General Practitioners (GP) frequently encounter Atopic dermatitis (AD) as it’s the most common dermatologic children’s disease. Black skins have particularities that change the way dermatologic diseases looks. It has been shown in international studies that “migrans erythema” and “pityriasis versicolor” were more difficult to diagnosed due to this. There is an under-representation of melanodermic patients in pedagogic supports (<2% in the SAURAT, <12% in American atlas)The primary endpoint was the rate’s comparison of diagnosis of eczema on melanodermic patients vs on leucodermic patientsA quantitative multicentric analytic cross-sectional study was run. This work took the participation of 54 GP working in French metropolis. Regional recruitment of the first 8 doctors appearing on Google, using a computer with no browsing history. The survey was tested beforehand and consisted in 2 parts: 1/ descriptive on GP 2/ iconographies with 7 photos of children seen in consultation (leucodermic children (n=2), melanodermic (n=4), distractor (n=1)). Photos were presented without clinical context, one per page without possibility of backtracking. Participants knew that the study focused on dermatology in melanodermic children, but not on DA. . Numbers of subjects to be included = 53. Responses were coded in « good », « false » and « don’t know ». The « don’t know » category was counted as « false ».Of the 65 participants, 54 were included in the analysis (378 responses). The analysis focused on 324 responses after excluding the distractor. Rate of incorrect diagnosis were 35,19% on white patients and 86,57% on melanodermic patients – difference statistically significant (p < 0,0001)This study’s strength are:  statistical methods with calculation of sample size and statistical power, original iconographies and impossibility of backtracking. Its limitations are the number of iconographies proposed, a possible selection bias. This study is questioning the loss of chance of melanodermic children toward eczema treatmentAD is children’s most frequent skin's disease. Thus, GP are meant to make the diagnosis of it daily. However, the lack of diversity and learning's methods way too stigmatizing during health studies leads to wanderings, errors and diagnosis delayed when diseases occurred on melanodermic children.

Acne is a common condition. In individuals with dark skin, it is often associated with post-inflammatory hyperpigmentation, which can affect quality of life. However, there are no specific xxx recommendations for this population.What treatments are effective for mild to moderate acne in individuals with dark skin?A systematic review of the literature (SR) was conducted in accordance with PRISMA guidelines. The Embase and Medline databases were searched from January 1995 to March 1, 2024. Articles were selected using a double-blind method, first by reading the titles, then the abstracts, and finally the full texts. The articles included had to evaluate drug treatments for mild to moderate acne in patients with dark skinned. Dark skinned was defined with phototype IV to VI Fitzpatrick and/or of Afro-Caribbean, African-american, or sub-Saharan African origin. The ROBIS, ROBINS1, and ROB2 grids were used to assess quality. Finally, efficacy measured by changes in acne grade, lesions, post-inflammatory hyperpigmentation, and tolerance were extracted.1,928 references were identified, 1,738 of which were excluded after reading the titles and abstracts. Sixteen studies were selected for full-text review, including eight post-hoc analyses of randomized controlled trials, two randomized controlled trials, six prospective studies. The included studies focused exclusively on topical treatments. The quality of the studies was low. There was little data on the use of benzoyl peroxide alone. Retinoids, azelaic acid, and combinations including benzoyl peroxide appear to be effective against acne and post-inflammatory hyperpigmentation, with good tolerability.The literature on acne treatment in people with dark skin remains limited, and there is a lack of studies of good methodological quality, limiting the generalizability of the results of this SR. The heterogeneity of the studies prevented the performance of a meta-analysis. In addition, the absence of articles evaluating cyclins and other oral treatments is a significant limitation.Given the prevalence of acne and the specific characteristics of dark-skinned patients consulting general practitioners, it seems necessary to promote high-quality research to address the possible specificities of treatment in this population.

Dermoscopy is a non-invasive skin examination technique that uses a dermoscope. Its effectiveness is well established for the early diagnosis of melanoma and for the evaluation of skin lesions in primary care. However, its integration into the daily practice of general practitioners (GPs) remains limited, partly due to insufficient training.The objective of this study was to provide an overview of dermoscopy training programs for general practitioners reported in the literature.A systematic literature review was conducted using the PubMed and Cochrane databases. Eligible studies described dermoscopy training for general practitioners or GP trainees. Excluded were literature reviews, studies focusing solely on teledermoscopy, artificial intelligence, or specific dermatological conditions. Methodological quality was assessed using the Cochrane Risk of Bias tool for randomized controlled trials and the Newcastle-Ottawa Scale for observational studies.Eighteen studies were included. Six main themes emerged: training content, format, duration, outcome measures, timing of evaluation, and prior training. Dermoscopy training improved knowledge, diagnostic confidence, and clinical impact among general practitioners. All studies reported post-training improvement.This review shows that, regardless of format, dermoscopy training significantly enhances the knowledge, diagnostic confidence, and clinical practice of general practitioners. Some studies demonstrated reductions in unnecessary biopsies and referrals to specialists. The included studies, however, presented methodological limitations such as selection bias, lack of long-term follow-up, and absence of local data. These remained obstacles to a generalization of the results.This literature review evaluated dermoscopy training for general practitioners. It showed that dermoscopy training allowed an improvement in diagnostic knowledge, clinical confidence, and the use of dermoscopy in daily practice, regardless of the training format.  The findings support the implementation of structured training programs combining theoretical input, clinical cases, and simple visual tools. Teaching dermoscopy in general practice could represent a lever to improve the early detection of skin cancers and to optimize the management of pigmented lesions. Its more systematic integration into initial and continuing medical education curricula could contribute to more effective patient care. Progressive integration of such training into GP residency curricula appears relevant.

Skin lesions are a frequent reason for seeking medical care. In XXX, the incidence of melanoma reached three times the national incidence, making early detection essential. The declining number of dermatologists, population ageing and the development of digital tools, including teledermatology, have contributed to the rise of dermoscopy in general practice. It broadens the scope of competence of general practitioners (GPs).To explore the perceptions and perspectives of GPs regarding the use of dermatoscope in the screening of skin cancers in primary care.A qualitative study using semi-structured interviews was conducted with GPs who owned and used a dermatoscope. The interview guide explored the place of dermatology in their daily practice, their motivations for acquiring a dermatoscope, and how its use had shaped their diagnostic confidence, workflow, and patient interactions. Verbatims were analyzed using an approach informed by grounded theory.GPs described the dermatoscope as an object of pleasure and constraint, of reassurance and fear of exceeding their limits. For GPs, it reduced diagnostic uncertainty and provided a sense of security when evaluating ambiguous lesions. This increased confidence helped them feel more legitimate in managing dermatological complaints. They feel that it enhanced patients' trust and conveyed the impression of a more thorough examination, improving acceptance of medical decisions like referral or monitoring. Beyond reassurance, dermatoscopy improved patient pathways by facilitating triage, accelerating referrals when needed, and helping GPs assess the urgency of lesions. The notion of pleasure was linked to the diversity of practice that this gave them. The anticipated integration of AI into dermatoscopic assessment was viewed as a promising tool to further strengthen diagnostic accuracy.For GPs, using a dermatoscope seems to have more interests than limits. By reducing uncertainty and diversifying GPS practices, the dermatoscope could help prevent professional exhaustion. As it redefins the role of GPs in skin cancer screening, it would be interesting to explore dermatologists' views on the contribution of the development of dermatoscopy in general medicine.Early dissemination of dermatoscopic training and raising patient awareness of the role of GPs in skin screening are key levers for strengthening skin cancer prevention in XXX.

Facing delays and limited access to dermatologists, general practitioners (GPs) increasingly rely on tele-expertise.This study analyzes the geographical distribution of GPs using an hospital's dermatologic tele-expertise network (TLX-N) and the factors influencing its use.A quantitative descriptive study was conducted using responses to a 23 items online questionnaire sent, between april and may 2024, to GPs who had used the platform at least once since 2022. The postal codes were used to locate the respondents from the different TLX-N medical centers. Comparative analyses (Wilcoxon-Mann-Whitney, Chi2) were performed to identify factors influencing the use of TLX-N from GPs inside or outside its perimeter of action. A multivariate analysis (logistic regression) was conducted on selected variables based on Akaike’s information criterion, to identify factors influencing the frequency of requests.A total of 274 GPs were contacted, 120 responses were included and analyzed. Respondents were mostly women (74,2%), established practitioners (70,8%), working in a multidisciplinary practice (84,1%), mean age was 37,6 ± 9,1 years old. The median distance to a TLX-N center was 5,1 km (IQR 1,6–9,4 km). In comparison to GPs inside the TLX-N perimeter of action, those outside were using tele-expertise by lack of nearby correspondents (p<0,05), they also expressed greater difficulties obtaining face-to-face consultations when required (p<0,05) and most of them discovered TLX-N thanks to the online platform’s indexing system (p<0,05). GPs outside the perimeter (OR 2,49; CI 1,15-5,58; p<0,05) and using TLX-N for its educational aspect (OR 3,07; CI 1,17-8,52; p<0,05) were associated with higher use frequency.This study is innovant as few studies described a perimeter of action for tele-expertise centers. Despite a high response rate, some analyses lacked statistical power due to the limited sample size. Postal code localization had limited precision, but most respondents were close to TLX-N centers and not necessarily in medically underserved areas, consistent with previous studies from the same region.Tele-expertise proved its effectiveness for GPs seeking a dermatological advice, although its implementation must be tailored to the diverse needs across the territory. Keywords : Telemedicine, general practice, primary care, dermatology.

Urticarial vasculitis (UV) is a type of small-vessel vasculitis that can resemble common urticaria. Due to its rarity, it poses a diagnostic challenge given its possible clinical behavior and implications.A healthy 29-year-old woman with a history of atopic dermatitis in childhood visits her family doctor due to a 6-month history of weekly outbreaks of pruritic erythematous wheal-like lesions over the entire body surface, lasting more than 48 hours despite treatment with corticosteroids and antihistamines, and leaving behind violaceous residual marks. She also presents, following the intake of dexketoprofen, with facial and plantar angioedema, for which her physician refers her to the hospital emergency department after administering intramuscular adrenaline. A general blood test reveals normal platelet counts, immunoglobulin levels, and tryptase values. She is advised to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) and referred to an allergy specialist. After three months, with persistent urticarial-type lesions despite high doses of corticosteroids and antihistamines, she is evaluated in the Allergy Department, where montelukast is added and new blood work is requested. Given normal complement levels but elevated antinuclear antibodies (ANA) and acute-phase reactants, she is referred to Dermatology for a skin biopsy. The biopsy result is consistent with urticarial vasculitis. She begins treatment with omalizumab, showing favorable progress.To prevent unnecessary treatments and clinical worsening, it would be advisable to perform an early punch biopsy and order tests for acute-phase reactants and ANA at the primary care level.Early evaluation by Dermatology may be a key tool for prompt diagnosis, given that many cases mimic common urticaria.It is important to emphasize the need to recognize persistent urticarial lesions as a potential manifestation of vasculitis through early biopsy, in order to avoid systemic deterioration and ineffective overtreatment.