supernatants; cyto- and syncitiotrophoblasts, as well as endothelial cells, expressed latent and lytic viral antigens. Increased apoptotic phenomena were visualized by the terminal deoxynucleotidyl transferase-mediated deoxyuridine nick end-labeling method in infected histocultures. Ex vivo, HHV-8 DNA and a latent viral antigen were detected in placenta samples from HHV-8-seropositive women. These findings demonstrate that HHV-8, like other human herpesviruses, may infect placental cells in vitro and in vivo, thus providing evidence that this phenomenon might influence vertical transmission and pregnancy outcome in HHV-8-infected women

The Varicella-Zoster Virus ORF47 Kinase Interferes with Host Innate Immune Response by Inhibiting the Activation of IRF3

The innate immune response constitutes the first line of host defence that limits viral spread and plays an important role in the activation of adaptive immune response. Viral components are recognized by specific host pathogen recognition receptors triggering the activation of IRF3. IRF3, along with NF-κB, is a key regulator of IFN-β expression. Until now, the role of IRF3 in the activation of the innate immune response during Varicella-Zoster Virus (VZV) infection has been poorly studied. In this work, we demonstrated for the first time that VZV rapidly induces an atypical phosphorylation of IRF3 that is inhibitory since it prevents subsequent IRF3 homodimerization and induction of target genes. Using a mutant virus unable to express the viral kinase ORF47p, we demonstrated that (i) IRF3 slower-migrating form disappears; (ii) IRF3 is phosphorylated on serine 396 again and recovers the ability to form homodimers; (iii) amounts of IRF3 target genes such as IFN-β and ISG15 mRNA are greater than in cells infected with the wild-type virus; and (iv) IRF3 physically interacts with ORF47p. These data led us to hypothesize that the viral kinase ORF47p is involved in the atypical phosphorylation of IRF3 during VZV infection, which prevents its homodimerization and subsequent induction of target genes such as IFN-β and ISG15

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