Journal Der Deutschen Dermatologischen Gesellschaft最新文献

Objective: This study investigates the association of melanoma risk with total-body nevus count and the presence of atypical nevi in younger (< 40 years) and older (> 60 years) individuals.

Methods: A pooled analysis was conducted within the M-SKIP project, based on multiple melanoma case-control studies. Associations were assessed through study-specific odds ratios (ORs), adjusted for potential confounders.

Results: Nine case-control studies were included, analyzing common nevi (2,674 melanoma cases/2,343 controls) and atypical nevi (2,459 cases/1,740 controls). High common nevus count was associated with increased melanoma risk in both younger (summary [s]OR = 2.56; 95% CI 1.64-4.01; I² = 31%) and older individuals (sOR = 2.06; 95% CI 1.06-4.00; I² = 67%), with no significant age-group difference (p = 0.57). In contrast, younger individuals exhibited a markedly higher risk of melanoma associated with the presence of at least one atypical nevus (sOR = 4.84, 95% CI 2.18-10.76; I² = 65%) compared to older individuals (sOR = 1.71 95%CI 1.07-2.74; I² = 39%), with a p value for the difference of 0.02.

Conclusions: These findings suggest age-specific differences in melanoma risk associated with nevus burden. Specifically, atypical nevi are a stronger risk factor in younger individuals. This could have significant implications for prevention strategies and clinical management, in particular for better identification of high-risk groups for targeted secondary prevention efforts.

Background: Erythropoietic protoporphyria (EPP) is a rare genetic disorder characterized by severe phototoxic reactions that occur within minutes of light exposure. In clinical studies, afamelanotide has been shown to prolong pain-free sun exposure, improve quality of life, and reduce the frequency and severity of phototoxic reactions.

Objective: To present the real-world data of the Austrian EPP cohort treated with afamelanotide.

Patients and methods: Data from all Austrian EPP patients treated with afamelanotide in 2023 (n = 20) were analyzed and compared to baseline data on quality of life, phototoxic burn tolerance time (PBTT), reported UV index on the day with the longest PBTT, and incidence and severity of phototoxic reactions.

Results: Before treatment, the EPP QoL score had a median of 11.11 (IQR 3.03-19.44) and increased to a median of 79.17 (IQR 75.00-97.22) under therapy. Phototoxic burn tolerance time (PBTT) increased from a median of 15 minutes (IQR 10-25) to a median of 250 minutes (IQR 120-300) under therapy. Before therapy 88% of patients had phototoxic reactions, while on therapy only 33% were affected. Treatment side effects were only mild and transient.

Conclusions: The real-world data of the Austrian cohort confirm the effectiveness and safety of afamelanotide in EPP patients.

Mycoplasma pneumoniae (MP) is a common pathogen responsible for diverse infections in children and adolescents, primarily affecting the respiratory tract. Besides causing atypical pneumonia, MP can also lead to extrapulmonary manifestations, including mucocutaneous, hematological, neurological, cardiac, and gastrointestinal symptoms. These extrapulmonary manifestations are often overlooked, complicating diagnosis and management. Here, we delineate the spectrum of cutaneous and non-cutaneous diseases caused by MP in children, focusing on the pathophysiology, clinical features, and treatment of mucocutaneous manifestations.

The German-language, consensus- and evidence-based S3 guideline on lichen sclerosus (LS) was developed based on the European "EuroGuiDerm Guideline on lichen sclerosus" under the leadership of the German Dermatological Society (DDG) and the German Society for Gynecology and Obstetrics (DGGG). Particular emphasis was placed on adapting the recommendations to the healthcare conditions in German-speaking countries. The interdisciplinary guideline development group consisted of 24 experts from 16 medical societies and actively included patient representatives in the development process. The guideline provides comprehensive recommendations on diagnosis, patient management, follow-up care, and patient education, as well as the treatment of both genital and extragenital LS in women, men, girls, and boys. Regardless of age or sex, ultrapotent or potent topical glucocorticosteroids in combination with emollients remain the standard therapy for genital LS. In male patients with LS-associated phimosis who do not respond sufficiently to standard therapy, circumcision with complete removal of the foreskin is indicated. For extragenital LS, phototherapy with UV light is recommended as an adjunct to topical treatment. Topical calcineurin inhibitors are second-line therapy.