[Dermatological consultation behind bars: an analysis on a three-year period in a French prison]

Since 1994, health care in French prisons is managed by the public hospital system. The hospitals created ambulatory consultation units for prisons and detention centers. Skin problems rapidly became a frequent reason for consultation. This is the first systematic assessment of needs concerning dermatological consultation in prisons.

A monthly dermatology consultation was established at the Colmar detention center in May 1996. We reviewed the files of all prisoners who attended between May 1996 and May 1999. Data collected concerned motivation for the consultation, drug use and serology for HIV and hepatitic C virus.

There were 280 consultations for 180 prisoners. All were men, mean age 30 years, who represented 16% of the total prisoner population. Most consulted for one or more benign skin conditions. The two most frequent conditions were acne (29%) and mycoses (13%). Drug use was found in 36% of the consulting prisoners (64/180). One was HIV-positive. Hepatitis C virus serology was positive in 19% of those tested (28/149), and in 39% of the drug users and 2% of the non-drug users. Motivation for consultation did not differ between drug users and non users, neither between seropositive and seronegative patients for hepatitis C virus.

This survey confirms the demand for dermatology consultation in the prison population and points out the frequency of hepatitis C virus in prisoners. A monthly specialized consultation was able to meet the basic demands concerning dermatology. Adapted management of hepatitis C virus in the prison population setting remains a difficult challenge.