Charles Taieb

The Shadow Report on Eczema is a patient-led synthesis of fifteen years of research on the real-world burden of atopic dermatitis, co-produced by the Association Française de l'Eczéma and academic partners across Europe. Drawing on over fifty peer-reviewed studies, it documents the full spectrum of disease impact—from suicidal ideation and sexual health to long-term stigmatisation and occupational consequences—across more than 10,000 patients in 27 countries. This initiative demonstrates that patient organisations can move beyond advocacy to become active contributors to the scientific evidence base.

Aims: Sexual health is a cornerstone of well-being among the least explored aspects of heart failure (HF) care. Guidelines offer minimal, male-focused recommendations, leaving female sexual health underaddressed. The ROMANT'IC study investigated how HF affects intimacy and sexuality across sex, age and symptom burden. Methods and results: ROMANT'IC was a national descriptive questionnaire study including1,398 patients with HF (921 men, 477 women; age 18–93 years). Overall, 655 (46.9%) provided detailed responses:491 (53.3%) men, 164 (34.4%) women indicating a reluctance to disclose information on sexuality (p<0.001). 57.8% men, and 53.7% women reported no sexual activity in the previous three months. Sexual inactivity varied significantly across age groups (χ2=17.02, p=0.001): 52.9% at 18–40 years, 50.0% at 41–55 years, 48.3% at 56–65 years, and 65.5% at ≥66 years and increased markedly with dyspnea severity: 47.8% at Grade 1, 50.3% at Grade 2, and 79.0% at Grades 3–4 (χ2=40.96, p<0.001). Men reported erectile dysfunction (49.0%) and treatment side effects (39.5%); women reported loss of desire (65.4%), reduced sense of seductiveness (61.5%), and depression (42.3%). Severe dyspnea independently predicted sexual inactivity (OR=3.88 [2.26–6.64], p<0.001), whereas sex and age were not significant after adjustment. Overall, 72–80% had never discussed sexuality with their cardiologist, regardless of dyspnea severity or age. Conclusion: HF profoundly alters sexuality. Dyspnea severity is the dominant independent driver of sexual inactivity and represents a potentially modifiable therapeutic target. These findings call for systematic, gender- and age-sensitive, dyspnea-graded sexual counselling in routine HF care.

Among patients with vitiligo, repigmentation improves perceived social outcomes but does not fully alleviate psychological burden. Nearly half of patients who achieve repigmentation report fear of losing regained pigmentation, highlighting treatment durability as an overlooked patient-relevant outcome.

Truncal acne (TA) affects 40–50% of adults with acne vulgaris and remains understudied despite its psychosocial impact. We aimed to evaluate the association of TA with stigmatization, psychosocial burden, healthcare utilization and treatment adherence, compared with exclusively facial acne (FA). We hypothesized that TA would be independently associated with greater psychosocial burden and healthcare utilization than FA alone. In this cross-sectional international online survey of 1,879 adults with physician-diagnosed acne (FA n=1,075; TA n=804) across 20 countries, multivariable logistic regression adjusted for age, sex and country showed that TA was independently associated with stigmatization (aOR 1.41 [95%CI 1.16–1.71]), hospitalization (aOR 1.73 [1.25–2.38]) and poor treatment adherence (aOR 1.26 [1.03 1.53]). Stigmatization was equally prevalent in truncal-only (49.2%) and combined facial-and truncal (50.5%) patients (aOR 1.00), indicating that it is intrinsic to truncal involvement rather than a consequence of facial disease. Truncal-only patients had lower dermatologist access (63.8% vs 78.9%) yet markedly higher hospitalization and surgical consultation rates. TA is independently associated with psychosocial burden and higher healthcare resource utilization; systematic trunk examination during acne consultations is warranted.

Atopic dermatitis (AD) is characterized by substantial clinical heterogeneity. Global severity is typically assessed using scores such as the POEM; however, lesion localization —– particularly on the face –— may generate psychosocial consequences partly independent of overall disease severity. This cross-sectional observational study (VISEABLE) included 1,400 French adults with physician-confirmed AD. Severity was measured using the POEM (Clear/Almost Clear: 0–7 vs. Moderate–severe: ≥8) and facial involvement using the BoFA (0–109; threshold=36, population median). Six phenotypes were defined through a 2×3 combination. The POEM and BoFA correlation was moderate (r=0.365; ρ=0.389; p0.25 for all comparisons). In multiple regression analysis restricted to patients with facial involvement, BoFA was the dominant independent predictor of stigmatization (β=11.44, p<0.001; partial R²=46.2 %; overall R²=0.532), superseding POEM (p=0.076, ns; partial R²=0.6%). Mild eczema with severe facial involvement generates a psychosocial burden comparable to that of moderate-to-severe eczema without facial involvement. Systematic BoFA assessment is essential in all patients with AD.

Historians of medicine have traditionally identified Sigmund Freud's encounter with Jean‐Martin Charcot at the Salpêtrière in Paris (1885–1886) as the decisive turning point in his intellectual development. Yet an earlier and largely overlooked phase of his medical formation may have played an equally formative role: his clinical service in dermatology and syphilology at the Vienna General Hospital, undertaken between 1883 and 1885. Freud worked successively under Abraham Anscherlik and Moriz Kaposi in one of the principal centres of syphilology in Europe, encountering daily patients with advanced neurosyphilis whose skin lesions coexisted with profound cognitive and psychiatric deterioration. This experience placed him at the crossroads of dermatology, neurology, and nascent psychiatry, confronting him with a fundamental clinical question—how can a somatic disease dismantle the structures of the mind?—that would later resonate throughout his theoretical programme. Revisiting this episode illuminates an underappreciated chapter in the history of dermatological medicine and resonates with contemporary psychodermatology's growing recognition of the bidirectional relationship between skin disease and psychiatric comorbidity.

Background: In moderate‐to‐severe psoriasis, residual lesions can be defined as “psoriasis lesions that persist despite well‐managed treatment, and which do not necessarily justify intensification or a change in treatment.” Residual lesions are accepted by guidelines and clinical trials. Objectives: The aim of this study was to evaluate the knowledge, identified risk factors, and management of residual psoriasis lesions among dermatologists. Methods: We performed a web‐based survey among French dermatologists between December 2024 and January 2025. Results: Among the 505 (21.0% of surveyed dermatologists) responders, 30.7% stated that the limit between “treatment ineffectiveness” and “residual disease” was unclear, and 88.6% declared to see patients with residual lesions. The profile of patients with residual lesions was middle‐age patients (30–70 years: > 56% of treated patients), males (97.0%), with incomplete treatment efficacy (67.7%), long‐standing psoriasis (47.6%), and past history of severe psoriasis (41.2%). Main identified locations were scalp (50.6%), elbows (48.3%), nails (43.0%), shins (40.0%), and knees (35.9%). One quarter (22.5%) of dermatologists declared not to anticipate treatment of residual disease. Conclusions: In everyday practice, residual psoriasis in patients undergoing systemic treatment is a reality and a major concern for dermatologists and patients, especially as, according to guidelines and clinical trials, incomplete treatment efficacy is tolerated.