Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross-sectional study among 2465 patients.

BACKGROUND: Hidradenitis suppurativa (HS), also referred to as acne inversa, is a debilitating skin disease characterized by inflammatory nodules, chronic abscesses and tunnels (fistulae and sinuses). The association with pilonidal sinus disease (PSD) is frequently reported but not well documented. OBJECTIVES: To determine the prevalence and characteristics of inflammatory skin lesions located in the intergluteal fold (IGF) of patients with HS. METHODS: This was an international multicentre retrospective cross-sectional study based on data collection from a large cohort of patients with HS with and without histopathology. Results From a total of 2465 patients with HS included in the study, 661 (27%) reported lesions in the IGF. These patients were significantly more often smokers and had more severe HS. Of the 238 patients with an available clinical diagnosis, intergluteal-HS (IG-HS) was diagnosed in 52 patients (22%) and PSD was diagnosed in 186 patients (78%). IG-HS was associated with the localization of HS in the proximity of the IGF, including the buttocks, genitals and the anus. There was a possibility of misclassification bias in this study as a clinical/image-based diagnosis or histopathology of the IGF lesions was not always available. CONCLUSIONS: The high prevalence of PSD suggests a strong link between both entities. Therefore, it may be useful to identify common pathophysiological mechanisms and develop common therapeutic strategies. What's already known about this topic? The occurrence of pilonidal sinus disease has not been clearly reported among patients with hidradenitis suppurativa/acne inversa. What does this study add? This is the first study that investigated the prevalence of pilonidal sinus disease among a large cohort of patients and identified the patient characteristics. Risk factors that might help to improve the management of patients were identified.

Who, why, where: an overview of determinants of sunbed use in Europe.

Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young-adult women, with intermediate skin type, a current employment and a medium/high socio-economic status. Typical users display sun-seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair-skinned individuals and among adolescents/pre-adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.

[New therapeutic approaches for hidradenitis suppurativa]. / Nouveautés thérapeutiques pour la prise en charge de la maladie de Verneuil.

Hidradenitis suppurativa (HS) is a chronic cutaneous disease with a prevalence ranging between 0.05 % and 4 % in the general population. The clinical presentation features painful, inflammatory nodules on the apocrine gland- bearing body regions, evolving later on in fluctuant abscesses, fistulas and hypertrophic scars. HS represents a significant burden for the patients, severely limiting their quality of life. The disease is still relatively unknown by physicians, the time-to-diagnose can be extremely long and the therapeutic measures available are currently limited. In this paper we review the medical and surgical options for HS with a particular focus on recent, new therapeutic approaches.

La maladie de Verneuil (hidradénite suppurée) est une affection dermatologique chronique affectant entre 0,05 % et 4 % de la population. La maladie se caractérise par la formation de nodules douloureux et inflammatoires en regard des zones cutanées riches en glandes apocrines. Ces nodules évoluent vers la formation de masses abcédées extrêmement douloureuses qui finissent par fistuliser à la peau et laisser place à des cicatrices hypertrophiques indélébiles. La maladie devient alors très vite un véritable handicap dans la vie quotidienne des patients qui en souffrent. Encore à l'heure actuelle, la maladie reste mal connue par le corps médical. Le diagnostic est posé souvent tardivement et l'éventail thérapeutique se retrouve ainsi restreint. Au travers de cet article, nous reverrons la prise en charge médicale et chirurgicale que nous pouvons proposer en tant que soignants à ces patients, avec un focus particulier sur les récentes nouveautés thérapeutiques.

[Melanoma secondary prevention]. / Dépistage du mélanome.

Melanoma represents a major public health problem. Its incidence is constantly rising and the mortality rate can be frightfully important if the diagnosis is delayed. Melanoma also exerts a significant economical burden on the society. Therefore there is a need of concrete and pragmatic public health strategies in order to enhance melanoma prevention. Primary prevention of melanoma consists in avoiding excessive exposure to ultraviolet rays,'which represent the main risk factor for the disease occurrence. Secondary prevention is a synonym of melanoma early diagnosis and can be obtained by means of two methods : patients' self-examination and medical examination. Both these examinations must be routinely and thoroughly performed, must be based on the ABCDE rule and the ugly duckling sign, and ideally must be aided by the use of total-body photography. Current international guidelines suggest that all cutaneous screenings should be performed using dermoscopy, a non-invasive imaging technique that allows improving considerably the diagnostic performance. More sophisticated imaging techniques, such as confocal microscopy, are also available in specialised centres. The current scientific evidence supports the efficacy of melanoma primary and secondary prevention programs as a tool to decrease melanoma mortality. Many skin cancer prevention campaigns have been organised worldwide. The most famous and successful in Europe is Euromelanoma.