[Locally advanced and metastatic cutaneous squamous cell carcinoma treated with cemiplimab]

The treatment of locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) essentially relies on surgery and eventually radiotherapy of the treated site and afferent lymph nodes. Unfortunately, some cases are no candidates for surgery or radiotherapy and a systemic treatment may be indicated. Chemotherapies are only partially efficacious and associated with potential toxicities. A recent study evaluating the efficacy and tolerance of cemiplimab, a PD1 antagonist for locally advanced and metastatic cSCC demonstrated an objective response rate of 49 % and 47 % for locally advanced and metastatic cSCC, while maintaining a response of at least 6 months of 63 % and 60 %, respectively. We present a clinical case of a patient with a locally advanced cSCC of the forehead with bone resorption and cervical lymphadenopathies. After failure of multiple surgical interventions and radiotherapies, he responded partially to cemiplimab immunotherapy with a good safety profile.

[When creams turn into a burden]

Topical treatment is the cornerstone of therapy for patients suffering from psoriasis. Its efficacy and safety have been demonstrated in a large number of publications. However, in daily life, the treatment outcome is often less satisfactory than the results published in the literature. This phenomenon is clearly linked to non-adherence. Indeed, patients with psoriasis frequently consider the topical therapies frequently as a heavy burden. The successful management of psoriasis with topical agents requires a perfect understanding between the patient and the practionner, which provides regular renewal of the patient's motivation.

[About the reticence to specific immunotherapy in alergic subjects]

The increasing number of allergic subjects and the alteration of their quality of life are major concerns of public health. Symptomatic treatments of allergic diseases are not always able to improve the patient's complaints. Allergic exploration aims to identify IgE-dependant mechanisms and subsequently to prove the responsibility of the detected allergen in the allergic disease. The efficacy of the specific immunotherapy (SIT) using allergens in either subcutaneous or sublingual forms has been proven in rhinitis, conjunctivitis, asthma and IgE-induced reactions to hymenoptera venom. The lack of training in allergology is an important reticence of general practitioners and specialists to prescribe SIT. Furthermore, the duration of the treatment and its important cost in Belgium (where, only venom SIT is reimbursed by the Social Security) interfere significantly with the compliance of the patients.

[Home plants and allergies]

Allergic manifestations due to outdoor plants are relatively well known, contrary to those related to home plants. This review presents the various allergens linked to home plants that may be responsible for several allergic manifestations affecting the skin, the lungs, the eyes, and the rhinopharynx. The ficus and its family members constitute the principal sources of the incriminated allergens.

[Corticosteroids and their vehicle in the treatment of scalp psoriasis]

This paper is concerned with the adequate use of topical corticosteroids for the treatment of scalp psoriasis. Very potent corticosteroids are indicated in all forms of psoriasis. The vehicle itself plays a significant role in any topical treatment. The choice of the vehicle depends on its biodisponibility and cosmetic aspect. Ideally, an easy-to-use vehicle will be preferred since it improves compliance to therapy. Foams, lotions, gels, and shampoos are better accepted than creams, pomades, ointments, and other substances with high residue content.

[Alveolar echinococcosis]

Alveolar echinococcosis is a serious parasitic disease, leading to large hepatic lesions. It must be distinguished from cystic echinococcosis, or hydatic cyst, caused by Echinococcus granulosus. Early diagnosis may allow surgical removal of the lesions by segmental hepatectomy, the only curative treatment. Parasitostatic medical treatment with albendazole may promote stabilization of the disease. Until recently, Belgium was considered a country at very low risk for alveolar echinococcosis, as no human case was reported, despite up to 51% of fox infection in southern Belgium autopsy series. Recently four patients presented with alveolar echinococcosis at the University Hospital Center of Liege, leading to the fear of a possible alveolar echinococcosis endemy in southern Belgium. Two of these patients underwent curative hepatectomy, but the other two had already pulmonary metastases at diagnosis and received palliative albendazole therapy. This article presents these cases, and reviews the clinical features of this parasitic disease.

[The clinical case of the month. Malignant whooping cough in an infant]

Morbidity and mortality of whooping cough remain significant among infants despite vaccination. This article presents a case of whooping cough with complications in a 3 month old infant who had already received his first dose of anti-pertussis vaccine at 2 months and 3 weeks of age.