{"title":"Nivolumab in der Adjuvanz und als Kombinationstherapie mit Ipilimumab beim fortgeschrittenen Melanom","authors":"","doi":"10.1159/000501737","DOIUrl":"https://doi.org/10.1159/000501737","url":null,"abstract":"","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124858041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Topische Therapie bei Psoriasis vulgaris - ein Behandlungspfad","authors":"S. Philipp","doi":"10.1159/000501219","DOIUrl":"https://doi.org/10.1159/000501219","url":null,"abstract":"Die topische Therapie besitzt auch im Zeitalter der Biologika und small molecules einen hohen Stellenwert in der Psoriasistherapie, sei es zur Behandlung milder Formen der Psoriasis oder unterstützend bei mittelschweren bis schweren Formen. Neben der Wahl geeigneter Wirkstoffe ist auch die Galenik von Bedeutung, um die Therapie zu optimieren. Der hier vorgestellte Behandlungspfad wurde im Rahmen der PsoNet-Sprecherkonferenz entwickelt und von den Teilnehmern der nationalen Versorgungskonferenz Psoriasis bestätigt. Er beinhaltet die aktuellen Therapieoptionen und stellt diese in einer Grafik dar. Als Goldstandard wird in der Initialtherapie der Plaque-Psoriasis die Fixkombination aus Calcipotriol 50 µg/g und Betamethason-Diproprionat 0,5 mg/g 1 mal täglich über 4 - 8 Wochen empfohlen. Am effektivsten ist der Schaum, jedoch sollte bei der Wahl der Grundlage auch die Patientenpräferenz einbezogen werden. Zur Erhaltungstherapie wird eine 1 - 2 mal wöchentliche (proaktive) Anwendung empfohlen. In zweiter Linie können Vitamin D Analoga und topische Steroide auch als Monotherapien zum Einsatz kommen. Zusätzlich werden spezifische Empfehlungen für besondere Therapiesituationen (Psoriasis inversa, Kopfpsoriasis, palmoplantare Psoriasis) gegeben. Auf die Festlegung von Therapiezielen wird spezieller Wert gelegt. Eine begleitende Basistherapie wird als selbstverständlich vorausgesetzt. Neue topische Wirkstoffe sind in der Pipeline.","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126934611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Extrakorporale Photopherese: Studie zum Langzeiteffekt bei chronischer Graft-versus-Host-Reaktion","authors":"P. Lehmann","doi":"10.1159/000500842","DOIUrl":"https://doi.org/10.1159/000500842","url":null,"abstract":"Background: Extracorporeal photopheresis (ECP) is a second-line therapy for steroid-refractory chronic graft-versus-host disease (cGVHD). Objective: We describe the long-term efficacy and tolerability of ECP according to the cutaneous phenotype of cGVHD and report on the reduced need for immunosuppressant drugs in this setting. Patients and Methods: Fourteen patients (8 females) with cutaneous and/or mucosal cGVHD, treated with ECP between October 2010 and May 2016 within a single center, were included. Final analyses included patients who had received ECP for at least 12 months. We prospectively evaluated the efficacy of ECP using lesion-specific clinical scores and by recording changed doses of systemic immunosuppressants. Results: Of the 14 patients, sclerotic skin lesions were present in 10 (71%). The mRODNAN score decreased in all patients from month 9 onwards, with 40 and 77% reductions at 12 and 36 months, respectively. Six patients (43%) presented with cutaneous lichenoid lesions: this score was reduced in all patients by month 3, reaching a 93% reduction by month 12. Five patients (36%) experienced oral mucosal lichenoid lesions: these scores were decreased by 55% at month 12 and by 100% by month 33. The use of systemic immunosuppressants was reduced in all patients; 4 patients could stop all immunosuppressant drugs after 2 years. ECP was stopped in 3 patients after a complete response. No major ECP-associated adverse effects were observed. Discussion and Conclusion: ECP was an effective long-term therapy for oral and cutaneous cGVHD: consequently, dose levels of therapeutic immunosuppression could be reduced.","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114161848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dermato-Onkologie","authors":"J. Maschke","doi":"10.1159/000501663","DOIUrl":"https://doi.org/10.1159/000501663","url":null,"abstract":"neoplastische Mikromilieu angesteuert. Zahlreiche Antikörper und Substanzen, die dort gezielt in den Zellund/oder Nukleinsäure Stoffwechsel eingreifen, werden bereits angewendet oder sind in der Pipeline. Wir alle haben den rasanten Verlauf der Entwicklung einer Vielzahl neuer Systemtherapeutika bei den chronisch entzündlichen Hauterkrankungen der Psoriasis und dem atopischen Ekzem erlebt. Erkrankungen, die durchaus bei den kutanen T-Zell-Lymphomen im Ekzemoder Plaquestadium zu den Differentialdiagnosen gehören. Bei diesen Entitäten überschneiden sich auch oft die lokaltherapeutischen Optionen, sodass der Zusammenfassungsbeitrag von Frau Dr. Philipp zur topischen Therapie bei Psoriasis vulgaris auch aus dermato-onkologischer Sicht sehr lesenswert ist. Wie spannend und herausfordernd z.B. aufgrund von Ansprechvarianten die neuen immunonkologischen Therapieansätze sein können, verdeutlicht der Fallbericht von Oliveira und Mitarbeitern, die das meta-","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122129297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Die Rolle des pH-Wertes bei Intertrigo oder zu trockener Haut","authors":"M. Braun‐Falco","doi":"10.1159/000496130","DOIUrl":"https://doi.org/10.1159/000496130","url":null,"abstract":"In order to maintain skin in «good condition» one can use cosmetic products. Importantly, those skin care products should fulfil specific requirements for specific life phases and specific skin conditions. In this review, we focused on 2 different age groups - namely, infants and the elderly - as well as on 2 specific skin conditions occurring in both age groups - very dry skin (Xerosis) and hyperhydrated skin (diaper rash). The goal in both conditions should be to maintain skin surface in its physiological acidic state, which is in turn crucial for the permeability barrier function, stratum corneum integrity/cohesion and antimicrobial defense. Skin care products formulated with an effective buffer system at a more acidic pH, for example 4, may be the best option to improve the acid mantle and skin barrier function and thus keep the skin in «good condition».","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"82 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128371971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dermatoskopie: Naevi besser verstehen","authors":"M. Schlaak","doi":"10.1159/000500866","DOIUrl":"https://doi.org/10.1159/000500866","url":null,"abstract":"Melanocytic naevi are common melanocytic proliferations that may simulate the appearance of cutaneous melanoma. Naevi commonly harbour somatic mutations implicated in melanomagenesis but in most cases lack the necessary genomic alterations required for melanoma development. While the mitogen-activated protein kinase pathway and ultraviolet radiation strongly contribute to naevogenesis, the somatic mutational landscape of dermoscopic naevus subsets distinguishes some of the molecular hallmarks of naevi in relation to melanoma. We herein discuss the classification of naevi and theories of naevogenesis and review the current literature on the somatic alterations in naevi and melanoma. This review focusses on the clinical-dermoscopic-pathological and genomic correlation of naevi that shapes the current understanding of naevi.","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"9 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116957143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Präventionskonzepte für Nahrungsmittelallergien im Wandel","authors":"V. Mahler","doi":"10.1159/000501010","DOIUrl":"https://doi.org/10.1159/000501010","url":null,"abstract":"In view of the dramatic rise in the prevalence of food allergy globally, effective prevention strategies have become a public health priority. Several models have emerged around the etiology of food allergy, including the hygiene hypothesis, dual allergen exposure hypothesis, and vitamin D hypothesis. These form the basis for current and potential prevention strategies. Breastfeeding remains a key pillar of primary allergy prevention. Other nutritional interventions, including the use of whey-based, partially hydrolyzed formula in non-breastfed infants, also play an important role. In recent years, there has been a shift away from prolonged food allergen avoidance to the proactive allergen introduction from 4 months of age. This approach is supported by 2 pivotal randomized clinical trials showing that the early introduction of peanut and other food allergens significantly reduces the risk of food allergy. However, the implementation of this strategy at the population level still raises significant logistic problems, including patient selection and development of suitable food formats for young infants. Other prevention strategies, including vitamin D supplementation, are currently under evaluation. Maternal elimination diets during pregnancy and lactation are not recommended for allergy prevention. The treatment of food allergies has also seen major transformations. While strict allergen avoidance is still the key treatment principle, there is a greater focus on desensitization and tolerance induction by oral and epicutaneous immunotherapy. In addition, specialized hypoallergenic infant formulas for the treatment of infants with cow's milk allergy have undergone reformulation, including the addition of lactose and probiotics in order to modulate the gut microbiome and early immune responses. Further research is needed to inform the most effective food allergy prevention strategies at the population level. In addition, the wider application of food allergen immunotherapy may provide better health outcomes and improved quality of life for families affected by food allergies.","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"131 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122061868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Kaleidoskop","authors":"","doi":"10.1159/000501253","DOIUrl":"https://doi.org/10.1159/000501253","url":null,"abstract":"Forscher der Universitätsklinik für Dermatologie am Inselspital in Bern haben eine Zellverwandtschaft entdeckt, die die Behandlung allergischer Hauterkrankungen wie Neurodermitis verbessern könnte. Um die Rolle der Th9-Zellen im Menschen besser zu verstehen, hat ein Forschungsteam der Dermatologie des Inselspitals und des Department for Biomedical Research der Universität Bern um Prof. Christoph Schlapbach diese Zellen genauer untersucht. Dabei entdeckte das Team, dass Th9-Zellen keine eigenständige Population, sondern eine Sonderform der bereits bekannten Th2-Zellen sind. Th2-Zellen tragen entscheidend zur Entstehung von Allergien bei. Sie Karger Kompass Dermatol 2019;7:165–169 DOI: 10.1159/000501253","PeriodicalId":390963,"journal":{"name":"Karger Kompass Dermatologie","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132573598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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