{"title":"Kongresskalender 2020","authors":"","doi":"10.1111/ddg.14055","DOIUrl":"https://doi.org/10.1111/ddg.14055","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87573110","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}
D. Niebel, Christine Brägelmann, J. Wenzel, T. Bieber
We report the case of a 75-year-old female patient who presented with recent flaccid blistering and intense itching for a week. Concomitantly she also experienced eye redness, for which she applied antibiotic eye drops (gentamicin), and mild oral paresthesia. A preceding common cold had just resolved by the time of presentation. The patient had a medical history of ulcerated melanoma (Breslow's thickness 10 mm) on her upper arm one year before. She was treated according to guidelines with wide excision and sentinel lymph node biopsy. Since then, repeated surgery revealed a total of five metastases in supraclavicular lymph nodes; the stage of disease was IIID (American Joint Committee on Cancer [AJCC 2017]: pT4b pN3c cM0 R0). Molecular pathology analysis of the tumor detected an activating neuroblastoma RAS viral oncogene homolog (NRAS) mutation, but no druggable BRAF gene mutation; the patient therefore received an adjuvant treatment with nivolumab. The first dose was given one month before formation of the skin lesions. Apart from hypertension and hypothyroidism there was no relevant comorbidity.
我们报告的情况下，一个75岁的女性患者谁提出了最近松弛起泡和强烈的瘙痒了一个星期。同时，她还经历了眼睛发红，为此她使用了抗生素滴眼液(庆大霉素)，并出现轻度口腔感觉异常。之前的一场普通感冒在演讲的时候已经好了。患者一年前有上臂溃疡性黑色素瘤(布雷斯洛厚度10毫米)病史。她接受了广泛切除和前哨淋巴结活检的治疗。此后，反复手术共发现5例锁骨上淋巴结转移;疾病分期为IIID (American Joint Committee on Cancer [AJCC 2017]: pT4b pN3c cM0 R0)。分子病理学分析发现肿瘤中存在活化性神经母细胞瘤RAS病毒癌基因同源物(NRAS)突变，但未发现可药物治疗的BRAF基因突变;因此，患者接受了纳武单抗的辅助治疗。第一剂在皮肤病变形成前一个月给药。除高血压和甲状腺功能减退外，无相关合并症。
{"title":"Unusual flaccid blistering with mucosal involvement upon immune checkpoint inhibition","authors":"D. Niebel, Christine Brägelmann, J. Wenzel, T. Bieber","doi":"10.1111/ddg.13954","DOIUrl":"https://doi.org/10.1111/ddg.13954","url":null,"abstract":"We report the case of a 75-year-old female patient who presented with recent flaccid blistering and intense itching for a week. Concomitantly she also experienced eye redness, for which she applied antibiotic eye drops (gentamicin), and mild oral paresthesia. A preceding common cold had just resolved by the time of presentation. The patient had a medical history of ulcerated melanoma (Breslow's thickness 10 mm) on her upper arm one year before. She was treated according to guidelines with wide excision and sentinel lymph node biopsy. Since then, repeated surgery revealed a total of five metastases in supraclavicular lymph nodes; the stage of disease was IIID (American Joint Committee on Cancer [AJCC 2017]: pT4b pN3c cM0 R0). Molecular pathology analysis of the tumor detected an activating neuroblastoma RAS viral oncogene homolog (NRAS) mutation, but no druggable BRAF gene mutation; the patient therefore received an adjuvant treatment with nivolumab. The first dose was given one month before formation of the skin lesions. Apart from hypertension and hypothyroidism there was no relevant comorbidity.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85890787","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":"Kongresskalender 2020","authors":"","doi":"10.1111/ddg.14034","DOIUrl":"https://doi.org/10.1111/ddg.14034","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88522082","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":"Journal‐Club","authors":"C. Bendick, Robert W. Gruber","doi":"10.1111/ddg.14010_g","DOIUrl":"https://doi.org/10.1111/ddg.14010_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73358999","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":"Deckblatt+Editoren","authors":"","doi":"10.1111/ddg.14020","DOIUrl":"https://doi.org/10.1111/ddg.14020","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81933649","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}
C. Fink, L. Uhlmann, Karsten Vogt, R. Schneiderbauer, C. Menzer, F. Toberer, Timo E. Schank, A. Enk, H. Haenssle
Dermatoscopy may be hindered by body hair, and the development of an automated hair removal algorithm (AuHRA) might improve the diagnostic accuracy. However, the physicians' exact level of hindrance and the clinical benefit attained by AuHRA has not been assessed. The objectives of this study are to quantify the physicians' level of hindrance by body hair and the level of improvement in the visibility of underlying dermatoscopic patterns after application of AuHRA to digital images of hair‐covered nevi.
{"title":"Physicians' level of hindrance by body hair in dermatoscopy and clinical benefit of an automated hair removal algorithm","authors":"C. Fink, L. Uhlmann, Karsten Vogt, R. Schneiderbauer, C. Menzer, F. Toberer, Timo E. Schank, A. Enk, H. Haenssle","doi":"10.1111/ddg.13967","DOIUrl":"https://doi.org/10.1111/ddg.13967","url":null,"abstract":"Dermatoscopy may be hindered by body hair, and the development of an automated hair removal algorithm (AuHRA) might improve the diagnostic accuracy. However, the physicians' exact level of hindrance and the clinical benefit attained by AuHRA has not been assessed. The objectives of this study are to quantify the physicians' level of hindrance by body hair and the level of improvement in the visibility of underlying dermatoscopic patterns after application of AuHRA to digital images of hair‐covered nevi.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78544989","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}
Magdalena Seidl-Philipp, U. Schatz, Irina Gasslitter, V. Moosbrugger-Martinz, S. Blunder, A. Schossig, J. Zschocke, M. Schmuth, R. Gruber
Ichthyoses are a heterogeneous disease group, which makes clinical classification challenging. An ichthyosis cohort at a center for genodermatoses is presented in detail.
鱼鳞病是一种异质性疾病，这使得临床分类具有挑战性。在遗传皮肤病中心鱼鳞病队列详细介绍。
{"title":"Spectrum of ichthyoses in an Austrian ichthyosis cohort from 2004 to 2017","authors":"Magdalena Seidl-Philipp, U. Schatz, Irina Gasslitter, V. Moosbrugger-Martinz, S. Blunder, A. Schossig, J. Zschocke, M. Schmuth, R. Gruber","doi":"10.1111/ddg.13968","DOIUrl":"https://doi.org/10.1111/ddg.13968","url":null,"abstract":"Ichthyoses are a heterogeneous disease group, which makes clinical classification challenging. An ichthyosis cohort at a center for genodermatoses is presented in detail.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80459278","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":"Journal‐Club","authors":"J. Weiß","doi":"10.1111/ddg.13994_g","DOIUrl":"https://doi.org/10.1111/ddg.13994_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87419709","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}
L. Kofler, C. Berg, K. Kofler, A. Geipel, H. Lipp, Alisa Müller, T. Eigentler, A. Forschner
Combined therapy of advanced melanoma with BRAF/MEK inhibitors leads to an improvement of overall survival [1–6]. In 2014, the combined HCV-NS5A/nucleotide polymerase inhibitor Harvoni® was approved for the treatment of chronic hepatitis C and demonstrated to be highly effective in previously untreated patients [7]. However, active hepatitis C was a common exclusion criterion in registration trials for metastasized melanoma and was also valid in the Combi-V and Combi-D trials [8, 9]. We describe a patient with an advanced nodular melanoma (pT3bN3M1b, stage IV) with a proven BRAF-V600E mutation. Clinical and radiological examination revealed the presence of pulmonary metastases as well as unresectable, painful, locoregional metastases. A chronic hepatitis C infection was known for some years but was not treated. Laboratory testing showed 42.400 IU HCV RNA/ml serum using a quantitative PCR (COBAS AmpliPrep/COBAS TaqMan HCV Quantitative Test, version 2.0; Roche Diagnostics Deutschland, Mannheim, Germany) as well as evidence of anti-hepatitis C antibodies. Based upon a recommendation of our interdisciplinary tumor board, targeted hepatitis C-therapy with ledipasvir 90 mg and sofosbuvir 400 mg (Harvoni®) was initiated for twelve consecutive weeks. Simultaneously, we started a combined targeted melanoma treatment with dabrafenib 300 mg (Tafinlar®) and trametinib 2 mg (Mekinist®). The tumor board recommended targeted melanoma therapy due to painful locoregional metastases, since a more rapid treatment could be expected than for checkpoint inhibitors. Initially, trametinib as well as ledipasvir/sofosbuvir were taken at the same time in the morning. At the first follow-up visit, the patient reported nocturnal chills and intermittent diarrhea. We excluded an infectious cause for these symptoms. As ledipasvir/sofosbuvir and trametinib are eliminated by the breast cancer resistant protein (BCRP), which is an efflux transport protein strongly expressed in barrier tissues, a competitive drug interaction may be assumed to underlie these adverse reactions [10]. We could not exclude an interaction via hepatic OATP1B3 uptake, which would result in higher BRAF/MEK-inhibitor plasma-levels [11]. Therefore, an interval of two hours after intake of BRAF/MEK inhibitors was recommended for ledipasvir/sofosbuvir, resulting in complete resolution of the symptoms. No further side effects have been reported by the patient so far. At a follow-up visit three months after completing the treatment with ledipasvir/sofosbuvir, HCV-RNA-PCR remained negative. We observed complete response of the melanoma metastases. The targeted therapy with dabrafenib and trametinib is currently continuing. Various side effects have been described for BRAF/MEK inhibitors, including diarrhea and chills. Therefore, careful clinical examination and a detailed anamnesis is of great importance. Good safety profiles for patients with hepatitis C have already been reported for anti-PD-1 therapy [12, 13].
{"title":"Simultaneous targeted therapy for metastatic melanoma and hepatitis C","authors":"L. Kofler, C. Berg, K. Kofler, A. Geipel, H. Lipp, Alisa Müller, T. Eigentler, A. Forschner","doi":"10.1111/ddg.13952","DOIUrl":"https://doi.org/10.1111/ddg.13952","url":null,"abstract":"Combined therapy of advanced melanoma with BRAF/MEK inhibitors leads to an improvement of overall survival [1–6]. In 2014, the combined HCV-NS5A/nucleotide polymerase inhibitor Harvoni® was approved for the treatment of chronic hepatitis C and demonstrated to be highly effective in previously untreated patients [7]. However, active hepatitis C was a common exclusion criterion in registration trials for metastasized melanoma and was also valid in the Combi-V and Combi-D trials [8, 9]. We describe a patient with an advanced nodular melanoma (pT3bN3M1b, stage IV) with a proven BRAF-V600E mutation. Clinical and radiological examination revealed the presence of pulmonary metastases as well as unresectable, painful, locoregional metastases. A chronic hepatitis C infection was known for some years but was not treated. Laboratory testing showed 42.400 IU HCV RNA/ml serum using a quantitative PCR (COBAS AmpliPrep/COBAS TaqMan HCV Quantitative Test, version 2.0; Roche Diagnostics Deutschland, Mannheim, Germany) as well as evidence of anti-hepatitis C antibodies. Based upon a recommendation of our interdisciplinary tumor board, targeted hepatitis C-therapy with ledipasvir 90 mg and sofosbuvir 400 mg (Harvoni®) was initiated for twelve consecutive weeks. Simultaneously, we started a combined targeted melanoma treatment with dabrafenib 300 mg (Tafinlar®) and trametinib 2 mg (Mekinist®). The tumor board recommended targeted melanoma therapy due to painful locoregional metastases, since a more rapid treatment could be expected than for checkpoint inhibitors. Initially, trametinib as well as ledipasvir/sofosbuvir were taken at the same time in the morning. At the first follow-up visit, the patient reported nocturnal chills and intermittent diarrhea. We excluded an infectious cause for these symptoms. As ledipasvir/sofosbuvir and trametinib are eliminated by the breast cancer resistant protein (BCRP), which is an efflux transport protein strongly expressed in barrier tissues, a competitive drug interaction may be assumed to underlie these adverse reactions [10]. We could not exclude an interaction via hepatic OATP1B3 uptake, which would result in higher BRAF/MEK-inhibitor plasma-levels [11]. Therefore, an interval of two hours after intake of BRAF/MEK inhibitors was recommended for ledipasvir/sofosbuvir, resulting in complete resolution of the symptoms. No further side effects have been reported by the patient so far. At a follow-up visit three months after completing the treatment with ledipasvir/sofosbuvir, HCV-RNA-PCR remained negative. We observed complete response of the melanoma metastases. The targeted therapy with dabrafenib and trametinib is currently continuing. Various side effects have been described for BRAF/MEK inhibitors, including diarrhea and chills. Therefore, careful clinical examination and a detailed anamnesis is of great importance. Good safety profiles for patients with hepatitis C have already been reported for anti-PD-1 therapy [12, 13]. ","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83963554","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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