Publications by authors named "Olivier Chosidow"

206 Publications

A framework for scabies control.

PLoS Negl Trop Dis 2021 Sep 2;15(9):e0009661. Epub 2021 Sep 2.

Division of Parasitic Diseases and Malaria, US Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.

Scabies is a neglected tropical disease (NTD) that causes a significant health burden, particularly in disadvantaged communities and where there is overcrowding. There is emerging evidence that ivermectin-based mass drug administration (MDA) can reduce the prevalence of scabies in some settings, but evidence remains limited, and there are no formal guidelines to inform control efforts. An informal World Health Organization (WHO) consultation was organized to find agreement on strategies for global control. The consultation resulted in a framework for scabies control and recommendations for mapping of disease burden, delivery of interventions, and establishing monitoring and evaluation. Key operational research priorities were identified. This framework will allow countries to set control targets for scabies as part of national NTD strategic plans and develop control strategies using MDA for high-prevalence regions and outbreak situations. As further evidence and experience are collected and strategies are refined over time, formal guidelines can be developed. The control of scabies and the reduction of the health burden of scabies and associated conditions will be vital to achieving the targets set in WHO Roadmap for NTDs for 2021 to 2030 and the Sustainable Development Goals.
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http://dx.doi.org/10.1371/journal.pntd.0009661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412357PMC
September 2021

Clinical and histological features of fixed drug eruption: a single-centre series of 73 cases with comparison between bullous and non-bullous forms.

Eur J Dermatol 2021 Jun;31(3):372-380

Pathology department, Henri Mondor hospital, AP-HP, 94010 Créteil Cedex, France, Intensive care unit, Henri Mondor hospital, AP-HP, 94010 Créteil Cedex, France, Reference centre for toxic bullous diseases and severe cutaneous adverse reactions TOXIBUL, Créteil, France.

The clinical and pathological aspects of fixed drug eruption (FDE) have been described based on a few case series. To compare bullous FDE (BFDE) and non-bullous FDE (NBFDE) and to determine whether BFDE can be histologically distinguished from other dermatoses presenting with an apoptotic pan-epidermolysis. In this retrospective monocentre study (2005-2016), FDE was classified as BFDE or NBFDE and localized (one anatomical site) or generalized (≥ two sites; GBFDE). Clinical data were extracted from charts, and images were reviewed. Skin biopsies were analysed and compared to the clinical presentation. Three dermatopathologists, blinded to the final clinical diagnosis, evaluated a subset of BFDE cases (n = 8) and 25 biopsies of other bullous diseases known to have an epidermal necrolysis (EN)-like pattern. In total, 73 patients were included in the study. Patients with BFDE (n = 58; GBFDE n = 48) were significantly older (p < 0.001). All patients with GBFDE were hospitalized; 25 had a complication (infectious; n = 19), and eight died (median age: 80). Histology revealed spongiotic (6.7%), interface dermatitis (48.3%) and EN-like (66.3%) patterns. The EN-like pattern was more frequent in BFDE than NBFDE (74% vs 27%; p = 0.008). Melanophages (100% vs 66%; p = 0.02) and massive dermal melanosis (40% vs 4%; p = 0.0005) were more prominent in NBFDE than BFDE. BFDE could not be reliably distinguished from other bullous diseases with EN-like patterns. BFDE belongs to the spectrum of skin conditions with an EN pattern, for which the concept of acute syndrome of apoptotic pan-epidermolysis (ASAP) was previously introduced. Clinical-pathological correlation is mandatory for a diagnosis of BFDE.
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http://dx.doi.org/10.1684/ejd.2021.4051DOI Listing
June 2021

Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study.

Ann Intensive Care 2021 Jul 2;11(1):102. Epub 2021 Jul 2.

Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.

Background: Compared to other life-threatening infection survivors, long-term health-related quality of life (QOL) of patients surviving necrotizing soft-tissue infections (NSTI) and its determinants are little known. In this monocentric prospective cohort including NSTI survivors admitted between 2014 and 2017, QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36), the Hospital Anxiety and Depression (HAD), the activity of daily living (ADL), instrumental ADL (IADL) scales and the Impact of Event Scale-Revised (IES-R). The primary outcome measure was the SF-36 physical component summary (PCS). NSTI patients were compared according to intensive care unit (ICU) admission status. ICU survivors were matched on SAPS II with non-NSTI related septic shock survivors.

Results: Forty-nine NSTI survivors were phone-interviewed and included in the study. Median PCS was decreased compared to the reference population [- 0.97 (- 2.27; - 0.08) SD]. Previous cardiac disease was the only variable associated with PCS alteration [multivariate regression coefficient: - 8.86 (- 17.64; - 0.07), p  =  0.048]. Of NSTI survivors, 15.2% had a HAD-D score  ≥  5 and 61.2% an IES-R score  ≥  33. ICU admission was not associated with lower PCS [35.21 (25.49-46.54) versus (vs) 41.82 (24.12-51.01), p  =  0.516], but with higher IES-R score [14 (7.5-34) vs 7 (3-18), p  =  0.035] and a higher proportion of HAD-D score  ≥  5 (28.6 vs 4.0%, p  =  0.036). Compared to non-NSTI septic shock-matched controls, NSTI patients had similar PCS [33.81 (24.58; - 44.39) vs 44.87 (26.71; - 56.01), p  =  0.706] but higher HAD-D [3.5 (1-7) vs 3 (1.5-6), p  =  0.048] and IES-R scores [18 (8-35) vs 8 (3-19), p  =  0.049].

Conclusions: Long-term QOL in NSTI survivors is severely impaired, similarly to that of non-NSTI septic shock patients for physical compartments, but with more frequent depressive and/or post-traumatic stress disorders. Only ICU admission and previous cardiac disease were predictive of QOL impairment.
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http://dx.doi.org/10.1186/s13613-021-00891-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253876PMC
July 2021

Update on French recommendations for the treatment of uncomplicated infections.

Int J STD AIDS 2021 Jun 14:9564624211023025. Epub 2021 Jun 14.

Bacteriology and National Reference Centre for Bacterial Sexually Transmitted Infections, APHP-Hospital Saint Louis, Paris, France.

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http://dx.doi.org/10.1177/09564624211023025DOI Listing
June 2021

Ivermectin as a potential treatment for COVID-19?

PLoS Negl Trop Dis 2021 06 1;15(6):e0009446. Epub 2021 Jun 1.

Sorbonne Université, Inserm UMR-S 1135, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), AP-HP, Groupement hospitalier Pitié-Salpêtrière, service de médecine interne 2, Paris, France.

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http://dx.doi.org/10.1371/journal.pntd.0009446DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8168910PMC
June 2021

Relapsing generalized bullous fixed drug eruption: A severe and avoidable cutaneous drug reaction. Three case reports.

Therapie 2021 Apr 16. Epub 2021 Apr 16.

Dermatology department, AP-HP, Henri Mondor Hospital, 51, avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France; Reference Center for Toxic Bullous Diseases and Severe Drug Reactions-TOXIBUL, 94000 Créteil, France; EA 7379 EpidermE, UPEC, 94000 Créteil, France.

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http://dx.doi.org/10.1016/j.therap.2021.04.004DOI Listing
April 2021

First Description of the Composition and the Functional Capabilities of the Skin Microbial Community Accompanying Severe Scabies Infestation in Humans.

Microorganisms 2021 Apr 23;9(5). Epub 2021 Apr 23.

Scabies Laboratory, Infectious Diseases Program, Biology Department, QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia.

Epidemiological studies link infection and impetigo. Scabies mites can promote (Group A ) and infections by breaching the skin barrier and excreting molecules that inhibit host innate immune responses. However, little is known about the composition and the function of the scabies-associated microbiota. Here, high-throughput whole-metagenome sequencing was used to explore the scabies-associated microbiome. Scabies mites including their immediate microenvironments were isolated from two patients with severe scabies in Northern Australia. Two ~45-50 million paired-end reads Illumina libraries were generated of which ~2 (5.1%) and 0.7 million (1.3%) microbial reads were filtered out by mapping to human (hg19) and mite draft genomes. Taxonomic profiling revealed a microbial community dominated by the phylum Firmicutes (A: 79% and B: 59%) and genera that comprise , , and . Assembly of the metagenome reads resulted in genome bins representing reference genomes of , (Group C/G), and . The contigs contained genes relevant to pathogenicity and antibiotics resistance. Confocal microscopy of a patient skin sample confirmed , Streptococci and in scabies mite gut and faeces and the surrounding skin. The study provides fundamental evidence for the association of opportunistic pathogens with scabies infection.
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http://dx.doi.org/10.3390/microorganisms9050907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8146700PMC
April 2021

TRIM33 gene somatic mutations identified by next generation sequencing in neoplasms of patients with anti-TIF1γ positive cancer-associated dermatomyositis.

Rheumatology (Oxford) 2021 Mar 25. Epub 2021 Mar 25.

Normandie University, UNIROUEN, IRIB, Inserm, U1234, Rouen, France.

Objective: To deep sequence the TRIM33 gene in tumours from patients with cancer-associated anti-TIF1γ autoantibody-positive dermatomyositis (DM) since TRIM33 somatic mutations in tumours may trigger this auto-immune disease.

Methods: Next generation sequencing of tumour DNA samples from patients with cancer-associated anti-TIF1γ autoantibody-positive DM. Fourteen tumours from 13 anti-TIF1γ autoantibody-positive DM individuals were sequenced along with 2 control tumours from non-DM individuals.

Results: Fourteen probable somatic variants from 4 tumours were identified in the TRIM33 gene.

Conclusion: These results are in accordance with the previous report of Pinal-Fernandez et al. and support the hypothesis of a role of TRIM33 gene mutations in the pathophysiology of anti-TIF1γ autoantibody-positive DM.
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http://dx.doi.org/10.1093/rheumatology/keab260DOI Listing
March 2021

[Infections cutanéo-muqueuses et des phanères, bactériennes et mycosiques, de l'adulte et de l'enfant].

Rev Prat 2020 11;70(9):e311-e318

Service de dermatologie, groupe hospitalier Henri-Mondor, AP-HP, faculté de santé, Créteil, France.

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November 2020

Choice of Systemic Drugs for the Management of Moderate-to-severe Psoriasis: A Cross-country Comparison Based on National Health Insurance Data.

Acta Derm Venereol 2021 Jun 22;101(6):adv00473. Epub 2021 Jun 22.

Department of Dermatology, Hôpital Henri-Mondor, 51, av du Maréchal de Lattre de Tassigny, FR-94010 Créteil Cedex, France. E-mail:

Current management of moderate-to-severe psoriasis may be heterogeneous between European countries, probably due to differences in the organization of care. The aim of this study was to compare the utilization of systemic treatments for psoriasis between 2 coun-tries. All adults with psoriasis who were registered in the French (SNDS) and the Dutch (VEKTIS) national health insurance databases between 2012 and 2016 were eligible for inclusion. In France, 105,035 (15%) of 684,156 patients and, in the Netherlands, 37,405 (28.6%) of 130,822 patients received at least a systemic agent. In France, the proportion of patients treated with systemic agents was constant, while the type of drugs dispensed shifted from non-biological to biological agents. In the Netherlands, the first systemic treatment was methotrexate and, in France, acitretin. In France, the choice of the first biologic was much more variable than it was in the Netherlands, where a large proportion of patients were dispensed ustekinumab. This study highlights discrepancies between France and the Netherlands concerning the choice of first non-biologic agent and first biologic agent for patients with psoriasis. These discrepancies may be due to differences in the healthcare systems between the 2 countries.
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http://dx.doi.org/10.2340/00015555-3765DOI Listing
June 2021

First-Line Biologic Therapy and Obesity in Moderate-to-Severe Psoriasis: Results from the Prospective Multicenter Cohort Psobioteq.

Dermatology 2021 3;237(3):338-346. Epub 2021 Feb 3.

Department of Dermatology, Hôpital Henri Mondor, Créteil, France,

Background: Obesity is associated with an increased risk of psoriasis.

Objective: In this study, we examined whether body mass index (BMI) is taken into account when choosing first-line biologic therapy for psoriasis.

Methods: In this cohort study, we compared obese (BMI ≥30 kg/m2) and non-obese patients for the first-line biologic therapy prescribed, its survival, reasons for discontinuation, therapy optimization, co-prescription of methotrexate and factors associated with long drug survival.

Results: A total of 931 patients were included: 594 (64%) were male, median age was 46 years (interquartile range 36-56). The most-prescribed biologic agents as first-line treatment were adalimumab (ADA; 42.7%), ustekinumab (UST; 29.9%) and etanercept (ETA; 22.9%); only frequency of infliximab (IFX) prescription differed between groups. Drug survival was significantly shorter for obese than non-obese patients (p < 2.10-4) and was worse for obese than non-obese patients for UST (p = 0.009) and ETA (p = 0.02), with no difference for ADA (p = 0.11). The main reason for discontinuation was primary inefficacy (62%), which was more frequent in obese than non-obese patients. The cumulative incidence of optimization did not significantly differ between the groups, except for ADA (SHR 1.91, 95% CI [1.23-2.96], p = 0.005). On multivariate analysis, risk of discontinuation was associated with only ETA as first-line biologic therapy (HR 1.51, 95% CI 1.04-2.19).

Conclusion: This study highlighted the lack of difference in prescription of first-line biologic treatment, except for IFX, between obese and non-obese patients presenting moderate-to-severe psoriasis. Drug survival in obese patients is shorter, mainly because of inefficacy, than in non-obese patients. This highlights the need for targeted pharmacological studies in obese individuals to find optimal administration schemes.
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http://dx.doi.org/10.1159/000513398DOI Listing
February 2021

Essential oils as potential triggers for bullous pemphigoid? A report of two patients.

Eur J Dermatol 2021 Feb;31(1):92-93

Dermatology department, AP-HP, Henri Mondor hospital, Créteil, France, Univ Paris Est Créteil EpidermE, Créteil, France, Reference center for auto-immune bullous diseases MALIBUL, AP-HP, Henri Mondor hospital, Créteil, France.

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http://dx.doi.org/10.1684/ejd.2020.3953DOI Listing
February 2021

Scabies-infested pregnant women: A critical therapeutic challenge.

PLoS Negl Trop Dis 2021 01 7;15(1):e0008929. Epub 2021 Jan 7.

Service de Dermatologie, Hôpital Henri Mondor, AP-HP, Université Paris-Est, Créteil, France.

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http://dx.doi.org/10.1371/journal.pntd.0008929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790223PMC
January 2021

Acute generalized exanthematous pustulosis induced by enoxaparin: 2 cases.

Contact Dermatitis 2021 Apr 17;84(4):280-282. Epub 2020 Nov 17.

Department of Dermatology, Reference Centre for Toxic Bullous Diseases and Severe Drug Reactions TOXIBUL, AP-HP, Hôpital Henri-Mondor, UPEC, Créteil, France.

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http://dx.doi.org/10.1111/cod.13734DOI Listing
April 2021

Missed Diagnosis of Epilepsy-Associated Scald Burns: Two Cases Initially Diagnosed as Bullous Dermatosis.

J Burn Care Res 2021 05;42(3):569-572

Department of Dermatology, AP-HP, Henri Mondor Hospital, Créteil, France.

Thermal burns can occur during seizure. This diagnosis can be difficult in case of atypical lesions, even more if the epilepsy is unknown and in case of seizures with loss of consciousness and/or an unwitnessed epileptic attack. We report two cases of cutaneous bullous lesions initially misdiagnosed as severe acute cutaneous adverse reactions (generalized bullous fixed drug eruption and Stevens-Johnson syndrome). In the two cases, the clinical aspect, necrotic evolution, and absence of obvious attributable medication allowed to revert to the diagnosis of burns due to boiling water revealing previously unknown epilepsy. For both, surgical management with skin graft was performed, and antiepileptic treatment was introduced. Facing unexplained burns, occult epilepsy should be investigated. Questioning of patient and relatives is crucial.
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http://dx.doi.org/10.1093/jbcr/iraa184DOI Listing
May 2021

[Oral isotretinoin : a major treatment for acne].

Rev Prat 2020 06;70(6):587-593

Service de dermatologie, AP-HP, hôpital Henri-Mondor, UPEC, Créteil, France.

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June 2020

Risk Factors for Seborrhoeic Dermatitis Flares: Case-control and Case-crossover Study.

Acta Derm Venereol 2020 Oct;100(17):adv00292

Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Sorbonne Université, INSERM, Paris, France.

Patients with flares of seborrhoeic dermatitis were compared with control outpatients seen during the same time-period in a case-control study, and with themselves while in remission in a case-crossover study. All patients consulted the same office-based dermatologist. During the study period, 189 cases and 189 controls were included in the case-control study, and 81 cases in the case-crossover study. Multivariate analysis was performed. Case-control study results were the following: past history of tobacco consumption (odds ratio (OR) 2.2 (95% confidence interval (CI) 1.1-4.6)), conflict as a dispute during the past month (OR 10.6 (95% CI 1.0-114.3)), alcohol consumption on a regular basis (OR 10.2 (95% CI 2.0-52.6)), and higher level of stress during the past month (OR 8.2 (95% CI 3.4-19.9)). Case-crossover study results were the following: higher level of stress during the past month (OR 4.5 (1.7-12.2)), association borderline significant for higher level of alcohol consumption (OR 5.4 (0.8-34.9)). These risk factors for flares of seborrhoeic dermatitis should be taken into account carefully in the daily management of seborrhoeic dermatitis.
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http://dx.doi.org/10.2340/00015555-3661DOI Listing
October 2020

Subungual scraping for the diagnosis of common scabies: A prospective observational study.

J Am Acad Dermatol 2021 Oct 1;85(4):994-996. Epub 2020 Oct 1.

Department of Dermatology, Saint Pierre - Brugmann and Queen Fabiola Children's University Hospitals, Université Libre de Bruxelles, Brussels, Belgium. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2020.08.130DOI Listing
October 2021

Tacrolimus 0.1% versus ciclopiroxolamine 1% for maintenance therapy in patients with severe facial seborrheic dermatitis: A multicenter, double-blind, randomized controlled study.

J Am Acad Dermatol 2021 May 30;84(5):1278-1284. Epub 2020 Sep 30.

Department of Dermatology, INSERM U1053, Bordeaux University Hospital, Bordeaux, France.

Background: No long-term maintenance therapy has been tested in patients with seborrheic dermatitis (SD).

Objective: We sought to compare the efficacy and tolerance of tacrolimus 0.1% ointment versus ciclopiroxolamine 1% cream as maintenance therapy for severe SD.

Methods: This double-blind randomized controlled study was conducted from 2014 to 2017 in 5 Dermatology Departments and 15 dermatology practices in France. Consecutive patients with severe and chronic facial SD were included. Patients were initially treated with desonide 0.05% cream twice daily for 7 days. Patients cleared after this open phase were randomized to receive tacrolimus 0.1% or ciclopiroxolamine 1% cream 2 times a week 24 weeks. The primary endpoint was disease-free-duration, defined as the time from randomization to first relapse.

Results: One hundred fourteen patients were randomized (tacrolimus, n = 57; ciclopiroxolamine, n = 57). Twelve patients relapsed in the tacrolimus group after a median delay of 91.5 days (range 15-195 days) versus 23 patients in the ciclopiroxolamine group (median delay, 27 days [range 13-201 days]). Comparison of disease-free duration curves showed that patients in the tacrolimus group had a longer duration of complete remission than those in the ciclopiroxolamine group (P = .018), corresponding to a hazard ratio of relapse of 0.44 (95% confidence interval 0.22-0.89; P = .022).

Limitations: The theoretical sample size was not reached.

Conclusion: Tacrolimus 0.1% is more effective than ciclopiroxolamine 1% as maintenance therapy for patients with facial SD.
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http://dx.doi.org/10.1016/j.jaad.2020.09.055DOI Listing
May 2021

[Warts treatments].

Rev Prat 2020 01;70(1):7-9

Service de dermatologie, hôpital Henri-Mondor, AP-HP, Créteil, France.

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January 2020

International recommendations for an effective control of head louse infestations.

Int J Dermatol 2021 Mar 7;60(3):272-280. Epub 2020 Aug 7.

Ghent University, Heymans Institute of Pharmacology, Gent, Belgium.

Head louse infestations continue to be a concern of public health in most countries, including the most developed ones. The present recommendations are intended to inform and stress the role and impact of the different authorities, institutions, industry, and the public in the control of head lice in order to reduce the prevalence of this parasite. We encourage health authorities to pursue more effective methods to correctly identify such infestations, and evaluate existing and new pediculicides, medical devices, louse repellents, and louse- and nit-removal remedies. Pediculicides and medical devices must have verifiable claims in the instructions for use and should be tested periodically to document current levels of resistance by lice to the active ingredients and to the formulated products. Where the prevalence of lice is claimed to be epidemic, children should be periodically evaluated objectively to document the actual level of prevalence. Continuing education for health providers and the general population promises to correct misinformation regarding the biology, prevention, and management of lice. Parents should regularly inspect their children for head lice and treat as necessary. Health authorities are encouraged to eliminate policies and practices that rely upon school exclusion as a means to reduce incidence and prevalence, e.g., the 'no-nit' policy which lacks scientific justification, and are counterproductive to the health and welfare of children.
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http://dx.doi.org/10.1111/ijd.15096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984059PMC
March 2021

Strong reactions to diltiazem patch tests: Plea for a low concentration.

Contact Dermatitis 2020 Sep 30;83(3):224-225. Epub 2020 Apr 30.

Department of Dermatology, Referral Centre for Toxic Bullous Diseases, AP-HP, Hôpital Henri-Mondor, UPEC, Créteil, France.

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http://dx.doi.org/10.1111/cod.13554DOI Listing
September 2020

The Management of Scabies in the 21st Century: Past, Advances and Potentials.

Acta Derm Venereol 2020 Apr 20;100(9):adv00112. Epub 2020 Apr 20.

Department of Dermatology, AP-HP, Hôpital Henri Mondor, FR-94010 Créteil, France.

Scabies is one of the most common skin diseases worldwide, affecting 150-200 million people yearly. Scabies affects young children in particular, and has the greatest impact in poor overcrowded living conditions. The burden of the disease is now well characterized, including group A Streptococcus and Staphylococcus aureus bacterial superinfections, with reports of nephritis, acute rheumatic fever, or fatal invasive sepsis secondary to scabies. Management of scabies remains largely suboptimal from diagnosis to treatment, and progress in the development of new therapeutic measures leading to cure is urgently needed. This review gives an overview of the current limitations in the management of scabies, an update on recent advances, and outlines prospects for potential improvements.
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http://dx.doi.org/10.2340/00015555-3468DOI Listing
April 2020

Early identification of patients at high risk of group A streptococcus-associated necrotizing skin and soft tissue infections: a retrospective cohort study.

Crit Care 2019 12 21;23(1):417. Epub 2019 Dec 21.

Service de Réanimation Médicale, Hôpitaux Universitaires Henri Mondor, Assistance Publique - Hôpitaux de Paris (AP-HP), Créteil, France.

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http://dx.doi.org/10.1186/s13054-019-2708-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925856PMC
December 2019

How to eliminate scabies parasites from fomites: A high-throughput ex vivo experimental study.

J Am Acad Dermatol 2020 Jul 17;83(1):241-245. Epub 2019 Dec 17.

Cellular and Molecular Biology Department, Infectious Diseases Program, Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Brisbane, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.jaad.2019.11.069DOI Listing
July 2020

Impact of a multidisciplinary care bundle for necrotizing skin and soft tissue infections: a retrospective cohort study.

Ann Intensive Care 2019 Oct 24;9(1):123. Epub 2019 Oct 24.

Service de Réanimation Médicale, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France.

Background: Necrotizing skin and soft tissue infections (NSTIs) require both prompt medical and surgical treatment. The coordination of multiple urgent interventions by care bundles has improved outcome in other settings. This study aimed to assess the impact of a multidisciplinary care bundle on management and outcome of patients with NSTIs.

Methods: Patients with NSTIs admitted between 2006 and 2017 were compared according to admission before or after bundle implementation (2012-2013). This bundle consisted mainly in (1) the creation of a multidisciplinary task force; (2) management guidelines on empirical antibiotics, intensive care unit admission criteria, a triage algorithm to accelerate operating room access; and (3) an active communication policy. Patient recruitment and management were compared between pre- and post-implementation periods. Main outcome was day 60-censored hospital survival.

Results: Overall, 224 patients were admitted: 60 before, 35 during, and 129 after bundle implementation. Admission after implementation was associated with increased yearly admissions (10 [8-13] vs 30 [24-43] patients/year, p = 0.014) and decreased mortality (30 vs 15%, HR = 0.49 [0.26-0.92]; p = 0.026) but was no longer a protective factor for mortality after adjustment on confounding factors (adjusted HR = 0.90 [0.43-1.88], p = 0.780). There was no significant difference regarding time to surgery (0 [0-1] vs 0 [0-1] days, p = 0.192) or rate of antibiotic treatment within 24 h (98% vs 99%, p > 0.99).

Conclusions: Implementation of a multidisciplinary care bundle for NSTIs was feasible, but in a retrospective study from an already experienced center was not associated with significantly increased survival after adjustment.
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http://dx.doi.org/10.1186/s13613-019-0598-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813408PMC
October 2019

Characteristics, Associated Diseases, and Management of Gram-negative Toe-web Infection: A French Experience.

Acta Derm Venereol 2019 Nov;99(12):1121-1126

Department of Dermatology, Bordeaux University Hospital, 33000 Bordeaux, France.

Gram-negative toe-web infection can cause pain and disability, be complicated by a long healing time, management failure, and cellulitis, and recur due to persistent predisposing factors. To describe the clinical features and management of Gram-negative toe-web infection and evaluate predisposing factors and associated diseases, their management, and the effect of controlling them on the rate of recurrence, we conducted a retrospective real-life study of patients with Gram-negative toe-web infection. Among the 62 patients (sex ratio 9:1), 31 experienced more than one episode of Gram-negative toe-web infection. Pseudomonas aeruginosa was the most prominent bacteria. Predisposing factors/associated diseases were eczema (66%), suspected Tinea pedis (58%), humidity (42%), hyperhidrosis (16%), psoriasis (11%), and vascular disorders (40%). Patients in whom associated diseases, such as eczema or psoriasis, were controlled did not relapse, suggesting the benefit of management of such conditions. We suggest that management of Gram-negative toe-web infection be standardised, with a focus on diagnosis and treatment of associated diseases.
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http://dx.doi.org/10.2340/00015555-3315DOI Listing
November 2019

Glucocorticoids for acute urticaria: study protocol for a double-blind non-inferiority randomised controlled trial.

BMJ Open 2019 08 21;9(8):e027431. Epub 2019 Aug 21.

Urgences-SAMU 93-Unité Recherche-Enseignement-Qualité, APHP, Hôpital Avicenne, Bobigny, France.

Introduction: This study protocol describes a trial designed to investigate whether antihistamine alone in patients with acute urticaria does not increase the 7-day Urticaria Activity Score (UAS7) in comparison with an association of antihistamine and glucocorticoids and reduces short-term relapses and chronic-induced urticaria.

Methods And Analysis: This is a prospective, double-blind, parallel-group, multicentre non-inferiority randomised controlled trial. Two-hundred and forty patients with acute urticaria admitted to emergency department will be randomised in a 1:1 ratio to receive levocetirizine or an association of levocetirizine and prednisone. Randomisation will be stratified by centre. The primary outcome will be the UAS7 at day 7. The secondary outcomes will encompass recurrence of hives and/or itch at day 7; occurrence of spontaneous hives or itch for >6 weeks; patients with angioedema at day 7, and 2, 6, 12 and 24 weeks; new emergency visits for acute urticaria recurrences at days 7 and 14, and 3 months; Dermatology Life Quality Index at days 7 and 14, and 3 and 6 months; and Chronic Urticaria Quality of Life Questionnaire at 6 weeks.

Ethics And Dissemination: The protocol has been approved by the and will be carried out in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. A steering committee will oversee the progress of the study. Findings will be disseminated through national and international scientific conferences and publication in peer-reviewed journals.

Trial Registration Number: NCT03545464.
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http://dx.doi.org/10.1136/bmjopen-2018-027431DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6707704PMC
August 2019

Beard dermatitis induced by coloration.

Contact Dermatitis 2019 Dec 21;81(6):471-473. Epub 2019 Aug 21.

Department of Dermatology, AP-HP, Hôpital Henri-Mondor, Créteil, France.

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http://dx.doi.org/10.1111/cod.13372DOI Listing
December 2019
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