French national reference center for toxic bullous dermatoses and severe toxidermas
The Reference Center for Toxic, Toxin and Toxidermal Bullous Dermatoses at Necker Hospital – Enfants Malades is made up of a multidisciplinary teams 
(several research projects and several medical and paramedical specialisation) coordinated by dermatologists. Its purpose is to support and accompany the child and his (or her) family in anticipation of the difficulties to come, and to alleviate as much as possible the individual burden of this family unit (in all socio-economic and psychological dimensions). Necker’s multidisciplinary pediatric platform provides care expertise in all the areas concerned by this group of rare childhood diseases: in dermatology, but also in ophthalmology, odontology, urology, pneumology, anesthesia and allergology .
The severe toxic dermatoses of the child can cause long hospitalizations and can be extremely painful, physically and psychologically, for the child but also his parents. The causes are medicinal, but also infectious, in this pediatric population, with differential diagnoses which will be important to differentiate quickly for a more rapid management of the child.
This reference center is affiliated with the Fimarad rare diseases healthcare network and the ERN Skin European reference network (ERN).
Medical
team
Dr Anne Welfringer-Morin
MD
In case of emergency
The week :
Via the secretariats
+33 (0)1 44 49 47 08/46 62
The dermatology emergency room (CUDR) is open 24 hours a day, every day in Necker, with on-call specialists.
- Dress syndrome
- Multifunctional ectodermosis
- Toxic epidermal necrolysis
- Exanthematic pustulosis
- Child’s Lyell syndrome
- Stevens Johnson syndrome
- Other severe toxiderma in children
- Staphylococcal epidermal necrolysis
Medical team
- Dr Anne Welfringer-Morin, coordinator
- Pr Christine Bodemer, head of the dermatology department
- Pr Smaïl Hadj Rabia, dermatologist
- Dr Olivia Boccara, dermatologist
- Dr Lilia Bekel, dermatologist
- Dr Nathalia Bellon, dermatologist responsible for pediatric allergology activity
Para-medical team
- Antoinette de Longcamp, psychologist
- Isabelle Corset, nurse
- Sandrine Compain, nurse
- Hélène Dufresne, socio-educational project manager
- Elodie Deladrière-Passignat, occupational therapist
- Fanny Léopole-dit-marie, physiotherapist
- Céline Greco, pain doctor
- Sarah Chaumon, pain nurse
There is currently no specific TPE program for severe pediatric toxiderma.
However local care for large cutaneous and mucous detachments for these exceptional pathologies for children has real similarities with genetic diseases with cutaneous detachments for which the Necker dermatology service is the coordinating site of the CRMR (MAGEC).
Therefore, the medical and paramedical experts of the dermatology department for this cutaneous-mucosal care, mutualise their expertise for the 2 reference centers.
> See the therapeutic education programs of the MAGEC center
Assessment of the individual burden during rare dermatological diseases (socio-economic and psychological dimension) involving severe toxiderma
Assessment of chronic sequelae in children
Interuniversity diploma in pediatric dermatology
University of Dijon, Nantes and Lyon
2021
– Childhood epidermal necrolysis and erythema multiforme major: a multicentre French cohort study of 62 patients.
L Giraud-Kerleroux, N Bellon, A Welfringer-Morin, S Leclerc-Mercier, I Costedoat, J Coquin, A Brun, A-M Roguedas-Contios, C Bernier, B Milpied, F Tétart, A Du Thanh, N Cordel, B Bensaid, C Fargeas, M Tauber, S Renolleau, F Boralevi, S Ingen-Housz-Oro, C Bodemer
J Eur Acad Dermatol Venereol, 2021 Oct, PMID: 34157175 DOI: 10.1111/jdv.17469
– Carrying out local care for epidermal necrolysis: survey of practices.
S Ingen-Housz-Oro, R Le Floch, A Alves, A Colin, R Ouedraogo, A Welfringer, O Dereure, N Besnard, C Bodemer, C Bernier, C Hoffmann, F Tétart, D Carpentier, N Cordel, E Elie, M Tauber, L Soubiron, B Milpied, N de Prost
J Eur Acad Dermatol Venereol, 2021 Feb, PMID: 32810302 DOI: 10.1111/jdv.16884
– Supportive care in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: an international, multidisciplinary Delphi-based consensus.
M-C Brüggen, S T Le, S Walsh, A Toussi, N de Prost, A Ranki, B Didona, A Colin, B Horváth, E Brezinova, B Milpied, C Moss, C Bodemer et al.
Br J Dermatol, 2021 Sep, PMID: 33657677 DOI: 10.1111/bjd.19893
– A 3-Year-Old Child With Fever, Severe Cheilitis, and Blisters of the Palms and Soles.
Jérémie F Cohen, Anne Welfringer-Morin, Julie Toubiana
Clin Infect Dis, 2021 May 4, PMID: 33945620 DOI: 10.1093/cid/ciaa1699
2020
– Neonatal staphylococcal scalded skin syndrome in a breastfed neonate.
L Fertitta, A Welfringer-Morin, V Rigourd, A Jamet, S Hadj-Rabia, F Lesage, C Bodemer
J Eur Acad Dermatol Venereol, 2020 Jan, PMID: 31420893 DOI: 10.1111/jdv.15889
– Management of ocular involvement in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: french national audit of practices, literature review, and consensus agreement.
D Thorel, S Ingen-Housz-Oro, G Royer, A Delcampe, N Bellon, C Bodemer, A Welfringer-Morin, D Bremond-Gignac, M P Robert, M Tauber, F Malecaze, O Dereure, V Daien, A Colin , C Bernier, C Couret, B Vabres, F Tetart, B Milpied, T Cornut, B Ben Said, C Burillon, N Cordel, L Beral, N de Prost, P Wolkenstein, M Muraine, J Gueudry
Orphanet J Rare Dis, 2020 Sep 22, PMID: 32962748 PMCID: PMC7510143 DOI: 10.1186/s13023-020-01538-x
2018
– Epidermal necrolysis French national diagnosis and care protocol (PNDS; protocole national de diagnostic et de soins).
Ingen-Housz-Oro S, Duong TA, Bensaid B, Bellon N, de Prost N, Lu D, Lebrun-Vignes B, Gueudry J, Bequignon E, Zaghbib K, Royer G, Colin A, Do-Pham G,Bodemer C, Ortonne N, Barbaud A, Fardet L, Chosidow O, Wolkenstein P; French National Reference Center for Toxic Bullous Dermatoses.
Orphanet J Rare Dis. 2018 Apr 10;13(1):56.
2017
– Probable DRESS syndrome induced by IL-1 inhibitors.
Polivka L, Diana JS, Soria A, Bodemer C, Quartier P, Fraitag S, Bader-Meunier B.
Orphanet J Rare Dis. 2017 May 11;12(1):87
2016
– Severe Skin Complications After Small Bowel Transplantation: Graft-Versus-Host Disease, DRESS, Virus, or Drug Toxicity?
Cruysmans C, Ferneiny MG, Fraitag S, Frange P, Chardot C, Bodemer C, Goulet O, Lacaille F.
Transplantation. 2016 Oct;100(10):2222-5.
Message on vaccination against SARS-CoV-2 (COVID-19) for all patients with toxic bullous dermatoses and severe toxidermas.
Dear patients, dear colleagues, we offer you the general recommendations for vaccination against COVID-19.
Enjoy your reading, and all the specialists at our reference center will be happy to answer any questions you may have.
Contact information
Necker-Enfants malades university hospital
> Dermatology department
149 rue de Sèvres
75743 PARIS Cedex 15
In Necker, the reference center for toxic bullous dermatoses and severe toxidermas in brief …
* data valid for 2022