La demande d’effacement de cicatrices cutanées

International audienceEn dermatologie, les progrès technologiques et leur médiatisation suscitent des demandes de plus en plus fréquentes d’effacement des cicatrices (cicatrices post–chirurgicales, cicatrices post-traumatiques, cicatrices d’acné, cicatrices auto-provoquées (excoriations, scarifications, automutilations) … Les attentes sont fortes et les demandes souvent pressantes chez ces patients qui ont une véritable souffrance avec sentiments de honte et culpabilité. Une réponse opératoire immédiate, sans entendre la demande latente derrière la demande d’effacement des cicatrices, risque d’aggraver la souffrance

La demande d’effacement de cicatrices cutanées

International audienceEn dermatologie, les progrès technologiques et leur médiatisation suscitent des demandes de plus en plus fréquentes d’effacement des cicatrices (cicatrices post–chirurgicales, cicatrices post-traumatiques, cicatrices d’acné, cicatrices auto-provoquées (excoriations, scarifications, automutilations) … Les attentes sont fortes et les demandes souvent pressantes chez ces patients qui ont une véritable souffrance avec sentiments de honte et culpabilité. Une réponse opératoire immédiate, sans entendre la demande latente derrière la demande d’effacement des cicatrices, risque d’aggraver la souffrance

Les excoriations cutanées (approche psychodynamique d'un trouble du comportement prenant directement la peau pour cible)

BREST-BU Médecine-Odontologie (290192102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Sicca symptoms are associated with similar fatigue, anxiety, depression, and quality-of-life impairments in patients with and without primary Sjögren's syndrome

International audienc

The Differential Diagnosis of Dry Eyes, Dry Mouth, and Parotidomegaly: A Comprehensive Review.

International audience: 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