Journal Der Deutschen Dermatologischen Gesellschaft最新文献

Background: Various treatments are available for rosacea, including lasers and energy-based devices (EBDs). However, the specific role of lasers and EBDs in rosacea management remains insufficiently defined in Germany. The aim of the study was to develop a comprehensive expert consensus on the use of lasers and EBDs in the treatment of rosacea.

Patients and methods: A three-phase study was conducted. First, a steering group performed a systematic literature review and meta-analysis. Second, a prospective, multicenter online survey gathered patient-reported experiences and treatment perspectives. Third, a structured, three-round Delphi process was implemented to discuss consensus statements based on the literature and patient input.

Results: A total of 185 patients participated in the survey. Based on the systematic review and patient questionnaire consensus was performed on (1) the role of lasers and EBDs across different rosacea phenotypes, (2) the integration of laser/EBD treatments with combination therapies, and (3) best practices for pre- and post-treatment care. 16 dermatologists contributed to the Delphi process.

Conclusions: This expert consensus offers practical guidance for incorporating laser and EBD therapies into rosacea treatment strategies. The Delphi process clarifies key aspects of their role in management, their integration into combination therapies and directions for future research.

Necrobiosis lipoidica (NL) is a rare granulomatous skin disease of unknown etiology that occurs frequently in association with diabetes mellitus and other comorbidities. The predilection site is the lower leg, particularly the pretibial areas. The exact pathogenesis remains unclear. Vascular disorders with microangiopathic changes and an autoimmune genesis are discussed. Necrobiosis lipoidica occurs three to six times more frequently in women. Men tend to show a more severe course and develop ulcerations more frequently. The diagnosis can often be established based on typical clinical and dermatoscopic findings. A biopsy should be performed in clinically unclear cases, in the presence of ulceration, or if there are signs of malignant transformation. Overall, the scientific data available for NL are still insufficient and there is a need for further research. However, as patients often experience a severely impaired quality of life, it is important to be aware of the limited scientific evidence and to translate it into practical therapeutic recommendations. This short version of the S1 guideline of the German Dermatological Society (DDG) summarizes the current evidence and, incorporating expert assessments, provides specific recommendations for everyday clinical practice.

Lip squamous cell carcinoma (SCC) accounts for approximately 30% of oral malignancies. Delayed diagnosis worsens the prognosis, leading to tumor growth, regional lymph node involvement, distant metastasis, and the need for invasive therapy. Dermoscopy is a practical, low-cost, and non-invasive diagnostic tool used to detect skin tumors. This review analyzed the common dermoscopic features of lip SCC and actinic cheilitis (AC). A search of MEDLINE, EMBASE, and Web of Science was made for original dermatoscopy studies. Pooled proportions were calculated using a random-effects model (95% CI). Eleven studies were included: 325 patients, 205 lip SCCs, and 122 ACs. Key dermoscopic findings in lip SCCs were white structureless areas 61.9%, ulceration 59.3%, white halos 57.7%, keratin scales 54.98%, pinkish-red background 50.5%, whitish-yellow colors 41.8%, and shiny white streaks 24.5%. Polymorphous vessels were found in 55.8%, and monomorphous in 44.1%. Vessel morphology was hairpin 30.90%, serpentine 22.27%, dotted 21.46%, and glomerular 11.20%. ACs exhibited white halos in 66.14% of cases, white structureless areas in 59.62%, white scales in 57.90%, yellow scales in 30.14%, ulceration in 32.43%, white circles in 9.94%, and had polymorphous (72.93%), hairpin (30.83%), or dotted (20.71%) vessels. Dermoscopy aids early detection of lip SCC and AC, though overlapping features can limit accurate distinction. Histopathological confirmation remains essential in difficult cases, and further studies should explore subgroup-specific dermoscopic patterns.

Chronic wounds place a considerable burden on patients and healthcare systems. Cold plasma technology has become increasingly established for the treatment of people with chronic wounds in recent years. Currently, various cold plasma devices are available. These all generate body-temperature plasmas as well as reactive oxygen and nitrogen species (ROS/RNS). They have not only antimicrobial effects, but also increase dermal blood flow and enhance cell proliferation. Thus, cold plasma-mediated, accelerated wound healing is based on several biological effects that synergistically act within one treatment. Therefore, the AWMF S2k guideline on the rational therapeutic use of cold physical plasma, published in 2022, recommends wound care using cold plasma technology. This article provides an overview of the clinical evidence, potential mechanisms of action, and safety aspects of the therapeutic use of cold plasma technology in chronic wounds.

Atopic dermatitis is the most prevalent chronic inflammatory skin disease, classically defined by its eczematous lesions and relapsing course. However, growing evidence over the past decade has revealed that this disease is in fact far more heterogeneous than previously thought - both in its clinical manifestations and in the underlying molecular and immunological mechanisms. This short review explores the evolving conceptual framework used to analyze atopic dermatitis, encompassing clinical presentations (phenotypes), immune polarization profiles (immunotypes), and the background disease-related and context-related factors that shape them. The aim of this review is to highlight how such heterogeneity influences disease severity, progression, and therapeutic response, particularly in the context of increasingly personalized treatment strategies. By synthesizing accumulated scientific and clinical insights, this short review provides clinicians with a practical guide to navigating the complex spectrum of AD and its underlying therapeutic targets. Recognizing and interpreting this multidimensional variability is essential for understanding disease course and optimizing treatment selection.

Background: Primary cutaneous lymphomas (PCL) are primarily composed of cutaneous T-cell lymphomas (CTCL), followed by cutaneous B-cell lymphomas (CBCL). This study aimed to assess the incidence and survival rates of PCL in Germany.

Methods: We analyzed data from the North Rhine-Westphalia Cancer Registry (2008-2021), which covers a population of 18 million. Age-standardized incidence rates and relative survival were calculated.

Results: The analysis included 3,853 patients with newly diagnosed PCL. Of these, 69.5% were CTCL, and 24.9% were CBCL. The age-standardized incidence of PCL was 10.8 per million person-years. The incidence of both CTCL and CBCL increased over time. PCL cases were also identified in children. The overall five-year relative survival for PCL was 89% (95% CI: 87-92%), with CTCL patients having a survival rate of 91% (95% CI: 88-94%) and CBCL patients of 86% (95% CI: 81-91%). Among patients with Sézary syndrome, the five-year relative survival was 53% (95%: CI:29-77%).

Conclusions: This study represents the largest population-based analysis of PCL in Germany, including both adults and children. The incidence of PCL was higher than previously reported. Additionally, we present the first survival data for PCL in Germany, revealing a notably higher survival probability for patients with Sézary syndrome.