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There is currently little information on switching biologics in pediatric psoriasis.To evaluate the real-world clinical practice and safety of switching biologics in the "Biological Treatments for Pediatric Psoriasis" (BiPe) cohort.Data for all 134 patients included in the BiPe cohort were analyzed. A further evaluation of the subpopulation of patients who switched from a first-line biologic to a second-line biologic was then conducted. Drug survival rates were also compared between biologics given as first-line or second-line agents.Overall, 29 patients (female: 55%; mean age: 16.6 ± 3.0 years) switched between two biologics. Etanercept (ETN) was the first-line biologic used in 23 patients: 16 (69.6%) switched to adalimumab (ADA) and seven (30.4%) to ustekinumab (UST). Six patients received first-line ADA and switched to UST. Loss of efficacy (62.1%), primary inefficacy (20.7%), and parental choice (6.9%) were the main reasons for switching biologics. One (3.4%) of the switches was performed because of adverse events or intolerance. For UST and ADA, the 18-month drug survival rate did not differ according to whether the agent was given as a first-line or second-line biologic (UST: P = .24; ADA: P = .68). No significant differences in drug survival rates were observed between the three different switches (ADA to UST, ETN to ADA, and ETN to UST).Our study provided key insights into the real-life clinical practice of switching biologics in pediatric psoriasis patients. However, more information and guidance on switching biologics in pediatric psoriasis are needed to improve real-life practice and outcomes.

Background: The prevalence and impact of pruritus, pain, and other sensory symptoms in skin diseases are poorly known. Objective: To assess the frequency of these symptoms with dermatoses and their association with depression using data from the “Objectifs Peau” survey. Methods: A representative sample of 20,012 French individuals was created using the usual quota method. Results: When patients suffered from both pruritus and skin pain, they had a higher relative risk of psychological suffering (2.9) than those who suffered only from pruritus (1.4) or skin pain (1.2). Pruritus was reported in 48.55% of patients with acne, 43.24% with mycoses, 44.35% with warts, and 36.51% with rosacea. For skin pain, the results were 11.22%, 27.59%, and 16.13% for atopic dermatitis, acne, and warts, respectively. Other unpleasant sensations, such as tingling or burning, were also frequently reported. Conclusion: Pruritus, pain, or other sensory symptoms were found to be common not only in classic pruritic skin diseases but also in acne, rosacea, or warts. The association of pruritus and pain dramatically increased psychological suffering. These symptoms must be systematically searched for in patients, especially since new therapeutic possibilities are emerging for the symptomatic treatment of pruritus.

Sun protection products serve as part of a strategy to prevent photoinduced skin cancers. The products currently on the market vary considerably, both in terms of their galenic formulation and their composition. Some are formulated using organic UV filters, some using mineral UV filters, and some using a mixture of both types. In this context, healthcare professionals, particularly dermatologists and pharmacists, are faced with selecting the product best suited to the patient/user, especially during summer. Our aim here is to establish a decision tree to enable an informed choice.

The French government imposed the first COVID-19 pandemic lockdown from March 17 until May 11, 2020. Only emergency cases and teledermatology (TD) were allowed in outpatient settings. A standardized questionnaire was developed to compare the satisfaction level of patients and their treating physicians. Our main question was whether the patients would perceive TD as a valid alternative for direct physical face-to-face consultation. Eighty-two patients and their 4 treating dermatologists from one dermatology department participated in the study (43 females, 39 males) with a mean age of 46.6 years (SD ±23.9). The reason for TD was a chronic disease in the majority (87.8%), and mainly as a follow-up (96.3%). Regarding satisfaction, almost all categories rated around 9 on a 0–10 verbal analogue scale. The same level of global satisfaction could be seen between the patients and the physicians as well as for the quality of the patient-physician relation and whether all questions could be addressed during the TC. Physicians showed significantly higher scores than patients only for the category of “length” of the consultation. Gender, age, as well as distance between the clinic and home of the patient were not influencing factors for satisfaction. Regarding the technical parameters, the evaluation was mostly comparable for patients and physicians, but overall lower than the relational satisfaction parameters, especially for image quality. Patients were significantly more motivated to continue the TD after the lockdown than their treating dermatologists. We see an interest for implementing TD in specialized centers with chronic patients coming from remote places for regular follow-ups. TD cannot replace in-person patient-physician interaction, but was helpful during the lockdown. As a result, TD might become part of dermatology training to prepare for future lockdown situations.

Triggering factors of sensitive skin are supposed to be physical, chemical (cosmetics, water, and pollutants), and occasionally psychological (stress). A recent meta-analysis showed that the most important triggering factor declared by subjects is the use of cosmetics. This study was designed to compare the consumption of cosmetic products in women with sensitive skin and controls. After a dermatological examination, women between the ages of 18 and 65 years with or without sensitive skin were recruited. They completed different questionnaires about the presence of sensitive skin and use of 28 cosmetics that could be applied on the face. The amount per application was recorded for all products used at least once a week on the face. In total, 160 women were included, with a mean age of 41 ± 13 years. Two groups of 40 women were created based on the sensitive scale (SS-10 score), with the lowest SS-10 scores (nonsensitive skin group) and the highest SS-10 score (sensitive skin group). The number of products used daily was similar in the 2 groups. Women with sensitive skin were significantly more frequent users of liquid soap/soap-free gel cleansers than those without sensitive skin (70 vs. 43%). There was no difference concerning the frequency of use of products in the 2 groups. Concerning the amount of product used by application, women with sensitive skin used twice as much cream per application compared with the women without sensitive skin: 511 ± 438 μg versus 290 ± 203 μg (p = 0.039). Concerning the composition of the cosmetic products used, the only difference concerned phenoxyethanol, which was more often present in the moisturizer of women without sensitive skin (66.7%) than in those with sensitive skin (32.4%) (p = 0.007). Women with sensitive skin were more likely to buy products recommended for sensitive skin by manufacturers. The relationship of causality between the use of cosmetics and sensitive skin cannot be established. Women with sensitive skin used different cosmetic products than women without sensitive skin. Women with sensitive skin used a higher amount of moisturizer, used products recommended for sensitive skin, and bought more cosmetic products at pharmacies than supermarkets. We hypothesized that subjects with sensitive skin are looking for products that improve the sensation of skin sensitivity.

In recent years, studying the central mechanism of itch has gained momentum. However, a proper meta-analysis has not been conducted in this domain. In this study, we tried to respond to this need. A systematic search and a meta-analysis were carried out to estimate the central mechanism of itch. The itch matrix comprises the thalamus and the parietal, secondary somatosensory, insular and cingulate cortices. We have shown that the basal ganglia (BG) play an important role in itch reduction. Finally, we explored itch processing in AD patients and observed that the itch matrix in these patients was different. In conclusion, this is the first meta-analysis on the central mechanisms of itch perception and processing. Our study demonstrated that different modalities of itch induction can produce a common pattern of activity in the brain and provided further insights into understanding the underlying nature of itch central perception.

Psoriasis is a common inflammatory skin disease that starts before the age of 40 years in 3/4 cases. Pregnancy in a couple where one of the future parents has psoriasis is therefore a frequent situation that the dermatologist may encounter and must anticipate. Contraception should be systematically discussed with psoriatic patients of childbearing age, as it is mandatory with certain treatments (as methotrexate or acitretin). Information for psoriatic women planning to become pregnant seems insufficient. Patients get a lot of information on the internet, with the risk of getting wrong information. Women's questions concern the impact of the disease on the fetus, the treatment of flare-ups during pregnancy, the transmission of the disease and the safety of medication during pregnancy. There was a tendency to consider that psoriasis does not affect fertility in men, but two recent studies have shown inflammation of the genital tract in men with psoriasis, with no evidence of an effect on fertility. Regarding the choice of treatment for psoriasis in men with a paternity project, methotrexate should be avoided in the 3 months prior to conception even though the data on many pregnancies occurring on methotrexate are reassuring. Other treatments can be continued. It does not seem that psoriasis affects women's fertility, however, studies are divergent concerning fertility with sometimes a decrease in fertility which would be multifactorial. Psoriasis is associated with many co-morbidities such as diabetes, obesity, high blood pressure, smoking, depression, and these co-morbidities can also affect fertility. Genital involvement is common in psoriasis and significantly alters the sexual life of patients. This location is important to investigate and treat. In women with psoriasis, the goal during pregnancy will be to keep the skin disease stable with treatment that is compatible with embryonic and fetal life. The risk-benefit balance should be carefully weighted and discussed with the patient. In a patient who is planning to become pregnant, the treatments to be favored will be according to the severity of the psoriasis: topical steroids, UVB, cyclosporine, anti TNFα, notably certolizumab pegol. In a patient who is planning to become pregnant and has already been treated for psoriasis, consideration should be given to the recommended delay between stopping treatment and conception.

International audience; OBJECTIVES: During the COVID-19 pandemic, numerous cases of chilblains have been reported. However, in most cases, RT-PCR or serology did not confirm SARS-CoV-2 infection. Hypotheses have been raised about an interferon-mediated immunological response to SARS-CoV-2, leading to effective clearance of the SARS-CoV-2 without the involvement of humoral immunity. Our objective was to explore the association between chilblains and exposure to SARS-CoV-2. METHODS: In this multicentre case-control study, cases were the 102 individuals referred to 5 referral hospitals for chilblains occurring during the first lockdown (March to May 2020). Controls were recruited from healthy volunteers’ files held by the same hospitals. All members of their households were included, resulting in 77 case households (262 individuals) and 74 control households (230 individuals). Household exposure to SARS-CoV-2 during the first lockdown was categorized as high, intermediate or low, using a pre-established algorithm based on individual data on symptoms, high-risk contacts, activities outside the home and RT-PCR testing. Participants were offered a SARS-CoV-2 serological test. RESULTS: After adjustment for age, the association between chilblains and viral exposure was estimated at OR=3.3, 95%CI (1.4-7.3) for an intermediate household exposure, and 6.9 (2.5-19.5) for a high household exposure to SARS-CoV-2. Out of 57 case households tested, 6 (11%) had positive serology for SARS-CoV-2, whereas all control households tested (n=50) were seronegative (p=0.03). The effect of potential misclassification on exposure has been assessed in a bias analysis. CONCLUSIONS: This case-control study demonstrates the association between chilblains occurring during the lockdown and household exposure to SARS-CoV-2. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT04455308.

Introduction De nombreux cas d’engelures ont ete rapportes pendant la premiere vague de la pandemie de COVID-19. Chez certains patients, des recidives ont ete observees. Cependant, la proportion de recidives et le profil clinique des patients susceptibles d’en presenter sont incompletement elucides a ce jour. Notre objectif etait de renseigner le devenir des engelures associees au SARS-CoV-2, et de determiner les facteurs de risque de guerison incomplete. Materiel et methodes Un questionnaire de suivi etait adresse le 31 decembre 2020 aux patients ayant consulte entre mars et mai 2020 aux CHU de Rennes, Nantes, Anger, Tours, et Brest pour des engelures. Une teleconsultation etait proposee a tous les patients ayant rapporte des manifestations acrales persistantes ou recidivantes. Resultats Parmi les 82 patients ayant presente des engelures, 27 (33 %) ont gueri sans recidive, et 33 (40 %) ont recidive apres la resolution des engelures du printemps 2020. Vingt-deux (27 %) ont developpe des manifestations acrales persistantes, de type acrocyanose principalement, suivies ou non de recidives d’engelures. La plupart des recidives d’engelures a eu lieu pendant l’automne ou l’hiver. Vingt pour cent des patients avaient des antecedents d’engelures, ce qui n’etait pas associe au fait de recidiver ou de conserver des manifestations acrales : odds ratio (OR) = 1,02 ; intervalle de confiance a 95 % (IC95 %) [0,79 ; 1,32]). En revanche, les femmes avaient significativement plus de risque de presenter des manifestations acrales persistantes ou recidivantes (OR = 1,30 ; IC95 % [1,06 ; 1,59]). L’âge, les symptomes systemiques de COVID-19, la localisation et la duree de l’episode initial n’etaient pas associees au fait de guerir ou de presenter des manifestations persistantes ou recidivantes. Par ailleurs, 2 patients rapportaient des arthralgies inflammatoires simultanees aux recidives d’engelures, et 4 gardaient un syndrome sec depuis les engelures. Discussion Dix mois apres avoir rapporte des engelures associees au SARS-CoV-2, deux tiers des patients ont fait l’experience de recidives d’engelures ou de manifestations acrales persistantes. Le regroupement des recidives sur l’automne et l’hiver, periode de seconde vague de Covid-19, mais aussi de temps froid et humide, peut faire evoquer 2 types de declencheurs : une reexposition au SARS-CoV-2 ou bien des conditions climatiques favorables aux engelures. Il a ete suppose que les engelures du printemps 2020 aient ete secondaires a une reponse interferon anti-SARS-CoV-2. La reponse immunologique pourrait etre de longue duree, et entrainer localement des manifestations acrales persistantes ou recidivantes, et meme au niveau systemique des symptomes de dysimmunite.

Introduction Le role des medicaments dans la survenue d’eruptions eczematiformes du sujet âge (EESA) a ete suggere dans une etude cas-temoin francaise montrant une frequence de prise des inhibiteurs calciques de 26 % chez les patients ayant une EESA (OR de 2,5 par rapport aux temoins sans eczema). Ces resultats ont ensuite ete confirmes par une etude retrospective americaine. Des cas isoles d’EESA ont depuis ete rapportes avec le clopidogrel, les IEC, les ARAII et les diuretiques. Notre etude initiale ayant ete realisee il y a 15 ans, nous en avons realise une nouvelle pour reevaluer l’association entre les prises medicamenteuses et les EESA. Materiel et methodes Cette etude retrospective a ete conduite dans 16 centres du GREAT, FISARD ou DAG de 2018 a 2020. Nous avons compare la frequence des 10 classes medicamenteuses les plus prescrites entre la population etudiee (patients de plus de 65 ans developpant un eczema chronique sans cause identifiee) et la population generale de reference du meme âge dont les donnees ont ete obtenues grâce a l’Echantillon Generaliste des Beneficiaires (EGB) issu de la base informatique de la Securite Sociale, apres standardisation indirecte sur le sexe et l’âge. Tous les patients inclus avaient des lesions eczematiformes etendues (plus de 20 % de la surface corporelle), depuis plus de 3 mois. Une biopsie cutanee evocatrice d’eczema devait avoir ete realisee ainsi qu’une immunofluorescence directe negative ou des anticorps BPAG 1 et 2 negatifs afin d’eliminer une pemphigoide au stade pre-bulleux. Les patients n’avaient pas d’antecedent de dermatite atopique dans l’enfance. Resultats Cent quatre vingt cinq patients (120 H et 65 F) d’âge moyen 79,5 ± 7,5 ans ont ete inclus. L’hypertension arterielle representait la comorbidite la plus frequente (69,7 % des patients). Les patients prenaient en moyenne 5,0 ± 3,2 medicaments. Les medicaments les plus frequemment prescrits etaient les inhibiteurs calciques (39,5 %), les statines (36,8 %), les antiagregants plaquettaires (31,9 %), les betabloquants (30,8 %), les ARA2 (29,2 %), les diuretiques thiazidiques (23,8 %), les IEC (22,7 %), les IPP (21,6 %), les diuretiques de l’anse (17,8 %) et les benzodiazepines (15,1 %). Un ou plusieurs medicaments etaient arretes chez 60 (32,4 %) patients. Parmi eux, 31 (51,7 %) ne presentaient plus de lesion a 6 mois. L’analyse comparative par rapport a l’EGB est en cours. Discussion Les caracteristiques des patients concordent avec celles observees dans notre etude precedente, en particulier la predominance masculine et la polymedication. La frequence de prise des inhibiteurs calciques (39,5 %) est encore plus elevee (× 1,5) que dans notre etude initiale confirmant le tres fort risque lie a cette classe medicamenteuse. La comparaison avec les donnees de l’EGB (analyse en cours avec resultats prevus prochainement) permettra peut-etre de mettre en evidence une association avec d’autres classes medicamenteuses.

Background Sensitive scalp or irritable bowel syndrome has been previously shown to be associated with sensitive skin. We wondered whether sensitive eyelids and sensitive eyes could also be associated with sensitive skin. Methods A cross-sectional epidemiological study was carried out on a representative sample of French people, according to the quota method, using a questionnaire. Results A total of 2048 subjects were included in the present study. Notably, 52.2% declared sensitive eyes, which was more frequent in women than in men. The subjects who reported sensitive eyes were more numerous according to the severity of skin sensitivity, the severity of sleep disorders and the presence of bright eyes. More than half of the subjects with sensitive eyes thought that they were sensitive to sun exposure, dust, computer or touch pads or dry air. The presence of sensitive eyelids was reported by 18.65% (more frequent in women) and was associated with sensitive skin and sensitive eyes, sun exposure and exposure to dust. Conclusion This study is the first to investigate sensitive eyelids or sensitive eyes. Sensitive eyelids can be considered a localization of sensitive skin. The concept of sensitive eyes is not commonly used by ophthalmologists and remains to be more precisely defined.

Until recently, itch pathophysiology was poorly understood and treatments were poorly effective in relieving itch. Current progress in our knowledge of the itch processing, the numerous mediators and receptors involved has led to a large variety of possible therapeutic pathways. Currently, inhibitors of IL-31, IL-4/13, NK1 receptors, opioids and cannabinoids, JAK, PDE4 or TRP are the main compounds involved in clinical trials. However, many new targets, such as Mas-related GPCRs and unexpected new pathways need to be also explored.

Introduction La peau sensible est un syndrome se manifestant par la survenue de sensations anormales (picotements, brulures, douleurs, prurit, fourmillements) en reaction a des stimulus qui ne devraient normalement pas declencher de telles sensations. Elle n’est pas expliquee par des lesions attribuables a une pathologie cutanee specifique. Ce syndrome frequent touche approximativement 50% de la population; il est plus frequent chez les femmes. S’agissant de symptomes subjectifs, le diagnostic est fait a l’interrogatoire, de facon ouverte ou en utilisant des questionnaires comme le Sensitive Scale (SS-10) en 10 questions, qui a ete valide en 2014. Materiel et methodes L’objectif de cette etude etait d’etablir une valeur-seuil du SS-10 pour etablir le diagnostic de peau sensible. Dans cette etude monocentrique prospective ont ete incluses des femmes de 18 a 65 ans, sans dermatose du visage, avec ou sans peau sensible. Apres un examen dermatologique, les sujets ont repondu a differents questionnaires sur la presence de la peau sensible (SS-10), ses caracteristiques et son retentissement sur la qualite de vie (questionnaire BoSS). Resultats 160 femmes d’âge moyen 41 ans ont ete incluses. Plus de la moitie (55 %) des participantes ont declare avoir une peau “tres sensible” (9 %) ou “sensible” (46 %). La distribution du score SS-10 parmi les participantes est presentee dans la figure 1. Les sujets avec peau sensible avaient un phototype plus clair et presentaient plus souvent une peau mixte ou seche que les sujets sans peau sensible. Les sensations les plus citees etaient l’irritabilite de la peau (79,2 %), la sensation de tiraillements (72,3 %) et les rougeurs (64,8 %) alors que seulement 27,5 % rapportaient une douleur. Le score BoSS moyen etait de 16,6 ± 10,0. Une correlation positive et statistiquement significative etait observee entre le score SS-10 et le score BoSS, montrant que le fardeau etait d’autant plus important que la peau etait plus sensible. La courbe ROC permettait d’etablir une valeur-seuil du SS-10 de 12,7 sur 100 pour detecter une peau sensible (sujets ayant repondu « sensible » ou « tres sensible »), avec une sensibilite de 72,4 % et une specificite de 90,3 %. Discussion Le syndrome de peau sensible est difficile a affirmer car il existe un continuum allant de l’absence de peau sensible a une peau tres sensible. Jusqu’a present, la majorite des etudes faites sur les peaux sensibles interrogeaient les sujets: « Avez-vous la peau tres sensible, sensible, peu sensible ou pas sensible ? ». Mais la definition de la peau sensible n’est pas forcement claire pour les patients et cette question ne semble donc pas assez precise pour vraiment etablir un diagnostic. L’auto-questionnaire SS-10 permettra ainsi un diagnostic plus precis de facon rapide, grâce a la determination de cette valeur-seuil. Nous proposons qu’une valeur de 13/100 soit utilisee pour le diagnostic de peau sensible.

Introduction De nombreux cas d’engelures ont ete rapportes depuis le debut de la pandemie de Covid-19. Cependant, la RT-PCR et la serologie ne mettaient pas en evidence d’infection a SARS-CoV-2 chez la majorite des patients. L’hypothese d’une reponse interferon-mediee au SARS-CoV-2, permettant une clairance rapide du virus qui ne pourrait alors pas activer l’immunite humorale, a ete soulevee et pourrait expliquer la seronegativite. Notre objectif etait de rechercher une association entre les engelures survenues pendant le premier confinement en France et l’exposition au SARS-CoV-2 au sein des foyers. Materiel et methodes Dans cette etude cas-temoins multicentrique, les cas etaient les 102 individus adresses entre mars et mai 2020 aux CHU de Rennes, Nantes, Angers, Tours, et Brest pour des engelures. Les temoins etaient recrutes a partir des fichiers de volontaires sains tenus par ces hopitaux. Tous les membres de ces foyers etaient inclus, constituant ainsi 77 foyers cas (262 individus) et 74 foyers temoins (230 individus). L’exposition des foyers au SARS-CoV-2 lors du premier confinement etait categorisee en 3 niveaux : faible, intermediaire ou eleve, a partir d’un algorithme prenant en compte les symptomes, les contacts a risque et les activites hors du foyer des individus de chaque foyer. Une serologie SARS-CoV-2 etait proposee a tous les individus. Resultats Apres ajustement sur l’âge, l’association entre engelures et exposition au SARS-CoV-2 au sein des foyers de confinement etait estimee a 3,3, intervalle de confiance a 95 % (1,4–7,3), pour un niveau d’exposition intermediaire, et a 6,9 (2,5–19,5) pour un niveau d’exposition eleve au SARS-CoV-2. Parmi les 57 foyers cas ayant eu une serologie, 6 (11 %) avaient developpe des anticorps anti- SARS-CoV-2, alors que tous les foyers temoins testes etaient seronegatifs (n = 50). Discussion Cette etude cas-temoin demontre l’association entre engelures et exposition des foyers au SARS-CoV-2 durant le premier confinement. Notre critere de jugement etant declaratif, un biais de memorisation etait possible. Cependant, meme si 20 % des patients etaient classes exposes au SARS-CoV-2 par erreur, la mesure d’association resterait significative.

Introduction Le RCP des biotherapies (BT) et de l’apremilast (APR) ne mentionne aucune contre-indication en cas d’antecedents de cancer solide. Cependant les recommandations francaises proposent de discuter au cas par cas avec l’oncologue l’initiation de BT/APR dans ces circonstances. Materiel et methodes Etude retrospective multicentrique au sein du GEM Resopso decrivant la tolerance BT/APR chez les patients psoriasiques aux antecedents de cancer solide. Criteres d’inclusion : patient ayant debute BT/APR apres le diagnostic de cancer. Criteres d’exclusion : carcinomes basocellulaires, carcinomes epidermoides cutanes(CEC) du groupe 1. Resultats Un total de 92 patients etaient inclus, 49 femmes, âge moyen 61,8 ans, rhumatisme psoriasique 21,7 %. Avant le diagnostic de cancer, 20 patients avaient deja recu une BT ; 87 patients avaient eu un cancer solide et 5 deux cancers. Il s’agissait de cancer du sein n = 30, melanome n = 13, prostate n = 10, colorectal n = 8, col uterin n = 6, ORL n = 6, urothelial n = 5, CEC du groupe 2 n = 5, rein n = 4, poumon n = 3, testicule n = 2, sarcome n = 2, thyroide n = 1, thymome malin n = 1, carcinome hepatocellulaire n = 1. Au diagnostic du cancer, 20 patients etaient sous BT. Le delai moyen entre le diagnostic de cancer et le debut de BT/APR etait de 82,6mois [0,7–347]. Le cancer etait en remission n = 83 (duree > 5 ans n = 40), stable n = 5, en progression n = 4. Le traitement du cancer etait en cours pour 9 patients au debut de BT/APR ; 92 patients recevaient 139 lignes de BT/APR : APR n = 52, anti-TNF n = 30, anti-IL17 n = 21,ustekinumab (UST) n = 18, anti-IL23p19 n = 18. Parmi ceux sous BT au diagnostic du cancer,18 beneficiaient d’un autre traitement apres le cancer (APR n = 11,UST n = 2, anti-IL17 n = 1, anti-IL23p19 n = 2,anti-TNF n = 2), 1 reprenait UST, chez 1 patient UST n’etait jamais interrompu. La duree moyenne de traitement par BT/APR etait de 27,3mois [1–126].Quatre patients ont eu une progression de leur cancer (cancer de vessie depuis 3 mois sous guselkumab, adenocarcinome rectal metastatique depuis 1 mois sous APR, 2 carcinomes canalaires infiltrants du sein sous hormonotherapie depuis 11 et 40 mois sous APR), 5 sont restes stables et 4 ont presente un nouveau cancer (CEC n = 4, carcinome epidermoide rectal metastatique n = 1) ; 5 patients sont decedes : progression du cancer n = 1, progression d’un cancer survenu sous BT n = 1, infection COVID 19 n = 1, autre n = 2. Discussion Il s’agit a notre connaissance de la plus grande serie de patients aux antecedents de cancer solide traites par BT/APR pour un psoriasis, avec 4,3 % de progression de cancer sous BT/APT. Une meta-analyse n’a pas trouve de surrisque de recurrence de cancer sous anti-TNF versus immunomodulateur et absence de traitement chez des patients traites pour des pathologies inflammatoires chroniques avec antecedent de cancer. Ces donnees doivent etre confirmees sur d’autres cohortes.

Sensitive skin is commonly assessed on the basis of self-reports from patients, and sometimes questionnaires, such as the Sensitive Scale-10, are used. The severity of sensitive skin follows a continuum, from the absence of sensitive skin to very sensitive skin. The aims of this cross-sectional study were to compare subjects with and without symptomatic sensitive skin and to propose diagnostic criteria for sensitive skin. A total of 160 women, between 18 and 65 years of age, with and without sensitive skin, and without any associated skin diseases, were recruited. Mean age was 41 years old. Fifty-five percent of participants reported having "very sensitive" or "sensitive" skin. In the sensitive skin group, the participants mainly experienced skin irritability (100%), tautness (97.5%), discomfort (90%) and redness (90%). According to the receiver operating characteristic curve, a Sensitive Scale-10 (SS-10) cut-off value of 12.7 can be used to detect sensitive skin (with a sensitivity of 72.4% and specificity of 90.3%).

Altres ajuts: European Academy of Dermatology and Venereology (EADV, 2016-012); Galderma S.A; Kiniksa Pharmaceuticals; Menlo Therapeutics. Chronic nodular prurigo is characterized by recalcitrant itch. Patient perspectives on therapeutic goals, satisfaction with therapy and efficacy of therapeutic regimens for this condition are unknown. This questionnaire study examined these issues in 406 patients with chronic nodular prurigo from 15 European dermatological centres. Improvements in itch, skin lesions and sleep were the most important goals. Emollients, topical corticosteroids and antihistamines were the most frequently used treatments, while a minority of patients were prescribed potent medications, such as systemic immunosuppressants and gabapentinoids. Most patients were not satisfied with their previous therapy (56.8%), while 9.8% did not receive any therapy despite having active disease. A substantial number of respondents (28.7%) considered none of the therapeutic options effective. Although chronic nodular prurigo is a severe disease, most patients were not treated with potent systemic drugs, which may contribute to the high levels of dissatisfaction and disbelief in available therapies. Specific guidelines for chronic nodular prurigo and the development of novel therapies are necessary to improve care.

International audience; Chronic pruritus (CP) is a frequent symptom in many skin and systemic diseases(1), including haematological malignancies. It is described in 30% of Hodgkin lymphoma patients and in patients with myeloproliferative disorders, particularly in polycythaemia vera(2,3). Serum protein electrophoresis (SPEP) is recommended in laboratory screening for CP(4). However, the literature about pruritus in monoclonal gammapathies (MGs) is scarce(5-7). The aim of this study was to determine the frequency and clinical characteristics of pruritus in patients with MGs in comparison to controls with normal SPEP results.

International audience; Pruritus is a common symptom of bullous pemphi-goid (BP), but has been poorly studied. The aim of this study was to analyse the characteristics of pruritus in patients with BP and its impact on their quality of life. A multicentre prospective observational study (in 15 French hospitals) was performed. A total of 60 patients were included, with a mean age of 77.4 years. Pru-ritus occurred daily in 85% of patients, with a mean pruritus intensity of 5.2/10. Tingling sensations were present in 72.4% of patients and burning sensations in 68.9%. Pruritus was exacerbated by stress, fatigue and xerosis. The mean ItchyQol score was 56.2/110 and the mean 5-D Itch Scale score was 16.5/25. The severity of pruritus was not related to age, sex, BP activity score, eosinophilia, or anti-BP230 and anti-BP180 autoantibodies. This study revealed that pruri-tus in BP is poorly tolerated and is an important cause of impaired quality of life. .

Background Palmoplantar pustulosis (PPP) and acrodermatitis continua of Hallopeau (ACH) are rare variants of psoriasis. Knowledge of the efficacy of biologics is scarce. Objectives To evaluate the real-life efficacy of tumour necrosis factor blockers and ustekinumab in PPP and in ACH. Methods A multicentre retrospective descriptive study was conducted in 19 dermatology departments, including all patients with PPP or ACH seen from 2014 to 2016 who received one of the studied biologics. The data were collected by a standardized document. Factors associated with complete clearance (CC) were analysed by multivariate analysis, estimating odds ratios (ORs) and 95% confidence intervals (CIs). Results Among 92 patients included, 50 received adalimumab, 44 ustekinumab, 36 etanercept and 31 infliximab. Improvement and CC were observed in 83.9% and 20.0% patients receiving infliximab, 75.0% and 38.6% ustekinumab, 57.1% and 20.0% etanercept and 60.4% and 29.2% adalimumab. We found no significant difference in CC rates or duration of treatment among the biological treatments (P = 0.18 and P = 0.10, respectively). On multivariate analysis, CC with etanercept was associated with the ACH form and not smoking [OR = 9.5 (95% CI 1.1-82.7), P = 0.04 and 0.1 (0.01-0.9), P = 0.04]; with ustekinumab, male sex and absence of obesity [6.0 (1.3-28.6), P = 0.02 and 4.7 (1.0-22.7), P = 0.05]; with adalimumab, the ACH form [11.9 (2.7-52.3), P = 0.001]; and with infliximab, obesity [5.6 (1.1-29.4), P = 0.04]. Conclusions We found no difference in efficacy between TNF blockers and ustekinumab and among the three different TNF blockers in real life for PPP or ACH, which reveals the heterogeneity of clinical response to biologics in pustular psoriasis as compared with plaque psoriasis.

BACKGROUND Irritable bowel and sensitive skin syndromes are common painful conditions that are poorly understood, with alterations of the peripheral (and possibly central) nervous system that lead to a lowering of perception thresholds as the main pathophysiological mechanism. METHODS A cross-sectional epidemiological study was carried out on a representative sample of French people, according to the quota method using a questionnaire. RESULTS Among the 5,000 respondents, 48.9% were men and 51.1% were women. According to the adapted Rome questionnaire, 14.6% suffered from irritable bowel syndrome. A total of 59.1% declared very sensitive or sensitive skin. A total of 73.1% of subjects had irritable bowel syndrome versus 52.3% in the other group without an irritable colon (p