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Background: The skin plays an important role in establishing interpersonal relationships, and thus visible skin disorders, which have a significant impact on physical appearance, influence other people's behaviours and attitudes., Objective: To develop and validate a dermatologic-specific questionnaire to evaluate stigmatization in individuals with visible skin conditions., Methods: Items were generated by a verbatim report based on qualitative interviews with patients with various dermatologic conditions. Subsequently, a study was implemented for psychometric analysis. A dermatology-specific stigmatization questionnaire (PUSH-D) was refined via item reduction according to inter-question correlations, consensus among experts and exploratory factor analysis. Internal consistency was determined by calculating Cronbach's α. Concurrent validity was determined by calculating the correlation between PUSH-D and the Dermatology Life Quality Index (DLQI) and the Rosenberg Self-Esteem Scale (RSES)., Results: From a primary list of 22 items, PUSH-D was reduced to a 17-item questionnaire, covering two pertinent dimensions based on the exploratory factor analysis. Construct validity was demonstrated, and PUSH-D showed good internal consistency (Cronbach's α = 0.9). PUSH-D correlated strongly with the DLQI 0.72 (p < 0.001) and moderately with the RSES 0.49 (p < 0.001)., Conclusion: PUSH-D allows a comprehensive view of the degree of stigmatization in visible skin disorders, as well as the comparability of stigmatization levels across various skin conditions., (© 2022 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)

Background: There is currently an alarming decrease in the number of dermatologists in private practice because of the limited number of new graduates, who are unable to compensate for departures into retirement among the "baby boom" generation. Our aim was thus to determine the socio-demographic characteristics of private dermatologists in France in 2011 to forecast the impact over the next 20 years., Materials and Methods: Analysis was performed of socio-demographic data (age, sex, place of practice, thesis year and mode of exercise) for all private dermatologists living in France in 2011 and identified in the Rosenwald Directory of Doctors. These data were combined with those of the National Council of the Order to determine the number of GPs and those of INSEE, giving the size and number of inhabitants of each department., Results: There are 3,197 privately practicing dermatologists in France, with a majority of women (65%). The average age is 52 years. Fifty-three per cent of dermatologists are aged over 55 years while 21% are aged between 50 and 54 years, 19% are aged between 40 and 49 and 5% are aged under 39 years. The density of dermatologists in France is 5.1/100,000 inhabitants. There are three types of density zone for dermatologists: high-density zones (over five dermatologists per 10(5) persons), comprising 24 departments (22% of the national territory) in which 61% of dermatologists are practicing; moderate-density zones (three to five dermatologists per 10(5) persons), comprising 41 departments (47% of the French territory in which 30% of dermatologists are practicing; low-density zones (less than three dermatologists per 10(5) persons), considered as "dermatological deserts", comprising 30 departments (31% the national territory) in which 10% of the country's dermatologists are practicing. The population projection shows a decrease in the number of dermatologists in private practice of 45% in 2020, 72% in 2025 and 84% in 2030., Discussion: Our study highlights the disparity in distribution of the density of liberal dermatologists in France. The departments in which the density of dermatologists is low are those where the number of general practitioners is small. In 2021, 54% of dermatologists currently in private practice will be aged over 65 and are therefore likely to end their professional practice. How can we anticipate the fall in the number of dermatologists in private practice over the coming two decades? This question must be addressed urgently., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Bruno Halioua,1 Laurent Misery,2,3 Sophie Seite,4 Veronique Delvigne,4 Clara Chelli,5 Jonathan Taieb,6 Charles Taieb7,8 1Dermatologue, Paris, France; 2Univ Brest, LIEN, F-29200, Brest, France; 3Department of Dermatologie, University Hospital of Brest, Brest, France; 4La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, France; 5Department of Dermatology-Venereology, Robert-Debré Hospital, Reims, France; 6APHP, Hôtel Dieu, Centre du Sommeil et de la Vigilance, Paris, France; 7European Market Maintenance, Assessment, Patients Priority Department, Fontenay-sous-Bois, France; 8Hôpital Necker Enfants Malades, Paris, FranceCorrespondence: Bruno HaliouaDermatologue, 56 Boulevard Saint-Marcel, Paris, 75005, FranceEmail haliouab@yahoo.frIntroduction: Previous studies showed more sleep disturbance (SD) in patients with cutaneous disorders (CD). During CD, unpleasant subjective symptoms [USS], such as itch, pain and others (tingling, burning, or tightness) have a negative influence on sleep quality. This study aims to evaluate the prevalence of SD in CD patients and to identify the influence of itch, pain and other unpleasant sensations on SD.Materials and Methods: An international, anonymized real-life survey was conducted with individuals [18− 75 years], with physician-confirmed CD, or without CD. The 25 items covered sociodemographic characteristics, feeling of overall sleep quality and skin unpleasant sensations. Severity of SD and unpleasant sensations were assessed using a 10-cm Visual Analogue Scale (VAS).Results: From 3834 analyzed questionnaires, 2871 (67.3%) were in the CD group and 863 (32.7%) in the control group. Patients with CD had significantly more SD (71.2% vs 32.7% in the control group, p< 0.0001). CD patients without any reported unpleasant sensation were at higher risk for SD than control subjects (OR 1,362 [95% CI 1.975– 2.405] p=0.0013). SS were highly associated with SD (OR 1.641 [95% CI 1.393– 1.933] p< 0.0001). Pruritus, pain and intermediate sensations were significant predictors of SD, with odds ratios of 1.670, 1.625 and 1.326, respectively. VAS sleep scores were strongly associated with pruritus (r: 0.25, p< 0.0001) and pain (r: 0.25 p< 0.0001) severity ratings.Discussion: SD is a common problem for patients with CD. Patients with subjective symptoms suffer more from SD, suggesting that they are aggravating factors, but are likely not the only reason for SD in CD patients. We found that during CD, intermediate sensations also contribute to SD. Despite some limitations and the potential bias due to the study design, our results confirm for the first time on an international level the influence of subjective symptoms on sleep quality in patients with CD.Keywords: unpleasant sensations, sleep quality, cutaneous disorders

This is a review of the efficacy of etretinate/acitretin in the treatment of psoriasis and of the currently reported side-effects. The data indicate that retinoids bring significant improvement (if not total clearing) with frequent low-morbidity but rarely serious side-effects. The most serious side-effect of etretinate/acitretin is teratogenicity. [ABSTRACT FROM AUTHOR]