DLQI as a major criterion for introduction of systemic agents in patients with mild psoriasis.

BACKGROUND: Psoriasis is a skin inflammatory chronic disease with negative physical, psychological and social repercussions for those affected. However, patients suffering from mild disease also complain about negative impact on their quality of life, making it difficult for physicians to choose the best treatment strategy. OBJECTIVES: Understanding the impact of systemic treatments on Quality of Life (QoL) in patients with mild psoriasis in daily practice. METHODS: This is a monocentric retrospective study analysing patients affected by mild psoriasis [Psoriasis Area and Severity Index (PASI) ≤ 6]. Patients were divided into two groups, depending on the treatment decision taken by the physicians: patients who received local and/or UV light therapies and patients who were treated with systemic therapies as a first choice. PASI and Dermatology Life Quality Index (DLQI) scores were measured at each visit. RESULTS: Patients who received systemic therapies as a first choice reported higher QoL impairment, mainly due to psoriasis lesions localized on visible areas. During Follow-up, this group showed better improvement of PASI score and DLQI compared to patients receiving local and/or UV light treatment. CONCLUSIONS: Our findings highlight the potential benefit of using systemic therapies in patients with mild psoriasis and high QoL impairment. This study will help physicians to make the right therapeutic decision in patients suffering from mild psoriasis.

[Two cases of pulmonary melanoma metastasis treated with radiofrequency: An alternative to surgical excision]. / Deux cas de métastases pulmonaires de mélanome traitées par radiofréquence : une alternative à la chirurgie.

BACKGROUND: based on consensual recommendations, surgery remains the standard treatment for curable lung metastases. In this setting, radiofrequency ablation of limited metastases has been described in numerous studies in recent years. We report herein two patients presenting with low-burden lung metastases from malignant melanoma treated by radiofrequency. PATIENTS AND METHODS: two patients presented with one to two limited burden lung metastases from malignant melanoma, respectively. Both patients received neoadjuvant chemotherapy leading to disease stabilization, after which the lung metastases were treated by radiofrequency. Both patients had complete remission following radiofrequency, with 12 and 21 months follow-up respectively. DISCUSSION: surgical treatment of solitary or scant pulmonary metastases from melanoma has proved its efficacy with a gain in overall and disease-free survival. Nevertheless, this treatment cannot be proposed in patients with contraindications for anaesthesia or compromised pulmonary function. In this population, radiofrequency ablation appears to offer a potentially valuable alternative to surgery. Additionally, the related morbidity and duration of hospitalisation associated with radiofrequency seemed to be improved. As seen in these two cases, the efficacy and increased survival achieved with radiofrequency appears comparable to those obtained through surgery.