European Journal of Dermatology最新文献

Hair ageing is a multifactorial process involving progressive deterioration of hair follicle structure and function, leading to reduced density, diameter, and overall hair quality. Inspired by advances in longevity science, the emerging concept of hair longevity shifts focus from reactive treatment of visible hair loss to proactive preservation of follicular health. Androgenetic alopecia (AGA), the most common form of non-scarring alopecia, illustrates hair ageing through mechanisms including follicular miniaturization, microinflammation, oxidative stress, and intrinsic cellular senescence. Despite the prevalence and psychological burden of age-related hair thinning, especially among women, preventive approaches remain underdeveloped. An analysis of 102 articles published between 2003 and October 2025 synthesized by an international expert working group and a comprehensive literature analysis allowed to establish a conceptual framework for hair longevity. The proposed model identifies nine hallmarks of hair ageing, grouped into structural, metabolic, and signalling dysfunctions influenced by genetic, hormonal, environmental, and lifestyle factors. Building on this framework, this work proposes an integrative approach to AGA management that incorporates pharmacological treatments, cosmetic formulations, nutritional supplementation, medical devices, and lifestyle-based strategies. Emphasizing prevention as well as treatment, the concept of hair longevity introduces opportunities for earlier intervention, improved patient education, and development of innovative, multi-targeted formulations to support lifelong scalp and hair health.

Androgenetic alopecia (AGA) or pattern hair loss is a non-scarring hair condition defined by gradually reduced, miniaturized hair follicles. It is a multifactorial disorder primarily triggered by dysregulation of the hair cycle due to alterations between the crosstalk of numerous cell subpopulations. To provide a focus on existing and novel management options, preceded by a short overview of the current knowledge about AGA. A group of international experts in AGA analysed 85 literature sources about AGA (retrieved from PubMed and Google Scholar and published between 2000 and 2025) and discuss current and novel treatment options. Recent research evidenced that targeting the hair follicle and the surrounding tissue, rather than solely relying on solutions offered by minoxidil, finasteride, or other products, provides a safe and highly beneficial improvement of AGA. The authors underscore the significant scientific value and crucial role of advanced dermocosmetics with proven clinical efficacy in the long-term management of AGA, in addition to pharmacological active ingredients or other treatment options. These innovations offer compelling early intervention strategies, potentially delaying reliance on lifelong pharmaceutical regimens and optimizing the overall patient journey and quality of life. In addition to current treatment options of AGA, novel topical non-pharmacological therapeutic options are available, helping to safely and efficiently treat this multifactorial hair condition.

Prurigo nodularis (PN) is a rare, severely pruritic chronic skin disease, which seriously reduces patients' quality of life. PN prevalence in Belgium is unknown. To investigate PN prevalence, patient profile, diagnosis, and treatment strategies in Belgium. These insights will better support patient identification and treatments choice to address their specific needs. An anonymous questionnaire was sent to 800 dermatologists for data collection; 65 dermatologists (8%) completed the survey. Also, a search query in the electronic medical records system of a Belgian university hospital was performed. Based on this study, estimated PN prevalence in Belgium is in the range of 0.04-0.09%. PN was most common in women between the ages of 50 and 70 with multiple comorbidities, most importantly atopy and psychological/psychiatric comorbidities. However, few PN patients were treated by a psychologist/psychiatrist. PN is mainly managed with topical therapies (hydration, topical steroids, and calcineurin inhibitors). Of PN patients in Belgium, 61% are severely affected (IGA-CNPG score: 3-4) and received additional systemic treatment (at the time of the survey: antihistamines, methotrexate, cyclosporine, and gabapentin/pregabalin). Treatment of PN is often challenging due to chronicity and frequently associated comorbidities, which limit medical treatment options. In this context, screening for comorbidities, such as diabetes mellitus and kidney disease, is important for patient management. Also, the presence of psychological or psychiatric problems should be assessed, and if necessary, referred to specialized treatment. Education of other medical specialists (e.g. general practitioners, nephrologists or internal medicine/endocrinologists) can foster early identification and a more holistic approach to these multimorbid patients.

Epidermal cysts (ECs) are the most common type of epithelial cyst. On ultrasound, ECs typically exhibit peripheral shadowing and posterior acoustic enhancement. However, their internal echogenicity varies, and the factors influencing these sonographic features remain largely unknown. Objectives: To identify factors associated with each ultrasound feature of ECs based on review of medical records and ultrasound findings of histologically confirmed EC patients. We reviewed ultrasound findings from 55 histologically confirmed EC cases. The cohort included 34 male patients, the mean age for all patients was 52.8 years, and the median EC diameter was 2.0 cm. Logistic regression analyses revealed that associated redness and pain tended to correlate with a lower frequency of peripheral shadowing, consistent with previous reports. In contrast, EC diameter was the only factor significantly associated with a smaller proportion of anechoic areas. Consistent with this, the Mann-Whitney test showed that the proportion of anechoic areas was significantly smaller in larger ECs. Additionally, logistic regression analyses demonstrated that EC diameter was significantly associated with the presence of filiform low echoic areas and hyperechoic areas. This study is the first to demonstrate a significant correlation between EC size and sonographic features. Larger ECs exhibited a smaller proportion of anechoic areas and a higher likelihood of containing hyperechoic areas. These findings suggest that EC size plays a key role in determining internal echogenicity, and recognition of these patterns may enhance the diagnostic accuracy of ECs on ultrasound.

The COVID-19 pandemic has influenced healthcare systems worldwide, which is also evident in the treatment of -malignant melanoma. In this study, the effects of the pandemic on the incidence and depth of invasion of malignant melanoma of the skin were investigated. We retrospectively investigated the incidence as well as the average tumour thickness during the course of the pandemic and the pre-pandemic year. Data from the Department of Dermatology at Hietzing Hospital, Vienna, were analysed. Average depth of invasion of malignant melanomas was measured by Breslow index (BI), and the total number of patients with diagnosed malignant melanomas that were excised was analysed. A significant reduction in excisions (pcorr.=0.007) was found based on comparison between the pre-COVID-19 cohort (227 subjects) and the cohort of the second year of the pandemic (136 subjects). The average BI was 1.1±1.14 mm in the pre-COVID-19 cohort, and 1.8 ± 2.3 mm in the first and 1.4±1.85 mm in the second-pandemic-year cohort. A significant difference in average tumour thickness was detected between the pre-COVID-19 and the first-pandemic-year cohort (pcorr. =0.003), as well as between the pre-COVID-19 and the second-pandemic-year cohort (pcorr.=0.027). The long-lasting effects of the pandemic are discussed based on the further decline in the number of excisions and a simultaneous increase in the average BI during the second year of the pandemic.