Venereology is the specialty that takes care of infections transmitted through sexual relations, also called venereal diseases..

It is attached to the dermatology, since most sexually transmitted infections (STIs, or STBBIs for sexually transmitted and blood-borne infections in Quebec) are manifested by lesions of the skin and mucous membranes.

Note that these diseases can also be treated in general medicine or internal medicine.

In addition to the AIDS (HIV) or chlamydia, very widespread, there are more than 30 sexually transmitted infectious agents in the world. These include:

• viruses (such as HIV, HPV, hepatitis B and C, herpes, etc.);
• bacteria (chlamydia, gonorrhea, syphilis, mycoplasmas, etc.);
• yeasts (Candida albicans);
• of protozoa (Trichomonas vaginalis…) ;
• d’ectoparasites (gale, phtiriase…).

According to the World Health Organization (WHO), every day more than one million people contract sexually transmitted infections (3).

It is estimated that 357 million people each year contract one of the following four STIs: chlamydia (131 million), gonorrhea (78 million), syphilis (5,6 million) and trichomoniasis (143 million) 3.

In developed countries, STIs and their complications are among the five most common reasons for consultation in adults (4).

Venereology is devoted to sexually transmitted diseases, the symptoms of which most often begin in the genitals, generally by:

• a lesion, ulceration, or “pimple”;
• oozing;
• urethral or vaginal discharge;
• itches ;
• pains ;
• burning during urination.

Among the most common infections (4), note:

• chlamydia caused by Chlamydia bacteria, which are the most common infections between 15 and 25 years old in women, and between 15 and 34 years old in men;
• HIV-AIDS;
• gonorrhea or gonorrhea, caused by bacteria;
• hepatitis B, which causes chronic liver disease;
• genital herpes;
• genital warts caused by human papillomaviruses (HPV or HPV), which can also cause cervical cancer and against which vaccines exist today;
• syphilis, caused by a bacteria called pale treponema;
• mycoplasma and trichomoniasis infections.

Although venereal disease can affect anyone who is sexually active, there are some recognized risk factors., specifically :

• the earliness of the first intercourse;
• having many sexual partners;
• having had an STI in the past.

To reach a diagnosis and identify the origin of the disorders, the dermatologist or venereologist:

• perform a clinical examination of the genitals;
• carry out, if necessary, a local sample;
• may have recourse to additional examinations (blood tests, cultures).

Venereology treatments are mainly based on drugs.

Many sexually transmitted infections can be treated :

• with appropriate antibiotics (chlamydia, gonorrhea, syphilis and trichomoniasis);
• by antivirals, in particular against herpes and HIV-AIDS infection, which do not cure the disease but make it possible to limit the symptoms;
• by immunomodulators in the case of hepatitis B.

Prevention remains the best way to fight STIs, however, by using condoms (condoms) during all sexual relations. Regular screenings can limit the spread of STIs and detect possible infections as early as possible.

The consultation with a venereologist does not involve any particular risks for the patient. However, it can be annoying for some, since it concerns an intimate area.

Venereologist training in France

To become a dermato-venereologist, the student must obtain a diploma of specialized studies (DES) in dermatology and venereology:

• he must first follow, after his baccalaureate, a common first year in health studies. Note that an average of less than 20% of students manage to cross this milestone;
• at the end of the 6th year, students take the national classifying tests to enter the boarding school. Depending on their classification, they will be able to choose their specialty and their place of practice. The internship in dermatology and venereology lasts 4 years.

Finally, to be able to practice as a pediatrician and hold the title of doctor, the student must also defend a research thesis.

Venereologist training in Quebec

After college studies, the student must pursue a doctorate in medicine. This first stage lasts 1 or 4 years (with or without a preparatory year for medicine for students admitted with college or university training deemed insufficient in basic biological sciences). Then, the student will have to specialize by following a residency in dermatology for 5 years.

Before going to the appointment with a venereologist, it is important to take any biology exams (blood tests, cultures) already carried out.

To find a venereologist:

• in Quebec, you can consult the website of the Federation of medical specialists or the Association of dermatologists of Quebec (â ?? µ), which offers a directory of its members;
• in France, via the website of the Ordre des médecins (6) or the French Society of Dermatology and Sexually Transmitted Pathologies (7). Many information, screening and diagnosis centers for STIs (CIDDIST) also offer free screening (8) throughout France.

The consultation with the venereologist is covered by the Health Insurance (France) or the Régie de l’assurance maladie du Québec.