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Psoriasis (Pso) and psoriatic arthritis (PsA) frequently have a negative impact on patients’ sexual health. We have developed a specific questionnaire assessing the impact of Pso and PsA on patient perception of sexuality: the QualipsoSex Questionnaire (QSQ). The aim of the present study was to further validate this questionnaire by checking its psychometric properties including validity, reliability, and responsiveness. A cross sectional observational study with a longitudinal component for responsiveness and test–retest reliability was performed in 12 centers in France including 7 dermatologists and 5 rheumatologists. Psychometric properties were examined according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) check-list. At baseline, 114 patients had Pso and 35 patients had PsA including 17 peripheral arthritis, 4 axial disease, 13 patients with both axial disease and peripheral arthritis and one patient with an undifferentiated phenotype. The mean Pso Area and Severity Index score was 12.5. Genital organs were involved in 44.7% of Pso cases. Internal consistency, construct validity, and reliability were good with Cronbach's α coefficient, measure of sampling adequacy and intraclass correlation coefficient respectively at 0.87, 0.84, and 0.93. The QSQ also demonstrated acceptable sensitivity to change. The QSQ has demonstrated good psychometric properties fulfilling the validation process relative to the recommendations of the COSMIN check list. The QSQ is simple to score and may hopefully be valuable in clinical practice and in clinical trials.

is missing (Short communication)

Coronavirus 19 (COVID‐19) was declared as a pandemic viral infection by the World Health organization on March 11th 2020. Usual clinical manifestations of COVID‐19 infection include fever, fatigue, myalgia, headache, diarrhea, dry cough, dyspnea that may lead to acute respiratory distress syndrome and death (1). Skin symptoms of COVID‐19 have been poorly described but may include erythematous rash, urticaria and chicken pox like lesions (2‐7). Angiotensin‐converting enzyme 2 (ACE2) is a cellular receptor for COVID‐19.

A previously healthy 57‐year‐old woman presented with fever (39 °C) lasting for 4 days, and dry cough and rash appeared 2 days before. Diffuse fixed erythematous blanching maculopapular lesions were present, asymptomatic over the limbs and trunk, with burning sensation over the palms (a, b). She denied any drug intake, excepting paracetamol for fever. Thorax computed tomography scan was typical of COVID‐19; nasopharyngeal swab polymerase chain reaction (PCR) confirmed SARS‐CoV‐2. Infectious enquiry was otherwise negative. Skin biopsy specimen showed slight spongiosis, basal cell vacuolation and mild perivascular lymphocytic infiltrate (c).

Some systemic and biologic psoriasis treatments [SBT] have been associated with an increased risk of infection.1 To date, more and more data regarding the risk of COVID‐19 infection in patients receiving SBT becomes available.2‐5 To enrich these data, we evaluated the frequency of severe COVID‐19 infections, defined as hospitalisation or death, in psoriasis patients receiving SBT, especially during the 4 months following SBT initiation.

Introduction De tres nombreux cas d’acrosyndromes, appeles aussi pseudo-engelures (PE), ont ete observes lors de la pandemie COVID-19 en mars/avril 2020, posant la question d’un lien avec le SARS-Cov-2. De recentes etudes ayant decrit des cas de « COVID long » avec des signes extra-cutanes persistant plus de 60 jours, il nous a semble interessant d’etudier l’evolution des PE dans une cohorte de patients, 10 mois apres les lesions initiales. Materiel et methodes En janvier 2021, nous avons realise une etude retrospective monocentrique aupres de 132 patients ayant ete adresses dans notre service entre le 1er mars et le 30 avril 2020 pour des PE. Les patients ayant presente des episodes d’engelures avant mars 2020 ont ete exclus (n = 2). Un questionnaire a ete adresse ; 95 reponses (72 %) ont ete recues. Resultats Au cours de l’episode initial la documentation COVID etait majoritairement negative. Durant les 10 mois suivants, 54 % des patients (52/95) ont eu au moins une recidive de PE, parmi lesquels 37 (71 %) ont eu une seule recidive, 12 (23 %) ont eu 2 recidives et 3 (6 %) ont eu au moins 3 recidives. Au cours de la 1re recidive, seuls 21 % des patients (11/52) avaient des symptomes generaux evocateurs de COVID ou un contage COVID. Sur les 13 patients ayant realise une PCR COVID, un seul avait un resultat positif. Seuls 21 % des patients (11/52) ont modifie leur mode de vie avant la 1re rechute. Au cours des 2e, 3e et 4e recidives, respectivement 2/15 (13 %), 1/3 et 1/3 des patients avaient des symptomes generaux evocateurs de COVID ; les 4 PCR realisees etait negatives. Au cours du suivi, des symptomes extra-cutanes persistants (asthenie, arthralgies, myalgies, anxiete, troubles de la concentration, dyspnee) etaient signales par 28 % des patients (27/95) et des symptomes cutanes persistants (paresthesies distales, acrocyanose, erythermalgie, phenomene de Raynaud, livedo) par 67 % (64/95). Discussion Dans l’hypothese d’un lien de causalite avec le SarS-CoV-2, nous avons montre une forte prevalence de symptomes persistants, les classant en « COVID long cutanes » et « COVID longs extra cutanes ». Plus de la moitie des patients adresses pour PE durant la premiere vague de Covid19 ont eu au moins une recidive. La majorite des recidives a eu lieu lors de la seconde vague epidemique. Une nouvelle exposition virale ne peut etre exclue bien que les examens aient ete le plus souvent negatifs. Le deuxieme confinement ayant ete moins strict que le premier, le role de la sedentarite nous semble peu probable. En revanche, la seconde vague s’etant deroulee en automne, le role du climat est a envisager. Une hypothese physiopathologique serait que les dommages vasculaires rapportes au cours du COVID soient exacerbes par des facteurs externes comme la baisse de la temperature, expliquant les recidives de PE et les symptomes cutanes persistants.

Guselkumab (Tremfya , Janssen Biotech, Inc., Horsham, PA, USA) is an anti-IL-23 p19 antibody, recently marketed for the management of moderate to severe psoriasis in adults. To date, there are only limited post-marketing data available on its effectiveness and tolerance. A retrospective, real-life multicenter study conducted in France and Belgium evaluated guselkumab tolerance and effectiveness at Month 4 (M4) in the treatment of cutaneous psoriasis, and to describe patient characteristics at baseline and after 4 months of treatment. Collected data included socio-demographic characteristics, psoriasis history (age at beginning, clinical type, associated psoriatic arthritis, previous treatments), comorbidities, psoriasis severity at beginning of treatment (PASI, PGA, DLQI) as well as about tolerance. A total of 194 patients were included; data was analyzed for 180 (14 were excluded due to missing PASI at inclusion or at M4).

International audience; BackgroundDupilumab is the first biologic available to treat atopic dermatitis (AD). Its effectiveness and safety were demonstrated in clinical trials.ObjectiveWe sought to assess the effectiveness and safety of dupilumab in adults with AD in a real-life French multicenter retrospective cohort.MethodsWe included patients treated during March 2017-April 2018. Efficacy outcomes, including Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores, were collected at baseline and 3 months when available. Adverse events (AEs) were recorded at follow-up.ResultsWe included 241 patients. The median ± interquartile range (IQR) follow-up time was 3.8 ± 3.7 months. A ≥75% improvement in SCORAD was achieved in 27 of 163 (16.6%) patients, and a ≥75% improvement in EASI was achieved in 40 of 82 (48.8%) patients. The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline (SCORAD ± IQR, 25 ± 21 vs 56 ± 27.4, P < 10−9 and EASI ± IQR, 4.1 ± 6.8 vs 17.9 ± 15.4, P < 10−9, respectively). Conjunctivitis was reported in 84 of 241 (38.2%) patients. The proportion with eosinophilia (>500 cells/mm3) during follow-up (57%) was higher than that at baseline (33.7%) (n = 172, P < 10−6). Dupilumab was stopped in 42 cases; 27 patients stopped because of AEs.LimitationsNo control group, missing data.ConclusionThis real-life study demonstrated a similar dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia.

International audience; Background Our suggested 'modern' concepts of 'neutrophilic dermatoses' (ND) and 'neutrophilic disease' were based on observations in adult patients and have not been studied in paediatric patients. Only a minority of ND occurs in children, and little is known about age-specific characteristics. Objectives To describe age-specific characteristics of ND in children and to study whether our suggested 'modern' classification of ND may be applied to children. Methods We conducted a retrospective multicentre study in a French cohort of 27 paediatric patients diagnosed with pyoderma gangrenosum (PG) or Sweet's syndrome (SS). Results Demographics and distribution of typical/atypical forms were similar in patients diagnosed with PG and SS. Atypical ND were more frequent in infants (90%), when compared to young children (60%) and adolescents (33%). Neutrophilic disease was observed in 17/27 patients and was most frequent in infants. Neutrophilic disease of the upper respiratory tract, as well as cardiac neutrophilic disease, was only observed in infants, whereas other locations were similarly found in infants, young children and adolescents. In infants and young children, ND were associated with a large spectrum of general diseases, whereas in adolescents associations were limited to inflammatory bowel disease and Behcet's disease. Conclusions Our study describes the concept of ND in paediatric patients and shows that they have some characteristics different from ND occurring in adults. ND occurring in infants can be associated with a large spectrum of general diseases. Occurrence of neutrophilic disease is frequent in children. Thus, ND occurring in young paediatric patients should incite clinicians to schedule complementary explorations in order to search for involvement of other organs and to rule out monogenetic autoinflammatory syndromes.

International audience; BACKGROUND:Biotherapies or targeted therapies are fairly new treatments indicated for moderate to severe psoriasis. The side effects appear to be mainly infectious or cancerous. The role of biotherapies in the development of a pre-cancerous condition, monoclonal gammopathy of undetermined significance (MGUS), has recently been debated in the literature.OBJECTIVES:To evaluate the incidence of MGUS in psoriasis patients treated with biotherapy.MATERIALS AND METHODS:This study was a French multicenter retrospective study carried out through the French multicenter study group RESOPSO. Data on the results of serum protein electrophoreses performed before and within at least six months after the start of the biotherapy were collected. Demographic data, medical history, and psoriasis treatment history were specified.RESULTS:Four hundred and forty three patients were eligible for inclusion. Of these, three presented with monoclonal gammopathy for which the assessment was in favor of MGUS. The average treatment period was 19.7 months. Six patients presented with MGUS prior to the treatment. These patients' immunoglobulin levels remained stable, with an average remission of 24 months. Only psoriatic rheumatism appeared to be statistically linked to MGUS.CONCLUSION:The incidence and frequency of MGUS in psoriasis patients treated with biotherapy do not appear to increase relative to the general population.