M. Le Moigne

Significant delay in the introduction of systemic treatment of moderate to severe psoriasis: a prospective multicentre observational study in outpatients from hospital dermatology departments in France

Background  There is a low rate of systemic treatment usage in moderate to severe psoriasis.

Healthcare cost impact of biological drugs compared with traditional systemic treatments in psoriasis: a cohort analysis in the French insurance database

Biological drugs have dramatically improved the management of moderate to severe psoriasis. Little is known about their economic impact in daily clinical practice.

Propionibacterium acnes phylotypes and acne severity: an observational prospective study

play an important role in defining the susceptibility, presentation and severity of autoimmune diseases. Findings from this study add to existing evidence that, although precise mechanisms for this association are not clearly delineated, an association was detectable between psoriasis and MS in this large U.S. population. Increased education and vigilance relevant to this association is likely warranted for both clinicians and patients. Further exploration via large, prospective studies, particularly in a U.S. population examining the risk of developing MS subsequent to a diagnosis of psoriasis, seems also warranted.

Psychiatric disorders with systemic retinoids: a systematic review of case reports

The question of the association between isotretinoin and the development of psychiatric disorders has been debated for the past 20 years. Some authors have argued that similar psychiatric symptoms or disorders could also be induced by other systemic retinoids1. However, few reports have included a formal assessment of the causal link between systemic retinoids and psychiatric disorders. This article is protected by copyright. All rights reserved.

TOXICAN: a guide for grading dermatological adverse events of cancer treatments

PurposeThe dermatological toxicity of cancer treatments is frequent and sometimes debilitating. Its reference classification, the NCI-CTCAE (National Cancer Institute–Common Terminology Criteria for Adverse Events), is sometimes difficult to use and does not include yet the newest toxicities. Our objective was to create a guide, TOXICAN, based on the CTCAE, which is easy to use in everyday practice and which facilitates the recognition and grading of these dermatological toxicities.MethodsThis guide was developed by a working group (“GESTIM”) comprising oncodermatologists, allergists, pathologists, and researchers from Nantes University Hospital. It was based on the dermatological toxicities found in the CTCAE and adapted to daily practice. These toxicities were grouped into categories and associated with photographs of typical cases to aid recognition. A simplified grading scale derived from the CTCAE was also created. This booklet was validated by means of user evaluation, and then the Delphi consensus method.ResultsWe selected 32 dermatological toxicities, including 12 created by our group, sorted into 7 categories: skin rash, dry skin/pruritus, hyperkeratotic papules, palmoplantar changes, hair and nail changes, mucosal changes, and others. Our simplified grading scale only differed from the CTCAE for one item, urticaria. Three items were modified after evaluation by the user group and 11 after application of the Delphi method.ConclusionThe objective of our practical guide is to facilitate the use of the CTCAE for recognizing and grading dermatological toxicity of cancer treatments in order to provide optimal guidance for therapeutic adaptations. Its impact on clinical practice remains to be evaluated.

Oral retinoids and depression: reply from the authors

We strongly agree with both teams that our review has limitations including the paucity of the information of some reported cases and the limitations inherent to the Naranjo score. Nevertheless, the Naranjo score was developed to achieve consensus in estimating the probability that a drug has caused an adverse event. It is the only tool that can be used to homogenize the reading of very heterogeneous notifications. This article is protected by copyright. All rights reserved.

Dysgueusie et perte de poids sous vismodegib : intérêt d’une prise en charge nutritionnelle spécifique

glions, + radiothérapie (n = 15), ou chimiothérapie (n = 6). Tous les patients avaient eu d’autres tumeurs cutanées avant ou simultanément. Au moins 2 patients ont présenté des récidives sur le site de la radiothérapie. Le traitement immunosuppresseur (TIS) a été réduit à différents stades d’évolution. Quinze patients sont décédés dont 4 de cause indépendante, 4 sont vivants et sans rechute avec un recul moyen de 2 ans et deux sont perdus de vue. Les 11 patients décédés de CEM avaient été négligents dans leur surveillance dermatologique et 10 avaient eu de la radiothérapie. Discussion.— Alors que les GO ont plus de carcinomes agressifs, notre étude montre que par rapport au nombre total de CE développés, le risque de métastase est relativement faible (1,8 %). Le bénéfice carcinologique apporté par une modification substantielle du TIS apparaît beaucoup plus important que celui de la radiothérapie qui chez certains GO semble même avoir un effet carcinogène. Conclusion.— Le retard de prise en charge et la surimmunodépression sont les facteurs qui paraissent les plus prédictifs de CEM chez les GO. Le traitement chirurgical avec des marges adéquates et la précocité de la révision du TIS semblent les éléments les plus importants pour la prévention des CEM. Déclaration d’intérêt.— Aucun.