Dermatologie (Heidelberg, Germany)最新文献

Ex vivo confocal laser scanning microscopy (EVCM) is a novel diagnostic method for bedside use with the possibility to perform rapid dermatopathological examinations on fresh tissue, while directly creating digital pictures. The aim of this article is to provide an overview of current study results in the field of EVCM. Due to the large number of studies in dermatology, the focus is set on the diagnosis of dermatological diseases. Nonmelanocytic cancer (NMSC) is considered the most studied disease in EVCM with high potential for clinical application. In addition, more studies on other dermatological diseases, such as neoplastic, infectious and even rare dermatological diseases, have shown promising results. The potential implementation of artificial intelligence (AI) in EVCM could make bedside diagnostics even more efficient and accelerate the clinical workflow. EVCM offers a user-friendly technology that mimics dermatopathology, thus, establishing its importance as an innovative addition to conventional dermatohistopathology. In addition to technical challenges, the current lack of immunohistochemistry in EVCM remains a limitation.

Background: Numerous patients admitted to a general hospital present skin changes as secondary findings. Approximately 800 dermatological consultations are performed annually at the Leipzig University Medical Center.

Objectives: The aim of this study was, after implementation of teledermatological consulting, the retrospective evaluation of that and the resulting satisfaction of the physicians involved.

Materials and methods: We carried out an analysis of all consultation requests, which were answered using store-and-forward technology via the photo documentation app imitoCAM® (imito AG Zurich/Switzerland) and the clinical information system SAP® (SAP Deutschland SE & Co. KG Walldorf/Germany) from 1 February to 31 July 2023, as well as of questionnaires on satisfaction, which were sent to the participating physicians after the consultation.

Results: Our analysis included 419 consultation requests, 90 of which were answered teledermatologically. The consultation dermatologists stated that 92% of the cases could be solved using only telemedical instruments. Moreover, 90.9% of the consulting physicians rated the technical implementation as good to very good and 47.5% of the consultation dermatologists estimated a time saving of at least 30-60 min.

Conclusions: Our study shows the enormous potential of teledermatology in the inpatient setting. Implementation of teleconsultation enables more efficient consultations, reduces time- and cost-intensive transportation and offers patients a more comfortable dermatological evaluation with reduced risk of infection.

Background: The update of the World Health Organisation (WHO) classification of skin tumours has led to new aspects in the classification of melanocytic tumours.

Objectives: Presentation of the classification of melanocytic tumours in light of current clinical, histological and genetic data.

Materials and methods: Review of the classification of melanocytic neoplasms in the fifth edition of the WHO classification of skin tumours, taking into account current disease concepts.

Results: Malignant melanoma is characterised by stepwise tumour progression and is a heterogeneous disease. Benign and intermediate precursor lesions with characteristic driver mutations can be defined for the different melanoma subtypes. Melanocytomas represent a growing group of intermediate neoplasms which, from a genetic point of view, lie between nevi and melanomas and usually have a benign course.

Conclusion: With the update of the WHO classification, genetic parameters are becoming increasingly relevant and shape the terminology. New terms such as 'melanocytoma' require a medical understanding of current disease concepts and good physician-patient communication for appropriate reporting of findings and therapy.