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Le Bris V, Chastaing M, Schollhammer M, Brenaut E, Misery L. Usefulness of Psychiatric Intervention in a Joint Consultation for the Treatment of Burning Mouth Syndrome: A Monocentric Retrospective Study. Acta Derm Venereol 2019; 99:813-817. [PMID: 30460375 DOI: 10.2340/00015555-3094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary burning mouth syndrome is a term used for chronic oral mucosal pain with no identifiable organic cause. The aim of the study was to evaluate the usefulness of a psychiatric intervention for treating burning mouth syndrome based on a joint consultation with a psychiatrist and a dermatologist. The study was proposed to all patients who visited this consultation group between 2001 and 2017 for the treatment of primary burning mouth syndrome. The patients answered a questionnaire that was administered via mail. Of the 57 patients diagnosed with primary burning mouth syndrome, 38 were included. Seven patients (18.4%) no longer had pain; 8 (21.1%) estimated that the pain had decreased by greater than 50%; 11 (28.9%) estimated the decrease at between 30 and 50%, and 12 (31.6%) estimated a less than 30% decrease. Only 14 patients (36.8%) remained under treatment with antidepressants, as compared to 63.2% before the psychiatric intervention. This psychiatric intervention could be considered a valuable tool in the global burning mouth syndrome treatment strategy.
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Affiliation(s)
- Vinciane Le Bris
- Department of Dermatology, University Hospital, FR-29609 Brest, France
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Le Bris V, Schollhammer M, Chastaing M, Brenaut E, Misery L. L’intérêt d’une consultation conjointe (dermatologue/psychiatre) dans la prise en charge thérapeutique des stomatodynies primaires. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Le Cleach L, Lebrun-Vignes B, Bachelot A, Beer F, Berger P, Brugère S, Chastaing M, Do-Pham G, Ferry T, Gand-Gavanou J, Guigues B, Join-Lambert O, Henry P, Khallouf R, Lavie E, Maruani A, Romain O, Sassolas B, Tran VT, Guillot B. Guidelines for the management of acne: recommendations from a French multidisciplinary group. Br J Dermatol 2018; 177:908-913. [PMID: 29052890 DOI: 10.1111/bjd.15843] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2017] [Indexed: 11/28/2022]
Affiliation(s)
- L Le Cleach
- Service de Dermatologie, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris (APHP), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010, Créteil, France.,Université Paris-Est Créteil-Val de Marne, EA7379 ÉpiDermE (Épidémiologie en Dermatologie et Évaluation des Thérapeutiques), 61, avenue du Général-de-Gaulle, 94010, Créteil Cedex, France
| | - B Lebrun-Vignes
- Centre Régional de Pharmacovigilance, Groupe Hospitalier Pitié-Salpêtrière-Charles-Foix, APHP, 47-83, boulevard de l'Hôpital, 75013, Paris, France
| | - A Bachelot
- Service d'Endocrinologie et Médecine de la Reproduction, Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Groupe Hospitalier Pitié-Salpêtrière-Charles-Foix, APHP, 47-83, boulevard de l'Hôpital, 75013, Paris, France.,UPMC Université Paris 06, 4, place Jussieu, 75005, Paris, France
| | - F Beer
- Accueil Médical de la SDAT, 10bis, rue du Dr-Edouard-Laguesse, 21000, Dijon, France
| | - P Berger
- 25, rue Saint-Jean, 14000, Caen, France
| | - S Brugère
- Collège de Gynécologie de Bordeaux et du Sud-Ouest, 35, rue de Turenne, 33000, Bordeaux, France
| | - M Chastaing
- Unité de Psychiatrie de Liaison, Service Hospitalo-Universitaire de Psychiatrie d'Adultes et de Psychologie Médicale secteur 1, CHU de Brest, 2, avenue Foch, 29609, Brest, France
| | - G Do-Pham
- Service de Dermatologie, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris (APHP), 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010, Créteil, France
| | - T Ferry
- Service de Maladies Infectieuses, Hospices Civils de Lyon, 3, quai des Célestins, 69229, Lyon, France.,Université Claude-Bernard Lyon 1, 43, boulevard du 11-Novembre-1918, 69100, Villeurbanne, France
| | | | - B Guigues
- 2b, avenue du Canada, 14000, Caen, France
| | - O Join-Lambert
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Laboratoire de Microbiologie Clinique, Groupe Hospitalier Necker-Enfants-Malades, APHP, 149, rue de Sèvres, 75015, Paris, France
| | - P Henry
- 43, rue de Foncillon, 17200, Royan, France
| | - R Khallouf
- 30, boulevard Heurteloup, 37000, Tours, France
| | - E Lavie
- Haute Autorité de Santé, 2, avenue du Stade-de-France, 93218, Saint-Denis, France
| | - A Maruani
- Université François-Rabelais Tours, 60, rue du Plat-d'Étain, 37000, Tours, France.,Service de Dermatologie, CHRU de Tours, 2, boulevard Tonnellé, 37044, Tours, France
| | - O Romain
- Service de Réanimation Néonatale, Hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140, Clamart, France
| | - B Sassolas
- Département de Médecine Interne et Pneumologie, Hôpital de la Cavale-Blanche, CHRU de Brest, 5, boulevard T.-Prigent, 29609, Brest, France
| | - V T Tran
- Département de Médecine Générale, Université Paris Diderot, 16 rue Huchard, 75018, Paris, France.,Centre de Recherche Épidémiologie Statistique, Sorbonne Paris Cité (CRESS-Inserm U1153), 1, place du Parvis-Notre-Dame, 75004, Paris, France
| | - B Guillot
- Département de Dermatologie, CHU de Montpellier, Université de Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34295, Montpellier, France
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Abstract
Psychogenic itch can be defined as "an itch disorder where itch is at the center of the symptomatology and where psychological factors play an evident role in the triggering, intensity, aggravation, or persistence of the pruritus." The disorder is poorly known by both psychiatrists and dermatologists and this review summarizes data on psychogenic itch. Because differential diagnosis is difficult, the frequency is poorly known. The burden is huge for people suffering from this disorder but a management associating psychological and pharmacological approach could be very helpful. Classification, psychopathology, and physiopathology are still debating. New data from brain imaging could be very helpful. Psychological factors are known to modulate itch in all patients, but there is a specific diagnosis of psychogenic itch that must be proposed cautiously. Neurophysiological and psychological theories are not mutually exclusive and can be used to better understand this disorder. Itch can be mentally induced. Opioids and other neurotransmitters, such as acetylcholine and dopamine, are probably involved in this phenomenon.
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Affiliation(s)
- Laurent Misery
- French Psychodermatology Group, French Society of Dermatology, Paris, France. .,Department of Dermatology, University Hospital of Brest, Brest, France. .,Laboratory of Neurosciences of Brest, University of Western Brittany, Brest, France.
| | - Sabine Dutray
- French Psychodermatology Group, French Society of Dermatology, Paris, France ,0000 0004 0472 3249grid.411766.3Department of Dermatology, University Hospital of Brest, Brest, France
| | - Myriam Chastaing
- French Psychodermatology Group, French Society of Dermatology, Paris, France ,0000 0001 2188 0893grid.6289.5Laboratory of Neurosciences of Brest, University of Western Brittany, Brest, France ,Department of Psychiatry and Medical Psychology, Unit of Liaison Psychiatry, Brest, France
| | - Martine Schollhammer
- French Psychodermatology Group, French Society of Dermatology, Paris, France ,0000 0004 0472 3249grid.411766.3Department of Dermatology, University Hospital of Brest, Brest, France
| | - Sylvie G. Consoli
- French Psychodermatology Group, French Society of Dermatology, Paris, France
| | - Silla M. Consoli
- French Psychodermatology Group, French Society of Dermatology, Paris, France ,0000 0004 1788 6194grid.469994.fDepartment of Consultation Liaison Psychiatry, Paris-Descartes University, Sorbonne Paris Cité, Paris, France
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Cornec D, Saraux A, Jousse-Joulin S, Pers JO, Boisramé-Gastrin S, Renaudineau Y, Gauvin Y, Roguedas-Contios AM, Genestet S, Chastaing M, Cochener B, Devauchelle-Pensec V. The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review. Clin Rev Allergy Immunol 2016; 49:278-87. [PMID: 24952023 DOI: 10.1007/s12016-014-8431-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Primary Sjögren's syndrome (pSS) is a frequent autoimmune systemic disease, clinically characterized by eyes and mouth dryness in all patients, salivary gland swelling or extraglandular systemic manifestations in half of the patients, and development of lymphoma in 5 to 10 % of the patients. However, patients presenting with sicca symptoms or salivary gland swelling may have a variety of conditions that may require very different investigations, treatments, or follow-up. Eye and/or mouth dryness is a frequent complaint in clinical setting, and its frequency increases with age. When evaluating a patient with suspected pSS, the first step is to rule out its differential diagnoses, before looking for positive arguments for the disease. Knowledge of normal and abnormal lachrymal and salivary gland physiology allows the clinician to prescribe the most adapted procedures for evaluating their function and structure. New tests have been developed in recent years for evaluating these patients, notably new ocular surface staining scores or salivary gland ultrasonography. We describe the different diagnoses performed in our monocentric cohort of 240 patients with suspected pSS. The most frequent diagnoses are pSS, other systemic autoimmune diseases, idiopathic sicca syndrome and drug-induced sicca syndrome. However, other diseases are important to rule out due to their specific management, such as sarcoidosis, granulomatosis with polyangeitis, IgG4-related disease, chronic hepatitis C virus or human immunodeficiency virus infections, graft-versus-host disease, and head and neck radiation therapy. At the light of these data, we propose a core of minimal investigations to be performed when evaluating a patient with suspected pSS.
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Affiliation(s)
- Divi Cornec
- Department of Rheumatology, Brest Teaching Hospital, Brest, France.,EA2216, INSERM ESPRI, ERI29, Université de Brest, Brest, France.,LabEx IGO, Brest, France
| | - Alain Saraux
- Department of Rheumatology, Brest Teaching Hospital, Brest, France.,EA2216, INSERM ESPRI, ERI29, Université de Brest, Brest, France.,LabEx IGO, Brest, France
| | - Sandrine Jousse-Joulin
- Department of Rheumatology, Brest Teaching Hospital, Brest, France.,EA2216, INSERM ESPRI, ERI29, Université de Brest, Brest, France.,LabEx IGO, Brest, France
| | - Jacques-Olivier Pers
- EA2216, INSERM ESPRI, ERI29, Université de Brest, Brest, France.,LabEx IGO, Brest, France.,Department of Odontology, Brest Teaching Hospital, Brest, France
| | | | - Yves Renaudineau
- EA2216, INSERM ESPRI, ERI29, Université de Brest, Brest, France.,LabEx IGO, Brest, France.,Department of Odontology, Brest Teaching Hospital, Brest, France.,Laboratory of Immunology, Brest Teaching Hospital, Brest, France
| | - Yves Gauvin
- Department of Ear, Nose, Throat, Brest Teaching Hospital, Brest, France
| | | | - Steeve Genestet
- Department of Neurological Functional Explorations, Brest Teaching Hospital, Brest, France
| | - Myriam Chastaing
- Department of Psychiatry, Brest Teaching Hospital, Brest, France
| | | | - Valérie Devauchelle-Pensec
- Department of Rheumatology, Brest Teaching Hospital, Brest, France. .,EA2216, INSERM ESPRI, ERI29, Université de Brest, Brest, France. .,LabEx IGO, Brest, France. .,Service de Rhumatologie, Hôpital de la Cavale Blanche, BP 824, 29609, Brest Cedex, France.
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Affiliation(s)
- M Chastaing
- Unité de psychiatrie de liaison, service hospitalo-universitaire de psychiatrie d'adultes et de psychologie médicale, CHU, 2, avenue Foch, 29200 Brest, France; EA4686, éthique, professionnalisme et santé, université de Brest, CHU, 2, avenue Foch, 29200 Brest, France; EA4685 (laboratoire de neurosciences de Brest), CHU, 2, avenue Foch, 29200 Brest, France
| | - L Misery
- EA4686, éthique, professionnalisme et santé, université de Brest, CHU, 2, avenue Foch, 29200 Brest, France; EA4685 (laboratoire de neurosciences de Brest), CHU, 2, avenue Foch, 29200 Brest, France; Service de dermatologie, CHU, 2, avenue Foch, 29200 Brest, France.
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Milin M, Cornec D, Chastaing M, Griner V, Berrouiguet S, Nowak E, Marhadour T, Saraux A, Devauchelle-Pensec V. Sicca symptoms are associated with similar fatigue, anxiety, depression, and quality-of-life impairments in patients with and without primary Sjögren's syndrome. Joint Bone Spine 2016; 83:681-685. [PMID: 26774177 DOI: 10.1016/j.jbspin.2015.10.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 10/28/2015] [Indexed: 09/30/2022]
Abstract
OBJECTIVE To compare quality of life (QoL), depression, anxiety, and fatigue in prospectively included patients with primary Sjögren's syndrome (pSS) or with sicca but no diagnosis of Sjögren's syndrome. METHODS Patients undergoing a multidisciplinary evaluation at a single university center in Brest, France, for suspected pSS and having sicca symptoms were included prospectively between November 2006 and December 2013. The same standardized investigations were performed in all patients. pSS and sicca not due to pSS diagnoses were based on evaluating physician opinion. Each patient completed three validated questionnaires on QoL (SF-36), fatigue (MFI), depression and anxiety (HADS). RESULTS Of the 95 included patients, 55 (57.9%) had pSS and 40 (42.1%) had sicca without pSS. Gender distribution, age, disease duration, and sicca symptoms were similar in the two groups. The pSS group had a significantly higher proportion of patients with abnormal objective tests for dryness (Schirmer's test and salivary flow rate). The SF-36, HADS, and MFI scores were similarly altered in the two groups. Anxiety was more common than depression in both groups. The most affected domains were vitality in the SF-36 and general/physical fatigue in the MFI. Extraglandular systemic involvement was not a major determinant of QoL alteration in patients with pSS. CONCLUSIONS Sicca symptoms are associated with severe alterations in SF-36, HADS, and MFI scores regardless of objective test abnormalities and pSS diagnosis. Anxiety is more common than depression and should be taken into account when managing all patients with sicca symptoms.
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Affiliation(s)
- Morgane Milin
- Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France.
| | - Divi Cornec
- Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
| | - Myriam Chastaing
- Psychiatric Unit, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
| | - Veronique Griner
- Psychiatric Unit, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
| | - Sofian Berrouiguet
- Psychiatric Unit, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
| | - Emmanuel Nowak
- Inserm CIC 0502, CHU de Brest, 29609 Brest cedex, France
| | - Thierry Marhadour
- Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
| | - Alain Saraux
- Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
| | - Valérie Devauchelle-Pensec
- Rheumatology Unit and Immunology Department (EA 2216), hôpital de la Cavale-Blanche, université Bretagne-Occidentale, CHU de Brest, BP 814, 29609 Brest cedex, France
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Le Cleach L, Lebrun-Vignes B, Bachelot A, Beer F, Berger P, Brugère S, Chastaing M, Do-Pham G, Ertel-Pau V, Ferry T, Gand-Gavanou J, Guigues B, Join-Lambert O, Henry P, Khallouf R, Lavie E, Maruani A, Romain O, Sassolas B, Tran VT, Guillot B. [Not Available]. Arch Pediatr 2016; 23:213-21. [PMID: 26774894 DOI: 10.1016/j.arcped.2015.11.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L Le Cleach
- Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France; Université Paris-Est Créteil-Val de Marne, EA7379 ÉpiDermE (épidémiologie en dermatologie et évaluation des thérapeutiques), 61, avenue du Général-de-Gaulle, 94010 Créteil cedex, France.
| | - B Lebrun-Vignes
- Centre régional de pharmacovigilance, groupe hospitalier Pitié-Salpétrière-Charles-Foix, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Bachelot
- Service d'endocrinologie et médecine de la reproduction, centre de référence des maladies endocriniennes rares de la croissance, hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, 47-83, boulevard de l'Hôpital, 75013 Paris, France; UPMC université Paris 06, 4, place Jussieu, 75005 Paris, France
| | - F Beer
- Accueil médical de la SDAT, 10bis, rue du Dr-Edouard-Laguesse, 21000 Dijon, France
| | - P Berger
- 25, rue Saint-Jean, 14000 Caen, France
| | - S Brugère
- Collège de gynécologie de Bordeaux et du Sud-Ouest, 35, rue de Turenne, 33000 Bordeaux, France
| | - M Chastaing
- Unité de psychiatrie de liaison, service hospitalo-universitaire de psychiatrie d'adultes et de psychologie médicale secteur 1, CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France
| | - G Do-Pham
- Service de dermatologie, hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - V Ertel-Pau
- HAS, 2, avenue du Stade-de-France, 93218 Saint-Denis, France
| | - T Ferry
- Service de maladies infectieuses, hospices civils de Lyon, 3, quai des Célestins, 69229 Lyon cedex 02, France; Université Claude-Bernard Lyon 1, 43, boulevard du 11-Novembre-1918, 69100 Villeurbanne, France; Centre international de recherche en infectiologie, Inserm 1111, 46, allée d'Italie, 69007 Lyon, France
| | | | - B Guigues
- CHU de Caen, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen, France
| | - O Join-Lambert
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Laboratoire de microbiologie clinique, hôpital universitaire Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 149, rue de Sèvres, 75015 Paris, France; Inserm U1151, équipe 11, institut Necker-Enfants-Malades, bâtiment Leriche, porte 9, 14, rue Maria-Helena-Vieira-Da-Silva, CS61431, 75993 Paris cedex 1, France
| | - P Henry
- 43, rue de Foncillon, 17200 Royan, France
| | - R Khallouf
- 30, boulevard Heurteloup, 37000 Tours, France
| | - E Lavie
- HAS, 2, avenue du Stade-de-France, 93218 Saint-Denis, France
| | - A Maruani
- Université François-Rabelais Tours, 60, rue du Plat-d'Étain, 37000 Tours, France; Service de dermatologie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France
| | - O Romain
- Service de réanimation néonatale, hôpital Antoine-Béclère, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France
| | - B Sassolas
- Département de médecine interne et pneumologie, hôpital de la Cavale-Blanche, CHRU de Brest, 5, boulevard T.-Prigent, 29609 Brest cedex, France
| | - V T Tran
- Département de médecine générale, université Paris Diderot, 5, rue Thomas-Mann, 75013 Paris, France; Centre de recherche épidemiologie statistique, (Inserm U1153) Sorbonne Paris Cité, 1, place du Parvis-Notre-Dame, 75004 Paris, France
| | - B Guillot
- Département de dermatologie CHU de Montpellier, université de Montpellier, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France
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Le Cleach L, Lebrun-Vignes B, Bachelot A, Beer F, Berger P, Brugère S, Chastaing M, Do–Pham G, Ertel-Pau V, Ferry T, Gand-Gavanou J, Guigues B, Join-Lambert O, Henry P, Khallouf R, Lavie E, Maruani A, Romain O, Sassolas B, Tran V, Guillot B. Prise en charge de l’acné. Traitement de l’acné par voie locale et générale. Ann Dermatol Venereol 2015; 142:692-700. [DOI: 10.1016/j.annder.2015.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Misery L, Legoupil D, Schollhammer M, Brenaut E, Abasq C, Roguedas-Contios AM, Chastaing M. [The announcement of bad news in dermatology]. Ann Dermatol Venereol 2014; 141:729-35. [PMID: 25442480 DOI: 10.1016/j.annder.2014.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L Misery
- Service de dermatologie, CHU, 2, avenue Foch, 29200 Brest, France; Groupe psychodermatologie, société française de dermatologie, 25, rue la Boétie, 75008 Paris, France.
| | - D Legoupil
- Service de dermatologie, CHU, 2, avenue Foch, 29200 Brest, France
| | - M Schollhammer
- Service de dermatologie, CHU, 2, avenue Foch, 29200 Brest, France; Groupe psychodermatologie, société française de dermatologie, 25, rue la Boétie, 75008 Paris, France
| | - E Brenaut
- Service de dermatologie, CHU, 2, avenue Foch, 29200 Brest, France
| | - C Abasq
- Service de dermatologie, CHU, 2, avenue Foch, 29200 Brest, France
| | | | - M Chastaing
- Groupe psychodermatologie, société française de dermatologie, 25, rue la Boétie, 75008 Paris, France; Unité de psychologie médicale, CHU, 2, avenue Foch, 29200 Brest, France
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Fleuret C, Le Toux G, Morvan J, Ferreira F, Chastaing M, Guillet G, Misery L. Use of Selective Serotonin Reuptake Inhibitors in the Treatment of Burning Mouth Syndrome. Dermatology 2014; 228:172-6. [DOI: 10.1159/000357353] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 11/04/2013] [Indexed: 11/19/2022] Open
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Misery L, Chastaing M, Touboul S, Callot V, Schollhammer M, Young P, Feton-Danou N, Dutray S. Psychogenic skin excoriations: diagnostic criteria, semiological analysis and psychiatric profiles. Acta Derm Venereol 2012; 92:416-8. [PMID: 22377838 DOI: 10.2340/00015555-1320] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Psychogenic excoriations are also called neurotic excoriations, dermatillomania or skin picking syndrome. We proposed diagnostic criteria and then performed a study of the psychiatric profiles of outpatients with psychogenic excoriations and the circumstances around the creation of these excoriations. Although the results must be interpreted with caution because the study was performed with only 10 patients, interesting data is provided about the onset of psychogenic excoriations, the behaviour of picking, and comorbidity. Common or specific characteristics were identified according to type of case. The majority of patients associated first excoriations with personal problems. Four patients reported abuse in childhood or adolescence. This study confirms that skin picking is an impulsive reaction and does not belong to the obsessive-compulsive disorders: impulsivity is defined by ineffective or failing control resulting in uninhibited behaviour.
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Affiliation(s)
- Laurent Misery
- Department of Dermatology, European University of Brittany, University of Brest, University Hospital, FR-29609 Brest, France.
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Aubert-Wastiaux H, Moret L, Le Rhun A, Fontenoy AM, Nguyen JM, Leux C, Misery L, Young P, Chastaing M, Danou N, Lombrail P, Boralevi F, Lacour JP, Mazereeuw-Hautier J, Stalder JF, Barbarot S. Topical corticosteroid phobia in atopic dermatitis: a study of its nature, origins and frequency. Br J Dermatol 2011; 165:808-14. [PMID: 21671892 DOI: 10.1111/j.1365-2133.2011.10449.x] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Topical corticosteroids remain the mainstay of atopic dermatitis therapy. Many atopic dermatitis therapeutic failures appear to be attributable to poor adherence to treatment due to topical corticosteroid phobia. OBJECTIVES To assess the facets, origins and frequency of fear of topical corticosteroid use among patients with atopic dermatitis. METHODS A questionnaire comprising 69 items, generated from information gathered during interviews with 21 patients and 15 health professionals, was given to consecutive patients consulting at the outpatient dermatology departments of five regional university hospitals or with 53 dermatologists in private practice. RESULTS A total of 208 questionnaires were analysed (including 144 from parents and 87 from adult patients, 27 of whom were also parents); 80·7% of the respondents reported having fears about topical corticosteroids and 36% admitted nonadherence to treatment. A correlation was found between topical corticosteroid phobia and the need for reassurance, the belief that topical corticosteroids pass through the skin into the bloodstream, a prior adverse event, inconsistent information about the quantity of cream to apply, a desire to self-treat for the shortest time possible or poor treatment adherence. Topical corticosteroid phobia was not correlated with atopic dermatitis severity. CONCLUSION Topical corticosteroid phobia is a genuine and complex phenomenon, common among French patients with atopic dermatitis, that has an important impact on treatment compliance.
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Affiliation(s)
- H Aubert-Wastiaux
- Department of Dermatology, CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44035 Nantes Cedex 1, France.
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Chastaing M. [Pathomimesis and Münchhausen syndrome]. Rev Prat 2009; 59:511-517. [PMID: 19462873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Factitious disorders, as pathomimesis and Münchhausen syndrome, have to be diagnosed early to avoid numerous exams and inadequate treatments, which intensify symptoms. Lesions are self-inflicted in a fully conscious manner. The patient does not search for direct benefits, hides his/her responsibility in the induction of lesions. Factitious disorders have to be differentiated from simulation and it is necessary to understand that they are the expression of an intense mental suffering, which is often unknown by the patient. Diagnosis is difficult, with various clinical manifestations, but it is not a diagnosis by a process of elimination: it is supported by the presence of personality disorders, usually borderline disorders. Management is complex and often disappointing. To keep a therapeutic relationship with the patient requires collaboration between all healthcare personals; psychotherapeutic treatment is possible only with the installation of a trusting relationship and with associated cares of physical symptoms.
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Affiliation(s)
- Myriam Chastaing
- Unité d e psychiatrie de liaison, service hospitalo-universitaire de psychiatrie d'adultese et de psychologie médicale, CHU Brest, hôpital de la Cavale Blanche, Brest cedex.
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Misery L, Mairesse H, Chastaing M. Bromose délirante : traitement par amisulpride et olanzapine. Ann Dermatol Venereol 2007; 134:575-6. [PMID: 17657190 DOI: 10.1016/s0151-9638(07)89275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Misery L, Alexandre S, Dutray S, Chastaing M, Consoli SG, Audra H, Bauer D, Bertolus S, Callot V, Cardinaud F, Corrin E, Feton-Danou N, Malet R, Touboul S, Consoli SM. Functional Itch Disorder or Psychogenic Pruritus: Suggested Diagnosis Criteria From the French Psychodermatology Group. Acta Derm Venereol 2007; 87:341-4. [PMID: 17598038 DOI: 10.2340/00015555-0266] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Functional itch disorder or psychogenic pruritus is a poorly defined diagnosis. This paper sets out the proposed diagnostic criteria of the French Psychodermatology Group (FPDG). There are three compulsory criteria: localized or generalized pruritus sine materia, chronic pruritus (>6 weeks) and the absence of a somatic cause. Three additional criteria from the following seven items should also be present: a chronological relationship of pruritus with one or several life events that could have psychological repercussions; variations in intensity associated with stress; nocturnal variations; predominance during rest or inaction; associated psychological disorders; pruritus that could be improved by psychotropic drugs; and pruritus that could be improved by psychotherapies.
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Affiliation(s)
- Laurent Misery
- Department of Dermatology, Brest University Hospital, Brest Cedex, France.
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Abstract
INTRODUCTION The announcement of a serious disease to a patient and an adequate information are never easy. Some physicians are more comfortable than others. However, some knowledges on usual reactions of patients and on new rules could be useful. CURRENT KNOWLEDGE AND KEY POINTS The complete information of the patient is a duty with regard to the law, although it could be facultative in some rare circumstances. The medical confidence has to be respected with all persons, even among close relations of the patient. It is not contradictory with a therapeutic alliance with these close relations. The announcement must be provided by the doctor who first suggested the diagnosis. An anxious reaction is normal. Mechanisms of defence, appropriate or not, are developed by the patient. Nonetheless, precise information seems to be less anxiogenic than non resolved questions. Fears of some physicians, who avoid information, often appear linked to their own anxiety. Nevertheless, good information is associated with adequate words and adequate choice of news. There is need to evaluate knowledges of the patient on his/her disease. FUTURE PROSPECTS Complete and adequate information must be associated with an early psychological (and sometimes social) help. It appears necessary for well-being of the patient but also maybe for his/her prognosis.
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Affiliation(s)
- L Misery
- Service de dermatologie, CHU de Brest, 29609 Brest cedex, France.
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