Dermatologie (Heidelberg, Germany)最新文献

Along with other environmental factors, ultraviolet radiation (UV-B, UV-A) definitely plays a role in skin aging and skin cancer. Recently, it has been shown that visible light and infrared radiation are also involved in the skin aging process. Visible light in the blue-green spectral range can be absorbed by certain molecules of the skin in a similar way to UV-A, thereby generating reactive oxygen species (ROS). Light in this spectral range can trigger erythema and an increase in pigmentation, possibly also inducing the expression of matrix metalloproteinases (MMP) such as MMP‑1 and, thus, contributing to visible skin aging. In contrast, visible light in the red spectral range can have the opposite effect, reducing erythema and periorbital rhytides (photorejuvenation). Radiation in the near-infrared spectral range (IR-A) penetrates deep into the skin and can increase the temperature in the skin through absorption in water, thereby altering cell activities. IR‑A radiation can be absorbed by biomolecules such as cytochrome c oxidase in the mitochondria of fibroblasts, where it triggers a significant increase in ROS. This results in a retrograde signaling cascade toward the cell nucleus and the expression of many genes, including MMP‑1. Under IR‑A, collagen formation also declines and angiogenesis occurs. All of these effects of IR‑A contribute to skin aging. Protective filters for the skin, such as those used for UVR radiation, are not available for IR and visible light. The use of creams containing antioxidants or iron oxide pigments could offer some protection in these spectral ranges.

Background: Per- and polyfluoroalkyl substances (PFAS) are a large group of anthropogenic chemicals that have been widely used in industrial manufacturing for decades. Due to their persistence in both the biotic and abiotic environment over many years, PFAS are also referred to as "forever chemicals." Some PFAS exhibit toxic properties and can harm both the environment and human health.

Objective: To describe the chemical properties, adverse health effects, and main exposure sources of PFAS, with a particular focus on the skin and inflammatory skin diseases.

Materials and methods: An unrestricted literature search was conducted in PubMed and Google Scholar to prepare a narrative review. The search terms included the following: atopic dermatitis, cutaneous, forever chemicals, PFAS, PFOA, psoriasis, skin, skin cancer, skin disease.

Results: Human skin exposure to PFAS occurs either through direct contact with contaminated cosmetics, personal care products, and textiles, or indirectly through the redistribution of systemically absorbed PFAS. Depending on the specific PFAS compound, as well as the duration and level of exposure, these substances can suppress cutaneous immune responses, induce oxidative stress, and trigger proinflammatory tissue reactions. Epidemiological studies have shown an association between PFAS exposure and atopic dermatitis, particularly among female study participants.

Conclusion: The currently available epidemiological and experimental evidence regarding the effects of PFAS on skin health remains limited in scope and strength. Given the near-ubiquitous presence of PFAS in the environment, further research is urgently needed to better understand the associated risks to the skin and to develop targeted preventive strategies.

Tuberculosis (TB) remains one of the leading infectious diseases worldwide and continues to pose a significant threat to global health. Cutaneous tuberculosis (CTB) is a rare extrapulmonary manifestation, with lupus vulgaris being its most common variant in western industrialized nations. We report a case of tuberculosis cutis colliquativa, initially misdiagnosed as cutaneous sarcoidosis, in which complete clinical remission with scarring was achieved following several months of antitubercular chemotherapy.

Botulinum toxin type A (BTX-A) is an established component of dermatological practice and is primarily used for the treatment of facial expression lines as well as axillary hyperhidrosis, and also for off-label dermatological conditions. Worldwide, BTX‑A preparations are available that differ in composition, activity, dosage, and approved indications. An identical BTX‑A active substance may be marketed under different brand names with a similar formulation but different approved indications.

Anti-p200 pemphigoid is a rare subepidermal blistering dermatosis with variable clinical manifestations that can mimic other bullous skin diseases. We report the case of a 65-year-old patient presenting with extensive bullae on the palms and soles, as well as mucosal erosions. These findings were initially consistent with a diagnosis of erythema multiforme. Direct immunofluorescence (DIF) revealed linear IgA, IgG, and C3 antibody deposits along the dermoepidermal junction. While indirect immunofluorescence (IIF) on salt split skin demonstrated IgA and IgG antibodies binding on the dermal side of the split, immunoblot analysis revealed the presence of antibodies against the 200-kDa protein p200 as well as against laminin-β4. Based on these findings, the diagnosis of IgA-positive anti-p200 pemphigoid, a very rare variant barely described in literature, was made. This case highlights the importance of thorough differential diagnosis in blistering diseases and emphasizes the diagnostic value of immunohistochemical techniques.

Melanocytic nevi display numerous clinical and histopathologic variants that may create diagnostic uncertainty. Forms such as halo nevi, Meyerson nevi, Spitz nevi, recurrent nevi, blue nevi, special-site nevi, and hormonally influenced nevi may exhibit features suggestive of malignancy, yet none of these characteristics alone imply malignancy. Histopathologic findings such as asymmetry, pagetoid spread, cytologic atypia, or dermal mitoses therefore require interpretation within the clinicopathologic context. A complete excision in toto is of particular importance, as superficial shave biopsies may alter or destroy characteristic architectural patterns and increase the risk of misinterpretation. In addition to classic nevus subtypes, diagnostic borderline lesions (e.g., SAMPUS [superficial atypical melanocytic proliferation of uncertain significance]; MELTUMP [melanocytic tumor of uncertain malignant potential]; MANIAC [melanocytic acral nevus with intraepidermal ascent of cells]) are discussed. The updated World Health Organization classification has introduced the category of melanocytoma, encompassing tumors with intermediate biological potential that may be more clearly delineated through molecular diagnostics. This article provides practical insight into the relevance of clinical information, key histopathologic criteria, and ancillary immunohistochemical and molecular studies as the foundation for diagnostic accuracy and structured management at the interface of dermatology and dermatopathology.

Background: Skin rejuvenation requires a combination of different treatment modalities, including lasers, intense pulsed light (IPL), radiofrequency, high-intensity focused ultrasound (HIFU), botulinum toxin, and fillers. A combined approach is considered optimal; however, same-day combination treatments are generally avoided, and laser treatments are usually performed prior to injection of fillers or toxin due to concerns that light-based energy may inactivate or degrade these substances.

Objective: The aim of this publication is to provide an overview of the literature on the use of combination therapies and the resulting treatment recommendations.

Methods: The literature review identified numerous studies on combination therapies in which lasers and energy-based devices (EBDs) were applied on the same day as injections of botulinum toxin A.

Conclusion: The identified studies consistently reported clinical improvement and no reduction in the efficacy of botulinum toxin A when administered in close temporal proximity, except in the case of fractional radiofrequency microneedling and HIFU.