[Children with psoriasis in secondary care: Clinical aspects and comorbidities diverge from the generally published data]. / Psoriasis de l'enfant vu en milieu libéral : les aspects cliniques et épidémiologiques diffèrent des données habituellement publiées.

BACKGROUND: Psoriasis affects 0.2-0.7 % of children and is associated with obesity. Published studies have been conducted in hospital settings (tertiary care). The PsoLib study evaluated childhood psoriasis in private practice (secondary care) in terms of epidemiology, clinical aspects and comorbidities. PATIENTS AND METHODS: This was a non-interventional, cross-sectional, multicenter study of children with psoriasis performed by 41 dermatologists working in private practice. The clinical and therapeutic aspects and comorbidities were systemically evaluated. We compared data to the χ-Psocar study performed in hospitals using the same methodology. RESULTS: In all, 207 children (girls: 60.4 %; mean age: 10.5±4.2 years) were included. Scalp psoriasis (40.6 %) was the most frequent clinical type, while plaque psoriasis represented 26 % of cases. Nail, tongue, and arthritic involvement were rare. Less than 1 % of children suffered from hypertension, diabetes or dyslipidemia, but 16.4 % were overweight and 7.0 % were obese. Severity (PG≥4 at peak) was associated with excess weight (P=0.01). CONCLUSION: Scalp psoriasis is the most frequent clinical type of psoriasis in childhood. Comorbidities and extracutaneous localization are rare. Even in private practice, the severity of the disease is associated with excess weight.

[Cost/effectiveness comparison of the vaccine campaign and reduction of sick leave, after vaccination against influenza among the Clermont-Ferrand University Hospital staff]. / Comparaison coût/bénéfice de la campagne vaccinale et de la réduction de l'absentéisme, après vaccination contre la grippe du personnel du CHU de Clermont-Ferrand.

OBJECTIVE: The aim of this study was to compare the cost of vaccination for the Clermont-Ferrand University hospital (CHU) personnel and the cost of sick leave among vaccinated and non-vaccinated employees in 2003, 2004, and 2005. DESIGN: The study included 7256 CHU staff (medical and non-medical personnel). The cost of sick leave was calculated on the basis of short-term disease (four to nine days) over the three months of the epidemic season in 2004, 2005, and 2006. RESULTS: In 2005, the overall cost of vaccination was 4.02 euros per vaccinated employee. Over the three years, the total sick leave reached 804 days for employees vaccinated against 5670 for non-vaccinated employees. In 2003, 2004, and 2005, the vaccinal coverage was 13, 20.5, and 30.1%, the mean duration of sick leave was 0.16, 0.17, and 0.18 day among vaccinated staff, and 0.26, 0.39, and 0.34 day among non-vaccinated staff corresponding to a benefit per vaccinated employee of 5, 26, and 20 euros, respectively for each year. The total benefit for the institution was 86,458 euros (4630+38,168+43,660). If the vaccinated rate of 75% recommended by the Haute Autorité de santé (HAS) had been reached, the additional benefit would have been 250,193 euros (33,157+152,256+65,180). CONCLUSIONS: The number of sick leave days and the related cost were approximately twice less important for vaccinated employees, economically justifying this vaccination including a period of weak epidemic, as checked over three consecutive years.

[Netherton's syndrome. Current aspects. Apropos of 9 cases]. / Syndrome de Netherton. Aspects actuels. A propos de neuf cas.

Data concerning 9 cases of Netherton's syndrome (NS) have been collected from 6 French dermatology units (table I). Analysis of these data has confirmed the information previously published, notably the prevalence of congenital ichthyosis erythroderma (CIE) as cutaneous manifestation in the neonatal period (77 p. 100), hair shaft dysplasia being rarely found at that stage (11 p. 100). In the majority of cases (5/9 in our series), CIE evolves in adults as ichthyosis linearis circumflexia (ILC), with trichorrhexis invaginata (TI) as the predominant hair shaft dysplasia. These data are in agreement with the diagnostic elements laid down by Dupré and Traupe. Some points may have been underestimated in the past. They include: hypernatraemic dehydration in the neonate; short stature and low weight (unrelated to endocrine disorders; mental and neurological retardation possibly associated with seizures. Various manifestations of hypersensitivity have been noted in 26 p. 100 of the published cases and in 6 of our 9 patients. The aggravating role played by hypersensitivity may be considered in some cases. NS must be regarded as a broad-spectrum disease the margins of which could be isolated skin manifestations in ILC and ichthyosis erythroderma with various associated disorders in cases with severe illness.

[Benign cutaneous lesions observed within the 1st 48 hours of life in 874 infants born at a maternity ward of a university hospital. Apropos of 148 cases]. / Lésions cutanées bénignes observées dans les 48 premières heures de vie chez 874 nouveau-nés d'une maternité de CHU. A propos de 148 cas.

A six months' follow-up study was carried out in the nursery of the University Hospital of Brest where neonates were systematically evaluated for dermatological abnormalities. 148 neonates had birthmarks which were erythema toxicum (ET) in 103 cases, vascular lesions in 19, pigmented in 8, and miscellaneous lesions in 18. These results were compared with those previously reported (1, 3, 6, 7, 9, 10, 13, 14). They confirmed the high frequency of ET in the second day of life and the low frequency of pigmented lesions at birth in Caucasians (less than 2 p. 100), as compared with their frequency in coloured people and Asians (25-40 p. 100) (10). The low proportion of salmon patches in this study may be explained by an inappropriate collection of data compared with previous reports (20-40 p. 100) (7, 10). A possible relation between the presence of ET and the later development of atopic dermatitis is discussed.