Impact de la conférence de consensus de 2001 sur la prise en charge de l’herpès cutanéo-muqueux chez l’immunocompétent par les dermatologues français

Abstract

Our aim was to assess the impact of the 2001 French Consensus Conference on the professional practices of French dermatologists treating immunocompetent patients with mucocutaneous herpes simplex infection (ocular herpes excluded). This conference was preceded by a survey that revealed a lack of homogeneity in practices. A questionnaire (similar to that of 2001) was submitted in 2003 to 205 dermatologists, half of whom had responded to the first survey. It contained 40 questions about diagnosis, prevention and treatment. The analysis compared the answers given in the 2001 survey with those of dermatologists either answering for the first time or answering again in 2003. In 2003, the response rate was of 96% (43% in 2001). Statistically significant changes were obtained for the following items: better knowledge of situations requiring a precise history of herpes infection, dramatic decrease in prescribing herpes serological tests, increase in prescribing serological tests for other sexually transmitted diseases in patients with genital herpes, better knowledge of prevention strategies, decreased intention of prescribing topical antiviral agents, increased intention of using oral antiviral agents in patients with recurrent genital or orofacial herpes and those with recurrent erythema multiforme. No statistically significant improvement was noted regarding: failure to prescribe any direct virology test to confirm herpes infection before prescribing long-term viral treatment, high use of "prophylactic" oral antivirals in patients with recurrence of UV-induced herpes. The fact that the telephone survey was conducted by a dermatologist rather than a service provider could account for the very high response rate observed. The utilization of a part of the sample of practitioners surveyed in 2001 lends credibility to the results. Our study nevertheless remains a survey of prescribing intentions rather than of actual practice. While the 2001 consensus conference on the practices of French dermatologists appears to have had a clear effect regarding numerous items, considerable progress is still required in certain diagnostic and therapeutic areas.