Journal Der Deutschen Dermatologischen Gesellschaft最新文献

The vulva is a periorificial skin area and as such represents a transitional zone with unique functional and physiological characteristics. Knowledge of its anatomy is limited among both the general population and healthcare professionals, and unrealistic expectations of normal proportions are common. Ignorance of anatomical variations can cause unnecessary anxiety. In Germany, specialists in gynecology and obstetrics most commonly treat neoplastic vulvar dermatoses, while chronic inflammatory dermatoses commonly affecting the female genitalia (such as psoriasis, atopic dermatitis, hidradenitis suppurativa, and vitiligo) are typically treated by dermatologists. Both specialties treat infectious vulvar dermatoses and sexually transmitted infections. Certain dermatoses, such as lichen sclerosus, lichen planus, and lichen simplex chronicus, tend to affect the vulva preferentially; however, terminology can be confusing. Therefore, this article provides basic information on vulvar anatomy and physiology and summarizes recommendations for the diagnosis and management of the most common vulvar dermatoses, with a special focus on chronic inflammatory dermatoses, to provide a useful guide for all involved specialists in daily practice. Interdisciplinary collaboration and the establishment of dedicated consultation hours may help to improve the clinical care of vulvar dermatoses.

Background and objectives: Studies have identified increased risks of pregnancy complications in expectant mothers with atopic dermatitis (AD). However, the associations between maternal AD and adverse pregnancy or offspring outcomes in Asians remain unexplored. Our aim was to investigate the relationship between maternal AD and adverse pregnancy and offspring outcomes in Taiwan.

Patients and methods: This retrospective cohort study collected data from Taiwan's National Health Insurance Research Database and the Taiwan Maternal and Child Health Database between 2003 and 2019. We recruited 15,495 AD mothers and 77,475 non-AD mothers, as well as 19,173 children born to AD mothers and 95,865 children born to non-AD mothers, using propensity score matching. Pregnancy and offspring outcomes were compared in the maternal and offspring cohorts, respectively.

Results: AD mothers had higher risks of threatened abortion, preeclampsia/eclampsia, premature rupture of membranes, threatened preterm labor, fetal growth restriction, antepartum hemorrhage, postpartum hemorrhage, anemia, surgical complications, infections, pulmonary events, and renal events, with adjusted hazard ratios of 1.09-1.71. Children born to AD mothers had increased risks of AD, allergic rhinitis, asthma, alopecia areata, and attention deficit hyperactivity disorder, with adjusted hazard ratios of 1.05-2.29.

Conclusions: There is a significant association between maternal AD and adverse pregnancy and offspring outcomes in Taiwan.

Background: Most patients with unresectable locally advanced cutaneous squamous cell carcinoma (cSCC) benefit from cemiplimab, but some do not respond. Our study aims to identify clinical and histopathological features predicting response to cemiplimab.

Patients and methods: We analyzed 15 patients treated with cemiplimab, assessing clinical, demographic, histopathological, and immunohistochemical characteristics and correlating them with treatment response. Furthermore, effectiveness and safety were evaluated in our cohort.

Results: Our cohort included 12 males and 3 females, with a mean age of 78.1 years. The majority of tumors, accounting for 66.7%, were located in the head and neck region. Treatment was well-tolerated, with only one grade 3 colitis. There was no correlation between immune-related adverse events and treatment response. Non-responders were younger (69.4 vs. 82.5 years). A history of hematological malignancy correlated with poorer response. High mitotic rate, poor tumor differentiation, high vimentin and p53, and low E-cadherin expression were associated with worse response. Conversely, higher intratumoral inflammatory infiltrate density, presence of necrotic areas, and lower mismatch repair-protein staining correlated with better response.

Conclusions: Cemiplimab is a safe and effective therapy, particularly in elderly patients. Well-differentiated tumors with low proliferative index, intratumoral inflammatory infiltrate, and tumor necrosis may predict better clinical response.