Search

Background Ultrasound imaging has recently benefited from the introduction of a new 70 MHz transducer able to provide high-resolution images, i.e. ultra-high-frequency ultrasound (UHFUS). Aim To study the morphological features of basal cell carcinomas (BCCs) and measure BCC thickness by means of UHFUS examination. Methods In this retrospective multicentric study, 171 consecutive patients underwent UHFUS examination between November 2018 and May 2019 for suspected BCC. Diagnosis was confirmed by histopathology. A series of morphological parameters including echogenicity, structure, borders, shape composition (presence of intralesional structures) were investigated along with objective measurements such as thickness (maximum distance between the surface of the epidermis and the deepest part of the tumour) and width. Results In total, 117 BCCs from 93 patients were examined, including superficial (n = 13; 11.1%), nodular (n = 64; 54.7%), infiltrative (n = 18; 15.4%), mixed subtypes (n = 20; 17.1%) and other subtypes (n = 2; 1.7%). The most frequently observed UHFUS parameters included: hypoechoic signal (n = 80; 68.4%, P < 0.001), homogeneous structure (n = 76, 65.0%, P = 0.01), well-defined borders (n = 77, 65.8%, P < 0.001) and elongated shape (n = 71, 60.7%, P < 0.001). An excellent correlation was found between the BCC thickness measured by UHFUS and the value estimated by histology (interclass correlation ≥ 0.80). Conclusion UHFUS is a new rapid and easy noninvasive skin imaging technique able to provide data on the dimensions and morphology of BCCs in real time and at the bedside. These characteristics mean UHFUS has a number of possible applications, ranging from presurgical mapping to the detection of disease recurrence and treatment monitoring.

The ensuing pilot investigation sheds new light on characterizing tumoral and non-tumoral human skin mechanical properties that will not only assist the dermatologist’s diagnosis but also could constitute the creation of an Artificial Intelligence database for upcoming research. A modern, non-invasive, and contact-free methodology—UNDERSKIN—was developed, and hinges upon Fourier transform computations that permit the analysis of surface wave dispersion with a specific skin inversion model and viscoelastic model. It yields a detailed look at how particle movements of the medium propagate throughout its near sub-surface, hence a novel knowledge of the mechanical responses of skin tumors. The research results display the tumors’ viscoelastic responses alongside their respective healthy skin outcomes for each skin layer as well as the dermatologist’s touch analysis. Although dermatologists are capable of sensing and having a fair overall assessment of what they are palpating, they are unable heretofore to quantify it and inform where the firmness or softness derives from, which it is necessary to be acquainted with so as to perform an accurate diagnosis, prognosis, treatment, future surgery, and teledermatology.

Background Amelanotic/hypomelanotic lentigo maligna and lentigo maligna melanoma (AHLM/LMM) may be very difficult to diagnose at an early stage. Objectives To quantify the predictive value of dermoscopic and reflectance confocal microscopy (RCM) features for AHLM/LMM. Methods Dermoscopic and RCM images of histopathologically diagnosed AHLM/LMM, amelanotic/hypomelanotic benign lesions (AHBL), and amelanotic/hypomelanotic basal and squamous cell carcinomas (AHBCC/AHSCC) of the head and neck from consecutive patients were retrospectively collected and blindly evaluated by three observers to assess presence or absence of dermoscopic and RCM criteria. Results Overall, 224 lesions in 216 patients including LM/LMM (n = 55, 24.6%), AHBL (n = 107, 47.8%) and AHBCC/AHSCC (n = 62, 27.7%) were analysed. Multivariable analysis showed that milky-red areas (OR = 5.46; 95% CI: 1.51-19.75), peripheral light brown structureless areas (OR = 19.10; 4.45-81.96), linear irregular vessels (OR = 5.44; 1.45-20.40), and asymmetric pigmented follicles (OR = 14.45; 2.77-75.44) at dermoscopy, and >= 3 atypical cells in five fields (OR = 10.12; 3.00-34.12) and focal follicular localization of atypical cells at dermo-epidermal junction (DEJ) (OR = 10.48; 1.10-99.81) at RCM were significantly independent diagnostic factors for AHLM/LMM vs. AHBL. In comparison with AHBCC/AHSCC, peripheral light brown structureless area (OR = 7.11; 1.53-32.96), pseudonetwork around hair follicles (OR = 16.69; 2.73-102.07), and annular granular structures (OR = 42.36; 3.51-511.16) at dermoscopy and large dendritic (OR = 6.86; 3.15-38.28) and round pagetoid cells (OR = 26.78; 3.15-227.98) at RCM led to a significantly increased risk of diagnosing AHLM/LMM. Conclusions Amelanotic/hypomelanotic lentigo maligna and lentigo maligna melanoma may have the same dermoscopic features of AHM on other body sites, such as milky red areas, peripheral light brown structureless areas and linear irregular vessels. These features, asymmetric pigmented follicles and at RCM >= 3 atypical cells in five fields and focal follicular extension of atypical cells at DEJ may help in recognizing AHLM/LMM even when LM conventional features (e.g., obliteration of hair follicles under dermoscopy and large pagetoid cells under RCM) are absent or present only in very small areas of the lesion.

The spectrum of pustular skin disorders (PSD) is large and particularly challenging, including inflammatory, infectious and amicrobial diseases. Moreover, although pustules represent the unifying clinical feature, they can be absent or not fully developed in the early stage of the disease. The line-field confocal optical coherence tomography (LC-OCT) is a recently developed imaging technique able to perform a non-invasive, in vivo, examination of the epidermis and upper dermis, reaching very high image resolution and virtual histology.We aimed to investigate the potentialities of LC-OCT in the non-invasive differential diagnosis of a series of 11 PSD with different aetiology, microscopic features, body location and incidence rates.Complete LC-OCT imaging (i.e. 2D/3D frames, videos) was performed on a total of 19 patients (10 females and 9 males) aged between 35 and 79 years. Images were blindly evaluated and compared with corresponding histopathologic findings.The LC-OCT imaging was able to detect with high accuracy the pustule structure including shape, margins, morphology and cellular content, along with peculiar epidermal and adnexal alterations in each condition, including: Acute Generalized Exanthematous Pustulosis, Generalized pustular psoriasis, Generalized pustular figurate erythema, Subcorneal Pustular Dermatosis, Intraepidermal IgA pustulosis, Palmoplantar pustulosis, Palmoplantar pustular psoriasis. Herpetic whitlow, Acrodermatitis continua of Hallopeau, Vesicopustular Sweet syndrome and Vesicopustular Eosinophilic cellulitis, with pustular appearance, were also compared.The new LC-OCT can represent a rapid, non-invasive and painless tool which can help differentiating among PSD of different aetiology and microscopic morphology in clinical mimickers in daily practice.

The isovector and isoscalar components of neutron-proton pairing are investigated in the N=Z unstable nuclei of the \textit{fp}-shell through the two-nucleon transfer reaction (p,$^3$He) in inverse kinematics. The combination of particle and gamma-ray detection with radioactive beams of $^{56}$Ni and $^{52}$Fe, produced by fragmentation at the GANIL/LISE facility, made it possible to carry out this study for the first time in a closed and an open-shell nucleus in the \textit{fp}-shell. The transfer cross-sections for ground-state to ground-state (J=0$^+$,T=1) and to the first (J=1$^+$,T=0) state were extracted for both cases together with the transfer cross-section ratios $\sigma$(0$^+$,T=1) /$\sigma$(1$^+$,T=0). They are compared with second-order distorted-wave born approximation (DWBA) calculations. The enhancement of the ground-state to ground-state pair transfer cross-section close to mid-shell, in $^{52}$Fe, points towards a superfluid phase in the isovector channel. For the "deuteron-like" transfer, very low cross-sections to the first (J=1$^+$,T=0) state were observed both for \Ni\phe\, and \Fe\phe\, and are related to a strong hindrance of this channel due to spin-orbit effect. No evidence for an isoscalar deuteron-like condensate is observed., Comment: 7 pages, 4 figures

Background: Basal cell carcinoma can simulate melanoma and specific dermoscopic criteria have not yet been defined in a large cohort. Objective: To identify dermoscopic “trump” characteristics for differential diagnosis, identify cluster groups and assess the clinical impact of this study's findings. Methods: Retrospective, multicentric comparative study of atypical, non-facial basal cell carcinoma (≥1seven-point checklist criteria) and melanoma (with at least one BCC criteria) at dermoscopy. Observed dermoscopic features were used to develop a proposed score. Lesion clusters were defined with hierarchical analysis. Clinical impact was assessed with a blinded reader study following this study's results. Results: A total of 146 basal cell carcinoma and 76melanoma were included. Atypical vascular pattern was common to most lesions (74.5%). Twelve trump features were included in the proposed score (sensitivity 94.1% and specificity 79.5%). Cluster analysis identified 3 basal cell carcinoma and 3melanoma clusters. Findings improved overall diagnostic accuracy and confidence (26.8% and 13.8%, respectively; p&nbsp

BACKGROUND Reflectance confocal microscopy (RCM) is particularly suitable for the study of skin ageing because it provides nearly histological information in vivo and non-invasively. However, there are no studies that evaluated RCM skin features of a large population older than 70 years. OBJECTIVES The aim of our investigation was to study age-related skin changes in an elderly population by RCM and to evaluate their topographical and gender differences. METHODS We obtained RCM images of photoprotected (volar arm) and chronic (face) and intermittently photoexposed (dorsal forearm) body sites of 209 volunteers (105 women and 104 men, mean age: 77.5, range 74-81 years). 15 previously reported and new RCM parameters related to skin ageing were assessed. RESULTS Photoexposed sites had thicker suprapapillary epidermis, more linear, distant and thin furrows, higher presence of mottled pigmentation, polycyclic papillae and coarse and huddled collagen and lower presence of dermal papillae than the photoprotected site. Irregular honeycomb pattern was not higher in photoexposed sites, indicating that it is probably more dependent on intrinsic ageing. Two ageing scores defined for facial skin ageing (epidermal disarray score and epidermal hyperplasia score) were found useful for the identification of photoageing. Gender differences only concerned some RCM parameters (i.e. thickness of different layers of the epidermis, furrows and collagen score) and some body sites, in line with the fact that women and men of our cohort had no major differences in clinically visible skin ageing. CONCLUSIONS Our study confirmed that RCM is a powerful non-invasive technique to microscopically quantify ageing signs and our observations contribute to highlight the differences between intrinsic and extrinsic ageing.

Background Tattooing is a widespread phenomenon, with an estimated prevalence of 10-30% in Western populations. For psoriasis patients, current recommendations are to avoid having a tattoo if the disease is active and they are receiving immunosuppressive treatments. Although scientific data supporting these recommendations are lacking, dermatologists are often reluctant to advocate tattooing in psoriasis patients. Objective We aimed to evaluate the frequency of tattoo complications in patients with psoriasis and determine whether the occurrence of complications was associated with psoriasis status and treatments received at the time of tattooing. Methods We performed a multicentre cross-sectional study. Adults with psoriasis were consecutively included and classified as tattooed or non-tattooed. Prevalence of complications associated with tattoos was then evaluated according to psoriasis onset and treatments. The study was divided into three parts, in which data were collected through a series of questionnaires filled in by the dermatologist. Complications included pruritus, oedema, allergic reaction/eczema, infection/superinfection, granuloma, lichenification, photosensitivity, Koebner phenomenon and psoriasis flare after tattooing. Diagnosis of complications was made retrospectively. Results We included 2053 psoriatic patients, 20.2% had 894 tattoos. Amongst non-tattooed patients, 15.4% had wished to be tattooed, with psoriasis being stated as a reason for not having a tattoo by 44.0% and 5.7% indicating that they planned to have a tattoo in the future. Local complications, such as oedema, pruritus, allergy and Koebner phenomenon, were reported in tattoos in 6.6%, most frequently in patients with psoriasis requiring treatment at the time of tattooing (P

The ISOL facility ALTO, located at Orsay in France, provides stable ion beams from a 15 MV Tandem accelerator and neutron-rich radioactive ion beams (RIB) from the interaction of a γ -flux induced by a 50 MeV 10 μA electron beam in a uranium carbide target. A magnetic dipole mass separator and a resonance ionization laser ion source allow to select the ions of interest. New setups are under preparation to extend the fundamental properties measured at ALTO of ground and excited states of exotic nuclei. For example, high-precision mass measurements for an accurate determination of the nuclear binding energy. To perform these measurements two devices will be hosted at ALTO: a radio frequency quadrupole to cool and bunch (RFQCB) the continuous radioactive beam and the double Penning trap mass spectrometer MLLTRAP, commissioned off-line at the Maier-Leibnitz Laboratory (MLL) in Garching, Germany. The unique production mechanism using photo-fission at the ALTO facility allows for mass measurements in a neutron rich area of nuclides of major interest around 132 Sn with less isobaric contamination than using proton drivers. In this context, we plan to measure neutron-rich silver isotopes (Z = 47, A > 121) to explore the possible weakening of the shell gap for Z

Background Although live and teledermoscopic examination has been successfully used to achieve non-invasive diagnosis of melanocytic skin lesions (MSLs), early melanoma (EM) and atypical nevi (AN) continue to be a challenge, and none of the various algorithms proposed have been sufficiently accurate. We designed a scoring classifier diagnostic method, the iDScore that combines clinical data of the patient with dermoscopic features of the MSL. Objective To test the accuracy of the iDScore in differentiating EM from AN in a teledermoscopy setting and to compare it with intuitive diagnosis, the ABCD rule and the seven-point checklist. Materials and methods A dedicated teledermoscopy web platform was designed. This involved the following: (i) collecting a large integrated clinical-historical-dermoscopic data set of difficult MSLs from eight European dermatology centres; (ii) online testing, education and training in using the iDScore. A total of 904 images were combined with age, sex, lesion diameter and body site data and evaluated on the platform by 111 participants with four levels of skill in dermoscopy. Each testing session consisted of 30 blind cases to examine consecutively by the above four methods. 'Management decisions' and personal participant data were also recorded. Results iDScore-aided diagnosis achieved satisfactory diagnostic accuracy for all lesions, irrespective of centre of affiliation, showing an average AUC of 0.776 in all participant testing sessions. All skill groups improved their accuracy by 10-16% with respect to intuitive diagnosis and the other methods, showing high concordance and avoiding wrong management decisions. Conclusion We demonstrated the validity of the iDScore method for managing suspicious MSLs in a large multicentric data set and a teledermoscopic setting. The platform designed for the iDScore project provides ready support for physicians of any dermoscopy skill level and is useful for education and training.

Resume Introduction La navigation electromagnetique endobronchique (ENB) est une methode recente basee sur la reconstruction en 3 dimensions du scanner thoracique et d’un guidage electromagnetique. Elle permet d’effectuer un cheminement jusqu’au nodule pulmonaire peripherique et, ainsi, de le biopsier. Methode Nous rapportons nos 30 premiers mois d’experience (juin 2016 a decembre 2018) de l’utilisation de l’ENB chez 101 patients. Resultats L’ENB a ete utilisee chez 3,5 % des patients adresses pour le diagnostic d’images pulmonaires anormales et representait 19 % des examens effectues en seconde intention. La sensibilite de l’ENB etait de 64 % (IC 95 % : 52–74 %) pour des lesions de 21 mm en moyenne, avec une progression au fil du temps (sensibilite 69 % les 18 derniers mois). La presence d’une bronche visible au sein de la lesion augmentait la sensibilite de l’ENB a 74 %. Un pneumothorax est survenu chez 5 patients (5 %) dont 4 draines. Aucun patient atteint de BPCO severe n’a presente de pneumothorax. Il n’y a eu aucune hemoptysie ni aucun deces lie a l’ENB. Conclusion La navigation electromagnetique endobronchique est une procedure peu invasive qui a parfaitement sa place pour le diagnostic histologique des nodules pulmonaires peripheriques, chez des patients pour qui aucune autre procedure n’a ete contributive ou n’etait realisable. Son utilisation en premiere intention est actuellement limitee par son cout.

The reduced transition probabilities B ( E 2 ; 0 g.s. + → 2 1 + , 2 2 + ) in Zn 70 and the full B ( E 2 ; 0 g.s. + → 2 + ) strength up to S n = 7.79 MeV in Ni 68 have been determined at the LISE/GANIL facility using the Coulomb-excitation technique at intermediate beam energy on a Pb 208 target. The γ rays emitted in-flight were detected with an array of 46 BaF 2 crystals. The angles of the deflected nuclei were determined in order to disentangle and extract the Coulomb and nuclear contributions to the excitation of the 2 + states. The measured B ( E 2 ; 0 g.s. + → 2 1 + ) of 1432(124) e 2 fm 4 for Zn 70 falls in the lower part of the published values which clustered either around 1600 or above 2000 e 2 fm 4 , while the B ( E 2 ; 0 g.s. + → 2 2 + ) of 53(7) e 2 fm 4 agrees very well with the two published values. The relatively low B ( E 2 ; 0 g.s. + → 2 1 + ) of 301(38) e 2 fm 4 for Ni 68 agrees with previous studies and confirms a local magicity at Z = 28 , N = 40 . Combining the results of the low-energy spectra of Ni 68 and Zn 70 and their shell-model interpretations, it is interesting to notice that four different shapes (spherical, oblate, prolate, and triaxial) are present. Finally, a summed E 2 strength of only about 150 e 2 fm 4 has been found experimentally at high excitation energy, likely due to proton excitations across the Z = 28 gap. The experimental distribution of this high-energy E 2 excitation agrees with shell-model calculations, but its strength is about two times weaker.

Our aim was to analyse whether biomarkers extracted from baseline 18F-FDG PET before anti-PD1 treatment contribute to prognostic survival information for early risk stratification in metastatic melanoma. Fifty-six patients, without prior systemic treatment, BRAF wild type, explored using 18F-FDG PET were included retrospectively. Our primary endpoint was overall survival (OS). Total metabolic tumoral volume (MTV) and forty-one IBSI compliant parameters were extracted from PET. Parameters associated with outcome were evaluated by a cox regression model and when significant helped build a prognostic score. Median follow-up was 22.1 months and 21 patients died. Total MTV and long zone emphasis (LZE) correlated with shorter OS and served to define three risk categories for the prognostic score. For low, intermediate and high risk groups, survival rates were respectively 91.1% (IC 95 80–1), 56.1% (IC 95 37.1–85) and 19% (IC 95 0.06–60.2) and hazard ratios were respectively 0.11 (IC 95 0.025–0.46), P = 0.0028, 1.2 (IC 95 0.48–2.8), P = 0.74 and 5.9 (IC 95 2.5–14), P

Aicardi-Goutieres syndrome (AGS) is a rare autosomal recessive disorder first described by Jean Aicardi and Francoise Goutieres in 19841 . Given the elevated serum and cerebrospinal fluid (CSF) levels of interferon-α (IFNα), it belongs to the group of type 1 interferonopathies2 . Cutaneous manifestations are the most frequent extra neurologic findings and include chilblain-like lesions (CLL), acrocyanosis, distal tapering of digits, and nail abnormalities3-5 .

Though the diagnosis of actinic keratoses is most often clinical, it is sometimes necessary to use non-invasive imaging methods to confirm this diagnosis. Reflectance confocal microscopic examination of actinic keratosis may reveal hyperkeratosis (i.e., detached, isolated or scaly corneocytes), parakeratosis (i.e., nucleated cells in the stratum corneum), dilated vessels and signs of solar elastosis, including clusters of moderately reflecting material and/or undulating shiny elastic fibres that are clearly visible in the superficial dermis. Hopefully, new in vivo microscopic imaging techniques such as line-field confocal optical coherence tomography will make it possible to obtain a three-dimensional examination of the skin and, thus, to further improve diagnostic accuracy of these lesions. © 2019 Elsevier Masson SAS. All rights reserved. Cet article fait partie du numero supplement Keratoses actiniques : comprendre et traiter realise avec le soutien institutionnel de Galderma International.

Methotrexate (MTX) is a major systemic treatment for moderate to severe plaque psoriasis. A randomized trial has recently been published evaluating a single weekly dosage (17.5mg), but few prospective real-life data are available. The main objective of this study was to prospectively evaluate the efficacy of MTX in real-life. The secondary objectives were to evaluate predictive parameters for treatment efficacy and the frequency of adverse events.A prospective cohort involving consecutive at in 25 centres belonging to GEM RESOPSO included all adults with plaque psoriasis in whom MTX treatment was initiated. The efficacy criterion was achievement of PASI 75 at week (W) 12/16. The impact of demographic data, psoriasis characteristics (duration, topography, rheumatism), dosage (W12/16 dosage, cumulative dose after 4 weeks), and mode of administration (subcutaneous vs. oral, concomitant use of folic acid) on efficacy was evaluated. Intention-to-treat (ITT),per protocol (PP), and multivariate analyses were performed.Two hundred and fifty-six patients (F/M: 105/151; mean age: 45.0 years; rheumatism: 12.6%) with plaque psoriasis were included. 99 patients were not analysed at W12/16 (16 because of inefficacy, 16 because of intolerance, 56 were lost to follow-up or had data missing). PASI 75 was achieved in 98 patients, with efficacy of 38.3% in the ITT analysis and 58.3% in the PP analysis. In the ITT analysis, absence of previous use of cyclosporine (P=0.01) and a cumulative dose of MTX60mg after 4 weeks (P0.0001) were associated with higher PASI 75 rates. In the PP analysis, only absence of previous use of cyclosporine (P=0.0009) was associated with a better PASI 75 results. There was no association between PASI 75 and patient characteristics (including body mass index), clinical aspects of psoriasis, route of administration, combination with folic acid, or W12/16 dose. Adverse events were reported by 34.8% of patients. These consisted mainly of digestive disorders (nausea, abdominal pain), asthenia and moderate hepatic cytolysis. The frequency of adverse events was correlated with methotrexate dosage.The efficacy of MTX in plaque psoriasis in this real-life study of 256 patients is consistent with the data in the literature, including the recently published randomized trial (41% PASI 75). This rate was unaffected by patient weight, route of administration and combined use of folic acid. Absence of previous use of cyclosporine appears to be associated with better efficacy although there is no clear explanation for this. The initial dosage (high dose in the first month) appears to be associated with superior efficacy for W12/W16.

Introduction Il n’y a pas, à notre connaissance, de publication décrivant précisément la sévérité et l’évolution de l’infection à SARS-CoV-2 dans la spondyloarthrite (SpA). Les données sur la COVID-19 issues des cohortes de patients avec maladies inflammatoires à médiation immunitaire concernent de faibles effectifs de SpA. Notre objectif était de décrire la sévérité et l’évolution de la COVID-19 dans une large cohorte de patients atteints de SpA (SpA axiale et rhumatisme psoriasique) et d’identifier les facteurs associés aux formes sévères. Patients et méthodes Patients : spondyloarthrites (SpA) de la French RMD COVID-19 cohort (cohorte observationnelle, nationale, multicentrique) avec un diagnostic de COVID-19 (clinique, PCR, scanner ou sérologie). Données collectées : démographiques, type de SpA, comorbidités, traitements, gravité de la COVID-19. La gravité de la COVID-19 a été classée en fonction des soins nécessaires : bénin = soins ambulatoires ; modéré = traitement hospitalier non intensif ; sévère = admission en unité de soins intensifs ou décès ; grave = modéré ou sévère. Analyses statistiques : des modèles de régression logistique ont été utilisés pour identifier les facteurs associés à ces formes graves. Toutes les variables avec p

BackgroundTo our knowledge, no published work has described precisely the severity and evolution of SARS-CoV-2 infection in patients with spondyloarthritis (SpA). Data on COVID-19 from cohorts of patients with immune-mediated inflammatory diseases concern small samples of SpA.ObjectivesOur objective was to describe the severity and course of COVID-19 in a large cohort of patients with SpA, including axial SpA (axSpA) and psoriatic arthritis (PsA), and to identify factors associated with severe forms.MethodsPatients: individuals with Spondyloarthritis (SpA) from the French RMD COVID-19 cohort (observational, national, multicenter cohort) with a diagnosis of COVID-19 (clinical, PCR, CT or serology) were included.Data collected: demographics, type of SpA, comorbidities, treatments, severity of COVID-19. Severity of COVID-19 was graded according to care needed: mild = outpatient care; moderate = non-intensive hospital treatment; severe = intensive care unit admission or death; severe = moderate or severe.Statistical analyses: Logistic regression models were used to identify factors associated with these severe forms. All variables with p ResultsBetween March 2020 and April 2021, 626 SpAs reported COVID-19 with a mild course in 508 cases (81.1%), moderate in 93 cases (14.8%), and severe in 25 cases (3.9%), including 6 deaths.The cohort analyzed included 349 women (55.8%), mean age 49.3 ± 14.1 years, mean BMI 27.1 ± 5.4 with 403 axSpA (64.4%), 187 PsA (29.9%) and 36 other SpA, duration of disease 11.3 ± 9.8 years; 352 (56.2%) had at least one comorbidity, of which obesity (23.6%), hypertension (15.5%), and smoking (10.4%) were the most frequent. Among them, 104 were treated with NSAIDs (16.6%), 186 with conventional synthetic disease-modifying antirheumatic drugs (DMARDs) including 156 MTX, and 460 (73.5%) with biological DMARDs (379 TNFi, 57 IL-17i, 15 IL-23p19/p40i, 9 others).The following variables were associated with severe COVID-19 outcomes: age, body mass index, chronic obstructive lung disease, cardiovascular disease, diabetes, hypertension, interstitial lung disease, renal failure, and corticosteroids intake.The factors independently associated with severe COVID-19 outcomes were corticosteroid intake (3.15 [CI95%: 1.46-6.76], p 0.004), and age (OR=1.06 [CI95%: 1.04-1.08], p ConclusionThe course of COVID-19 was mild for the majority of SpA patients (81.1%). Corticosteroid intake was associated with more severe COVID-19 outcomes, whereas TNFi were found to be protective.Disclosure of InterestsNone declared

Spatially-correlated overabundances of $^{15}$N and $^{18}$O observed in some low-density graphite meteoritic grains have been connected to nucleosynthesis taking place in the helium-burning shell during core-collapse supernovae. Two of the reactions which have been identified as important to the final abundances of $^{15}$N and $^{18}$O are $^{18}$F($n,\alpha$)$^{15}$N and $^{18}$F($n,p$)$^{18}$O. The relative strengths of the $^{18}$F($n,\alpha$)$^{15}$N and $^{18}$F($n,p$)$^{18}$O reactions depend on the relative $\alpha_0$ and $p_0$ decays from states above the neutron threshold in $^{19}$F in addition to other properties. Experimental data on the charged-particle decays from these highly excited states are lacking or inconsistent. Two experiments were performed using proton inelastic scattering from LiF targets and magnetic spectrographs. The first experiment used the high-resolution Q3D spectrograph at Munich to constrain properties of levels in $^{19}$F. A second experiment using the Orsay Split-Pole spectrograph and an array of silicon detectors was performed in order to measure the charged-particle decays of neutron-unbound levels in $^{19}$F. A number of levels in $^{19}$F have been identified along with their corresponding charged-particle decays. The first state above the neutron threshold which has an observed proton-decay branch to the ground state of $^{18}$O lies 68 keV above the neutron threshold while the $\alpha$-particle decays from the neutron-unbound levels are generally observed to be much stronger than the proton decays. Neutron-unbound levels in $^{19}$F are observed to decay predominantly by $\alpha$-particle emission, supporting the role of $^{18}$F($n,\alpha$)$^{15}$N in the production of $^{15}$N in the helium-burning shell of supernovae. Improved resonant-scattering reaction data are required in order to be able to determine the reaction rates accurately.

Classical novae result from thermonuclear explosions producing several $\gamma$-ray emitters which are prime targets for satellites observing in the MeV range. The early 511 keV gamma-ray emission depends critically on the $^{18}$F(p,$\alpha$)$^{15}$O reaction rate which, despite many experimental and theoretical efforts, still remains uncertain. One of the main uncertainties in the $^{18}$F(p,$\alpha$)$^{15}$O reaction rate is the contribution in the Gamow window of interference between sub-threshold $^{19}$Ne states and known broad states at higher energies. Therefore the goal of this work is to clarify the existence and the nature of these sub-threshold states. States in the $^{19}$Ne compound nucleus were studied at the Tandem-ALTO facility using the $^{19}$F($^3$He,t)$^{19}$Ne charge exchange reaction. Tritons were detected with an Enge Split-pole spectrometer while decaying protons or $\alpha$-particles from unbound $^{19}$Ne states were collected, in coincidence, with a double-sided silicon strip detector array. Angular correlations were extracted and constraints on the spin and parity of decaying states established. The coincidence yield at $E_x$ = 6.29 MeV was observed to be high spin, supporting the conclusion that it is indeed a doublet consisting of high spin and low spin components. Evidence for a broad, low spin state was observed around 6 MeV. Branching ratios were extracted for several states above the proton threshold and were found to be consistent with the literature. R-matrix calculations show the relative contribution of sub-threshold states to the astrophysically important energy region above the proton threshold. The levels schemes of $^{19}$Ne and $^{19}$F are still not sufficiently well known and further studies of the analogue assignments are needed. The tentative broad state at 6 MeV may only play a role if the reduced proton width is large.

The unbound proton-rich nuclei $$^{16}$$ F and $$^{15}$$ F are investigated experimentally and theoretically. Several experiments using the resonant elastic scattering method were performed at GANIL with radioactive beams to determine the properties of the low lying states of these nuclei. Strong asymmetry between $$^{16}$$ F– $$^{16}$$ N and $$^{15}$$ F– $$^{15}$$ C mirror nuclei is observed. The strength of the $$nucleon-nucleon$$ effective interaction involving the loosely bound proton in the $$s_{1/2}$$ orbit is significantly modified with respect to their mirror nuclei $$^{16}$$ N and $$^{15}$$ C. The reduction of the effective interaction is estimated by calculating the interaction energies with a schematic zero-range force. It is found that, after correcting for the effects due to changes in the radial distribution of the single-particle wave functions, the mirror symmetry of the $$n-p$$ interaction is preserved between $$^{16}$$ F and $$^{16}$$ N, while a difference of 63% is measured between the $$p-p$$ versus $$n-n$$ interactions in the second excited state of $$^{15}$$ F and $$^{15}$$ C nuclei. Several explanations are proposed.

Introduction Les patients ayant une maladie bulleuse auto-immune (MBAI) etant a risque d’infection (âge, traitement corticoide et/ou immunosuppresseur), nous avons evalue le risque de la COVID-19 et de ses formes severes chez les patients ayant une MBAI. Materiel et methodes Cette etude retrospective multicentrique (49 services de dermatologie) a inclus tous les cas connus de COVID survenus entre janvier et juin 2020 en France metropolitaine. Les cas ont ete classes en certains (PCR + ), probables (PCR− ou non faite, TDM pulmonaire evocateur) ou possibles (PCR et TDM negatifs ou non faits mais signes cliniques et/ou cas contacts). L’incidence cumulee des cas de COVID a ete calculee a partir des cas certains et hospitalises de patients MBAI suivis dans chaque service, puis comparee a celle dans la population generale sur la meme periode (donnees Sante Publique France) apres standardisation indirecte sur l’âge et la region. L’incidence et le pronostic ont ete analyses pour l’ensemble des MBAI et pour le sous-groupe ayant recu du rituximab (RTX) dans les 9 derniers mois. Resultats Incidence : 59 cas de COVID-19 ont ete recenses (âge : 73,1 ± 16,2 ans) parmi 5180 patients suivis pour une MBAI : 29 (49 %) correspondaient a des cas certains, 8 (14 %) probables et 22 (37 %) possibles. Les MBAI etaient une PB (n = 21, 36 %), une P muqueuse (PM) (PC/EBA, n = 19, 32 %), un pemphigus (n = 18, 31 %) et 1 P gestationnelle (n = 1, 2 %). Le ratio d’incidence standardise (RIS) etait de 0,42 [IC95 % : 0,20–0,80] p = 0,005 pour les PB, 1,02 [0,37–2,26], p = 0,91 pour les pemphigus et de 1,18 [0,55–2,23], p = 0,62 pour les PM. Parmi les 516 patients ayant recu du RTX, on comptait 22 cas possibles probables ou certains d’infection COVID correspondant a un RI = 5,37 [3,15–8,96], parmi lesquels 13 cas probables ou certains (RI = 4,90 [2,43–9,40]) par rapport aux patients n’ayant pas recu de RTX, et un RI de formes certaines et hospitalisees de 3,62 [1,29–8,85]. Pronostic 30 cas (51 %) ont ete hospitalises pour COVID et 15 (25 %) sont decedes (RR = 1,63 [0,83–2,55] p = 0,13 par rapport a la population generale ajustee a l’âge et a la region. Un patient MBAI avait 3,4 [2,2–5,1] fois plus de risque de deceder sur la periode epidemique s’il contractait la COVID que s’il ne la contractait pas. L’âge moyen des patients ayant une forme severe (hospitalisation ou deces) de COVID etait plus eleve que celui de ceux ayant une forme non severe (77,9 ± 11,2 vs 65,0 ± 19,3, p = 0,006). Les RR de forme severe des PM/pemphigus avec COVID probable ou certaine traites par RTX (âge moyen 68,8 ± 14,9) etaient respectivement de 0,77 [0,45–1,33] p = 0,33 et de 0,51 [0,08–2,56] p = 0,40 par rapport aux PM/pemphigus avec COVID non traites par RTX (âge moyen 76,7 ± 9,1). Discussion La COVID entraine une forte surmortalite chez les patients MBAI. L’incidence semble particulierement elevee parmi les patients ayant recu du RTX, sans que l’on puisse conclure a une plus grande severite de la COVID-19 chez ces patients.

Background Line-field confocal optical coherence tomography (LC-OCT) is a non-invasive optical technique recently developed for skin examination in vivo. It provides real-time, high-resolution vertical images with an isotropic resolution of similar to 1 mu m and a penetration depth of similar to 500 mu m. Objectives Study goals were to qualitatively/quantitatively characterize healthy skin at different body sites using LC-OCT. Methods The skin of young healthy volunteers was imaged with a handheld LC-OCT imaging device. Seven body sites (back of the hand, forehead, cheek, nose, chest, forearm and back) were investigated. An independent qualitative [cutaneous structures' description; visibility of keratinocytes' nuclei and dermal-epidermal junction (DEJ)] and quantitative [stratum corneum (SC)/epidermal thicknesses; height of dermal papillae] assessment of the LC-OCT images was performed. Results A total of 88 LC-OCT images were collected from 29 participants (20 females; nine males; mean age 25.9 years). Keratinocytes' nuclei and DEJ were visible in the totality of images. The different layers of the epidermis and the remaining cutaneous structures/findings were visualized. Body sites-related variability was detected for SC/epidermal thicknesses and height of dermal papillae. Inter-observer agreement was excellent (SC thickness), good-to-excellent (epidermal thickness) and moderate-to-good (papillae). Conclusions Line-field confocal-OCT provides non-invasive, real-time imaging of the skin in vivo with deep penetration and high resolution, enabling the visualization of single cells. The histology-like vertical view provides an easy way to recognize/measure different cutaneous structures/findings. LC-OCT appears as a promising technique for the examination of physiological/pathological skin.

An inelastic $\alpha$-scattering experiment on the unstable $N=Z$, doubly-magic $^{56}$Ni nucleus was performed in inverse kinematics at an incident energy of 50 A.MeV at GANIL. High multiplicity for $\alpha$-particle emission was observed within the limited phase-space of the experimental setup. This observation cannot be explained by means of the statistical-decay model. The ideal classical gas model at $kT$ = 0.4 MeV reproduces fairly well the experimental momentum distribution and the observed multiplicity of $\alpha$ particles corresponds to an excitation energy around 96 MeV. The method of distributed $m\alpha$-decay ensembles is in agreement with the experimental results if we assume that the $\alpha$-gas state in $^{56}$Ni exists at around $113^{+15}_{-17}$ MeV. These results suggest that there may exist an exotic state consisting of many $\alpha$ particles at the excitation energy of $113^{+15}_{-17}$ MeV., Comment: Accepted for publication in the European Physical Journal A

Background Early diagnosis and subtype classification of basal cell carcinoma (BCC) are crucial to reduce morbidity and optimize treatment. Good accuracy in differentiating BCC from clinical imitators has been achieved with existing diagnostic strategies but lower performance in discriminating BCC subtypes. Line-field confocal optical coherence tomography (LC-OCT) is a new technology able to combine the technical advantages of reflectance confocal microscopy and OCT. Objectives To identify and describe LC-OCT criteria associated with BCC and explore their association with BCC subtypes. Methods Basal cell carcinoma were imaged with a handheld LC-OCT device before surgical excision. LC-OCT images were retrospectively evaluated by three observers for presence/absence of criteria for BCC. Multivariate logistic regression models were used to find independent predictors of BCC subtypes. Results Eighty-nine histopathologically proven BCCs were included, of which 66 (74.2%) were pure subtypes [superficial BCC (sBCC): 19/66 (28.8%); nodular BCC (nBCC): 31/66 (47.0%); infiltrative BCC (iBCC): 16/66 (24.2%)]. Lobules, blood vessels and small bright cells within epidermis/lobules were the most frequent criteria for BCC. LC-OCT criteria independently associated with sBCC were presence of hemispheric lobules, absence of lobule separation from the epidermis, absence of stretching of the stroma; with nBCC were presence of macrolobules, absence of lobule connection to the epidermis; and with iBCC were presence of branched lobules. Conclusions This was the first study describing the characteristics of BCC under LC-OCT examination. We proposed morphologic criteria, which could be potentially useful for diagnosis and subtype classification of BCC, as well as for its therapeutic management. Future studies are needed to assess these hypotheses.

INTRODUCTION : Les tumeurs stromales gastro-intestinales (GIST) sont des sarcomes digestifs les plus fréquents et constituent 18 à 20% de l’ensemble des sarcomes des tissus mous. Ce sont des tumeurs mésenchymateuses du tractus gastro-intestinal avec un risque élevé de transformation maligne. Leur diagnostic repose sur l’histologie et la mise en évidence de l’expression de C-KIT par immunohistochimie ou d’une mutation de KIT ou PDGFRA par biologie moléculaire. Elles peuvent se développer sur l’ensemble des segments du tube digestif allant de l’œsophage jusqu’à l’anus. Elles sont souvent asymptomatiques. Le diagnostic est fortuit dans la majorité des cas. Le traitement curatif reste la résection chirurgicale, associé à un inhibiteur sélectif des récepteurs de la tyrosine kinase (Imatinib) en adjuvant ou en néo-adjuvant pour améliorer la morbi-mortalité associée aux GIST. L’objectif de cette étude était d’analyser les résultats de la prise en charge des GIST au Centre Hospitalier de Vichy. MATERIELS ET METHODES : Entre 2010 et 2020, les données de six patients opérés au centre hospitalier de Vichy pour GIST ont été analysées. Les paramètres étudiés étaient : l’âge, le sexe, les antécédents, les circonstances de découvertes, le bilan morphologique, le geste opératoire, les données anatomopathologiques, le suivi et la morbi-mortalité. RESULTATS : Il s’agissait de cinq hommes et une femme avec âge moyen de 72,16 ans (58 – 80 ans). Le délai moyen d’évolution était de huit mois (zéro à 14 mois). Le diagnostic était fortuit dans deux cas. La douleur abdominale atypique était le maitre symptôme dans trois cas. Un cas a été reçu dans un tableau de syndrome d’irritation péritonéale. L’écho-endoscopie avec l’examen histologique de la pièce de biopsie a permis de poser le diagnostic dans cinq cas. L´histologie de la pièce opératoire a confirmé le diagnostic dans un cas. Le type fusiforme était la forme histologique prédominante. L’estomac était la localisation la plus fréquente. La taille moyenne des GIST était de 7,3x4 cm avec un C-KIT positif chez tous les patients. Une chimiothérapie néoadjuvante a été faite chez un patient. La chirurgie était curative et par voie laparoscopique chez quatre patients. Une chimiothérapie adjuvante à base d´imatinib à raison de 400 mg/j chez trois patients a été instauré. Un patient avait présenté une fistule de l’anastomose œso-jéjunale à J6 post-opératoire jugulée par un drainage et une antibiothérapie. La mortalité était nulle. CONCLUSION : Les GIST sont des tumeurs mésenchymateuses les plus fréquentes du tractus digestif avec une localisation préférentielle gastrique. La chirurgie par approche laparoscopique, avec les progrès de la biologie moléculaire et l’introduction de la thérapie ciblée ont amélioré la prise en charge de ces tumeurs en termes de morbi-mortalité.

Background The anatomical location of atypical melanocytic skin lesion (aMSL) was never combined into an algorithm for discriminating early melanomas (EM) from atypical nevi (AN). Aims To investigate the impact of body location on the intuitive diagnosis performed in tele-dermoscopy by dermatologists of different skill levels. A further aim was to evaluate how the integration of the body location could improve an algorithm-aided diagnosis. Methods We retrospectively collected 980 standardized dermoscopic images of aMSL cases (663 AN, 317 EM): data on the anatomical location were collected according to 15 body sites classified into 4 macro-areas of chronically/ frequently/seldom/rarely exposure. Through a teledermatology web platform, 111 variously skilled dermoscopists performed either the intuitive diagnosis and 3 algorithm-assisted diagnostic tests (i.e., iDScore, 7-point checklist, ABCD rule) on each case, for a total of 3330 examinations. Results In the rarely photoexposed area (side, bottom, abdomen), AN were the most tricky (i.e., highest quote of false positives), due to a frequent recognition of dermoscopic features usually considered as suggestive for melanoma in these lesions; the EM at these sites received the highest quote of false negatives, being generally interpreted as "featureless" according to these traditional parameters, that were more frequently displayed on the chronically photoexposed area. In rarely and seldom photoexposed area, intuitive diagnosis fails to achieve adequate accuracy for all aMSLs, as the ABCD rule and the 7-point checklist; by applying the iDScore algorithm the diagnostic performance was increased by 15% in young and 17% in experts. Conclusions The body location of an aMSL can affect the quality of intuitive dermoscopic diagnosis, especially in sun-protected areas. Accuracy can be improved by using the iDScore algorithm that assign a different partial score of each body site.

International audience; Background/Objectives Sarcopenia defined by the association of skeletal muscle mass depletion and a decreased physical performance is underdiagnosed in chronic obstructive pulmonary disease (COPD) patients. The objective was to assess prevalence of sarcopenia and malnutrition in hospitalized COPD patients during an acute exacerbation, after 6 months follow-up and the 1-year survival. Subjects/Methods Hospitalized COPD patients were recruited for the assessment of body composition, handgrip strength, respiratory function, and maximal inspiratory and expiratory pressures (MIP and MEP), during hospitalization and 6 months later. Sarcopenia was defined according to the criteria of the European Working Group on Sarcopenia in Older Adults, malnutrition was defined according to French criteria 2007. Survival data were collected 12 months after hospitalization. Results We analyzed data from 54 patients, aged 68 +/- 9 years and BMI 26.9 +/- 7.8 kg/m(2), with an average FEV1 of 1.13 +/- 0.49 l (45 +/- 16% predicted value). Sarcopenia and malnutrition prevalence were, respectively, 48% and 52% during hospitalization, 30% and 30% after 6 months. MIP and MEP were lower in sarcopenic patients (p = 0.01 and 0.009, respectively). In multivariate analysis, skeletal muscle mass index and MIP were positively correlated at 6 months' follow-up (r = 0.40, p = 0.04). The 1-year survival rate was lower in sarcopenic patients (65 vs 86%, p = 0.03), particularly when malnutrition was associated (p = 0.02). Conclusions Sarcopenia in COPD patients is highly prevalent during and after recovery of an acute exacerbation, exposing to lower survival. A multimodal management is required to treat sarcopenia and improve prognosis.

In vivo reflectance confocal microscope (RCM) is a high-resolution noninvasive imaging technique that was initially focused on the diagnosis of skin cancers. A rising number of other indications have been later described among which the diagnosis and management of infectious dermatological disorders. RCM is particularly suitable for the identification of Sarcoptes scabies, Demodex folliculorum, Ixodes, Dermatophytes, and Candida species in the clinical practice and for the follow-up after treatment. RCM cannot observe virus directly. However, the cytopathic effect associated with some virus can be recognized even in a pre-vesicular stage. In addition, thanks to its noninvasiveness, RCM allows pathophysiological studies.

The first investigation of the single-particle structure of the bound states of 17C, via the d(16C, p) transfer reaction, has been undertaken. The measured angular distributions confirm the spin-parity assignments of 1/2+ and 5/2+ for the excited states located at 217 and 335 keV, respectively. The spectroscopic factors deduced for these states exhibit a marked single-particle character, in agreement with shell model and particle-core model calculations, and combined with their near degeneracy in energy provide clear evidence for the absence of the N = 14 sub-shell closure. The very small spectroscopic factor found for the 3/2+ ground state is consistent with theoretical predictions and indicates that the {\nu}1d3/2 strength is carried by unbound states. With a dominant l = 0 valence neutron configuration and a very low separation energy, the 1/2+ excited state is a one-neutron halo candidate., Comment: 7 pages, 5 figures, Accepted for publication in Physics Letters B

Resume Objectif L’objectif principal de cette etude etait d’analyser les facteurs associes a l’existence d’un delai diagnostique significatif chez les patients atteints d’hidradenite suppuree (HS) en France. Malades et methodes Cette etude nationale prospective multicentrique realisee d’octobre 2015 a mars 2016 incluait tous les patients consultant pour une HS. Les donnees concernant les patients etaient recueillies a l’aide d’un questionnaire standardise. Des analyses univariee et multivariee ont ete effectuees afin de recueillir les facteurs associes a un delai diagnostique significatif, defini comme un delai d’au moins 5,5 ans entre les premiers signes de la maladie et son diagnostic formel. Resultats Les 16 centres ont inclus 312 patients (62 % de femmes) d’âge moyen 35 ans. L’âge moyen de debut de l’HS etait de 22 ans. Respectivement 170 (54 %), 114 (37 %) et 45 (15 %) patients avaient consulte au moins 3, 5 et 10 medecins avant le diagnostic formel, qui etait pose par un dermatologue dans 64 % des cas. Les premiers signes d’HS etaient apparus en moyenne 6,2 ans avant la premiere consultation de dermatologie et 8,4 ans avant le diagnostic. Un tabagisme actif (Odd Ratio (OR) ajuste 1,85; p = 0,027) et un debut des signes a un âge plus precoce (OR ajuste 0,92; p Conclusion Ces resultats soulignent l’errance medicale des patients atteints d’HS, mais ne montrent pas d’association entre les caracteristiques sociodemographiques ou economiques des patients et l’existence d’un delai diagnostique significatif.

Background Cutaneous endometriosis (CE) is rare and its dermoscopic features were reported only in 3 patients. The aim of this study was to examine a case of pigmented CE with multiple non-invasive imaging techniques, to compare the obtained images with histopathology and to define their utility in an early diagnosis of the disease. Case report We performed dermoscopy, high-frequency ultrasound (HFUS), in vivo and ex vivo reflectance confocal microscopy (RCM) of a pigmented CE arising on the caesarean scar of a phototype IV patient, along with histologic studies. Dermoscopy showed a greyish background and a brownish pigmentation. HFUS shows well-demarcated anechoic areas corresponding to ectopic endometrial tissue at histopathologic examination. RCM and OCT only showed the alterations of the epidermis. Conclusion High-frequency ultrasound could represent a very useful tool for an early diagnosis of CE and its usefulness could be tested in patients with unusual cyclical pain, even before skin lesion appearance. RCM allowed the visualization of skin surface modification due to underlying endometriosic tissue. Dermoscopy showed a new aspect that was probably related to the mix of blood extravasation (ie, greyish background) and epidermal pigmentation (ie, brown pigmentation).

Background Recently, it has been shown that reflectance confocal microscopy (RCM) could identify subclinical basal cell carcinoma (BCC) during vismodegib treatment of locally advanced BCC. Objectives To evaluate specificity and sensitivity of clinical, dermoscopic and RCM examination for BCC in patients with multiple BCCs treated by vismodegib. Methods Ninety four BCCs had 710 clinical, dermoscopic and RCM examinations during 72 weeks of vismodegib treatment. Thirty-eight were biopsied at the end of the treatment. Sensitivity and specificity for these 38 lesions were calculated. BCC diagnoses of clinical, dermoscopic and RCM examination on all the 710 investigations were compared using chi-square test. Results Reflectance confocal microscopy was extremely more sensitive than dermoscopy and clinical examination and slightly less specific (sensitivity of 95%, 35% and 33% and specificity of 81%, 88% and 86% for RCM, dermoscopy and clinical examination, respectively) for the identification of residual BCC in the 38 biopsied cases. Considering all the 710 observations, RCM correctly diagnosed more BCCs than dermoscopy and clinical examination. Conclusion Reflectance confocal microscopy is a non-invasive technique that can detect subclinical residual BCC during and after vismodegib treatment helping the clinician to identify incomplete tumour regression.

Introduction Les lesions pigmentees des muqueuses genitales ne sont pas rares et leur diagnostic a l’aide de la dermatoscopie × 20 est parfois complexe. La microscopie confocale in vivo (MCIV) est plus performante mais d’usage limite notamment du fait de son cout financier. Or, une camera de dermatoscopie avec un grossissement × 400 a recemment ete commercialisee, permettant une vision a l’echelle cellulaire a moindre cout. Nous avons souhaite comparer ces deux techniques d’imagerie pour l’exploration des tumeurs genitales pigmentees. Materiel et methodes Il s’agit d’une etude observationnelle, prospective et monocentrique menee au CHU de Saint-Etienne, d’octobre 2017 a mai 2019, lors de consultations mixtes des muqueuses genitales. Nous avons collige les donnees cliniques, de MCIV et de dermatoscopie × 400 de 207 lesions genitales pigmentees. Les images ont ete lues par trois investigateurs experts. Les criteres suivants etaient recherches : un patron en anneaux plus ou moins etires, la presence de cellules dendritiques, dodues, rondes et fusiformes. La concordance intra-evaluateur entre les criteres observes en dermatoscopie × 400 et ceux observes en MCIV etait analysee grâce au coefficient kappa de Cohen. La correlation etait consideree comme presque parfaite pour un kappa superieur a 0,80, forte pour un kappa entre 0,60 et 0,80, moderee pour un kappa entre 0,40 et 0,60 et faible en deca. Resultats Notre serie comprenait 183 melanoses, 19 naevus, 1 carcinome basocellulaire, 2 condylomes et 2 melanomes. La concordance entre la dermatoscopie × 400 et la MCIV etait moderee a forte pour l’identification du patron en anneaux (kappa calcule pour chacun des trois evaluateurs respectivement a 0,64 ; 0,53 ; 0,49) et des cellules rondes en amas (kappa 0,65 ; 0,75 ; 0,55). La concordance etait forte pour les cellules dendritiques (kappa 0,63 ; 0,78 ; 0,76) et dodues (kappa 0,73 ; 0,62 ; 0,63). Elle etait parfaite (kappa 1 pour les 3 evaluateurs) pour les cellules rondes isolees et les cellules fusiformes. Discussion Notre serie est representative des donnees de la litterature en ce qui concerne la repartition des differents types de lesions. La concordance entre les criteres observes en MCIV et ceux observes en dermatoscopie × 400 est globalement bonne, et ce pour chacun des 3 evaluateurs. La dermatoscopie × 400 semble pouvoir analyser un certain nombre de criteres identiques a la MCIV. Elle parait donc prometteuse dans l’exploration des tumeurs pigmentees genitales. Sa facilite d’apprentissage et son cout abordable devrait en faire un outil diagnostique utilisable a grandes echelles chez les dermatologues.