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Aesthetic Dermatology Cellulite
buttress limiting the outpouching of fat lobules on pinching the skin. This
condition may represent a hormonal-dependent reactive process to Gérald E Piérard is a Professor in the Department of
sustained mechanical tensions caused by enlarging adipocyte lobules.
Dermatology at the University of Liège and Chairman of
the Department of Dermatopathology at the University
Full-blown cellulite is recognised by a lumpy, bumpy and dimpled skin
Hospital of Liège. He is Past President of the
surface. It likely represents subjugation of the hypertrophic response of International Society of Dermatopathology (ISDP) and
the hypodermal fibrous strands when their resistance is overcome by
the European Group for the Efficacy Measurement on
Cosmetic and Other Topical Products (EEMCO) Group.
progressive fat accumulation. Histological aspects are then reminiscent
Dr Piérard is the Founder and President of the Mosan
of striae distensae within the hypodermal fibrous strands. Thus, Study Group of Pigmented Tumours and the Founder of
mechanobiology plays a prominent role and the process is influenced
the Laboratory of Skin Bioengineering and Imaging at the University of Liège. He has
also written more than 1,000 peer-reviewed articles and book chapters.
by, although not directly dependent on, the waist-to-hip ratio.
Claudine Piérard-Franchimont is an Associate Professor
at the University of Liège and a Senior Registrar in the
Any attempt at treating cellulite is much like trying to ignore the normal
Department of Dermatopathology at the University
female physiology. Why should women be depressed about something Hospital of Liège. She is also a Project Manager in
that is a normal part of their typical anatomy? Why should attention be
Dermocosmetic Science and Head of the Department
of Dermatology at the Regional Hospital of Huy.
focused on preventing or eliminating what appears to be the inevitable?
Dr Piérard-Franchimont is the author of more than 500
Perhaps cosmetic dermatology should take a closer look at how some peer-reviewed articles and book chapters.
skin conditions are defined. ■
1. Draelos ZD, Marenus KD, Cellulite. Etiology and purported 8. Piérard GE, Nizet JL, Piérard-Franchimont C, Cellulite: From 13. Curri SB, Cellulite and fatty tissue microcirculation, Cosmet
treatment, Dermatol Surg, 1997;23:1177–81. standing fat herniation to hypodermal stretch marks, Am J Toilet, 1993;108:51–8.
2. Draelos ZD, The disease of cellulite, J Cosmet Dermatol, Dermatopathol, 2000;22:34–7. 14. Rosenbaum M, Prieto V, Hellmer J, et al., An exploratory
2005;4:221–2. 9. Quatresooz P, Xhauflaire-Uhoda E, Piérard-Franchimont C, investigation of the morphology and biochemistry of
3. Lanska DJ, Lanska MJ, Hartz AJ, et al.,“Factors influencing et al., Cellulite histopathology and related cellulite, Plast Reconstr Surg, 1998;101:1934–9.
anatomic location of fat tissue in 52953 women, Int J Obes, mechanobiology, Int J Cosmet Sci, 2006;28:207–10. 15. Rossi ABR, Vergnanini AL, Cellulite: a review, J Eur Acad
1985;9:29–38. 10. Lucassen GW, van der Sluys WLN, van Herk JJ, et al., The Dermatol Venereol, 2000;14:251–62.
4. Singh D, Adaptive significance of female physical effectiveness of massage treatment on cellulite as 16. Piérard-Franchimont C, Piérard GE, Henry F, et al., A
attractiveness: role of waist-to-hip ratio, J Pers Soc Psychol, monitored by ultrasound imaging, Skin Res Technol, 1997;3: randomized, placebo-controlled trial of topical retinol in
1993;65:456–66. 154–60. the treatment of cellulite, Am J Clin Dermatol, 2000;1:360–74.
5. Piérard GE, Commentary on cellulite: skin 11. Querleux B, Cornillon C, Jolivet O, Bittoun J, Anatomy and 17. Silver FH, Siperko LM, Seehra GP, Mechanobiology of force
mechanobiology and the waist-to-hip ratio, J Cosmet physiology of subcutaneous adipose tissue by in vivo transduction in dermal tissue, Skin Res Technol, 2003;9:3–23.
Dermatol, 2005;4:151–2. magnetic resonance imaging and spectroscopy: 18. Hermanns-Lê T, Uhoda I, Piérard-Franchimont C, et al.,
6. Smalls LK, Lee CY, Whitestone J, et al., Quantitative model relationships with sex and presence of cellulite, Skin Res Factor XIIIa-positive dermal dendrocyte and shear wave
of cellulite: three dimensional skin surface topography, Technol, 2002;8:118–24. propagation in human skin, Eur J Clin Invest, 2002;32:
biophysical characterization and relationship to human 12. Mirrashed F, Sharp JC, Krause V, et al., Pilot study of 847–51.
perception, J Cosmet Sci, 2005;56:105–20. dermal and subcutaneous fat structures by MRI in 19. Quatresooz P, Piérard GE, Cellulite in a mechanobiological
7. Rawlings AV, Cellulite and its treatment, Int J Cosmet Sci, individuals who differ in gender, BMI and cellulite grading, perspective, Eur Dermatol Rev, 2007;2:57–60.
2006;28:175–90. Skin Res Technol, 2004;10:161–8.
Editor’s Recommendations
Impact of the VIH Infection on Skin Cancers the methods used were skin color and assessing using the Visi-
Quatresooz P, Piérard-Franchimont C, Piérard GE, Rev Med Liege, 2009;64(1);37–40.
Chroma VC100 technology. The authors compared the effects of
freezing or cooling hypertrophic scars developed in 45 pregnant
This article primarily reviews a series of skin cancers and how they
Caucasian women. The article concluded that freezing or cooling
are more frequent or show a worsened course and outcome in
hypertrophic scars helps to reduce erythema of hypertrophic
HIV-treated patients. The article focuses on how the leading
scars. This effect probably results from an inhibitory action
neoplasms correspond to basal and squamous cell carcinomas,
exerted on the microvasculature. ■
some primary cutaneous lymphomas and malignant melanomas.
The article concludes that early diagnosis and radical treatment on First-line Dermatologic Emergencies
sight should be considered. ■ Piérard-Franchimont C, Devillers C, Paquet P, Quatresooz P, Nikkels AF, Piérard GE,
Rev Med Liege, 2008;63(12):710–14.
Revisiting Biothermal Effects on Erythematous
Hypertrophic Scars During Pregnancy
The article discusses dermatological emergencies and how they
Nizet JL, Piérard GE, Quatresooz P, J Cosmet Dermatol, 2009;8(1):27–31.
encompass a series of distinct diseases of infectious, autoimmune
and environmental origins and how they account for a number of
The article focuses on how pregnancy is possibly associated with consultations at the general practitioner’s office and in emergency
altered wound healing and the development of hypertrophic and units of medical centres. The authors review the most common
keloidal scarring. The article discusses how the management of conditions including urticaria, angioedema, infectious cellulitis,
these lesions may prove to be difficult, and there are no acute photodermatoses, the Lyell syndrome, some other
universally accepted treatment protocols. The study assesses paroxysmal severe adverse drug reactions, burns, erythroderma
erythema fading of hypertrophic scars following cold applications; and the Kaposi-Juliusberg varicelliform eruption. ■
72 EUROPEAN DERMATOLOGY
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