{"title":"[Drug reaction with eosinophilia and systemic symptoms (DRESS): a hypersensitivity reaction with various symptoms].","authors":"A Hansel, E Oms, M Tronnier","doi":"10.1007/s00105-024-05364-1","DOIUrl":"10.1007/s00105-024-05364-1","url":null,"abstract":"<p><p>Drug reaction with eosinophilia and systemic symptoms (DRESS) is an illness which is difficult to diagnose because of its various symptoms. In our case, a patient with small spotted exanthema with nearly erythroderma and eosinophilia presented to the emergency room. Systemic steroid therapy was started on suspicion of a drug reaction. Over the course of time, the patient's general condition deteriorated significantly and the patient developed cholecystitis, Staphylococcus aureus bacteremia, pneumonitis and cytomegalovirus reactivation. With this case report, we want to show that DRESS is a disease that is difficult to treat and can develop after a long delay.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"809-813"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141175572","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":"[Phosphodiesterase 4 inhibitors in dermatology : Role in the treatment of skin diseases].","authors":"Morna F Schmidt, Nicole Albuscheit, Amir S Yazdi","doi":"10.1007/s00105-024-05407-7","DOIUrl":"10.1007/s00105-024-05407-7","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammatory skin diseases are of great social and medical importance and require effective drug therapy. Phosphodiesterase 4 (PDE4) inhibitors represent a possible therapeutic option by regulating inflammatory processes. PDEs cause the release of proinflammatory cytokines by interfering with signaling pathways. The PDE4 inhibitors apremilast (treatment of psoriasis and Behçet's disease), roflumilast (treatment of chronic obstructive pulmonary disease), and crisaborole (treatment of atopic dermatitis) are currently approved in Europe.</p><p><strong>Psoriasis: </strong>Apremilast is used for second-line treatment of plaque psoriasis and psoriatic arthritis and has a favorable side effect profile. Topical PDE4 inhibitors are currently being researched and have not yet been approved by the European Medicines Agency (EMA).</p><p><strong>Atopic dermatitis: </strong>The topical PDE4 inhibitor crisaborole was approved by the EMA in 2020 as a topical treatment alternative to glucocorticoids and calcineurin inhibitors. Although the substance has shown good tolerability in studies and also alleviates the accompanying itching, it did not find its way onto the German market. BEHçET'S DISEASE: Apremilast is approved for the treatment of Behçet's disease in adults with refractory, severe oral ulcers.</p><p><strong>Outlook: </strong>Case studies have also demonstrated the efficacy of systemic PDE4 inhibition in other skin diseases (including blistering autoimmune dermatoses, lichen planus, and acantholytic genodermatoses). The substances are also being researched and used to treat extracutaneous inflammatory diseases.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"791-797"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115601","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}
Laurie Eicher, Mattis Bertlich, Lars E French, Michael Flaig, Eva Oppel
{"title":"[Nail problem].","authors":"Laurie Eicher, Mattis Bertlich, Lars E French, Michael Flaig, Eva Oppel","doi":"10.1007/s00105-024-05341-8","DOIUrl":"10.1007/s00105-024-05341-8","url":null,"abstract":"","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":"75 Suppl 1","pages":"37-39"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302435","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":"[Variants of biotechnological drugs in dermatology : Status quo and future].","authors":"Johannes Wohlrab, Adina Eichner","doi":"10.1007/s00105-024-05403-x","DOIUrl":"10.1007/s00105-024-05403-x","url":null,"abstract":"<p><p>Biotechnological drugs, so-called biopharmaceuticals, have complex structures, have special physicochemical characteristics and are subject to special regulatory laws. In addition to recombinant monoclonal antibodies, proteins and fusion proteins, a large number of biotechnological variations have been developed, of which antibody fragments, nanobodies, peptides, and antibody-drug conjugates in particular have found their way into clinical application. In addition to strategies for the treatment of oncological diseases, chronic inflammatory diseases in particular are being addressed, which are also becoming of great importance in dermatology. The advantages of biopharmaceuticals are increasingly being recognised and developed as part of special strategies for topical application. Due to the rapid development of molecular medicine, new targets for biopharmaceuticals are constantly being identified, and pharmacokinetically favourable biotechnological molecules are being created using refined methods. It can be assumed that this development will lead to even more highly innovative therapeutic and diagnostic options.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"775-780"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019725","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":"[Janus kinase inhibitors for skin disorders].","authors":"Farzan Solimani, Kamran Ghoreschi","doi":"10.1007/s00105-024-05406-8","DOIUrl":"10.1007/s00105-024-05406-8","url":null,"abstract":"<p><p>Immune factors such as interferon‑ɣ and interleukin 4 belong to the group of cytokines that are dependent on type I/II receptors for their signal transmission. Upon activation, these receptors transmit their signal to the cell nucleus and, thus, modulate gene transcription via a signaling cascade consisting of Janus kinases (JAK). This family of four kinases (JAK 1, JAK 2, JAK 3, and tyrosine kinase 2 (TYK2)) subsequently activate members of the signal transducer and activator of transcription (STAT). This finding turned the JAK/STAT signaling pathway into a pharmacological target for the treatment of inflammatory diseases in which cytokines using type I/II receptors play a pathogenic role. In 2018, the European Medicines Agency (EMA) approved tofacitinib for the treatment of psoriatic arthritis. This was the first approval of a JAK/STAT pathway inhibitor for patients treated by dermatologists and rheumatologists. Since then, several new JAK inhibitors have been approved for dermatologic diseases such as atopic dermatitis, alopecia areata, vitiligo, and plaque-type psoriasis. In addition, JAK inhibitors are being investigated for the treatment of many other skin diseases. Thus, systemic JAK inhibitors complete the spectrum of immunotherapeutics with a broader immunological approach compared to monoclonal antibodies. The low molecular weight of JAK inhibitors enables the preparation of these drugs for both systemic and topical administration. Their utilization could represent a valuable alternative to topical steroids. The safety profile of JAK inhibitors must be taken into account. Possible long-term effects may become apparent in the next few years. This article describes both approved JAK inhibitors and relevant new JAK inhibitors that are promising candidates for approval as therapeutics in dermatology.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"781-790"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115600","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":"[Mental disorders from climate and environmental changes using the example of dermatology].","authors":"Lea Dohm, Susanne Saha, Kristina Fronhoffs, Uwe Gieler","doi":"10.1007/s00105-024-05396-7","DOIUrl":"10.1007/s00105-024-05396-7","url":null,"abstract":"<p><strong>Background: </strong>Global climate and environmental changes impose a significant impact on human health by increasing prevalences of chronic and acute skin diseases. Climate-associated environmental changes can also trigger or intensify mental illnesses independently of a skin disease.</p><p><strong>Aim: </strong>Discussion of the effects of the climate and environmental changes on dermatological diseases applying the biopsychosocial model.</p><p><strong>Materials and methods: </strong>A selective literature search in the PubMed database and other sources was conducted.</p><p><strong>Results: </strong>The biopsychosocial model considers complex interactions between biological, psychological, and social factors. In view of the consequences of climate and environmental changes, an extension of the model is proposed for the first time in order to address new challenges. The modified presentation supports the understanding of the dynamics and underscores that in dermatological care not only direct health effects of climate and environmental changes have to be dealt with, but also with an increasing number of mental illnesses, which in turn are to be regarded as direct and indirect health effects.</p><p><strong>Conclusion: </strong>Coping with the predicted increase in the burden of disease and the decline in the available labor force associated with demographic change poses a major challenge. In order to maintain the functionality of the healthcare system, the prompt implementation of resource-efficient, sustainable measures in all areas of society is essential. The integrative consideration of dermatological and psychological complaints in the context of climate and environmental changes requires the adaptation of content for the education, training, and continuing education of specialists.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"704-710"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908523","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":"[Patient survey on the use of video consultation in the outpatient treatment of chronic pruritus].","authors":"P Petzinka, S Ständer, C Juhra, C Zeidler","doi":"10.1007/s00105-024-05377-w","DOIUrl":"10.1007/s00105-024-05377-w","url":null,"abstract":"<p><strong>Background: </strong>Analyses of patient evaluations and barriers to the implementation of teledermatology procedures are still rare. The aim of this study was to determine whether administrative processes have an influence on the patient evaluation of telephone and video consultations.</p><p><strong>Methods: </strong>With the help of a patient survey, assessments of the processes and organisation surrounding the outpatient appointment were asked. These were then compared to the assessment of whether the telephone or video consultation is an alternative to on-site consultation.</p><p><strong>Results: </strong>In all, 1538 patients took part in the survey. Significant correlations were found between the evaluation of the telephone or video consultation and the distance between the place of residence and the outpatient clinic, whether the patient had already been seen several times or for the first time, as well as the evaluation of the waiting time for the appointment, the organisation before the appointment and the waiting time in the outpatient clinic.</p><p><strong>Conclusions: </strong>The study shows that even after the Coronavirus pandemic, telephone and video consultations remain an important tool for patients to contact their physician. However, patients' perceptions of the processes around the outpatient appointment have an influence on their willingness to participate in a digital consultation.</p>","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"721-726"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592270","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}
Matthias D Kaufmann, Michael Erdmann, Stefan Schliep, Caroline Voskens, Carola Berking, Jürgen P Bauerschmitz
{"title":"[Simultaneous presentation of two skin lesions suspected of being malignant].","authors":"Matthias D Kaufmann, Michael Erdmann, Stefan Schliep, Caroline Voskens, Carola Berking, Jürgen P Bauerschmitz","doi":"10.1007/s00105-024-05365-0","DOIUrl":"10.1007/s00105-024-05365-0","url":null,"abstract":"","PeriodicalId":72786,"journal":{"name":"Dermatologie (Heidelberg, Germany)","volume":" ","pages":"747-750"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238870","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}