Dermatologie (Heidelberg, Germany)最新文献

{"title":"[From adjuvant to neoadjuvant treatment: New options in systemic therapy for melanoma].","authors":"Miriam Mengoni, Christoffer Gebhardt, Sebastian Haferkamp","doi":"10.1007/s00105-025-05512-1","DOIUrl":"10.1007/s00105-025-05512-1","url":null,"abstract":"","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"337-338"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112368","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":"[Diffuse hyperpigmentation in systemic sclerosis].","authors":"Sven-Niklas Burmann, Johanna Matull, Frank Oellig, Jörg H W Distler, Alexander Kreuter, Andrea-Hermina Györfi","doi":"10.1007/s00105-025-05494-0","DOIUrl":"10.1007/s00105-025-05494-0","url":null,"abstract":"<p><p>Pigment disorders are commonly observed in patients with systemic sclerosis. They can occur in up to 50% of those affected and include both hypo- and diffuse hyperpigmentation. The latter can be an indicator of vascular involvement and suggest a severe course of the disease. We report on the case of a patient with diffuse cutaneous systemic sclerosis who, in addition to severe vascular complications including digital ulcerations, necrosis, and autoamputations, developed diffuse hyperpigmentation.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"373-376"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733482","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":"[BASCULE syndrome in a 12-year-old girl].","authors":"Carl Maximilian Thielmann, Frederik Krefting, Wiebke Sondermann","doi":"10.1007/s00105-025-05472-6","DOIUrl":"10.1007/s00105-025-05472-6","url":null,"abstract":"","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"371"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617877","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":"[Adjuvant treatment for melanoma].","authors":"Sebastian A Wohlfeil","doi":"10.1007/s00105-025-05510-3","DOIUrl":"10.1007/s00105-025-05510-3","url":null,"abstract":"<p><strong>Background: </strong>Despite adequate treatment the probability of recurrence of malignant melanoma is high in patients with corresponding risk factors. Adjuvant treatment significantly reduces this risk; however, the choice of the appropriate adjuvant treatment can be difficult.</p><p><strong>Objectives: </strong>This article presents the currently available adjuvant therapies (immune checkpoint inhibition with PD‑1 inhibitors and targeted therapy with BRAF and MEK inhibitors) and a comparison of the effectiveness of treatment in stage III.</p><p><strong>Material and methods: </strong>A literature search, a discussion of relevant approval studies and discussion of register data were carried out.</p><p><strong>Results: </strong>Although the available adjuvant therapies significantly reduce the risk of recurrence of malignant melanoma, approximately one quarter of the patients still experience recurrence within the first 2 years. Comparisons of clinical register data show that adjuvant targeted therapy for BRAF-mutated stage III melanoma is superior to PD‑1 inhibition. The final analysis of the COMBI-AD study, the approval trial of dabrafenib and trametinib, shows a survival benefit for melanomas with BRAF^V600E mutations but not for BRAF^V600K mutations compared to placebo .</p><p><strong>Conclusion: </strong>New therapeutic approaches are urgently needed to further reduce the risk of recurrence of melanoma in the adjuvant setting. Therefore, suitable patients should be included in appropriate adjuvant clinical studies, if these are available at the respective sites.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"339-344"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121562","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":"[Neoadjuvant treatment of melanoma].","authors":"Miriam Mengoni, Evelyn Gaffal, Andreas Dominik Braun","doi":"10.1007/s00105-025-05507-y","DOIUrl":"10.1007/s00105-025-05507-y","url":null,"abstract":"<p><strong>Background: </strong>The introduction of adjuvant treatment with immune checkpoint inhibitors (ICI) and BRAF/MEK inhibitors has significantly improved recurrence-free (RFS) and distant metastasis-free survival (DMFS) for melanoma patients. However, a significant improvement in overall survival (OS) has currently not been demonstrated in phase III clinical trials. Furthermore, not all patients benefit from adjuvant systemic therapy. For these patients, perioperative and neoadjuvant systemic therapy represent a promising new therapeutic approach.</p><p><strong>Objective: </strong>In this review, we explore the origins of neoadjuvant and perioperative therapy for melanoma therapy and describe the current state of clinical trials. We also address the opportunities and hurdles for the integration of these novel therapy concepts into routine clinical practice.</p><p><strong>Results: </strong>Current studies have shown an improved RFS and DMFS for patients with melanoma ≥ stage IIIB treated with neoadjuvant and perioperative systemic therapies compared to adjuvant systemic therapy. Pathologic response is proving to be an excellent prognostic marker for the success of neoadjuvant therapy. ICI appears to be superior to treatment with BRAF/MEK inhibitors in the neoadjuvant setting and therefore constitutes the current preferred neoadjuvant treatment strategy.</p><p><strong>Discussion: </strong>The efficacy of perioperative and neoadjuvant systemic therapies in melanoma patients suggests that these therapy concepts should be integrated into routine patient care. However, neoadjuvant and perioperative therapies are only available for patients with resectable metastases, and the current lack of approval represents an obstacle to the use of neoadjuvant systemic therapies in routine care in Germany.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"345-353"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121566","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":"[Bilateral carpal tunnel syndrome in a patient with malignant melanoma undergoing adjuvant pembrolizumab therapy].","authors":"S Weyer-Fahlbusch, M Sandersfeld, C Ritthaler, L Hauck, P Dücker, L Susok, T Gambichler","doi":"10.1007/s00105-025-05480-6","DOIUrl":"10.1007/s00105-025-05480-6","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs) are successfully used in multiple malignant diseases. Their spectrum of adverse effects includes dermatological, endocrinological, gastrointestinal, and hepatic toxicities, as well as rare neurological side effects affecting the central nervous system and more frequently the peripheral nervous system. Pre-existing neurological disorders may deteriorate. Bilateral carpal tunnel syndrome (CTS) rarely occurs. In the present case, an 83-year-old patient with stage IIIC malignant melanoma (MM) developed pain, swelling, and paresthesia in both hands after five adjuvant therapy cycles with pembrolizumab 200 mg. Following the diagnosis of bilateral CTS, pulse therapy with prednisolone was initiated and subsequently reduced to a maintenance dose of 20 mg orally. Despite the necessary escalation of ICI therapy to ipilimumab/nivolumab due to MM progression, CTS improved under concomitant prednisolone therapy and physiotherapy.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"377-382"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055319","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":"[Encyclopedist with a love of detail : Aulus Cornelius Celsus and his dermatological expertise].","authors":"Werner Golder, Waltraud Golder","doi":"10.1007/s00105-025-05515-y","DOIUrl":"10.1007/s00105-025-05515-y","url":null,"abstract":"<p><strong>Background: </strong>The Roman author Aulus Cornelius Celsus wrote an eight volume encyclopedia of medicine. His remarks on terminology are considered paradigmatic in all fields of medicine. The dermatological pathology of Celsus has so far been analyzed mainly in summary descriptions of the medical knowledge of antiquity. A modern text-based interpretation of the contributions of the author to the diagnosis and treatment of skin diseases is missing.</p><p><strong>Objectives: </strong>What kind of diagnostic and therapeutic expertise do the dermatological reports of Celsus convey?</p><p><strong>Materials and methods: </strong>The medical encyclopedia of Celsus has been examined for anamnestic, diagnostic, therapeutic and prognostic statements on diseases of the skin.</p><p><strong>Results: </strong>The work of Celsus contains 31 chapters and notes in which diseases of the skin are described. By far the most are found in the fifth book which is dedicated to pharmacotherapy. The majority of the texts are divided into information on anamnesis and location, the results of the physical examination and the description of the changing aspect of the lesions under treatment. Ulcers, gangrene, erysipelas, boils and carbuncles, papules, pustules, impetigo and scabies are represented in particular detail. Elephantiasis, the so-called sacred fire and alopecia occupy a distinct position. In addition to the treatment with topically applicable remedies, the author discusses surgical measures and the use of cupping glasses.</p><p><strong>Conclusion: </strong>Reading the dermatological reports and commentaries of the author shows that he saw in the efflorescences both isolated diseases and signs of generalized suffering. A perfect example of this evaluation is inflammatory redness. On the one hand, many of the names used by Celsus for skin diseases are firmly embodied in current terminology; on the other hand, a considerable number of appellations can not be found in modern nomenclature, despite their well-defined importance for differential diagnosis. The use of cupping heads and bloodletting was widespread within the treatment of dermatoses, because the so-called bad juices were held responsible for the development of the majority of efflorescences due to the lack of differentiated etiological knowledge of the physicians.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"393-399"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082411","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":"[Value of surgery for malignant melanoma in the context of current adjuvant and neoadjuvant treatment concepts].","authors":"Mareike Alter, Ralf Gutzmer","doi":"10.1007/s00105-025-05511-2","DOIUrl":"10.1007/s00105-025-05511-2","url":null,"abstract":"<p><p>The field of melanoma treatment is also dynamic with respect to surgical procedures. In the treatment of the primary tumor the safety margins have been reduced based on study data. In surgery of the regional lymph nodes elective lymph node dissection has been discontinued in favor of sentinel lymph node (SLN) extirpation. Whether SLN extirpation can even be dispensed with in view of adjuvant treatment, particularly in patients with thicker primary tumors, needs to be further investigated. In the stage of regional macrometastasis, neoadjuvant or perioperative drug treatment should be considered before surgical measures. In the case of distant metastasis and disseminated disease, systemic treatment is also the first choice and in the case of local complications or oligoprogression under systemic treatment, surgical measures can also be considered.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"365-370"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057871","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":"[Biomarkers in adjuvant and neoadjuvant treatment of melanoma].","authors":"Julian Kött, Christoffer Gebhardt","doi":"10.1007/s00105-025-05506-z","DOIUrl":"10.1007/s00105-025-05506-z","url":null,"abstract":"<p><strong>Background: </strong>Personalized treatment of melanoma is becoming increasingly more important. Biomarkers offer the possibility of controlling treatment more precisely and reducing side effects.</p><p><strong>Objective: </strong>The aim of this text is to provide an overview of current tissue-based, blood-based and radiological biomarkers and their clinical application in melanomas.</p><p><strong>Material and methods: </strong>A literature research and analysis of current studies on biomarkers in adjuvant and neoadjuvant treatment of melanomas were carried out and relevant congress contributions were additionally included.</p><p><strong>Results: </strong>Tissue-based programmed cell death 1 ligand 1 (PD-L1) expression, interferon gamma (IFNγ) signature, gene expression profiles (GEP) and tumor mutational burden (TMB) are of prognostic and predictive relevance. Blood-based circulating tumor DNA (ctDNA) in the sense of a liquid biopsy should be emphasized as a personalized biomarker for longitudinal tracking during treatment or aftercare. Positron emission tomography computed tomography (PET-CT) and body composition enable an improved assessment of treatment efficiency. There are currently no data from prospective validation studies on these biomarkers; initial data from the NivoMela study are awaited.</p><p><strong>Conclusion: </strong>The combination of tissue-based, blood-based and radiological biomarkers in terms of multiparametric approaches is promising but further prospective validation is needed for broad clinical use. These are currently not comprehensively implemented in the clinical routine in centers or in remuneration procedures.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"361-364"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008774","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":"[New therapeutic approaches in the neoadjuvant/adjuvant treatment of melanoma].","authors":"Veronika Zenderowski, Laura Schreieder, Konstantin Drexler, Sebastian Haferkamp","doi":"10.1007/s00105-025-05508-x","DOIUrl":"10.1007/s00105-025-05508-x","url":null,"abstract":"<p><strong>Background: </strong>Although effective treatment options for malignant melanoma already exist, currently available adjuvant and neoadjuvant therapies are not always sufficient to prevent relapse or ensure a long-term treatment response. Many patients develop resistance or show inadequate responses to existing therapies. Therefore, there is an urgent need for new and more effective therapeutic approaches in the adjuvant and neoadjuvant settings to sustainably improve patient prognosis.</p><p><strong>Objective: </strong>This study provides an overview of current developments in melanoma treatment, with a particular focus on the adjuvant and neoadjuvant application of novel immunotherapies.</p><p><strong>Material and methods: </strong>A literature search and discussion of relevant recent studies was carried out.</p><p><strong>Results: </strong>Adjuvant mRNA-based adjuvant treatment combined with pembrolizumab demonstrated a significantly improved relapse-free survival compared to pembrolizumab monotherapy (79% vs. 62%). The value of adjuvant LAG‑3 antibodies in combination with PD‑1 blockers remains inconclusive. A neoadjuvant intralesional treatment with daromun after complete removal of tumor tissue reduced the risk of recurrence by 41% and led to a significant extension in relapse-free survival (16.7 months vs. 6.8 months). Tebentafusp improved overall survival in metastatic uveal melanoma and is currently being investigated in the adjuvant and neoadjuvant setting.</p><p><strong>Discussion: </strong>The mRNA-based treatment combined with checkpoint inhibitors have the potential to induce long-term immune responses. The efficacy of LAG-3 inhibitors in the adjuvant setting is currently under evaluation in clinical studies. The immunocytokine treatment with daromun shows promising results in the neoadjuvant setting by stimulating both local and systemic immune responses. Future studies should focus on identifying optimal combinations of treatment to improve the long-term prognosis of patients.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"354-360"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129372","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}