HautarztPub Date : 2022-01-01Epub Date: 2021-11-30DOI: 10.1007/s00105-021-04912-3
J Augustin, M Sander, D Koller
{"title":"[Relevance of health geographic research for dermatology].","authors":"J Augustin, M Sander, D Koller","doi":"10.1007/s00105-021-04912-3","DOIUrl":"https://doi.org/10.1007/s00105-021-04912-3","url":null,"abstract":"<p><p>The association between geographic and medical aspects is a well-known phenomenon, which also occurs in dermatological research. This article reviews the field of health geography, the history of the association between spatial location and health, and focuses on current areas of research. Research focusing on explaining regional variations in health refer to individual aspects and needs, population factors, environmental factors, and health care delivery structures in specific regions, as well as the interaction between them. Regional healthcare research is primarily concerned with access to health services and on the utilisation of those services. Methodologically, the analysis of geodata and the application of geographic information systems (GIS) and spatial modelling play a major role in this field. Dermatological research and dermatological practice can benefit from the findings of the regional analysis of access, utilisation, and variations in order to obtain a more detailed picture of care and thus to optimise care.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"73 1","pages":"5-14"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39790649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-09-20DOI: 10.1007/s00105-021-04885-3
A Langenbruch, N Mohr, F Abeck, J Schmitt, S Ständer, T Werfel, D Thaçi, S Weidinger, M Augustin
{"title":"[Quality of care for patients with atopic dermatitis in Germany-no improvements in indicators after ten years].","authors":"A Langenbruch, N Mohr, F Abeck, J Schmitt, S Ständer, T Werfel, D Thaçi, S Weidinger, M Augustin","doi":"10.1007/s00105-021-04885-3","DOIUrl":"https://doi.org/10.1007/s00105-021-04885-3","url":null,"abstract":"<p><strong>Background: </strong>With AtopicHealth1, the first national care study on atopic dermatitis (AD) was conducted in 2010. At that time, about one third of the patients undergoing treatment by dermatologists showed severe limitations in quality of life, which indicated an insufficient quality of care. The aim of the present study was to characterise the current care of patients with AD undergoing dermatological treatment in comparison between different severity grades, as well as in comparison to 2010 and to psoriasis.</p><p><strong>Methods: </strong>The Germany-wide multicentre cross-sectional study \"AtopicHealth2\" recorded clinical data, quality of life (DLQI), therapies, preventive behaviour and patient-defined treatment benefit (PBI). Patients with an indication for systemic therapy were considered moderately to severely affected for subgroup analyses, the others mildly affected.</p><p><strong>Results: </strong>Between 2017 and 2019, 1291 patients (median age 41 years, 56.5% female) were enrolled by 111 centres. Compared with 2010, there were no improvements in quality of life (DLQI 8.5 in both studies), severity (SCORAD 45.4 vs. 42.3 in 2010) or treatment benefit (PBI 2.2 vs. 2.4 in 2010). Moderately to severely affected patients were more likely to show impaired quality of life (45.4% vs. 23.6%) and less likely to have relevant treatment benefits (PBI < 1: 21.3% vs. 13.2%) than mildly affected patients. In contrast to psoriasis, patients with AD revealed higher quality of life limitations (DLQI 8.5 vs. 6.1) and lower treatment benefit (PBI 2.2 vs. 2.8).</p><p><strong>Discussion: </strong>Compared to 2010, there is no improvement in the quality of care for AD in Germany. Compared to psoriasis, patients with AD show higher burden and lower treatment benefit, which underlines the need for therapeutic innovations.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1079-1089"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8613161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39432965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-11-18DOI: 10.1007/s00105-021-04909-y
Stephan Traidl, Thomas Werfel
{"title":"[Allergen immunotherapy for atopic dermatitis].","authors":"Stephan Traidl, Thomas Werfel","doi":"10.1007/s00105-021-04909-y","DOIUrl":"https://doi.org/10.1007/s00105-021-04909-y","url":null,"abstract":"<p><p>Since the first report of allergen-specific immunotherapy (AIT) by Noon et al. 110 years ago, a multitude of clinical and in vitro studies have been performed to identify the effects of the only curative treatment for allergies. However, in atopic dermatitis (AD), one of the most prevalent skin diseases, it is rarely used, despite evidence showing that aeroallergens can contribute to disease exacerbation. This review gives an overview about the studies, meta-analyses, and current guideline recommendations regarding AIT in AD patients. There is a distinct heterogeneity in the study designs, different allergens and application forms, endpoints and patient cohorts, which hinders the comparability of studies. Several trials depict a beneficial effect of AIT in AD patients suggesting that at least a subgroup of patients can benefit from treatment. Further developments in the field of AIT may advocate broader use in AD patients.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1103-1112"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8600498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39902458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-01-01DOI: 10.1007/s00105-020-04706-z
E Rabe, E Földi, H Gerlach, M Jünger, G Lulay, A Miller, K Protz, S Reich-Schupke, T Schwarz, M Stücker, E Valesky, F Pannier
{"title":"Medical compression therapy of the extremities with medical compression stockings (MCS), phlebological compression bandages (PCB), and medical adaptive compression systems (MAC) : S2k guideline of the German Phlebology Society (DGP) in cooperation with the following professional associations: DDG, DGA, DGG, GDL, DGL, BVP.","authors":"E Rabe, E Földi, H Gerlach, M Jünger, G Lulay, A Miller, K Protz, S Reich-Schupke, T Schwarz, M Stücker, E Valesky, F Pannier","doi":"10.1007/s00105-020-04706-z","DOIUrl":"https://doi.org/10.1007/s00105-020-04706-z","url":null,"abstract":"","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 Suppl 2","pages":"37-50"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00105-020-04706-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38772071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-04-14DOI: 10.1007/s00105-021-04811-7
Daniela Jäger, Narges Soltanpour, Maximillian Gassenmaier, Sebastian Volc, Stephan Forchhammer
{"title":"[Intertriginous plaques with pustules in a patient with systemic lupus erythematosus].","authors":"Daniela Jäger, Narges Soltanpour, Maximillian Gassenmaier, Sebastian Volc, Stephan Forchhammer","doi":"10.1007/s00105-021-04811-7","DOIUrl":"https://doi.org/10.1007/s00105-021-04811-7","url":null,"abstract":"","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1113-1115"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00105-021-04811-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25587526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-10-20DOI: 10.1007/s00105-021-04900-7
Sandra Schuh, C Ruini, E Sattler, J Welzel
{"title":"[Confocal line-field OCT].","authors":"Sandra Schuh, C Ruini, E Sattler, J Welzel","doi":"10.1007/s00105-021-04900-7","DOIUrl":"https://doi.org/10.1007/s00105-021-04900-7","url":null,"abstract":"<p><p>Optical coherence tomography (OCT) and confocal laser microscopy (CLSM) are established non-invasive methods in clinical dermatological routine diagnosis. Whereas CLSM is especially useful to distinguish between nevi and melanoma, OCT is suitable for the diagnosis and differentiation of non-melanoma skin cancer. Line-field confocal optical coherence tomography (LC-OCT) is a new innovative device, which has better cellular resolution than OCT and a higher penetration depth than CLSM. Similar to CLSM, LC-OCT also allows 3D images in real time to be taken. Therefore LC-OCT is very useful for the examination of skin lesions of all kinds, since it unites the features of CLSM and OCT.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1039-1047"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39536293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-10-27DOI: 10.1007/s00105-021-04906-1
D Hartmann
{"title":"[Ex vivo confocal laser scanning microscopy for melanocytic lesions and autoimmune diseases].","authors":"D Hartmann","doi":"10.1007/s00105-021-04906-1","DOIUrl":"https://doi.org/10.1007/s00105-021-04906-1","url":null,"abstract":"<p><strong>Background: </strong>Ex vivo confocal laser scanning microscopy (CLSM) enables bedside histology and offers the surgeon a direct intraoperative tissue examination.</p><p><strong>Objectives: </strong>To determine whether this innovative, ultra-fast diagnostic tool can be expanded beyond nonmelanoma skin cancer, particularly basal cell carcinoma, to other indications including melanocytic lesions and autoimmune diseases.</p><p><strong>Materials and methods: </strong>Review of literature and summary of the current knowledge and experience of the use of ex vivo CLSM in melanocytic lesions and in autoimmune diseases.</p><p><strong>Results: </strong>Up to date experience of the use of ex vivo CLSM in melanocytic lesions and in autoimmune diseases is limited but promising. Current knowledge on melanocytic lesions in ex vivo CLSM and their examples together with classic ex vivo CLSM features are presented. Previous results on the use of ex vivo CLSM in autoimmune dermatoses are presented, and future application possibilities of ex vivo CLSM are discussed.</p><p><strong>Conclusions: </strong>The method is particularly suitable for the rapid examination of basal cell carcinomas during Mohs surgery but could also be used in the future for the intraoperative examination of melanocytic and autoimmune skin lesions.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1058-1065"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-07-30DOI: 10.1007/s00105-021-04868-4
Sigbert Jahn, Julia Föhr, Evangelia Diamanti, Matthias Herbst
{"title":"[Treatment of atopic dermatitis with dupilumab : A retrospective cohort analysis from dermatological practice].","authors":"Sigbert Jahn, Julia Föhr, Evangelia Diamanti, Matthias Herbst","doi":"10.1007/s00105-021-04868-4","DOIUrl":"https://doi.org/10.1007/s00105-021-04868-4","url":null,"abstract":"<p><p>We present the results of a retrospective data analysis of a practice cohort of 44 patients with atopic dermatitis treated with the IL-4/13 receptor antibody dupilumab for up to 3 years. Patients were followed up over a period of 21 months during specialized consultation hours named Immunodermatology, which was established to guarantee comprehensive documentation. The patient's characteristics regarding age and sex distribution, severity and duration of disease were comparable with the patient collectives in large, pivotal studies. The therapeutic efficiency however was high (percentage of patients with EASI50, -75, -90 after 16 weeks: 94, 84, 60%, respectively) and long lasting (86% EASI90 after 52 weeks on therapy) under everyday conditions in the clinical setting. Approximately half of the patients had facial skin or eye involvement either in their history or at the start of treatment. This group of patients proved to need more and intense care because facial dermatitis and periocular dermatitis, which often involved conjunctivitis, took longer to heal, relapses occurred, and an additional topical treatment was often required. We did not observe any severe side effects during the 48 patient-years analyzed in this study. Dupilumab proved to be a safe and efficient treatment for atopic dermatitis in dermatological practice.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1071-1078"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00105-021-04868-4","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39259424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HautarztPub Date : 2021-12-01Epub Date: 2021-03-24DOI: 10.1007/s00105-021-04799-0
Katja Dicke, Vasileios Dervenis, Axel Hauschild, Thomas Dirschka
{"title":"[Local tumor control of metastatic Merkel cell carcinoma in a 90-year-old woman].","authors":"Katja Dicke, Vasileios Dervenis, Axel Hauschild, Thomas Dirschka","doi":"10.1007/s00105-021-04799-0","DOIUrl":"https://doi.org/10.1007/s00105-021-04799-0","url":null,"abstract":"<p><p>Merkel cell carcinoma (MCC) is a rare and aggressive form of skin cancer. Many people suffer early local recurrences and distant metastases. The anti-PDL1 (PDL1: programmed death ligand 1) antibody avelumab has been approved as first-line treatment for advanced MCC in Europe. It is also an alternative treatment for old and multimorbid patients.</p>","PeriodicalId":12970,"journal":{"name":"Hautarzt","volume":"72 12","pages":"1090-1093"},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00105-021-04799-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25512108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}