Perfectionnement en Pédiatrie最新文献

{"title":"Prise en charge des scabioses chez l’enfant de moins de 15 kg, la femme enceinte ou allaitante : recommandations du Centre de preuve de dermatologie et de la Société française de dermatologie pédiatrique","authors":"Aurélie Morand , Amandine Weill , Olivier Chosidow , Bernard Guillot , Thomas Hubiche , Stéphanie Mallet , Centre de Preuves de la Société Française de Dermatologie et du Groupe de Recherche de la Société Française de Dermatologie Pédiatrique","doi":"10.1016/j.perped.2025.07.005","DOIUrl":"10.1016/j.perped.2025.07.005","url":null,"abstract":"<div><div>Nous faisons état des recommandations récentes de prise en charge de la gale des enfants <<!--> <!-->15<!--> <!-->kg, des femmes enceintes et allaitantes qui ont été émises par le Centre de preuve de dermatologie et la Société française de dermatologie pédiatrique. Le groupe de travail propose en première intention :</div><div>– enfants ≥<!--> <!-->2 ans : perméthrine 5 %, benzoate de benzyle 10 % ou ivermectine orale 200<!--> <!-->μg/kg en préparation magistrale,</div><div>– enfants de 2 mois à 2 ans : perméthrine 5 % ou benzoate de benzyle 10 %,</div><div>– enfant<!--> <!--><<!--> <!-->2 mois : perméthrine 5 %,</div><div>– femmes enceintes au 1<sup>er</sup> trimestre : perméthrine 5 % ou benzoate de benzyle 10 %,</div><div>– femmes enceintes au 2<sup>e</sup> et 3<sup>e</sup> trimestres et Femmes allaitantes : perméthrine 5 %, benzoate de benzyle 10 % ou ivermectine orale 200<!--> <!-->μg/kg.</div><div>Pour les cas contacts :</div><div>– cercle primaire : traiter suivant les recommandations précédentes ; préférer l’ivermectine orale chez les patients asymptomatiques pour favoriser l’observance,</div><div>– cercle secondaire : traiter les enfants <<!--> <!-->5 ans s’il y a ≥<!--> <!-->2 cas dans la collectivité ou si gale hyperkératosique chez le cas index,</div><div>– cercle tertiaire : traiter si gale hyperkératosique chez le cas index.</div><div>L’état cutané conditionne la décision. Une formule orale pédiatrique d’ivermectine doit être développée. La gestion épidémique doit être coordonnée.</div></div><div><div>The Dermatology Proof Center and the French Society of Pediatric Dermatology have recently published guidelines on the management of scabies in children weighing less than 15<!--> <!-->kg and in pregnant and breastfeeding women. The working group proposed the following first-line treatment algorithms:</div><div>– children ><!--> <!-->2 years: 5% permethrin or 10% benzyl benzoate or compounded preparation of 200<!--> <!-->μg/kg oral ivermectin,</div><div>– children from 2 months to 2 years: 5% permethrin or 10% benzyl benzoate,</div><div>– children <<!--> <!-->2 months: 5 % permethrin,</div><div>– pregnant women in first trimester: 5% permethrin or 10% benzyl benzoate,</div><div>– pregnant women in second and third trimesters and breastfeeding women: 5% permethrin or 10% benzyl benzoate or 200<!--> <!-->μg/kg oral ivermectin.</div><div>For contact cases:</div><div>– primary circle: treat according to previous recommendations ; prefer oral ivermectin in asymptomatic patients to encourage compliance,</div><div>– secondary circle: treat children aged <<!--> <!-->5 if there are ≥<!--> <!-->2 cases in the community or if there is hyperkeratotic scabies in the index case,</div><div>– tertiary circle: treat if there is hyperkeratotic scabies in index case.</div><div>Assessment of the skin condition is important in decision-making. A pediatric oral formulation of ivermectin should be developed. Furthermore, epidemic ","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 3","pages":"Pages 205-212"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Éditorial","authors":"Jean-Charles Picaud","doi":"10.1016/S2588-932X(25)00168-8","DOIUrl":"10.1016/S2588-932X(25)00168-8","url":null,"abstract":"","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 3","pages":"Pages 3S1-3S2"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145160007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment explorer un souffle cardiaque chez l’enfant ?","authors":"Laurent Bonnemains , Sibylle Castelnovo , Jeanne Bordet","doi":"10.1016/j.perped.2025.07.010","DOIUrl":"10.1016/j.perped.2025.07.010","url":null,"abstract":"","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 3","pages":"Pages 201-204"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"La HAS recommande enfin le dépistage systématique du CMV pendant la grossesse","authors":"Jean-François Magny","doi":"10.1016/j.perped.2025.08.001","DOIUrl":"10.1016/j.perped.2025.08.001","url":null,"abstract":"","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 3","pages":"Pages 189-190"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quelles sont les bases fondamentales de l’évaluation clinique des mineurs auteurs de violences sexuelles ?","authors":"Martine Balençon","doi":"10.1016/j.perped.2025.07.009","DOIUrl":"10.1016/j.perped.2025.07.009","url":null,"abstract":"","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 3","pages":"Pages 196-200"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biais implicites, stéréotypes et disparité de prise en charge en pédiatrie","authors":"Romain Guedj","doi":"10.1016/j.perped.2025.04.011","DOIUrl":"10.1016/j.perped.2025.04.011","url":null,"abstract":"","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 2","pages":"Pages 112-116"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergie au chat chez l’enfant : du diagnostic à la prise en charge","authors":"Myriam Zakariya , Ania Carsin","doi":"10.1016/j.perped.2025.04.014","DOIUrl":"10.1016/j.perped.2025.04.014","url":null,"abstract":"<div><div>L’allergie au chat chez l’enfant se manifeste principalement par une rhinite et/ou une conjonctivite allergique. Troisième cause d’allergie respiratoire après les acariens et les pollens, elle est souvent associée à l’asthme et à la dermatite atopique. Le diagnostic de l’allergie au chat est basé sur l’anamnèse et la clinique, ainsi que sur les tests cutanés<!--> <!-->±<!--> <!-->le dosage des IgE spécifiques. Les tests multi-allergéniques de dépistage ne sont pas recommandés, sauf en cas de faible suspicion clinique pour éliminer le diagnostic. La polysensibilisation aux pneumallergènes concerne 75 % des patients allergiques, ce qui nécessite de rechercher tous les allergènes cliniquement pertinents, notamment les acariens. La classification ARIA (Allergic Rhinitis and its Impact on Asthma) permet d’évaluer la fréquence et la sévérité des symptômes. L’allergie au chat peut entraîner diverses complications: ORL (otites, sinusites), orthodontiques (respiration buccale, malocclusions), troubles du sommeil et altération de la qualité de vie. Elle constitue également un facteur de risque de développement et de non-contrôle de l’asthme. Le traitement repose en priorité sur la réduction de l’exposition, incluant l’éviction du chat, souvent refusée par les familles. Le traitement symptomatique associe lavages nasaux, corticoïdes intranasaux et antihistaminiques oraux. L’immunothérapie allergénique (ITA) au chat est possible par voie sublinguale dès l’âge de 5 ans pour une durée de 3 ans, bien que le niveau de preuve demeure relativement faible.</div></div><div><div>Cat allergy in children primarily manifests as allergic rhinitis and/or conjunctivitis. It is the third leading cause of respiratory allergy after dust mites and pollen and is often associated with asthma and atopic dermatitis. The diagnosis of cat allergy is based on medical history and clinical symptoms as well as on skin tests and/or specific IgE dosage. Multi-allergen screening tests are not recommended unless there is a low clinical suspicion to rule out the diagnosis. Polysensitization to aeroallergens occurs in approximately 75% of allergic patients, requiring the identification of all clinically relevant allergens, particularly dust mites. The ARIA classification helps assess the frequency and severity of symptoms. Cat allergy can lead to various complications, including ENT issues (otitis, sinusitis), orthodontic problems (mouth breathing, malocclusions), sleep disorders, and reduced quality of life. It is also a risk factor for asthma development and poor asthma control. Treatment primarily focuses on reducing exposure, including cat avoidance, which is often refused by families. Symptomatic treatment combines nasal irrigation, intranasal corticosteroids, and oral antihistamines. Allergen immunotherapy (AIT) for cat allergy is the only treatment that can alter the disease trajectory. AIT is indicated via the sublingual route from the age of 5 for a duration of 3 years.</di","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 2","pages":"Pages 142-150"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infos médicaments","authors":"","doi":"10.1016/j.perped.2025.04.015","DOIUrl":"10.1016/j.perped.2025.04.015","url":null,"abstract":"","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 2","pages":"Pages 184-187"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"« Quoi de neuf » sur les biothérapies dans l’asthme chez l’enfant ?","authors":"Guillaume Lezmi","doi":"10.1016/j.perped.2025.04.008","DOIUrl":"10.1016/j.perped.2025.04.008","url":null,"abstract":"<div><div>L’asthme sévère (AS) de l’enfant est majoritairement associé à une inflammation de type 2 avec éosinophilie, allergie, signalisation impliquant des alarmines et des cytokines de type 2. La relevance de ces mécanismes a conduit à l’élaboration de biothérapies. Les biothérapies sont des anticorps monoclonaux ciblant les IgE circulantes, les cytokines, ou les récepteurs cytokiniques impliqués dans la physiopathologie de l’AS<em>.</em> Elles sont prescrites de façon personnalisée, selon le phénotype d’AS que présente le patient et s’administrent par injections sous-cutanées. Quatre biothérapies ont l’AMM dans l’AS de l’enfant : l’omalizumab (anti-IgE), le dupilumab (anti-IL4Rα), le mepolizumab (anti-IL-5) et le tezepelumab (anti-TSLP). Elles réduisent les exacerbations, améliorent la fonction respiratoire et la qualité de vie. Choisir une biothérapie reste complexe en l’absence de biomarqueurs prédictifs d’efficacité et requiert des discussions multidisciplinaires dans des centres experts.</div></div><div><div>Severe asthma (SA) in children is predominantly associated with type 2 inflammation, characterized by eosinophilia, allergy, and signaling pathways involving alarmins and type 2 cytokines. The relevance of these mechanisms has led to the development of biologic therapies. Biologics are monoclonal antibodies targeting circulating immunoglobulin E (IgE), cytokines, or cytokine receptors involved in the pathophysiology of SA. They are prescribed in a personalized manner, based on the patient's asthma phenotype, and administered via subcutaneous injections. Four biologics are currently approved in children with SA: omalizumab (anti-IgE), dupilumab (anti-IL-4Rα), mepolizumab (anti-IL-5), and tezepelumab (anti-TSLP). These treatments reduce exacerbations and improve lung function and quality of life. However, choosing the appropriate biologic remains challenging due to the lack of predictive biomarkers of efficacy and requires multidisciplinary discussions within expert centers.</div></div>","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 2","pages":"Pages 99-103"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Que faire devant une incontinence anale chez l’enfant ?","authors":"Hugues Piloquet,&nbsp;Batoul Samarji","doi":"10.1016/j.perped.2025.04.009","DOIUrl":"10.1016/j.perped.2025.04.009","url":null,"abstract":"<div><div>L’incontinence anale, définie par le passage de selles dans les sous-vêtements après l’âge de 4 ans, peut entraîner un handicap important sur les plans familial et social. Elle est rarement d’origine organique, justifiant alors des examens complémentaires et un avis pédiatrique spécialisé. Dans la majorité des cas, elle est secondaire à une constipation chronique fonctionnelle terminale ancienne et mal prise en charge. Un traitement séquentiel (évacuation du fécalome, laxatifs, modification alimentaire, rééducation) est nécessaire, associé à un suivi au long cours pour vérifier son efficacité. Une évaluation psychologique peut également être nécessaire pour prendre en charge les troubles émotionnels ou comportementaux associés. Une approche individualisée et progressive permet d’adapter au mieux la prise en charge. Dans l’encoprésie « vraie », fonctionnelle non rétentionnelle, une prise en charge psychologique, voire psychiatrique est nécessaire.</div></div><div><div>Anal incontinence, defined as the passage of feces in the underwear after the age of 4, can cause significant family and social handicaps. It is rarely of organic origin, in which case it warrants further investigation and specialist pediatric advice. In the majority of cases, it is secondary to long-standing and poorly managed chronic terminal functional constipation. Sequential treatment (evacuation of the fecal impaction, laxatives, dietary modification, re-education) is necessary, combined with long-term monitoring to check its effectiveness. A psychological assessment may also be necessary to deal with associated emotional or behavioral problems. An individualized, step-by-step approach is the best way to tailor the treatment. In the case of functional encopresis that is not retentive, psychological or even psychiatric treatment is necessary.</div></div>","PeriodicalId":101006,"journal":{"name":"Perfectionnement en Pédiatrie","volume":"8 2","pages":"Pages 169-175"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144240405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}