Background and objectives: Malignant melanoma affects younger working individuals. This study investigated work ability and sick leave within one year after diagnosis, as well as the impact of rehabilitation and psycho-oncological measures on employment outcomes.
Patients and methods: In this monocentric, prospective, observational cohort study, 221 patients (62.4% females), aged 19-65, participated. 78.5% had tumor stage IB or lower at baseline. Routine clinical documentation, occupational history, work ability, subjective prognosis of employment, need for and satisfaction with rehabilitation measures were repeatedly assessed.
Results: 181 patients (82%) were employed at first visit, 172 (78%) at last visit. Approximately 75% of patients initially rated work ability as "moderate", with up to 9 sick leave days. In the following year, sick days increased significantly in patients with stage IB and IIA (p = 0.044) and highly significantly in patients with stage II B and above (p < 0.001). Psycho-oncologic consultation (24%) and rehabilitation (18%) did not change the significantly worse self-rated work ability of these patients.
Conclusions: Melanoma affects work ability, even in tumor stages without lymph node involvement or distant metastasis. Controlled clinical trials would be useful to evaluate the success of rehabilitation and psycho-oncological interventions for patients with melanoma.
Background and Objectives: We assessed the prevalence of oral lichen sclerosus in a cohort of women affected with vulvar lichen sclerosus (VLS).
Patients and Methods: This prospective, observational study included adult female patients with a histologically proven VLS who attended the Vulva Clinics of three Dermatology Units from January 2020 to July 2023. During this period, all VLS patients were asked to be examined in their oral cavities in order to detect any possible sign of oral diseases, which were then biopsied.
Results: Three hundred women (mean age 64.5 ± 13.0 years) were included, of whom 21 (7%) had a concurrent extragenital LS. In six (2%) patients, white, non-removable lesions were found at oral inspection and biopsied. All cases were histologically lichen planus. No other clinically relevant oral lesions were found. The six women with histologically proven oral lichen planus had more frequent periodontal and autoimmune diseases than the other included subjects.
Conclusions: Our findings confirm the absolute rarity of oral involvement in patients with VLS. They suggest that the oral mucosa, unlike the genitals, is a setting which weakly leads to development of LS, also in predisposed subjects.
Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are rare, predominantly drug-induced, acute life-threatening diseases of skin and mucosae. SJS and TEN are nowadays considered as variants of one disease entity with varying degrees of severity called epidermal necrolysis (EN). EN is associated with high morbidity and mortality and constitutes a major disease burden for affected patients. The guideline “Diagnosis and treatment of epidermal necrolysis (Stevens-Johnson syndrome and toxic epidermal necrolysis)” was developed under systematic consideration of existing scientific literature and in a formal consensus process according to regulations issued by the Association of Scientific Medical Societies in Germany (AWMF) to establish an evidence-based framework to support clinical decision-making. The interdisciplinary guideline commission consisted of representatives from various specialist societies and of patient representatives. The guideline is aimed at specialists in the fields of dermatology, ophthalmology, plastic surgery, intensive care, and pediatrics in hospitals and offices, as well as other medical specialties involved in the diagnosis and treatment of EN. The guideline is also aimed at patients, their relatives, insurance funds, and policymakers. The second part is concerned with the topics of supportive therapy in the acute phase of EN and outpatient follow-up treatment.
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