[Frequency of contact sensitization to modern dressings used to treat chronic leg ulcer]. / Fréquence des sensibilisations de contact aux pansements modernes utilisés sur les ulcères de jambe.

INTRODUCTION: Allergic contact dermatitis around chronic leg ulcers (CLU) is a common complication in patients presenting CLU and prolongs healing times. The aim of this study was to describe the rate of sensitization to modern dressings (MD) used in these patients and to assess whether there is a relation between the number of sensitizations and ulcer type, the time from onset of the ulcer, and patient age and gender. PATIENTS AND METHODS: We conducted a retrospective study at Reims University Hospital between 2010 and 2014 that included all patients with CLU of vascular etiology surrounded by eczematous lesions, and who had one of the patch-tests in the following 3 series: European baseline±leg ulcers±corticosteroids. RESULTS: Among the 73 patients included, 43 % were polysensitized. Thirty-three patients (45 %) were sensitized to MD (38 % to hydrocolloids, 18 % to hydrogels, 7 % to hydrocellular dressings, 7 % to hydrofiber dressings, 5 % to contact layers and 3 % to alginates). Median age and sex did not differ between "polysensitized" patients and "non-polysensitized" patients (P=0.84 and P=0.25, respectively). Polysensitization was more frequent among patients presenting ulcers for more than 5 years (P=0.032). CONCLUSION: Practically half of all patients presenting CLU with surrounding contact dermatitis had sensitization to modern dressings (mostly hydrocolloids and hydrogels). The rate of sensitization increased with the length of presence of CLU.

[Impact of neurological diseases on the prognosis of bullous pemphigoid: A retrospective study of 178 patients]. / Impact pronostique des maladies neurologiques au cours de la pemphigoïde bulleuse : étude rétrospective de 178 cas.

BACKGROUND: Bullous pemphigoid (BP) mainly affects elderly patients. It is often associated with neurological disorders, which constitute a major risk factor of the disease. The aim of our study was to determine whether neurological disorders, particularly dementia, influence outcome and mortality in BP patients. PATIENTS AND METHODS: We conducted a retrospective study of all patients with BP seen in our dermatology department consecutively between 1997 and 2011. Clinical, immunological and therapeutic data, number of relapses and survival status were compared according to the presence at diagnosis of neurological disorders, particularly dementia. RESULTS: Among the 178 patients included, an associated neurological disease was present in 84 (47.2%) and dementia in 43 (24.2%) at the time of diagnosis of BP. Patients with associated dementia were older and had a lower Karnofsky index. Sixty-four patients (37.8%) had had at least one clinical relapse of BP, chiefly within the first 18 months after starting therapy. Coexistent neurological disease was not associated with BP relapse (P=0.55) contrary to an extensive BP phenotype at diagnosis (P=0.008). Coexistent neurological disease and/or dementia were associated with higher mortality (P=0.03 and P<0.001, respectively), but did not modify the type or the total duration of BP treatment. CONCLUSION: A coexistent neurological disease or dementia at the time of diagnosis of BP significantly increase the risk of mortality and shortens the duration of clinical follow-up of patients with BP, thus limiting the analysis of their influence on the outcome of BP itself.

[Survey of post-graduate training for Dermatology and Venereology residents in France (2005-2010)]. / État des lieux de la formation des internes en DES de dermato-vénéréologie en France (2005-2010).

BACKGROUND: Training procedures for dermatology residents have never been evaluated in French university hospitals. The present study describes the methods used over the last 5 years. METHODS: This was a retrospective survey using a questionnaire sent to French dermatology-residents completing their residency between 2005 and 2010. The data collated included information on theoretical aspects (courses, local, regional or national seminars, meetings) and on practical training (consultations, surgery, laser and cosmetic dermatology), research, post-residency assistantship and additional university diplomas, as well as overall opinions on dermatology training. Statistical analysis was descriptive and comparative according to the number of dermatology teachers (professors, senior lecturers) in the region in which training was given. RESULTS: One hundred and twenty-two questionnaires were analyzed: 72 from regions with two or less than two university hospital dermatology teachers (group 1) and 50 with more than two such teachers (group 2). Fewer residents had completed a research year in group 1 (19% vs 40%; P=0.01), but the two groups were comparable concerning post-graduate training (DESC) (16%) or post-residency (87%) placement. There were no differences concerning local theoretical training or participation in seminars or meetings, apart from inter-regional seminars, which were more frequent in group 2 (24% vs 3%; P<0.001). There were no differences between the two groups in terms of personal consultations (91%), surgery (62%), laser treatment (13%) or cosmetic dermatology (3%). Satisfaction rates regarding theoretical and practical training were similar in both groups (69% vs 70% and 72% vs 78%, respectively). DISCUSSION: This is the first survey carried out with the aim of evaluating suitability of training for dermatology residents in France with regard to the "reference" dermatological practice recently submitted to the French health ministry. The present results, obtained from 47% of residents receiving training during this period, show only very few differences concerning dermatology residency training with respect to the number of university hospital dermatology teachers, apart from research training. CONCLUSION: Despite an overall good opinion on their residency, the dermatology residents involved underlined the need for greater focus on teaching of technical skills (surgery, laser, cosmetic dermatology).