An Unusual Case of Cocaine-induced Neutrophilic Systemic Disease.

is missing (Short communication).

Skin cancer screening in Switzerland: Cross-sectional trends (1997-2012) in socioeconomic inequalities.

INTRODUCTION: Skin cancer is one of the most common malignancies. Despite controversy over its efficacy, skin cancer screening has become widespread although socioeconomic screening inequalities have been documented. Switzerland has the highest rate of melanoma in Europe but Swiss trends in skin cancer screening and social disparities have not been investigated. This study aims to evaluate trends in skin cancer screening and its association with socioeconomic indicators in Switzerland between 1997 and 2012. METHOD: We used data from four waves (from 1997 to 2012) of the population-based Swiss Health Interview Survey. Multivariable Poisson regressions with robust variance were used to estimate weighted prevalence ratio (PR) and 95% Confidence Intervals (CI) adjusting for demographics, health status and use of healthcare. RESULTS: This study included 60,764 participants with a mean age of 49.1 years (standard deviation (SD) 17.2) and 53.6% of women. Between 1997 and 2012, the weighted prevalence of ever life-time skin examination and skin examination in the current year increased by 38.2% and 35.3% respectively (p-value <0.001). Participants with a lower education level, lower income and living in non-metropolitan areas were less often screened than their counterparts. Educational differences in ever life-time skin examination increased over time (p-value for trend = 0.036). CONCLUSION: While skin cancer screening prevalence in Switzerland increased from 1997 to 2012, most social inequalities persisted over time and educational inequalities increased. Dermatologists should be alerted that populations with lower education should be given special attention.

[Effectiveness of sunscreen against melanoma]. / Efficacité des écrans solaires contre le mélanome.

Melanoma represents the fifth most common cancer in Switzerland and its incidence is rising over the past decades. A new debate is going on about the efficacy of sunscreen against the risk of developing melanoma. Few studies have proven its efficacy with a significant risk of overexposure to sunlight due to the feeling of overprotection offered by those sunscreens. The role of the physician is to explain this risk and to integrate sunscreens among a wide range of other strategies existing in primary prevention of melanoma.

Le mélanome représente le cinquième cancer le plus fréquent en Suisse, avec une incidence qui ne fait qu'augmenter depuis des décennies. Parmi les mesures de prévention primaire, un nouveau débat a émergé concernant l'efficacité des écrans solaires contre le mélanome. Peu d'études ont en effet réussi à démontrer un bénéfice des écrans solaires pour prévenir la survenue de mélanome avec un risque non négligeable de surexposition aux rayons solaires inhérent au sentiment de surprotection offert par ces produits. Le rôle du médecin est d'expliquer ces risques et d'intégrer les écrans solaires dans les mesures photoprotectrices à disposition, en insistant sur l'importance des mesures de protection physique.

Chronic Prurigo: An Unusual Presentation of Hodgkin Lymphoma.

BACKGROUND: Prurigo nodularis is a condition of unknown origin defined by papulonodular eruption and intense pruritus. Hodgkin lymphoma often presents nonspecific initial symptoms. An association between systemic malignancy and cutaneous manifestations has long been documented. We report a case of prurigo nodularis as a first presentation of Hodgkin lymphoma. CASE: A 35-year-old woman presented with a 2-year history of pruritus. Previously diagnosed with bedbugs, the pruritus persisted even after insect eradication, with the appearance of papulonodular lesions consistent with chronic prurigo. The pruritus and the pain were refractory to all treatments. She had no past medical history or clinical, radiological, or laboratory findings. A lymphadenopathy was revealed 2 years after onset of the symptoms. Lymph node biopsy showed a nodular sclerosis Hodgkin lymphoma. The patient was initiated on chemotherapy and the skin lesions decreased. CONCLUSION: This case report of chronic prurigo as the first manifestation of a systemic malignancy reminds us of the importance of a systematic diagnostic approach to this kind of patients initially and throughout time, especially if the symptoms do not respond to treatment. Our case may question the role of imaging examinations in the management and follow-up of a persistent prurigo nodularis.

Alcohol policy changes and 22-year trends in individual alcohol consumption in a Swiss adult population: a 1993-2014 cross-sectional population-based study.

OBJECTIVE: Evidence on the impact of legislative changes on individual alcohol consumption is limited. Using an observational study design, we assessed trends in individual alcohol consumption of a Swiss adult population following the public policy changes that took place between 1993 and 2014, while considering individual characteristics and secular trends. DESIGN: Cross-sectional study. SETTING: Swiss general adult population. PARTICIPANTS: Data from 18 963 participants were collected between 1993 and 2014 (aged 18-75 years). OUTCOME MEASURES: We used data from the 'Bus Santé' study, an annual health survey conducted in random samples of the adult population in the State of Geneva, Switzerland. Individual alcohol intake was assessed using a validated food frequency questionnaire. Individual characteristics including education were self-reported. 7 policy changes (6 about alcohol and 1 about tobacco) that occurred between 1993 and 2014 defined 6 different periods. We predicted alcohol intake using quantile regression with multivariate analysis for each period adjusting for participants' characteristics and tested significance periods. Sensitivity analysis was performed including drinkers only, the 10th centile of highest drinkers and smoker's status. RESULTS: Between 1993 and 2014, participants' individual alcohol intake decreased from 7.1 to 5.4 g/day (24% reduction, p<0.001). Men decreased their alcohol intake by 34% compared with 22% for women (p<0.001). The decrease in alcohol intake remained significant when considering drinkers only (28% decrease, p<0.001) and the 10th centile highest drinkers (24% decrease, p<0.001). Consumption of all alcoholic beverages decreased between 1993 and 2014 except for the moderate consumption of beer, which increased. After adjustment for participants' characteristics and secular trends, no independent association between alcohol legislative changes and individual alcohol intake was found. CONCLUSIONS: Between 1993 and 2014, alcohol consumption decreased in the Swiss adult population independently of policy changes.