Dermatologie (Heidelberg, Germany)最新文献

Cutaneous metastasis of pleural mesothelioma is a rare manifestation and poses a diagnostic challenge due to its histopathological heterogeneity. We present a clinical case in which cutaneous metastasis of a known pleural mesothelioma was initially misdiagnosed. The correct diagnosis of cutaneous metastasis of a pleural mesothelioma was only confirmed through detailed immunohistochemical analysis. Precise histological classification is of high clinical relevance, as the therapeutic approach particularly depends on the histological subtype and the patient's Eastern Cooperative Oncology Group (ECOG) performance status. Early and accurate diagnosis, as well as timely initiation of appropriate therapy, are prognostically important.

Ultraviolet (UV) radiation is the primary risk factor for the development of both melanocytic and nonmelanocytic skin cancer. In particular, UVA and UVB radiation are the main cause for DNA damage and inflammatory responses that promote tumor formation, thus, contributing to the development of basal cell carcinoma, squamous cell carcinoma, and melanoma. Furthermore, repeated exposure to UV light accelerates premature skin aging (photoaging), resulting in visible structural changes. In recent years, the incidence of skin cancer in Germany has been steadily increasing. Preventive measures, in addition to regular screening examinations, play a crucial role. This includes UV avoidance, consistent use of protective clothing, and the application of appropriate sunscreens. Dermatologists have the crucial responsibility to educate patients about the effects of UV exposure and to promote effective protection strategies. In this regard, personalized approaches to sun protection will continue to play an increasingly important role. Future UV protection concepts will be tailored to take into consideration individual factors such as skin type and genetic predisposition, as well as exposomal influences. These factors would then be further evaluated using artificial intelligence to enable truly personalized sun protection. This personalized approach aligns with the broader trend toward precision medicine but also presents scientific, ethical, and practical challenges. Responsible implementation will therefore be essential to ensure these innovations are applied safely and equitably.

This CME training course focuses on various aspects of how clinical case reports (with or without images) can be published in compliance with data protection regulations-without compromising scientific integrity. In this article, practical guidance for medical specialists who wish to document, publish, or use cases for educational purposes in journals, lectures, or online formats is offered.

Background: Microplastics (MPs) are polymeric particles ranging from 1-5000 µm in size; while a rather limited share is intentionally manufactured, the majority is generated through abrasion during plastic use or results from environmental fragmentation of larger plastic pieces. These persistent emerging pollutants potentially harm fauna, flora, and humans. Nanoplastics (NPs) comprise identical materials but are smaller than 1 µm (1000 nm); due to their small size, they potentially cross epithelial barriers.

Objectives: Outlining occurrence and biological effects of micro- and nanoplastics (MNPs) on skin and mucosa and its environmental dermatologic relevance.

Materials and methods: Literature search using PubMed and Google Scholar regarding the terms 'microplastics', 'nanoplastics', 'skin' and "cutan*" without time limit to provide a narrative review.

Results: The in vivo effects of MNPs on cutaneous physiology remain largely unknown. However, environmental MNPs may carry harmful chemicals and pathogens and there is in vitro evidence indicating proinflammatory and cytotoxic effects as well as promoting senescence.

Conclusion: Experimental approaches investigating MNP effects on skin health face significant limitations and implementation challenges. Given the ubiquitous environmental occurrence of MNP particles, extensive research is warranted to understand their occurrence, fate, and skin health impacts.

A 4-month-old female infant presented with congenital periorbital skin changes. The patient showed bilateral periorbital erythema, telangiectasia and eczematous skin lesions resembling "raccoon eyes" which resulted in a clinical diagnosis of neonatal lupus erythematosus. The diagnosis was confirmed by the detection of elevated anti-Ro antibodies in both the infant and her mother. No cardiological or other abnormalities were found.

Background: Particulate matter (PM) is recognized as a relevant environmental factor affecting overall heath. Growing evidence suggests that PM also impacts skin health. In addition, PM may accelerate skin aging through inflammatory processes and oxidative stress.

Objectives: This review summarizes the adverse effects of PM on the skin, relevant exposure routes, and associated skin disorders.

Materials and methods: Current population-based studies, experimental in vitro and in vivo investigations and review articles examining the effects of PM on the skin were evaluated. Database searches (PubMed and Google Scholar) used the following keywords: particulate matter, oxidative stress, skin damage, skin diseases, atopic dermatitis, psoriasis, and skin aging.

Results: PM triggers oxidative stress, promotes the release of proinflammatory cytokines, disrupts the skin barrier, and modulates immune responses. Collectively, these mechanisms contribute to the development or exacerbation of inflammatory skin disorders such as atopic dermatitis and psoriasis and accelerate extrinsic skin aging. These effects can be influenced by other environmental factors and genetic predisposition.

Conclusion: Current evidence suggests that PM may have a potential impact on skin disorders and premature skin aging. Dermatologists should consider exposure risks and preventive strategies. Future research should increasingly focus on long-term effects, interactions with environmental factors, and robust population-based studies (e.g., intervention studies) to better understand these relationships.

Trichophyton (T.) tonsurans is an anthropophilic dermatophyte known as 'mat fungus' among wrestlers. Dermatomycoses caused by this pathogen have recently been diagnosed more frequently in Germany. A new route of infection is the transmission of T. tonsurans in barbershops. In this article, the laboratory diagnostic detection of T. tonsurans is assessed. Skin and hair samples, preferably from Saxony, Saxony-Anhalt and Thuringia and from all over Germany, were analysed. The mycological detection of T. tonsurans from skin scales, hair roots and swabs were based on culture methods. From 2011, diagnostics were supplemented by polymerase chain reaction-enzyme linked immunosorbent assay (PCR-ELISA). Selected dermatophyte strains were identified by sequencing the internal transcribed spacer (ITS) region of the ribosomal DNA in order to differentiate them from morphologically similar dermatophytes, in particular T. quinckeanum, which has also increased in prevalence during the period under investigation. From 2022, real-time (RT)-PCR with melting curve analysis was also used. Multiple isolates from one patient were only statistically considered once. If there were more than 3 months between two fungal detections, this was categorised as a new infection. For years, T. tonsurans was a rarely diagnosed dermatophyte. Until 2014, a maximum of 12 isolates were found per year. The detection rate rose to 20/year for the first time in 2015. A significant increase was observed from 2017 onwards. A significant increase was recorded from 2017 to 2019, with 38-71 cases of T. tonsurans annually. This was accompanied by a sustained outbreak of dermatophytosis caused by T. tonsurans at the Leipzig wrestling club. From 2020, there was an even more significant increase in T. tonsurans. The detection figures rose from 101/year to 347 in 2023. The provisional peak was reached in 2024 with 538 T. tonsurans infections. The increase is continuing. Two to three times more boys and men are affected than girls and women. The average age of patients is 15-20 years. The antimycotic treatment of tinea capitis, tinea barbae and tinea faciei should almost always be combined topical and systemic (oral). The drug of choice for oral treatment is terbinafine, but itraconazole is also effective. Fluconazole can also be used successfully in individual cases, especially as a powder for oral suspension as an alternative to tablets or capsules.