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The first international congress for dermatology was held in Paris in 1889. This was the same year as the 100th anniversary of the French Revolution, which was being celebrated in Paris with the construction of the Eiffel Tower, a symbol of the country. Dermatology Congresses have been developing since the beginning and continue today. Dr. Hüseyin Hulki Bey is a physician who has not only contributed to the history of world medicine, but also to the history of Turkish medicine. During his attendance at the first dermatology congress, he presented an alternative treatment for syphilis than that which was known in Ottoman medicine at the time. In this study, the speech of Turkish physician Hüseyin Hulki Bey, who attended the first dermatology congress in history, is investigated. [ABSTRACT FROM AUTHOR]

Background: Even in countries having nearly universal healthcare provision some individuals forgo or postpone healthcare to which they are entitled. Socioeconomic and geographic inequalities can make access to healthcare difficult for some people, such that they fail to seek it, particularly if they deem the type of care as non-essential. The need to pay at the point of care, the complexity and cost of top-up health insurance, and delays or only partial reimbursement can discourage take-up of care. This can affect the general health of the population. Methods: To estimate the rate of forgoing healthcare in the general French population, between 2015 and 2018 we conducted a nationwide cross-sectional survey of individuals visiting French primary healthcare insurance agencies (Caisse Primaire d'Assurance Maladie, CPAM). We asked whether the person had foregone or postponed healthcare in the last 12 months, if so the types of healthcare forgone or put-off, and reasons. Individuals were stratified by the type of complementary (top-up) health insurance they had. Results: Out of 164 092 individuals who responded, 158 032 were included in the analysis. Respondents had either private complementary (top-up) insurance (60%), top-up insurance subsidized by the state (29%), or no top-up health insurance (11%). Forgoers (n=40 115; 25.4%) most often lived alone (with or without children), were unemployed, and/ or female. Dental care (54%) and consultations with ophthalmologists, gynaecologists and dermatologists (41%) were most commonly forgone. The reasons were: inability to advance payment and/or to pay the uninsured part (69%), time constraints and difficulty in obtaining appointments (26%). Conclusion: We present a snapshot of forgoing healthcare in a developed country, highlighting the need for continuing review by policy-makers of payment regimens, insurance cover, availability and accessibility. While initiatives have already emerged from the results, further reforms are needed to address the problem of people forgoing preventative or perceived non-urgent healthcare, particularly for disadvantaged subgroups. [ABSTRACT FROM AUTHOR]

It is important to understand patients' and dermatologists' perceptions of various aspects of atopic dermatitis, but there is a lack of studies on quality of life and stakeholder viewpoints in this therapy area. The aim of this study was to compare patients' and dermatologists' viewpoints regarding the impact of atopic dermatitis that is uncontrolled by topical corticosteroids. Data were collected from 348 adult patients who responded to self-administered questionnaires, and 150 telephone interviews with the dermatologists who selected them. Patients and dermatologists reported both convergent and divergent assessments of the impact of atopic dermatitis and its treatment. Notable areas of agreement were regarding the safety of emollients, the time required and difficulty of applying topical corticosteroids, especially to certain parts of the body. Divergent views involved the perceived efficacy of available treatments and the impact of atopic dermatitis on professional life. A greater understanding of these differences would help dermatologists to optimize patient care. [ABSTRACT FROM AUTHOR]

Background: French guidelines recommend stopping biologic treatment of psoriasis between 3 and 24 weeks before conception in accordance with the relevant Summary of Product Characteristics (SmPC). The aim of this study was to evaluate the real-life practice of dermatologists in the management of pregnant women with psoriasis previously treated with biologic agents. We wished to assess the level of practitioner adherence to the relevant SmPCs., Material and Methods: We conducted a study in collaboration with GRPso and Resopso. A computerized questionnaire was completed by the practitioners. We performed descriptive statistics and studied the profile of the practitioners, their level of confidence with continuation of biological agents during pregnancy, and their reported practices on the use of biological agents in pregnancy. Statistical analyses were performed using XLSTAT. A p-value of less than 0.05 was considered significant., Results: A total of 63 dermatologists (women: 71%; mean age 43.8 years) participated in this study, the majority of whom were hospital-based (87%). Recommendations were followed by 36.5% of practitioners, while 44% reported discontinuing biologic agents on diagnosis of pregnancy, and 20.5% reported using these agents during pregnancy. Among dermatologists with more than ten years of experience, 19% reported following the SmPC. Among dermatologists with a patient base >200 (patients treated with biologic agents for psoriasis), 19% reported following the SmPC compared to 54% of practitioners with less than 50 patients. The mean age of dermatologists following the SmPC was 41 years vs. 47 years for those not following the SmPC., Discussion: The majority of practitioners do not follow recommendations on discontinuation of biologic agents before the planning of pregnancy by patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Background: Difficulty obtaining a dermatological consultation is an obstacle to the early diagnosis of melanoma. On the one hand, patients survival depends on the lesion thickness at the time of diagnosis. On the other hand, dermatologists treat many patients with benign lesions. Optimizing patient care pathways is a major concern. The aim of the present study was to assess whether the e-mail transmission of photographs of suspected melanoma lesions between general practitioners (GPs) and dermatologists reduces the time to dermatological consultation for patients whose suspicious skin lesions ultimately require resection., Methods: We conducted a cluster-randomized controlled study in primary care involving 51 French GPs between April 2017 and August 2019. A total of 250 patients referred to a dermatologist for a suspected melanoma lesion were included GPs were randomized to either the smartphone arm or the usual care arm. In the smartphone arm, the GPs referred patients to the dermatologist by sending 2 photographs of the suspicious lesion using their smartphone. The dermatologist then had to set up an appointment at an appropriate time. In the usual care arm, GPs referred patients to a dermatologist according to their usual practice. The primary outcome was the time to dermatological consultation for patients whose lesion ultimately required resection., Results: 57 GPs volunteered were randomized (27 to the smartphone arm, and 30 to the usual care arm). A total of 125 patients were included in each arm (mean age: 49.8 years; 53% women) and followed 8 months. Twenty-three dermatologists participated in the study. The time to dermatological consultation for patients whose suspicious skin lesion required resection was 56.5 days in the smartphone arm and 63.7 days in the usual care arm (mean adjusted time reduction: -18.5 days, 95% CI [-74.1;23.5], p = .53)., Conclusions: The e-mail transmission of photographs from GPs to dermatologists did not improve the dermatological management of patients whose suspicious skin lesions ultimately required resection. Further research is needed to validate quality criteria that might be useful for tele-expertise in dermatology., Trial Registration: Registered on ClinicalTrials.gov under reference number NCT03137511 (May 2, 2017)., (© 2024. The Author(s).)

Purpose: To evaluate the modalities of methotrexate prescription for moderate to severe psoriasis by dermatologists in France. Patients and Methods: We performed a national online practice survey between October and December 2020. Results: A total of 254 dermatologists responded, 237 reported prescribing methotrexate for moderate to severe psoriasis in adults, of which 57% as a first line systemic treatment. Nineteen percent reported performing a test dose at the initiation of treatment. Methotrexate was prescribed orally in 54.7% of cases, subcutaneously in 44.8% of cases and intramuscularly in 0.4% of cases. The initial weekly dose of methotrexate was < 15 mg for 30% of the dermatologists and ≥ 15 mg for 70% of them. Two hundred and three dermatologists had already change the route of administration for methotrexate from the oral to injectable form due to poor tolerance (48.3%), lack of efficacy (35%) or lack of compliance (16.7%). Two hundred thirty-four dermatologists (98.7%) reported prescribing folic acid with methotrexate, and 79.3% reported prescribing tests evaluating the risk of hepatic fibrosis. Forty-three percent of dermatologists have not initiated or have reduced their prescriptions since the beginning of the pandemic of COVID-19. Prescribing patterns were different according to the type of practice (private practice versus hospital/mixed practice). Conclusion: Methotrexate is used by the majority of dermatologists interviewed for moderate to severe psoriasis in adults, with heterogeneity of practices. [ABSTRACT FROM AUTHOR]

Combined therapies involve the use of multiple drugs to increase efficacy and reduce the toxicity of individual treatments. We performed a survey carried out among French and Italian paediatric dermatologists (SFPD, GrPso, SIDerP) to better understand the reasons for using or avoiding these combinations. The survey was completed by 61 paediatric dermatologists (France, 57.4%; Italy, 42.6%; hospital practice, 98.4%; members of societies of paediatric societies and/or psoriasis working groups, 73.8%). Thirty-nine (63.9%) had previously used or planned to use the combined therapies, most commonly TNF-α inhibitors with acitretin or methotrexate. The most common reasons for dermatologists not using combined therapies were a lack of information about the safety (27.3%) or effectiveness (22.7%) of the combinations and the absence of recommendations on how to use combined therapies (22.7%). The main reason for using these treatments was to improve the outcome of biologic therapies in cases of partial efficacy or loss of efficacy. The most frequent clinical situations in which the dermatologists indicated that they combined therapies were to control a loss of efficacy (82.1%) and to treat psoriasis flare-ups (51.3%). Combined therapies have been used by the majority of paediatric dermatologists in the treatment of childhood psoriasis. Absence of information about these combined therapies, and no guidelines about their use are major limits for their use. However, these combined therapies should be considered for the treatment of children with severe psoriasis, psoriatic arthritis and recalcitrant disease. Their use needs to be clarified in future management guidelines. [ABSTRACT FROM AUTHOR]

Objective: Local wound infections are a major challenge for patients and health professionals. Various diagnostic and therapeutic options are available. However, a generally accepted standard is still lacking in Europe. The aim was to develop an easy-to-use clinical score for the early detection of local wound infections, as a basis for decisionmaking on antiseptic therapy or decolonisation. Method: An interdisciplinary and interprofessional panel of experts from seven European countries was brought together to discuss the various aspects of diagnosing local wound infections. Results: The result was the adoption of the Therapeutic Index for Local Infections (TILI) score, developed in Germany by Initiative Chronische Wunden e.V., specifically for health professionals not specialised in wound care. Available in six European languages, the TILI score could also be adapted for different European countries, depending on their specific national healthcare requirements. The six clinical criteria for local wound infection are erythema to surrounding skin; heat; oedema, induration or swelling; spontaneous pain or pressure pain; stalled wound healing; and increase and/or change in colour or smell of exudate. Meeting all criteria indicates that antiseptic wound therapy could be started. Regardless of these unspecific clinical signs, there are also health conditions for the clinical situation which are a direct indication for antimicrobial wound therapy. These include the presence of wound pathogens, such as meticillin-resistant Staphylococcus aureus, septic surgical wound or the presence of free pus. Conclusion: The development of the new internationally adapted TILI score, which could also be used by any caregiver in daily practice to diagnose local infections in acute and hard-to-heal wounds, is the result of expert consensus. However, the score system has to be validated through a clinical evaluation. This is to be performed in expert centres throughout Europe. Declaration of interest: JD has received research support, lecture fees and travel-cost reimbursements from 4M, Coloplast, Convatec, Draco, Engelhardt, Paul Hartmann, KCI, Lohmann&Rauscher, Mölnlycke, SastoMed and Urgo. RL has received research support, lecture fees and travel-cost reimbursements from Mölnlycke and Urgo. AK has received research support, lecture fees and travel-cost reimbursements from 3M, B. Braun Melsungen, Bode/Paul Hartmann, Ethicon, Lohmann&Rauscher, Mundipharma, Oculus, SastoMed Schülke&Mayr, SERAG-WIESSNER and Urgo. JVS has received research support, lecture fees and travel-cost reimbursements from Mundipharma, Histocell, Quesper and Urgo. This work was supported by an unlimited grant from Urgo Medical. The views expressed are those of the authors and do not necessarily reflect those of Urgo Medical. The company had no direct influence on the content of this paper. [ABSTRACT FROM AUTHOR]

Background: The public perception of dermatologists, highly relevant for implementing strategies to improve dermatological care, has been scarcely investigated in France, in regard to the background where the number of active dermatologists is continuously decreasing. Objective: This study sought to investigate the French public's perception of dermatologists, as well as the physician–patient relationship in dermatology area. Methods: A sample of 5000 inhabitants (aged ≥15–80 years) of Metropolitan France, seeking medical advice for a skin condition, were invited in July 2018 to fill in a digital structured questionnaire. Results: The sample's gender ratio and geographical distribution proved representative of the French general population. Compared to 33.2% of respondents having consulted a general practitioner (GP), 20.6% had consulted a dermatologist over the past 12 months, the main reasons being a chronic skin condition (37%), surgical intervention (18%) and naevi check‐up (15%). When confronted with acute skin problems, survey participants stated their GP was the first healthcare reference (54% of cases). This may be explained by two distinct phenomena: the declining demography of dermatologists and specific peculiarities of the French healthcare system. Contrarily, the dermatologist was the first care provider for chronic skin problems (47% of cases). On answering the question whether they were satisfied with their last dermatological consultation, 76% declared to be very satisfied/satisfied, vs. 24% dissatisfied/very dissatisfied. Some 78% were given a prescription at consultation end, considered efficacious by 91% and well tolerated by 98%. Conclusion: Our study findings underline the central role of dermatologists in skin care as valued and trusted care providers in France. Further educational and political strategies appear warranted to improve patient referral to dermatologists and decrease waiting times, thereby improving patients' well‐being and satisfaction, as well as care quality provided. [ABSTRACT FROM AUTHOR]

Objective. To gain insight into clinical practice regarding referral, early diagnosis and other aspects of the management of patients with dcSSc in Europe and the USA. Methods. Semi-structured interviews were conducted with 84 rheumatologists (or internal medicine physicians) and 40 dermatologists in different countries (the UK, France, Germany, Italy, Spain and the USA). Physicians were asked to identify key steps in the patient pathway relating to patient presentation, diagnosis and referral, in addition to other treatment and follow-up processes. Results. The interviewed physicians reported that late presentation with dcSSc was common, with some patients presenting to primary care physicians after symptoms had persisted for up to 1 year. Awareness of dcSSc is reported to vary widely among primary care physicians. Final diagnosis, generally following guideline-based recommendations, was by rheumatologists in most cases (or internal medicine physicians in France) and they remained responsible for global patient management, with lesser involvement in diagnosis and management by dermatologists. Specialist centres were not well defined and did not exist in all countries. Conclusion. Patients and primary healthcare providers can be unaware of the symptoms of dcSSc, therefore presentation and referral to specialist care are often late. Thus, improved awareness among patients and primary care physicians is necessary to facilitate earlier referral and diagnosis. Once referred, more consistent use of the modified Rodnan skin score at diagnosis and follow-up may help to monitor disease progression. Furthermore, establishing specialist centres may help to promote such changes and improve patient care. [ABSTRACT FROM AUTHOR]

Importance The term dermatoporosis has been proposed to describe clinical signs and functional consequences of age-related extreme skin fragility. Objective To create a simple dermatoporosis self-diagnosis tool ( IDA: Index Dermatoporosis Assessment) and to use this tool to estimate the prevalence of dermatoporosis in France. Design, setting and participants A specific dermatoporosis questionnaire was developed with the help of senior dermatologists and survey experts. This questionnaire was submitted to consecutive individuals aged ≥65 years who consulted a dermatologist. At the end of the consultation, the dermatologist was asked to assess 'whether or not' dermatoporosis was present. In a second step, the final questionnaire was mailed to a representative sample of the French population aged ≥65 years in order to estimate the prevalence of dermatoporosis. Results The initial questionnaire, consisting of two modules (24 questions), was validated in 173 individuals aged ≥65 years) during a dermatologist consultation. Dermatologists diagnosed 46% of the individuals with dermatoporosis. The final validated questionnaire consisted of 14 items, 12 consisting in presence or absence of clinical signs and two items consisting of the self-assessment by individuals of skin ageing on neckline and hands (none/moderate/significant/very significant). A scoring system was generated to quote quantitatively dermatoporosis (from 0 if no sign of dermatoporosis to 20 maximal dermatoporosis). The area under the receiver operator curve was 0.8535, indicating a very good ability of the questionnaire to differentiate between individuals. A cut-off value of 11 was linked to positive and negative predictive values of 0.78 and 0.81, respectively. In a second step, using the questionnaire in a representative sample of the French population ( n = 533), the estimated overall prevalence of dermatoporosis was 37.5% in French subjects aged ≥65 years [27.5% (males) vs. 43.9% (females); P < 0.05]. The estimated prevalence of dermatoporosis was twice higher in subjects with eczema or atopic dermatitis during childhood than in the population without dermatoporosis (60.6% vs. 33.4%, P < 0.001). Individuals with dermatoporosis also reported a higher prevalence of itching, long-term corticosteroid use, anticoagulant use and prior sun exposure. Conclusions and relevance Using a new simple dermatoporosis self-diagnosis tool, this study provides a previously unprecedented insight into the high prevalence of dermatoporosis in elderly individuals. IDA questionnaire is a short (14-item) and easy to use tool for evaluating dermatoporosis in adults and may allow an easy evaluation of each subject. [ABSTRACT FROM AUTHOR]

Background Dermoscopy is acknowledged to improve the diagnostic accuracy of melanoma by several concordant meta-analyses. However, the use of dermoscopy was not considered as a high level of evidence diagnostic tool by French Health Authorities. However, as shown in Australian, American and in our recent surveys, dermoscopy is used by most of dermatologists in private practice. Objectives To analyse the use, beliefs, teaching given and research produced in dermoscopy in dermatology departments of French hospitals. Methods A questionnaire about the use, available equipment, teaching activities and published research on dermoscopy was mailed to all chairmen of dermatology departments in French both academic and non-academic hospitals. Results Seventy-six of 110 mailed questionnaires were returned. The majority of centres claimed to use dermoscopy (97.5%), but it seemed heterogeneous among practitioners according to their age and position. The use of dermoscopy was four times higher in non-academic centres ( P = 0.015). Centres located in the south east of France were higher users comparing with others ( P = 0.004). Earlier detection of melanoma was the most important advantage reported. Excessive training time was the most important reported disadvantage. Twenty-five percent of centres had dedicated clinics for pigmented lesions. Few centres (14.5%) run formal dermoscopy training programs. Most centres (74.7%) declared a use of dermoscopy for the diagnosis of non-tumoral diseases. Conclusions This is the first European study evaluating the use of dermoscopy among hospital. Despite a large use, dermoscopy-dedicated teaching and research time appeared to be insufficient. [ABSTRACT FROM AUTHOR]

Background To date, no strategy for improving early diagnosis of melanoma has been evaluated on a population basis in France. Objective To evaluate the efficacy of a general practitioner ( GP) awareness and training campaign in a pilot French geographical region (Champagne-Ardenne), including 1·34 million inhabitants, 1241 GPs, 56 dermatologists and a population-based melanoma registry. Methods All GPs received repeated awareness postal mailings in 2008 and 398 (32·1%) attended training sessions organized by 27 dermatologists. The pre- (2005-7) and post-campaign (2009-11) periods were compared for the following: primary endpoint - the world-standardized incidence of very thick melanomas ( VTM) (Breslow thickness ≥ 3 mm); secondary endpoints - the mean Breslow thickness; the proportions of VTM and of thin (< 1 mm) melanomas among invasive cases; and the ratio of in situ/all melanoma cases. Similar measures were performed in the control area of Doubs/Belfort territory (655 000 ha), where no similar campaign was carried out. Results The incidence of VTM decreased from 1·07 to 0·71 per 100 000 habitants per year ( P = 0·01), the mean Breslow thickness from 1·95 to 1·68 mm ( P = 0·06) and the proportion of VTM from 19·2% to 12·8% ( P = 0·01). The proportion of thin and in situ melanomas increased from 50·9% to 57·4% ( P = 0·05) and from 20·1% to 28·2% ( P = 0·001), respectively. No significant variation was observed in Doubs/Belfort territory. Conclusion These results strongly support the efficacy of such a campaign targeting GPs and provide a rationale for a larger public health campaign in France, including training of GPs by dermatologists and encouraging patients to ask their GP for a systematic skin examination. [ABSTRACT FROM AUTHOR]

Background Epidermal growth factor receptor (EGFR) inhibitors are part of the therapeutic arsenal available for advanced cancer. However, they are frequently associated with cutaneous side-effects, which can hamper compliance, lead to treatment refusal and impair quality of life. Objective To know the attitudes of French oncologists who deal with this skin toxicity. This work is one of the steps to build a therapeutic algorithm of side-effects induced by EGFR inhibitors taking both evidence-based medicine and standard practices into account. Methods Physicians completed a questionnaire as part of regional meetings, before any discussion. Questions concerned the management of 11 clinical situations in the context of EGFR inhibitor prescription. Results Sixty-seven questionnaires were analysed. The collaboration with dermatologists was especially planned for persisting or worsening lesions beyond 2 weeks, but never considered at the time of the introduction of targeted therapy. The results demonstrated the difficulties encountered in diagnosing and grading skin lesions. Attitudes of oncologists were uniform for preventive care and management of mild lesions for which moisturizing and cyclines were widely prescribed. Significant differences appeared in the treatment of less typical cases such as the involvement of skin appendages, secondary infections of folliculitis or cases associated with radiodermatitis. Discrepancies existed also for what to do in relation with maintenance or interruption of EGFR inhibitor mainly if they were responsible for severe lesions. Conclusion This original survey emphasizes the interest of greater multidisciplinary collaboration and the necessity to harmonize practice. [ABSTRACT FROM AUTHOR]

Background Systematic studies of delusional infestation (DI), also known as delusional parasitosis, are scarce. They lack either dermatological or psychiatric detail. Little is known about the specimens that patients provide to prove their infestation. There is no study on the current presentation of DI in Europe. Objectives To determine the number of true infestations, to assess with which pathogens patients believe themselves to be infested, and to gather details about the frequency and nature of the specimens and the containers used to store them, based on European study centres. Methods Retrospective study of consecutive cases with suspected DI from six centres (Dermatology, Psychiatry, Tropical Medicine) in four European countries (U.K., Germany, Italy, France). Results In total, 148 consecutive cases of suspected DI were included, i.e. the largest cohort reported. None of the patients had evidence of a genuine infestation, as shown by examinations by dermatologists and/or infectious disease specialists. Only 35% believed themselves to be infested by parasites; the majority reported a large number of other living or inanimate (17%) pathogens. Seventy-one patients (48%) presented with what they believed was proof of their infestation. These specimens were mostly skin particles or hair, and rarely insects (only very few of which were human pathogenic or anthropophilic, and none of these could be correlated with the clinical presentation), and only 4% were stored in matchboxes (three of 71). Conclusions This first multicentre study of DI in Europe confirms that the term 'delusional infestation' better reflects current and future variations of this entity than 'delusional parasitosis'. The presentation of proofs of infestation, commonly referred to as 'the matchbox sign', is typical but not obligatory in DI and might better be called 'the specimen sign'. [ABSTRACT FROM AUTHOR]

AbstractObjectives:The studys objectives were (a) to characterize physicians attitudes and practices in relation to treating male pattern hair loss (MPHL), (b) to examine differences vis-à-vis physician distinctions, and (c) to consider the findings in relation to published research on MPHL patients treatment-seeking experiences.Methods:The online survey across six countries (United States, France, Germany, Spain, Japan, and Korea) involved 466 physicians (263 dermatologists and 203 primary care physicians [PCPs]) who at least occasionally treat patients for MPHL.Results:Over 50 of physicians were cognizant of patients concerns and the impact of hair loss on patients quality of life. Moreover, 65 were comfortable talking about MPHL with patients, and 62 were comfortable recommending treatment. On the other hand, about one-third of surveyed physicians were not especially comfortable assessing and treating MPHL. Relative to PCPs, dermatologists reported a significantly greater likelihood of spending time answering questions about MPHL and treatments (89 vs. 74%, p < 0.001), providing informational materials or brochures about MPHL (58 vs. 28, p < 0.001), and letting the patient know that he/she frequently treats MPHL (40 vs. 28, p < 0.006). Similar significant differences were evident in comparisons of frequent and non-frequent treaters. The primary goal physicians set for patients was prevention of additional hair loss (79); secondary goals included preventing additional hair thinning/loss with potential for re-growth (65) and informing patients they would see visible results within a year (63). Study limitations include a lack of verification that physicians responses reflect their actual clinical practice and the possibility that physicians enrolled in a research database do not represent the general physician population.Conclusions:In contrast to physicians less experienced with MPHL treatment, dermatologists and other physicians frequently treating MPHL have attitudes and practices that may foster a favorable context for MPHL patient care. [ABSTRACT FROM AUTHOR]

Background Few epidemiological studies assessing the prevalence of chronic dermatosis are available in France and most of these studies have used biased samples drawn from specific subpopulations. As several recent studies have mentioned that self-reported diagnosis either underestimates or overestimates disease prevalence, the validity of such data is questionable. Objectives To evaluate the agreement between self-reported and dermatologists’ diagnoses for five chronic dermatoses: acne, eczema, fungal infection, psoriasis and seborrhoeic dermatitis, and to analyse the factors associated with patients’ diagnosis knowledge. Patients/methods A cross-sectional study was conducted on the national day of skin tumour screening in April 2003. A self-administered questionnaire was completed by patients and a standard form was completed by dermatologists after clinical examination. A total of 4622 adults were examined by a dermatologist in 134 screening centres across France. The agreement between self-reported and dermatologists’ diagnoses was analysed using the kappa index. Characteristics of patients who were aware of their diagnosis were compared with those of patients who were not, by using multivariate logistic regression models. Results The demographic characteristics of the sample differed from those of the French population. The self-reported prevalence was significantly lower than the actual prevalence for all diseases except eczema. Underestimations ranging from 23% to 35% were observed in nearly all subgroups of our population. The agreement between self-reported and dermatologists’ diagnoses was low to moderate. Many cases of chronic skin diseases were diagnosed in patients who did not report them. Diagnosis knowledge was poorer in those above 54 years of age and better for patients treated for the condition and those with impairment of social life. Conclusions We observed a low agreement between self-reported and dermatologists’ diagnoses for five chronic diseases. Self-reports underestimated the actual prevalence of four of five common diseases. [ABSTRACT FROM AUTHOR]

Objective: Making a differential diagnosis of psoriatic arthritis (PsA) is not straightforward. This is partly because of its heterogeneous presentation and partly because many patients with PsA are initially diagnosed with psoriasis and treated in primary care or by dermatologists, with referral to rheumatologists being delayed. Once diagnosed, optimal disease control requires frequent specialist monitoring, adjustment or switching of therapies, and management of comorbidities and concomitant diseases, as well as attention to patients' overall well-being. Given the breadth of expertise that diagnosis and management of PsA requires, we sought to define a collaborative, structured framework that supports the optimisation of multidisciplinary care for patients with PsA in Europe.Methods: An expert panel comprising four rheumatologists, three dermatologists, two specialist nurses and one psychologist-from Spain, the United Kingdom, The Netherlands, Germany, France and Italy-met face-to-face to take part in a modified Delphi exercise.Results: The result of this exercise is a set of recommendations that are based on combining published evidence with the panel's extensive clinical experience. Recommendations can be implemented in a number of ways, but the central call-to-action of this framework is the need for improved collaboration between dermatologists (or primary care physicians) and rheumatologists. This could occur in a variety of different formats: standard referral pathways, multidisciplinary physician meetings to discuss patient cases, or 'one stop', combined clinics.Conclusion: We anticipate that when the majority of patients with PsA receive regular multidisciplinary care, improved patient outcomes will follow, although robust research is needed to explore this assumption. [ABSTRACT FROM AUTHOR]

Pays tribute to Henries Feulard, the secretary of the First International Congress of Dermatology and Syphiligraphy in Paris, France, who died on May 4, 1897. Background information on the family and career of Feulard in dermatology and venereology; Contributions of Feulard on the improvement of clinical dermatology in France; Scientific publications authored by Feulard.

Profiles Jean Louis Marc Alibert, the father of French dermatology. Family and educational background; Career highlights; Significant contribution of Alibert to the field of dermatology.

Dermatology in France today remains an essentially clinical discipline. The rapid development of laboratory facilities in major hospital centers has provided dermatologists with better means for clinical research. In cancer research, researchers D. Orth in Villejuif and O. Croissant at the Pasteur Institute are interested in papilloma viruses. In connective tissue research, L. Robert and his group in Creteil have studied the metabolism of elastic tissue, whereas J. Frey, head of the Biochemistry Laboratory at the Medical School of St-Etienne, is working on proline hydroxylase in collagen synthesis. P. Sengel in Grenoble is well known for his work on embryology and morphogenesis of skin. Tissue culture work on epidermal cells is being pursued at the Rothschild Foundation in Paris.

The article reports on French dermatologist Anne-Charles Lorry. Lorry was born in 1726 in a suburb of Paris. His father, Francois Lorry, was a professor of law at the University of Paris while his mother, the former Madeleine LaFosse, was a member of an artistic family. By age 36, Lorry was one of the three most famous physicians in Paris and possessed a large practice drawn from all classes of Parisian society, he had a reputation for generosity, kindliness and wisdom. In 1775, Lorry was a founding member of the Royal Society of Medicine. Because of the fact that his professional language was Latin, he for many years was the principal luminary of this Society whose deliberations were always conducted in the Latin tongue.

Primary burning mouth syndrome is a term used for chronic oral mucosal pain with no identifiable organic cause. The aim of the study was to evaluate the usefulness of a psychiatric intervention for treating burning mouth syndrome based on a joint consultation with a psychiatrist and a dermatologist. The study was proposed to all patients who visited this consultation group between 2001 and 2017 for the treatment of primary burning mouth syndrome. The patients answered a questionnaire that was administered via mail. Of the 57 patients diagnosed with primary burning mouth syndrome, 38 were included. Seven patients (18.4%) no longer had pain; 8 (21.1%) estimated that the pain had decreased by greater than 50%; 11 (28.9%) estimated the decrease at between 30 and 50%, and 12 (31.6%) estimated a less than 30% decrease. Only 14 patients (36.8%) remained under treatment with antidepressants, as compared to 63.2% before the psychiatric intervention. This psychiatric intervention could be considered a valuable tool in the global burning mouth syndrome treatment strategy.

Background: While some information on psoriasis impact on pregnancy is available, very little is known on the preoccupations of women afflicted by the disease or on the dermatologists' (D) positioning as to psoriasis and pregnancy. The 'Objectifs Peau' project demonstrated a 4.7% prevalence of psoriasis in women aged 18-45 years in France., Objective: This project sought to further address these issues in view of a targeted action plan., Methods: A questionnaire was made available to 361 D of different types., Results: Overall, 152 D answered the questionnaire, 50.7% working in private or mixed practice and 49.3% in hospitals, with 63% females (DF) and 37% males (DM). Over the last 3 months, the mean percentage of women of child-bearing age seen by these D was 28.6%. The main issue addressed by D upon psoriasis diagnosis was the patient's wish to become pregnant in the short-term (84%), while the compatibility of drug treatment with pregnancy was the issue prioritized by patients (64%). Among DM and DF, 46% and 29% reported having been confronted with an unplanned pregnancy, with their reaction mainly dependent on the treatment taken in 66%. Regarding follow-up, 26% D declared having shared their decision-making with gynaecologists, while 56% considered the first pregnancy trimester to be the highest-risk period. Only 28% D were familiar with existing recommendations, with only 21% of them considering them appropriate., Conclusion: Overall, 26.2% of French psoriasis women are of child-bearing potential, in line with our dataset (28.6%). Only 56% D considered the 1st pregnancy trimester to be the highest-risk period, with only one-third familiar with existing recommendations. The gap between recommendations and actual practices must be addressed through policies that take women's preoccupations better into account., (© 2019 European Academy of Dermatology and Venereology.)

Background: Dermatologists are recommended to ask psoriasis patients about musculoskeletal complaints to allow early detection and treatment of psoriatic arthritis (PsA). Screening tools have been developed to help identify patients warranting further rheumatologic assessment, but evidence suggests room for improvement in their diagnostic value and ease of use for outpatient practice., Objective: To develop and internally validate a brief tool for dermatologists to screen patients to refer to a rheumatologist for PsA diagnosis., Methods: After the literature review, 23 items were selected, covering pain at various locations and inflammatory signs of PsA. The validation study was conducted in medically diagnosed psoriasis patients consecutively recruited between 2012 and 2014 (Saint Joseph Hospital, Paris, France). Patients were enrolled by a dermatologist who helped to complete the questionnaire. Diagnosis of PsA was established by a rheumatologist based on CASPAR criteria. Multivariate logistic regression models were performed to build the scale, assessing discrimination through sensitivity, specificity and area under the ROC curve (AUC). Final model was internally validated using bootstrapping techniques., Results: One hundred and sixty-eight patients were recruited, of whom nine were excluded for known PsA and 21 did not attend the rheumatologist consultation. Of 137 included patients (median age 43 years, 59.6% men), 21 (15.3%) had a PsA diagnosis. Final regression model retained four independent items, including evocative signs of dactylitis, inflammatory heel pain, bilateral buttock pain and peripheral joint pain with swelling in patients aged <50. A total score (the PURE-4) was computed (0-4 points) that demonstrated excellent discriminative power (AUC = 87.6%; Sensitivity = 85.7% and Specificity = 83.6% at the threshold of ≥1/4 points), with no evidence for over-optimism in bootstrapped internal validation., Conclusion: These findings demonstrate the good diagnostic properties of a new screening scale using only four easy-to-collect items. If confirmed in other populations, it may prove useful in outpatient dermatology clinics for triage of psoriasis patients requiring further assessment by the rheumatologist., (© 2018 European Academy of Dermatology and Venereology.)

The article focuses on The Société Française de Dermatologie Pédiatrique (SFDP). It states that the Society elects its president for a term of 3 years while its secretary for a term of 6 years. The article explains that the Society is in line with the realization of its objectives which include organizing national annual meetings, international meetings, continuous medical education, and clinical research.

Rare skin cancers (such as Merkel cell carcinoma, dermatofibrosarcoma protuberans, Kaposi’s sarcoma...) refer to a mixed group of clinical, histological, immunohistological and evolutive diseases of which the management requires multidisciplinary expertise. Their cumulated incidence is 1/100 000 per year. Dermatologists are usually the first practitioners concerned by their management, with the help and cooperation of a network of dermatopathologists specialized in oncology. Management of these cancers varies greatly from one hospital to another. In 2008, the French national institute on cancer has funded a network of rare skin cancer specialists (K-CUR) so as to bring all efforts together on a large national scale. The aim of this project is: 1) to improve the clinical practice and to make the best techniques available to affected patients; 2) to ameliorate the training of the professionals; and 3) to improve clinical, epidemiologic, pathophysiological and genetic research on these cancers. [ABSTRACT FROM AUTHOR]

Highlights the First Congress of the French Society for Dermatologic Surgery that was held in Paris, France, in May 1999. Attendees of the event; Theme; Topics discussed during the convention.

This article focuses on the organization American Academy of Dermatology and its national program on dermatology which has reported that in glowing terms the spirit of cooperation exists between dermatologists in Bulgaria and France and their colleagues in the United States. In Bulgaria, severe atopic dermatitis is treated by sending the individual to the mountains for several weeks each year, with little treatment except topical corticosteroids. Similarly, severe psoriasis is treated by sending the patient to the Black Sea for sun and salt water.

The article offers information on various medical meetings in 2014 which include the 94th Annual Meeting of the British Association of Dermatologists in Glasgow, Scotland, XV World Congress on Cancers of the Skin in Edinburgh and Scientific Meeting of the Fondation Rene' Touraine in France.

The article presents the minutes of the meeting of the International Dermatological Committee of June 21st to 22nd, 1965 in Paris, France. Topics discussed include the participation of the committee in several meetings of the World Health Organization, as well as the officials chosen to represent the committee at those meetings.

The author discusses aspects of pharmacoepidemiological evidence that change the clinical and prescribing practice in the management of acne vulgaris. He mentions the pharmacovigilance centers in France which operate to monitor, analyze and report adverse reactions to drugs and advise on evidenced-based governmental health policy changes. However, the author thinks that the approach is restrictive of therapeutic freedom for dermatologists in conveying good prescribing practice in acne care.

This article presents information on several symposiums on dermatology. One of the symposium was the international symposium on "Percutaneous Absorption of Steroids." The symposium will be held on 5-6 April 1979, in Paris, France. The main topics will be Percutaneous absorption of steroids including theoretical aspects, reservoir effect of skin, bioavailability and effects of different vehicles on percutaneous absorption. Metabolism of steroids in skin, hair growth; topical use of oestrogens, androgens, antiandrogens and corticosteroids. Another symposium was the annual hair transplant symposium which will be held in Hot Springs, Arkansas, U.S. on 25-27 January 1979. International Multidiscipline faculty will be composed of both dermatologists, otolaryngologists and plastic surgeons.

This article reports that the third Franco-British dermatological meeting was held at Nantes, France this year under the presidency of P. Joulia and was arranged by Y. Bureau. It was attended by about 30 British dermatologists. On May 9, 1958 was a meeting of the Societe Francaise de Dermatologie et de Syphiligraphie to which British visitors were invited. The day was taken up with many papers and a very full discussion on the nodular hypodermic eruptions of the legs. The enthusiasm and cordiality of professors Joulia and Bureau and their compatriots contributed much to the pleasure of the occasion.