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Anne-Claire Fougerousse,1 François Maccari,1,2 Philippe Guillem,3 Ziad Reguiai4 On behalf of the GEM ResoVerneuil1Dermatology Department, Military Teaching Hospital Bégin, Saint Mandé, France; 2Dermatology, Private Practice, Saint-Maur-des-Fossés, France; 3Visceral Surgery department, Clinique du Val d’Ouest, Ecully, France; 4Dermatology Department, Polyclinique Courlancy-Bezannes, Reims, FranceCorrespondence: Anne-Claire Fougerousse, Dermatology department, Military Teaching Hospital Bégin, Saint Mandé, France, Tel +1 43 98 50 00, Email ac.fougerousse@gmail.comPurpose: Antibiotics are used for hidradenitis suppurativa’s management with limited evidence. Choice of antibiotics is based on small randomized controlled trial or open case-series.Patients and Methods: We performed a practice survey in Resoverneuil, a French network of physicians treating hidradenitis suppurativa, to identify the antibiotic strategy according to the Hurley stage. Online questionnaire was sent to all members of ResoVerneuil between January and February 2021.Results: In total, 108 physicians answered the survey: 37.6% were hospital based, 34.6% had a private practice and 27.8% a mixed practice, and 13.8% had a dedicated consultation for hidradenitis suppurativa. Sixty-three physicians reported seeing fewer than 5 patients with hidradenitis suppurativa per month; 29 seeing 5 to 15 patients per month; and 9 seeing more than 15 patients per month. More than 90% declared prescribing antibiotics for flares in Hurley 1 and 2 stages, and 83% in Hurley 3 stages, mostly amoxicillin-clavulanic acid and pristinamycin. Of these physicians, 29.7% declared prescribing a background antibiotic therapy for Hurley 1 stage with less than 4 flares per year, and more than 75% for Hurley 1 stage with more than 4 flares per year, Hurley 2 and Hurley 3 stages; mostly cyclins, combination of rifampicin and clindamycin and sulfamethoxazole-trimethoprim.Conclusion: This survey underlines the heterogeneity in antibiotic prescription for hidradenitis suppurativa in France, particularly as background therapy.Keywords: hidradenitis suppurativa, antibiotics, practice survey

Raphaella Cohen-Sors,1 Anne-Claire Fougerousse,2 Ziad Reguiai,3 Francois Maccari,2 Emmanuel Mahé,4 Juliette Delaunay,5 Aude Roussel,2 Maud Amy de la Breteque,4 Caroline Cottencin,6 Antoine Bertolotti,7 Hélène Kemp,8 Guillaume Chaby1 1Dermatology Department, Amiens-Picardie University Hospital Center, Amiens, France; 2Dermatology Department, Military Teaching Hospital Bégin, Saint-Mandé, France; 3Dermatology Department, Polyclinic Courlancy, Reims, France; 4Dermatology Department, Argenteuil Hospital, Argenteuil, France; 5Dermatology Department, University Hospital, Angers, France; 6Dermatology Department, University Hospital, Lille, France; 7Dermatology Department, University Hospital, Saint-Pierre, Ile de la Réunion, France; 8Hematology Department, Amiens-Picardie University Hospital Center, Amiens, FranceCorrespondence: Guillaume Chaby Email chaby.guillaume@chu-amiens.frBackground: Few studies addressing the safety and efficacy of biological therapy (BT) or apremilast (APR) in patients with psoriasis with a history of hematologic malignancy (HM) exist.Aim: To describe the tolerance and efficacy of BT and APR in moderate-to-severe psoriasis in patients with a history of in-remission or evolving HM.Methodology: A retrospective, multicenter chart review of the tolerance and efficacy of BT or APR in patients with moderate-to-severe psoriasis and a clinical history of in-remission or evolving HM.Results: Twenty-one patients with severe psoriasis and a history of HM were included in France by the GEM Resopso study group. Of the 16 patients treated with one or more BT lines, none showed recurrence of their HM which was considered as stable or in remission, and only 2 patients showed an evolution of their HM which had been considered as stable at the beginning of treatment. In the 10 patients treated with APR, the HM of one patient who also received BT worsened. The 3 evolutions did not impact the treatment with BT or APR. Tolerance was very satisfactory, with a low occurrence of infections. Regarding efficacy, only one patient treated with APR did not achieve any notable clinical improvement.Conclusion: Despite supportive data regarding tolerance, the heterogeneity of the analyzed population and limited available data, BT and APR should be used with caution in this patient population and investigations on larger cohorts should be conducted to further assess their tolerance in this patient population.Keywords: biological therapies, apremilast, psoriasis, hematological malignancies

Anne-Claire Fougerousse,1 Caroline Jacobzone,2 Laure Mery-Bossard,3 Ziad Reguiai,4 Catherine Droitcourt,5 Charles Taieb,6 François Maccari7 On behalf of GEM ResoEczema Group1Dermatology Department, Hôpital d’Instruction des Armées Bégin, Saint Mandé, Val de Marne, France; 2Dermatology Department, Hôpital du Scroff, Groupe Hospitalier Bretagne Sud, Lorient, Morbihan, France; 3Dermatology Department, Centre Hospitalier Intercommunal Poissy Saint Germain en Laye, Saint-Germain-en-Laye, Yvelines, France; 4Dermatology Department, Polyclinique Courlancy, Reims, Marne, France; 5Dermatology Department, Centre Hospitalier Universitaire, Rennes, Ille et Vilaine, France; 6Emma Clinic, Fontenay-sous-Bois, Val de Marne, France; 7Private Practice, Saint-Maur-des-Fossés, Val de Marne, FranceCorrespondence: Anne-Claire FougerousseDermatology Department, Hôpital d’Instruction des Armées Bégin, Saint Mandé, Val de Marne, FranceEmail ac.fougerousse@gmail.comPurpose: Recent studies have illustrated that systemic medications are underused for treating adult atopic dermatitis (AD) and that dermatologists have concerns regarding the safety profile of cyclosporine in AD.Patients and Methods: We performed a national online practice survey between March and April 2020.Results: A total of 305 dermatologists responded, 57% with hospital-based activity and 43% with private practice. Overall, 46.9% prescribed cyclosporine for adult AD. Before initiating treatment, 56.9% did not perform evaluation scoring. Reasons for not prescribing cyclosporine were no eligible patients (24.7%), lack of information (52.6%), need for hospital prescription (31.2%), and lack of experience (79.2%). Fifty-four percent of the dermatologists prescribed methotrexate for adult AD. Before initiating treatment, 50.5% did not perform evaluation scoring. Reasons for not prescribing methotrexate were no eligible patients (46.7%), lack of information (39.3%), lack of experience (25.2%), and not approved for AD (47.4%). A total of 2.1% dermatologists prescribed other systemic treatments for adult AD, 9.8% prescribed corticosteroids and 56.4% prescribed dupilumab.Conclusion: Systemic treatments for AD are used by half of dermatologists, although cyclosporine and dupilumab must be initiated in hospitals in France. Methotrexate is more frequently used than cyclosporine, although it is not approved for this indication in France. A vast majority of dermatologists do not perform any evaluation scoring before initiating systemic treatment for adult AD.Keywords: atopic dermatitis, cyclosporine, methotrexate, practice survey

François Maccari,1,2 Anne Claire Fougerousse,2,3 Ziad Reguiai,2,4 Charles Taieb5,6 1Private Practice, La Varenne St Hilaire, Paris, France; 2Reso Pso, Dermatologist Network, Paris, France; 3Military Teaching Hospital Bégin, Saint Mandé, Paris, France; 4Service De Dermatologie, Polyclinique Courlancy, Reims, France; 5FIMARAD, Hôpital Necker Enfants Malades, Paris, France; 6European Market Maintenance Assessment, Vincennes, Paris, FranceCorrespondence: Charles Taieb Email charles.taieb@emma.clinicBackground: Little is known about how women of childbearing age with psoriasis experience contraception, sexuality and pregnancies through the lens of their skin condition.Objective: To evaluate the experiences and expectations in this group of patients.Materials and Methods: In total, 235 women aged between 18 and 45 years old completed an online survey. We collected the characteristics of psoriasis, contraception and pregnancy history. Psoriasis severity was measured using the Simplified Psoriasis Index. Patient quality of life was assessed using the Dermatology Life Quality Index (DLQI) and the Short Form-12.Results: Psoriasis was mild in 78% of cases. The mean DLQI score was 8.8, highlighting a moderate impact of psoriasis. In total, 28% of the women had no current follow-ups, while at least two distinct physicians followed 21% of these patients. In total, 31.5% of the women felt that they could discuss sexuality during their consultations. In addition, 63% of respondents had a contraceptive method, but more than half of the women reported that contraception was rarely or never discussed during the consultations. In total, 63% had at least one pregnancy, and 61.5% reported that the doctor managing their psoriasis did not discuss their pregnancy during consultations. Psoriasis worsened during pregnancy for 21% of the respondents but improved in 34%. Among women who were not pregnant, less than 15% reported that the doctor in charge of their psoriasis discussed family planning and pregnancy possibilities.Conclusion: Our study shows that the management of women of childbearing age with psoriasis must be improved with respect to sexuality, contraception and pregnancy planning.Keywords: psoriasis, women, childbearing