Jean-François Stalder M.D

University of Nantes | UNIV Nantes · Département de Médecine Générale et Médecine

Introduction (contexte de la recherche) La dermatite atopique (DA) est une dermatose inflammatoire chronique fréquente ayant un retentissement important sur la qualité de vie des patients concernés. Le pharmacien, en tant que dernier professionnel de santé interagissant avec le patient avant la dispensation des soins, joue un rôle clé dans l’éducat...

In chronic skin diseases such as atopic dermatitis (AD), therapeutic failure due to poor patient adherence to treatment is commonly reported. Therapeutic patient education (TPE) is an approach to improve self-management and adherence. Several studies demonstrated that TPE programmes have positive effects on disease management resulting in decreased...

Since the introduction of active vaccination against SARS‐CoV‐2 infection, there has been a debate about the risk of developing severe allergic or anaphylactic reactions among individuals with a history of allergy. Indeed, rare cases of severe allergic reactions have been reported in the United Kingdom and North America. By february 2021 a rate of...

Atopic dermatitis (AD) is a highly pruritic, chronic inflammatory skin disease. The diagnosis is made using evaluated clinical criteria. Disease activity and burden are best measured with a composite score, assessing both objective and subjective symptoms, such as SCORing Atopic Dermatitis (SCORAD). AD management must take into account clinical and...

Atopic dermatitis (AD) is a disease that can have a high impact on quality of life, especially due to itch and skin pain. This paper utilizes expertise from members of the International Society of Atopic Dermatitis (ISAD)/Oriented Patient‐Education Network in Dermatology (OPENED) task force to review the epidemiology, pathophysiology and exacerbati...

This is the report from the fifth meeting of the Harmonising Outcome Measures for Eczema initiative (HOME V). The meeting was held on 12–14 June 2017 in Nantes, France, with 81 participants. The main aims of the meeting were (i) to achieve consensus over the definition of the core domain of long‐term control and how to measure it and (ii) to priori...

La dermatitis atópica (DA) es una enfermedad multifactorial que afecta al 10-20% de los niños y al 3-8% de los adultos en Europa occidental y Estados Unidos. El aumento de la frecuencia en los países en vías de desarrollo sugiere una gran influencia de los factores ambientales en la fisiopatología de esta enfermedad. El efecto sobre la calidad de v...

Background: Erythropoietic protoporphyria (EPP) is a rare metabolic disorder, characterized by photosensitivity, caused by errors of the haem biosynthetic pathway. Avoidance of sun exposure is recommended; however, some patients suggested a paradoxical improvement of symptoms when they move to sunny areas. Objectives: In a national French study,...

Introduction La pemphigoïde de la grossesse (PG) est une dermatose bulleuse auto-immune jonctionnelle due à la production d’auto-anticorps (Ac) IgG dirigés contre la portion NC16A de la protéine transmembranaire hémidesmosomale BP180. Le diagnostic repose sur la positivité de l’IFD, constamment négative dans l’éruption polymorphe de la grossesse (P...

Introduction L’observance thérapeutique est médiocre pour les traitements classiques du psoriasis. Le but de notre étude était d’évaluer l’observance des patients sous biothérapies et les déterminants d’une mauvaise observance. Patients et méthodes Il s’agissait d’une étude observationnelle rétrospective multicentrique réalisée de septembre 2013 à...

Introduction Les neurofibromes internes (NF-int) au cours de la neurofibromatose 1 (NF1) sont à risque de transformation maligne ou de compression d’organe. Le seul traitement actuel est la chirurgie d’exérèse, souvent impossible compte tenu de localisation multiples et radiculaires. La voie de signalisation mTOR est perturbée dans la NF1 ; la pert...

Introduction L’Eczéma chronique des mains (ECM) est une pathologie fréquente qui engendre souvent des répercussions importantes sur la vie personnelle et professionnelle. La première cause d’ECM est la dermite irritative engendrée par un lavage des mains inadéquat, l’exposition à des produits irritants et la mauvaise utilisation des gants. En 2013...

Wet wrapping (WW) appears to be effective in severe atopic dermatitis (AD) in children resistant to topical treatment. Seventeen children were included and were directed to use WW every night (≥6 hr) until lesions disappeared, followed by maintenance treatment of two to three treatments per week. The mean Scoring Atopic Dermatitis (SCORAD) score at...

The perception of stigmatization of patients with psoriasis is largely due to misconceptions and negative prejudice about this skin disease. 'Uneducated' judgments can give rise to discriminatory behaviours. Evaluate the prevalence, in France, of misconceptions, negative prejudice and discriminatory behaviour towards psoriasis patients. Online surv...

IntroductionCutaneous arterio-venous malformations (AVM) are high-flow vascular malformations made up of a direct link between arteries and veins without intermediary capillary space. ‘Distal limb's AVM’, which mean involving hands or feet, are rare and their functional prognosis is often poor. Little is known about their early clinical symptoms. T...

Iconographie disponible sur CD et Internet.

Iconographie disponible sur CD et Internet.

Iconographie disponible sur CD et Internet.

Background: Treatment refusal, which is defined as a patient actively refusing to take treatment despite physician recommendations, has never been evaluated in psoriasis. Objective: To investigate refusal of topical treatments by patients living with psoriasis in France. Methods: Using responses to an internet study, participants who refused t...

Table S1. Detailed voting results.

Objective: It was hypothesized that neuropsychological impairments in children with neurofibromatosis type I (NF1) are associated with brain areas of increased T2-weighted signal intensity on MRI. Systematic and extensive examination of this hypothesis remains however scarce, particularly regarding executive dysfunction whereas hyperintensities ar...

Objective: Self-assessment scores such as the Patient-Oriented Scoring of Atopic Dermatitis (PO-SCORAD) index being recommended by public health authorities for chronic disease management, we aimed at analysing correlations between PO-SCORAD and physician and patient assessment scores of atopic dermatitis (AD) severity and quality of life. Method...

Background CLOVES syndrome (Congenital Lipomatous asymmetric Overgrowth of the trunk with lymphatic, capillary, venous, and combined-type Vascular malformations, Epidermal nevi, Skeletal anomalies) is a sporadic malformational syndrome that has recently been described (mutation of PIK3CA), with asymmetric body hypertrophy, lipomatous hamartoma of t...

Atopic dermatitis (AD) is the most frequent children's chronic skin disease. Management of AD can be difficult because local treatments must be adapted to the skin's condition. Between consultations, sudden changes in the state of the disease can make it difficult to manage local treatment. Parents and children need information that will help them...

This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term...

The skin is the largest organ of the body, providing a protective barrier against bacteria, chemicals and physical insults while maintaining homeostasis in the internal environment. Such a barrier function the skin ensures protection against excessive water loss. The skin's immune defence consists of several facets, including immediate, non-specifi...

L’eczéma chronique des mains (ECM) est une dermatose inflammatoire d’origine multifactorielle entraînant une altération importante de la qualité de vie. La prise en charge de l’ECM fait appel à des traitements essentiellement locaux et des mesures de protection cutanée. L’application de ces mesures est souvent imparfaite à l’origine de nombreux éch...

Our study investigated spontaneous versus reactive cognitive flexibility in children with neurofibromatosis type 1 (NF1) and their comorbidity with attention-deficit hyperactivity disorder (ADHD). Thirty children with NF1 aged 7 to 12 years old were compared to 60 healthy controls matched by age, gender, and parental education. On the basis of Esli...

Therapeutic patient education (TPE) is a patient-centred process that entails the transfer of skills (e.g. self-management, treatment adaptation) from a trained healthcare professional to patients and/or their carers. TPE has been shown to help improve adherence, prevent complications, and improve quality of life (QoL) in chronic illnesses such as...

Atopic dermatitis: some general remarks. Atopic dermatitis, also called atopic eczema, is a chronic inflammatory skin disease, usually observed in infants but which can also occur in adults and elderly people. Increasingly prevalent, atopic dermatitis today constitutes a public health issue, notably as a result of the influence of the environment o...

Therapeutic education provides a significant benefit in terms of quality of life and compliance in patients suffering from atopic dermatitis. The setting up of care networks could also play a major role in lowering the cost of treatments, as shown by the experience of Nantes University Hospital's atopy school.

Atopic dermatitis is a chronic inflammatory skin disease characterized by episodes of acute eczema alternating with periods of remission. It is a common disease, Its prevalence is estimated to be between 10 and 15 %. The affected areas change depending on the age of the child. Treatment consists of topical corticosteroids for which safety for the p...

The fear of using topical corticosteroids, usually called topical corticophobia, is a frequent concern for atopic dermatitis patients and/or their parents. Assessing patients' atopic dermatitis and their parents' topical corticosteroid phobia is an essential step to improving adherence to treatment. Because topical corticophobia appears to be a com...

Poor adherence is frequent in patients with atopic dermatitis (AD), leading to therapeutic failure. Therapeutic patient education (TPE) helps patients with chronic disease to acquire or maintain the skills they need to manage their chronic disease. After a review of the literature, a group of multispecialty physicians, nurses, psychologists, and pa...

Therapeutic patient education (TPE) has proven effective in increasing treatment adherence and improving quality of life (QoL) for patients with numerous chronic diseases, especially atopic dermatitis (AD). This study was undertaken to identify worldwide TPE experiences in AD treatment. Experts from 23 hospitals, located in 11 countries, responded...

  Atopic dermatitis (AD) can be extremely disabling and may cause psychological problems for affected children and their families. Moisturizers and emollients are important in the baseline daily skin care of patients with AD. To assess the effect of a 3-month, twice-daily treatment with an emollient on the quality of life (QoL) of parents with a ch...

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conduct...

There is limited information regarding the acceptability of injection devices for biological agents. The primary objective of the study was to investigate patients' perceptions on the acceptability of two devices delivering etanercept. The secondary objectives of the study were to explore whether patients' attributes are associated with preferences...

IntroductionAmicrobial pustulosis of the skin folds represents a new entity within the spectrum of neutrophilic dermatoses. This disease is characterized by acute onset of pustular lesions in the skin folds, association with an autoimmune disorder, and improvement under systemic corticosteroids.ObservationA 24-year-old woman had been presenting pus...

Ulcerated infantile hemangiomas (IH) are a therapeutic challenge. Propranolol, a nonselective beta-blocker, was recently introduced as a novel treatment for IH. To evaluate our experience of propranolol in the management of ulcerated IH. A national, multicenter, retrospective, observational study was conducted. Data were collected from the medical...

Auteur(s) : Helene AUBERT-WASTIAUX1 helene.aubert.wastiaux@gmail.com, Sebastien BARBAROT1, Francoise MECHINAUD2, Celine BOSSARD1, Jean-Francois STALDER3 1 Clinique dermatologique, CHU Hotel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France 2 Hematologie pediatrique, CHU Hotel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France 3 Anatomo-patho...

In this study, we tested the hypothesis that action planning is impaired in children with neurofibromatosis type 1 (NF1). Thirty-six children with NF1 were pair-matched to 36 healthy controls (HC) on age (range, 7-12 years), sex, and parental education level, and both groups were administered three action-planning tasks. To examine the relation of...

Zinc is a cofactor for several enzymes involved in many metabolisms. Zinc deficiency induces various disorders such as acrodermatitis enteropathica, either inherited or acquired. We report three cases of premature infants (24-31 wks gestational age) with low birthweight (650 to 940 g) and enteropathy, two of whom presented with necrotizing enteroco...