Characteristics of Pruritus in Bullous Pemphigoid and Impact on Quality of Life: A Prospective Cohort Study.

Pruritus is a common symptom of bullous pemphigoid (BP), but has been poorly studied. The aim of this study was to analyse the characteristics of pruritus in patients with BP and its impact on their quality of life. A multicentre prospective observational study (in 15 French hospitals) was performed. A total of 60 patients were included, with a mean age of 77.4 years. Pruritus occurred daily in 85% of patients, with a mean pruritus intensity of 5.2/10. Tingling sensations were present in 72.4% of patients and burning sensations in 68.9%. Pruritus was exacerbated by stress, fatigue and xerosis. The mean ItchyQol score was 56.2/110 and the mean 5-D Itch Scale score was 16.5/25. The severity of pruritus was not related to age, sex, BP activity score, eosinophilia, or anti-BP230 and anti-BP180 autoantibodies. This study revealed that pruritus in BP is poorly tolerated and is an important cause of impaired quality of life.

Clinical Characteristics of Pruritus in Systemic Sclerosis Vary According to the Autoimmune Subtype.

Pruritus is a frequent symptom in systemic sclerosis (SSc), with a prevalence of 40-65%, but its pathophysiology is poorly understood. This study investigated the immunological component of pruritus. Fifty-six patients with SSc responded to a standardized questionnaire regarding both SSc disease and pruritus characteristics. Among patients with SSc, those with pruritus did not display a particular immunological profile (inflammatory, humoral, and/or cellular factors), but pruritus was, in most cases, concomitant with the development of SSc. Thus, pruritus characteristics were evaluated further, according to the detection of anti-centromere autoantibodies (ACA), into ACA+ (n = 17) and ACA- (n = 19). The ACA+ subgroup was characterized by a longer evolution of SSc and pruritus, pruritus present outside the sclerotic area, and a shorter daily duration of pruritus. In conclusion, the concomitant appearance of the 2 processes and the differences observed between ACA+ and ACA- subgroups support the presence of an immunological component in pruritus.

Occupational Contact Dermatitis Caused by Artichokes.

Introduction: Few cases of skin diseases caused by exposure to artichokes have been published. Artichokes contain sesquiterpene lactones, which are known to be sensitizing. Irritant contact dermatitis (ICD) has also been diagnosed. To our knowledge, no protein contact dermatitis (PCD) has yet been reported to be induced by artichoke. Objectives: The aim of this study was to identify the different types of contact dermatitis that may be due to occupational exposure to artichokes and the professions concerned. Materials and Methods: We conducted a descriptive study, retrieving data from the French national database of occupational diseases for the period of 2001 to 2018. Results: Fifty-six cases were retrieved, and 10 cases were included in this study after data analysis and reading the clinical reports: 7 allergic contact dermatitis (ACD), 2 PCD, and 1 ICD caused by artichokes. Patients were farmers (4), agri-food workers (3), market gardener (1), cashier (1), and store employee (1). Conclusions: This is the first series of occupational contact dermatitis that can be induced by artichokes. Exposure to artichokes can lead to ICD, ACD, PCD, and perhaps contact urticaria. The sesquiterpene lactone mix patch test is not always sufficient to confirm an ACD by artichokes. Irritant contact dermatitis can be associated with ACD from artichokes or evolve on its own.

Occupational asthma, rhinitis and contact urticaria in a salmon-processing worker.

We report a case of occupational allergy to salmon combining allergic asthma, allergic rhinitis and allergic contact urticaria in a 59-year-old salmon-processing worker. Parvalbumin is the most common allergen, but indeed sensitisation to tropomyosin, preservatives and spices could occur.

Hearing Impairment in French Merchant Seafarers: Retrospective Study on Data from 8308 Audiometric Tests.

Background: A high level of occupational noise exposure has been noted in the fishing sector. Yet, less is known regarding other navigation groups, such as merchant seafarers, since a French study in the 1980s. This study assesses hearing impairment (HI) in a French merchant seafarers' population. Methods: We collected data of all audiograms performed in 2018 and 2019 for French merchant seafarers. For each seafarer, hearing ability was measured in both ears using pure-tone audiometry at the following frequencies: 0.5, 1, 2, 3, 4, 6, and 8 kHz. Hearing threshold levels (HTLs), or the intensity of sound below which no sound is detected, were measured in decibels Sound Pressure Level (dB SPL) at each frequency and recorded in 5 dB increments. For HI, we used the validated definition of the American Speech−Language−Hearing Association (ASHA). Results: We were able to include statistical analysis results of 8308 audiograms. In a multiple logistic regression adjusted for age, experience, and class of navigation, we found that experience of more than 14 years Odds Ratio OR 1.28 (CI 95% 1.07−1.53), age 31−40 OR 2.2 (CI 95% 1.4−3.4), and >40 years OR 14, 3 (IC 95% 9.7−21) and marine engineers OR 1.26 (IC 95% 1.01−1.57) were still risk factors for HI. Conclusion: In 2018, Marine engineers were still the workers' group with a higher risk of HI in merchant seafarers but, notch at 4 Hz, specific of noise-induced hearing loss, has improved. They have an HI close to the definition of socioacousis and mean deficit differences with deck and services' merchant seafarers improved. Our results could be interpreted as a limitation of occupational noise exposure impact in a merchant seafarers' population, needing an improvement in prevention measures and also encouraged to continue to improve onboard working conditions.

Occupational Exposures and Esophageal Cancer: Prog Study.

Esophageal cancer is the sixth most common cause of cancer death worldwide. In France, Brittany is one of the regions most seriously affected. This increased incidence is usually linked to high rates of alcohol overconsumption and smoking, established risk factors for esophageal cancer, but the region has special occupational exposures. We aim to describe the occupational exposures of patients with esophageal cancer. Between June and October 2020, we conducted a monocentric descriptive study in a French Teaching Hospital and identified 37 eligible patients. We gathered data through a systematic individual interview for each participant and by an analysis of their medical file. We were able to include 36 patients; most were men (n = 27, 75.0%) and smokers (n = 25, 69.4%), 21 (58.3%) presented an adenocarcinoma esophageal cancer, 13 (36.1%) a squamous cell cancer, and 2 other types. On occupational exposure, patients declared respectively high exposure by manipulating asbestos materials for 11 (30.6%) patients, regularly in contact with benzene by handling fuel in 7 cases (19.4%), chlorinated solvents in 4 cases (11.1%), pesticides in 4 cases, and ionizing radiation exposure in 3 patients (8.3%). Our findings support the creation of a large-scale study to explore the impact of occupational exposures, particularly exposure to asbestos and hydrocarbons.