Ann Dermatol Vener
-
Dermatologists frequently provide training for general practitioners, but such training is not systematic and evaluation is rare. ⋯ This initial study shows the immediate impact of medical training sessions on general practitioners/occupational physicians to be important in terms of sensitization and moderate but significant in terms of improved diagnosis of pigmented lesions. The longer term impact, as well as the impact of the campaign on physicians not taking part in the medical training sessions, remains unknown. This study militates in favor of the involvement of general practitioners and occupational physicians in mass screening for melanoma in collaboration with dermatologists. The 2004 campaign in the Haut-Rhin Department also included information for the general public. The primary evaluation criterion of the campaign will be change in incidence of thick melanomas recorded by the departmental cancer registry.
-
Sequels can be observed in toxic epidermal necrolysis. Persistence of mucosal ulcerations is not a classical complication of this disease. We describe two case reports of mucous membrane ulcerations (oral and genital) which have remained many months after the acute phase of toxic epidermal necrolysis. ⋯ Complications of toxic epidermal necrolysis mainly occur at the acute phase. The most well documented sequelae are ophthalmological lesions. The most frequent cutaneous sequelae are cutaneous pigmentary changes and nail dystrophy. We report two observations of persistent mucous membrane erosions many months after the acute phase of toxic epidermal necrolysis. The pathophysiology of this complication, is rarely described and still remains unclear.
-
Impetigo herpetiformis is a rare dermatitis that occurs during pregnancy and may be life threatening for both mother and child. In this case report, we present an Ondine curse involving the baby, and the good response to isotretinoine. ⋯ Our case is typical of impetigo herpetiformis. Maternal and infant complication may be life threatening and we report a real Ondine curse the etiology of which remains unknown. Moreover, this observation is unusual because the lesions did not clear despite delivery and good treatment. In our opinion, the great improvement with isotretinoine would suggest it could be used as first line treatment.
-
The aim of this survey is to ascertain if the incidence of isotretinoin exposed pregnancies was reduced by the late recommendations of prescription and issue (AMM modification on 06/08/2001 and 25/09/2001). ⋯ Despite 3 successive isotretinoin prescription and issue recommendations strengthening in childbearing women, pregnancies can't be totally avoided. Bad compliance concerns the prescription and/or an incomplete or not understood information by the patient who does not scrupulously apply the care and contraception agreement. However, this study does not allow to assess the proportion of issued prescriptions despite their non-accordance with the licence criteria. The National Commission of Pharmacovigilance did not like to limit isotretinoin prescription to dermatologists only. It estimates that the administrative authority must intensify information by dermatologists, general practitioners and pharmacists, about measures to take to avoid an exposure to isotretinoin during pregnancy.