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

Background, Since 1994, health care in French prisons is managed by the pub lic hospital system. The hospitals created ambulatory consultation units fo r prisons and detention centers. Skin problems rapidly became a frequent re ason for consultation. This is the first systematic assessment of needs con cerning dermatological consultation in prisons. Material and methods, A monthly dermatology consultation was established at the Colmar detention center in May 1996 We reviewed the files of all priso ners who attended between May 1996 and May 1999 Data collected concerned mo tivation for the consultation, drug use and serology for HIV and hepatitic C virus. Results. There were 280 consultations for 180 prisoners. All were men, mean age 30 years, who represented 16% of the total prisoner population. Most c onsulted for one or more benign skin conditions. The two most frequent cond itions were acne (29%) and mycoses (13%). Drug use was found in 16% of the consulting prisoners (64/180). One was HIV-positive. Hepatitis C virus sero logy was positive in 19% of those tested (28/149), and in 39% of the drug u sers and 2% of the non-drug users. Motivation for consultation did not diff er between drug users and non users, neither between seropositive and seron egative patients for hepatitis C virus. Discussion. 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 d emands concerning dermatology. Adapted management of hepatitis C virus in t he prison population setting remains a difficult challenge.