Background. - Early detection of melanoma constitutes a major challenge and is a common reason for dermatological consultations. There is no recent data on melanomas diagnosed in the private medical sector in France, nor on the circumstances of diagnosis. Patients and methods. - This was a retrospective observational study on records collating data on all new consecutive cases of melanoma diagnosed between January 2015 and June 2018, in the private sector only, by volunteer dermatologists belonging to the association for continuing medical education, "Dermatologie Paris XV". A data collection sheet was prepared on which to record information about the dermatologist, the patient, the main complaint, the characteristics of the melanoma, and the initial treatment given, using the computerized list provided by our dermatopathology offices. Results. - The study involved 383 cases of melanoma, 37% in situ and 63% invasive, which consisted chiefly of superficial spreading melanoma. The median age of the cohort was 61 years and patients were predominantly female (58%). Follow-up of high-risk patients and complete routine examination (in those consulting for another reason) resulted in direct detection by a dermatologist of 202 of the 383 melanomas (52.7%); these melanomas had a lower median Breslow index than the rest of the cohort and were thin in the main. When patients consulted for a suspect lesion (139 cases), the lesion had been identified mostly by either the patient or by a relative (61% of cases). The decision to consult was made chiefly by the patients themselves, and the Breslow index was thicker. An initial consultation for nevus screening resulted in diagnosis of 42 melanomas, i.e. only 11% of the cohort. Dermoscopy was performed by 92% of the dermatologists participating in the study. Melanoma excision was performed in the office by the practitioner in 75% of cases, and management was validated at multidisciplinary meetings in 65% of cases. Conclusion. - In terms of French primary care, dermatologists in private practice play a key rote in ensuring early detection and initial management of melanoma. (C) 2020 Elsevier Masson SAS. All rights reserved.

Journal of the European Academy of Dermatology and VenereologyVolume 30, Issue 1 p. 143-146 Letter to the Editor Dermatological side-effects in hepatitis C infected patients under a triple regimen associating pegylated interferon, ribavirin and telaprevir C. Bernardeschi, C. Bernardeschi Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceSearch for more papers by this authorL. Valeyrie-Allanore, Corresponding Author L. Valeyrie-Allanore Department of Dermatology, Referral center for toxic bullous diseases, Assistance-Publique-Hopitaux de Paris, Hôpital Henri Mondor, Créteil, France Université Paris Est, Créteil, FranceCorrespondence: L. Valeyrie-Allanore. E-mail: [email protected] and N. Dupin. E-mail: [email protected]Search for more papers by this authorN. Ortonne, N. Ortonne Université Paris Est, Créteil, France Department of Pathology, Assistance-Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, FranceSearch for more papers by this authorL. Gressier, L. Gressier Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceSearch for more papers by this authorN. Wallet-Faber, N. Wallet-Faber Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceSearch for more papers by this authorP.-H. Bernard, P.-H. Bernard Department of Hepatology, Hôpital Saint-André, Bordeaux, FranceSearch for more papers by this authorC. Hezode, C. Hezode Université Paris Est, Créteil, France Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Creteil, FranceSearch for more papers by this authorJ.-C. Duclos-Vallée, J.-C. Duclos-Vallée Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Hôpital Paul Brousse, FranceSearch for more papers by this authorD. Samuel, D. Samuel Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Hôpital Paul Brousse, FranceSearch for more papers by this authorV. Mallet, V. Mallet Université Paris Descartes, Paris, France Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, FranceSearch for more papers by this authorS. Pol, S. Pol Université Paris Descartes, Paris, France Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, FranceSearch for more papers by this authorB. Milpied, B. Milpied Department of Dermatology, Hôpital Saint-André Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceSearch for more papers by this authorN. Dupin, Corresponding Author N. Dupin Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceCorrespondence: L. Valeyrie-Allanore. E-mail: [email protected] and N. Dupin. E-mail: [email protected]Search for more papers by this author C. Bernardeschi, C. Bernardeschi Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceSearch for more papers by this authorL. Valeyrie-Allanore, Corresponding Author L. Valeyrie-Allanore Department of Dermatology, Referral center for toxic bullous diseases, Assistance-Publique-Hopitaux de Paris, Hôpital Henri Mondor, Créteil, France Université Paris Est, Créteil, FranceCorrespondence: L. Valeyrie-Allanore. E-mail: [email protected] and N. Dupin. E-mail: [email protected]Search for more papers by this authorN. Ortonne, N. Ortonne Université Paris Est, Créteil, France Department of Pathology, Assistance-Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, FranceSearch for more papers by this authorL. Gressier, L. Gressier Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceSearch for more papers by this authorN. Wallet-Faber, N. Wallet-Faber Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceSearch for more papers by this authorP.-H. Bernard, P.-H. Bernard Department of Hepatology, Hôpital Saint-André, Bordeaux, FranceSearch for more papers by this authorC. Hezode, C. Hezode Université Paris Est, Créteil, France Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Creteil, FranceSearch for more papers by this authorJ.-C. Duclos-Vallée, J.-C. Duclos-Vallée Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Hôpital Paul Brousse, FranceSearch for more papers by this authorD. Samuel, D. Samuel Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Hôpital Paul Brousse, FranceSearch for more papers by this authorV. Mallet, V. Mallet Université Paris Descartes, Paris, France Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, FranceSearch for more papers by this authorS. Pol, S. Pol Université Paris Descartes, Paris, France Department of Hepatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, FranceSearch for more papers by this authorB. Milpied, B. Milpied Department of Dermatology, Hôpital Saint-André Centre Hospitalier Universitaire de Bordeaux, Bordeaux, FranceSearch for more papers by this authorN. Dupin, Corresponding Author N. Dupin Department of Dermatology, Assistance-Publique-Hôpitaux de Paris, Groupe Hospitalier Cochin, Paris, France Université Paris Descartes, Paris, FranceCorrespondence: L. Valeyrie-Allanore. E-mail: [email protected] and N. Dupin. E-mail: [email protected]Search for more papers by this author First published: 03 September 2014 https://doi.org/10.1111/jdv.12635Citations: 5Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1Jacobson IM, McHutchison JG, Dusheiko G et al. Telaprevir for previously untreated chronic hepatitis C virus infection. N Engl J Med 2011; 364: 2405–2416. 2Zeuzem S, Andreone P, Pol S et al. Telaprevir for retreatment of HCV infection. N Engl J Med 2011; 364: 2417–2428. 3Roujeau J-C, Mockenhaupt M, Tahan SR et al. Telaprevir-related dermatitis. JAMA Dermatol 2013; 149: 152–158. 4Cacoub P, Bourlière M, Lübbe J et al. Dermatological side effects of hepatitis C and its treatment: patient management in the era of direct-acting antivirals. J Hepatol 2012; 56: 455–463. 5Kardaun SH, Sidoroff A, Valeyrie-Allanore L et al. Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist? Br J Dermatol 2007; 156: 609–611. 6Dupin N, Mallet V, Carlotti A, Vallet-Pichard A, Pol S. Severe skin rash in case of readministration of telaprevir in a patient who previously experienced a non severe rash. Hepatol 2012; 55: 2042–2043. Citing Literature Volume30, Issue1January 2016Pages 143-146 ReferencesRelatedInformation

HIV-infected patientsmay develop rare anogenital pseudotumoral herpes potentially mimicking epidermoid carcinoma. We assessed treatment in five new cases with a median follow-up of 3.3 years. Recurrence and clinical nucleoside analog resistance were observed in all patients. All drug treatments were only temporarily curative and clinical responses varied between patients and recurrences. Foscavir seemed to be the most appropriate second-line treatment and cidofovir or thalidomide should be considered as alternative treatments.

Vemurafenib, a selective BRAF (v-raf murine sarcoma viral oncogene homologue B1) kinase inhibitor, is a new targeted biotherapy that improves survival in patients with metastatic melanomas harbouring the BRAF V600E mutation. However, this drug has significant dermatological adverse effects. We report a new severe cutaneous reaction to this drug associated with acute kidney injury (AKI). Four patients presented a generalized grade 3 (Common Terminology Criteria for Adverse Events) erythematous eruption with hyperkeratosis pilaris, 5-14days after the introduction of vemurafenib. These symptoms were associated with AKI in all cases and transitory hypereosinophilia in two cases. Vemurafenib treatment was stopped in three patients and the dose was reduced in the fourth, leading to a gradual improvement of skin symptoms and renal function. Positron-emission tomography scans showed a complete response in three cases and a major response in one case. Vemurafenib was reintroduced at a lower dose, without a relapse of the rash, but renal function again deteriorated. Thus, we report a cluster of four cases of AKI associated with similar, severe, grade 3 cutaneous drug reactions related to vemurafenib.

ABSTRACT Syphilis diagnosis is based on clinical observation, serological analysis, and dark-field microscopy (DFM) detection of Treponema pallidum subsp. pallidum , the etiological agent of syphilis, in skin ulcers. We performed a nested PCR (nPCR) assay specifically amplifying the tpp47 gene of T. pallidum from swab and blood specimens. We studied a cohort of 294 patients with suspected syphilis and 35 healthy volunteers. Eighty-seven of the 294 patients had primary syphilis, 103 had secondary syphilis, 40 had latent syphilis, and 64 were found not to have syphilis. The T. pallidum nPCR results for swab specimens were highly concordant with syphilis diagnosis, with a sensitivity of 82% and a specificity of 95%. Reasonable agreement was observed between the results obtained with the nPCR and DFM methods (kappa = 0.53). No agreement was found between the nPCR detection of T. pallidum in blood and the diagnosis of syphilis, with sensitivities of 29, 18, 14.7, and 24% and specificities of 96, 92, 93, and 97% for peripheral blood mononuclear cell (PBMC), plasma, serum, and whole-blood fractions, respectively. HIV status did not affect the frequency of T. pallidum detection in any of the specimens tested. Swab specimens from mucosal or skin lesions seemed to be more useful than blood for the efficient detection of the T. pallidum genome and, thus, for the diagnosis of syphilis.

HIV-individuals are at risk for human T-lymphotropic virus (HTLV) coinfection and neurological diseases. Little is known about the impact of HAART among coinfected patients. In this study, 47 out of 428 HIV individuals were coinfected with HTLV (10.9%). Coinfection was an independent variable associated with neurological outcome (odds ratio 8.73). Coinfection was associated with myelopathy [chi square (X2 ) U 93, P< 0.001], peripheral neuropathy (X2 U 6.5, P U 0.01), and hepatitis C virus infection (X2 U 36.5, P< 0.001). HAART did not appear to protect against neurological diseases and had no impact on HTLV proviral load.

Eosinophilic esophagitis (EoE) is a multifactorial esophageal inflammation, with a genetic predisposition, which combines a deficient esophageal mucosal barrier, an abnormal immune reaction to environmental allergens mediated by Th2 interleukins, immediate esophageal lesions and dysmotility, with secondary remodeling and fibrosis. Symptoms include reflux, abdominal pain, and food impaction, with a variation according to age. Fibroscopy shows major and minor endoscopic and histologic criteria, with a mucosal count ≥ 15 eosinophils/high power field (Eo/hpf). A new entity has been defined, where gastroesophageal reflux disease (GERD) and EoE share responsibility: the PPIs-sensitive form of EoE (PPI-REE). Children with fibroscopy showing ≥ 15 Eo/hpf need a second endoscopy following 8 weeks of PPI treatment. EoE has a strong association with other atopic disorders. Allergy testing (specific IgE blood test and skin prick tests [SPTs]) identifies patients at risk of anaphylaxis (14.8% of cases). The dietary therapy is based on a 4- to 12-week elimination test followed by endoscopy to check the disappearance of eosinophilic infiltration. The “dietary approaches are the amino acid-based formula, the allergy testing-based targeted diet, and the six-food elimination diet (empirical elimination of milk, wheat, soy, eggs, peanut/nuts, and fish/seafood). A recent first-line trial elimination of milk has been suggested, with wheat as a second elimination, if necessary. Dietary therapy allows remission and catch-up growth in 65% of cases. Swallowed topical steroids (budesonide in viscous gel or fluticasone propionate for nebulization) are an alternative, for which efficacy varies according to clinical and/or histological criteria and with relapses occurring at dosage tapering. Their use may be restricted by side effects, such as oral and/or esophageal candidiasis. The impact on long-term bone health and growth is unknown. Maintenance therapy is not standardized and is team-dependent, combining or not elimination diets and long-term steroids. The long-term risk of EoE is esophageal stenosis (25%) and endoscopic dilation may be repeated. Biotherapies have shown isolated histological improvement without significant clinical efficacy.

BACKGROUND:Atorvastatin is a widely-used therapeutic statin given for hypercholesterolaemia and for prevention of cardiovascular events. We report herein the occurrence of a drug reaction with eosinophilia and systemic symptoms (DRESS) secondary to intake of this drug. CASE REPORT:A 58-year-old woman presented with a febrile skin rash and facial oedema, appearing 6weeks after the start of atorvastatin for dyslipidaemia. The clinical features associated disseminated polymorphic lesions, oral mucosa involvement and systemic symptoms (fever, abdominal pain, diarrhoea, polyarthralgia and adenomegaly). Blood tests showed hypereosinophilia up to 11,540/mm(3), inflammatory syndrome and anicteric cholestasis without cytolysis. Serological tests for hepatitis B and C, HIV, EBV, HHV-6, HHV-8, CMV and human Parvovirus B-19 were negative. Cutaneous histology was unspecific. A diagnosis of DRESS secondary to atorvastatin was suspected. The clinical outcome was favourable after atorvastatin discontinuation. DISCUSSION:To our knowledge, this is the first description of atorvastatin inducing DRESS, a severe life-threatening drug eruption. Atorvastatin has previously been implicated in various cutaneous adverse events. Because of their potentially serious side effects, prescription of statins must be carefully evaluated.