Background.The outcome for patients with dermatitis artefacta is not well known.The primary objective of this single-centre retrospective study was to describe the initial clinical aspects and the prognosis of the dis...Background.The outcome for patients with dermatitis artefacta is not well known.The primary objective of this single-centre retrospective study was to describe the initial clinical aspects and the prognosis of the disease.The secondary objective was to describe the somatic and psychological management and longterm treatment of these patients.Patients and methods.Records of patients with dermatitis artefacta followed in the dermatology department over the 15 last years were reviewed independently by 2 dermatologists.Diagnostic criteria consisted of evocative clinical pictures and the exclusion of other forms of dermatosis.Data collection included:file analysis,photographs,review questionnaires sent to general practitioner or completed during a phone call to patients(follow-up data).Results.Thirty-one patient files were selected:23 women and 8 men,mean age 31 years(SD = 14.8).Clinical aspects included:erythema(50%),ulceration(37%),crust(23%)and blisters(17%).The main sites were the face(67%)and arms(43%).Topical treatment was prescribed in all cases and systemic treatment was prescribedin 23%of cases.Psychological support was offered to 65%of the patients and was accepted by 50%.A follow-up study was performed for 17 patients and showed serious complications in 4 cases consisting of psychosis(n = 2)and/or severe self-mutilation(n = 3)occurring over several years following diagnosis(5 years for one patient and 12 years for 2 patients).Discussion.The results confirm the usual and characteristics of dermatitis artefacta such as predominance in young female patients,with lesions affecting visible areas(face,upper legs).In contrastwith published studies,no cases of attempted suicide were observed in our series,although severe dermatitis artefacta was evidenced in only a minority of patients.展开更多
Background: The preference of women patients for women physicians has been shown in many specialties. Women patients awaiting a lower endoscopy have been shown to have a preference for women endoscopists. The reasons ...Background: The preference of women patients for women physicians has been shown in many specialties. Women patients awaiting a lower endoscopy have been shown to have a preference for women endoscopists. The reasons for this preference and the strength of this preference have not been studied in the primary care setting. Methods: A questionnaire was given to female patients who were waiting for primary care appointments at 4 offices. Patients reported sociodemographic characteristics, experiences with colorectal cancer (CRC), barriers to CRC screening, gender preference of their physician, the significance, and reasons for this preference. Results: A total of 202 women patients aged 40 to 70 years (mean 53 years)- completed the questionnaire. Of these patients, 43% preferred a woman endoscopist, and of these, 87% would be willing to wait >30 days for a woman endoscopist, and 14% would be willing to pay more for one. The most common reason (in 75% ) for this gender preference was embarrassment. Univariate analysis revealed that gender of the primary care physician (PCP), younger patient age, current employment, and no previous history of colonoscopy were predictors of preference for a woman endoscopist. Of these variables, only female gender of the PCP (OR 2.84: 95% CI[1.49, 5.40]ABSTRACT) and employment (OR 2.4: 95% CI[1.23, 4.67]) were positive predictors for a woman endoscopist preference by multivariable analysis; 5% stated that they would not undergo a colonoscopy unless guaranteed a woman endoscopist. The sole independent factor associated with adherence to screening was PCP recommendation (OR 2.93: 95% CI[1.63, 5.39]). Conclusions: Women patients frequently prefer a woman endoscopist, and this preference is reported as being strong enough to delay the procedure and to incur personal expense. It is an absolute barrier to endoscopy according to 5% in this subset of women surveyed. Interventions must be made in the primary care setting to address this issue and to increase the participation of women patients in CRC screening.展开更多
文摘Background.The outcome for patients with dermatitis artefacta is not well known.The primary objective of this single-centre retrospective study was to describe the initial clinical aspects and the prognosis of the disease.The secondary objective was to describe the somatic and psychological management and longterm treatment of these patients.Patients and methods.Records of patients with dermatitis artefacta followed in the dermatology department over the 15 last years were reviewed independently by 2 dermatologists.Diagnostic criteria consisted of evocative clinical pictures and the exclusion of other forms of dermatosis.Data collection included:file analysis,photographs,review questionnaires sent to general practitioner or completed during a phone call to patients(follow-up data).Results.Thirty-one patient files were selected:23 women and 8 men,mean age 31 years(SD = 14.8).Clinical aspects included:erythema(50%),ulceration(37%),crust(23%)and blisters(17%).The main sites were the face(67%)and arms(43%).Topical treatment was prescribed in all cases and systemic treatment was prescribedin 23%of cases.Psychological support was offered to 65%of the patients and was accepted by 50%.A follow-up study was performed for 17 patients and showed serious complications in 4 cases consisting of psychosis(n = 2)and/or severe self-mutilation(n = 3)occurring over several years following diagnosis(5 years for one patient and 12 years for 2 patients).Discussion.The results confirm the usual and characteristics of dermatitis artefacta such as predominance in young female patients,with lesions affecting visible areas(face,upper legs).In contrastwith published studies,no cases of attempted suicide were observed in our series,although severe dermatitis artefacta was evidenced in only a minority of patients.
文摘Background: The preference of women patients for women physicians has been shown in many specialties. Women patients awaiting a lower endoscopy have been shown to have a preference for women endoscopists. The reasons for this preference and the strength of this preference have not been studied in the primary care setting. Methods: A questionnaire was given to female patients who were waiting for primary care appointments at 4 offices. Patients reported sociodemographic characteristics, experiences with colorectal cancer (CRC), barriers to CRC screening, gender preference of their physician, the significance, and reasons for this preference. Results: A total of 202 women patients aged 40 to 70 years (mean 53 years)- completed the questionnaire. Of these patients, 43% preferred a woman endoscopist, and of these, 87% would be willing to wait >30 days for a woman endoscopist, and 14% would be willing to pay more for one. The most common reason (in 75% ) for this gender preference was embarrassment. Univariate analysis revealed that gender of the primary care physician (PCP), younger patient age, current employment, and no previous history of colonoscopy were predictors of preference for a woman endoscopist. Of these variables, only female gender of the PCP (OR 2.84: 95% CI[1.49, 5.40]ABSTRACT) and employment (OR 2.4: 95% CI[1.23, 4.67]) were positive predictors for a woman endoscopist preference by multivariable analysis; 5% stated that they would not undergo a colonoscopy unless guaranteed a woman endoscopist. The sole independent factor associated with adherence to screening was PCP recommendation (OR 2.93: 95% CI[1.63, 5.39]). Conclusions: Women patients frequently prefer a woman endoscopist, and this preference is reported as being strong enough to delay the procedure and to incur personal expense. It is an absolute barrier to endoscopy according to 5% in this subset of women surveyed. Interventions must be made in the primary care setting to address this issue and to increase the participation of women patients in CRC screening.
