The promise of a dermatological diagnosis in 72 hours. After an exam of less than 15 minutes flat. While solutions are increasing to remedy the shortcomings of medical dermatology slots (see opposite), the Pratts pharmacy, in Sanary, illustrates this movement.
She has just deployed a new screening service. Simple and ultra-available access. “We receive with or without an appointment”confirms the Dr Nicolas Panardie, holder of the pharmacy since 2020 who set up this consultation service deployed by Skinmed, whose assets he discovered as part of the program Special Envoy on France 2, in April. “I told myself that I could meet the demandhe slips. In June, we carried out forty screening “.
At a cost of 15 euros still not reimbursed
That morning, Geneviève Lamandé, 78, made an appointment. The Sanaryenne decided the day before, after reading the advertising panel placed in front of the pharmacy of which it is a client. She wants a diagnosis for two lesions. “At a classic dermato, no appointment possible for six months”she breathes, reading the explanatory little prospectus given to him by Nicolas Panardie who receives her in her office and to whom she presents her vital card. “Examination of a cost of 15 euros for three lesions may be reimbursed in the future”observes the pharmacist.
The prospectus details the self-exam that the person who wishes a diagnosis must first perform. “This to determine what lesion to photograph”details the Dr Panardie, before bringing a mobile phone on the objective of which a dermatoscope (tool made up of a magnifying lens and light) allows it to fix each of the lesions.
Via a dedicated application, the photos taken are transmitted to a computer where a pre-diagnosis is given by artificial intelligence, which alerts with a color system. From green to red depending on the likely degree of severity. “All the elements are then sent electronically for analysis to a dermatologist, who will make the medical diagnosis”completes the pharmacist.
Under 3 to 5 days, an email is then sent to the diagnosed person asking him to go to the pharmacy to seek his results.
Results that pose four alert levels: nothing to report, re -examining, consultation in three months and fast consultation. “In the latter case, the dermatologist establishes a letter of recommendation and addresses the patient to a dermatology service”. HIA Sainte-Anne, in Toulon, in this case. Medical management is then reimbursed. “Already one or two melanomas and carcinomas (skin cancers) have been detected”concludes Nicolas Panardie.
At the Anhia Sthe-Anne, 50 requests per day
The National Hospital for the Instruction of Armed Forces (HNIA) Sainte-Anne, bridgehead. “Initially our sovereign mission is support for the armed forces, with more and more requests, but indeed, we also participate in the supply of territory”poses the chief doctor Aude, assistant to the head of the only hospital dermatology service of Var, the sole hospital service of military dermatology at the national level and the only military consultation service in France with that of the Hnia Bégin in Paris.
“Despite the difficulties, we take care of all the most serious pathologies that require hospital careconfirms the chief doctor. For this we work with the doctors of the territory, the treating physicians who can request us with a letter and a photo via a secure email address between health professionals “.
In the case of a pathology deemed severe an answer is provided to the attending physician. The patient can then be supported. With periods of responses that lie down because the military patients, whose requests are priority, is increasingly important. “Three weeks ago, I managed between 25 and 50 daily, military and civil requests”figure the dermatologist who, of course, judges favorably the continuing education of general practitioners in dermoscopy and dermatology, provided by the HIA Sainte-Anne, requested in particular by associations of general practitioners.
“More and more general and qualified general practitioners”
The D Wilfrid Guardigli, general practitioner in La Seyne, is also the president of the Professional Territorial Health Community (CPTS) of La Seyne – Toulon – West and co -president of the Departmental Federation of CPTS du Nord.
Do you need more dermatologists?
The problem does not come from a lack of professionals, but from the fact that dermatologists practice more aesthetic medicine at the expense of medical pathology, where there are therefore fewer slots available. Do you know that there are as many dermatologists in Nice as in all of England? And that dermatology is the first specialty chosen by medical students?
However, it still has become fairly easy to quickly get a diagnosis?
Two axes develop today. On the one hand, there are television television possibilities. A solution practiced by more and more general practitioners and carried out thanks to photos taken by smartphone and sent to colleagues dermatologists who then quickly answer the question of diagnosis. On the other hand, many general practitioners are formed in dermatoscopy, so as to facilitate diagnostics with more sophisticated devices. Again, the photos can be sent to a dermatologist.
What to do when the presence of a dubious lesion has proven?
Some generalists can remove lesions, as well as visceral surgeons. In case of cancer pathology, patients are then addressed to a hospital dermatology service.
On the agglomeration, is the Hnia Sainte-Anne, the reference?
Only the Sainte-Anne hospital has such a service in the Var. It is also the establishment that trains our general practitioners.
Household houses in Bormes et collobrières
At the rate of half a day per week, the multi-professional health center (MSP) PIN PIN PAGE Santé de Bormes and its collobrières antenna (open thanks to a partnership with the town hall which provides) offer dermatological medicine permanences provided by trained doctors and equipped with dermatoscope.
“This represents around twenty consultations per week, Calculates Virginie d’Arco, coordinator. But answers can also be given to patients who arise for general consultations “. Open consultations by appointment (or even without, if urgency), in Bormes, Monday to Friday from 8 a.m. to 8 p.m. and Saturday from 8 a.m. to noon; In Collobrières, Monday, Thursday and Friday, from 9 a.m. to 12:30 p.m. and from 2 p.m. to 6 p.m.
The data is exchanged with a dermatologist in a secure manner on specialized platforms, and an opinion is given. “The patient can then be oriented in a dermatologist or addressed to a general surgeon who will remove the lesion”complete Virgine d’Arco. In Bormes, an exhibition is also organized on the theme of health gestures to be set up to protect itself from the sun and the flyers of recommendations and information distributed in the two health homes.
