Dermatologie (Heidelberg, Germany)最新文献

Aesthetic medicine is undergoing a substantial shift toward more objective, algorithm- and data-driven decision-making, with artificial intelligence (AI)-supported facial analysis playing a pivotal role. Modern systems such as CAARISMA™ capture the face holistically using anatomical landmarks, integrate these into the evaluation of different aesthetic dimensions, and translate them into easily interpretable scores such as Facial Aesthetic Index (FAI), Facial Youthfulness Index (FYI), and the Skin Quality Index (SQI). These indices enable standardized and reproducible aesthetic diagnostics, free from subjective, practitioner-specific influences. Clinically, they lead to more structured consultations, individualized treatment plans, and improved communication between physician and patient. At the same time, AI-based, data-driven aesthetic diagnostics and treatment planning can enhance efficiency and treatment quality in daily practice and allow for long-term monitoring of outcomes. Challenges at the interface between AI and aesthetics lie in the areas of bias, transparency, and data protection, all of which must be addressed to ensure responsible use of these technologies.

Erysipelas is an acute bacterial infection of the skin and lymphatic vessels, predominantly caused by Streptococcus pyogenes. Atypical localizations such as the trunk, as well as rare clinical variants including bullous or multifocal erysipelas, may complicate the diagnostic process and require differentiation from other blistering or widespread erythematous conditions, such as staphylococcal scalded skin syndrome (SSSS), toxic epidermal necrolysis (TEN) or cellulitis. In immunocompromised or oncologically pretreated patients, erysipelas should be considered even in unusual presentations.

Leflunomide is a an isoxazole derivative used as an immunosuppressive drug in rheumatoid arthritis and psoriatic arthritis. It is a pyrimidine synthesis inhibitor that has an inhibiting effect of tumor necrosis factor alpha (TNF α) signaling. We present a case of with generalized pustular skin lesions after intake of leflunomide, which resemble a pustular exacerbation of a pre-existing psoriasis as well as a generalized pustular psoriasis.

Soft tissue injections have become one of the most commonly performed minimally invasive procedures in aesthetic medicine. Concomitant to the rapid rise in performed treatments, reports of vascular complications have increased, including skin necrosis, and in rare cases even irreversible vision loss. The common denominator of these complications is the underlying anatomy: the face contains a dense and highly variable network of arteries and veins, interconnected through multiple anastomoses, making the prediction of their course difficult. An in-depth understanding of vascular and layer-specific anatomy as well as regional "danger zones" is hence essential for the safe and effective use of fillers and other injectable treatments. This article highlights the vascular and layered anatomy of the face, region-specific injection strategies, and evidence-based principles for the prevention and management of vascular complications.

A patient presented with bullous dermatosis. Clinically, the skin lesions showed a gyrate pattern resembling erythema gyratum repens (EGR). We diagnosed anti-p200 pemphigoid, which, like EGR, is a possible paraneoplasia. A search for tumors confirmed the presence of bronchial carcinoma. Other case reports with combined occurrence also point to underlying malignancies. This case highlights the importance of differential diagnosis in cases of figured efflorescences and bullous dermatoses and the need to investigate paraneoplasia.

Skin diseases affecting people with skin of color (SoC; Fitzpatrick skin types IV-VI) have not been given adequate attention in dermatological training in Germany. This study aims to present teaching formats developed to improve medical students' skills in managing these diseases. A literature search was conducted in PubMed Medline using predefined criteria, which resulted in seven studies being included. Most of the teaching formats were offered on a voluntary basis, with participant numbers ranging from 20 to 172. Our review shows that interventions focusing on SoC in dermatological education can enhance medical students' diagnostic abilities and subjective confidence in their skills. This overview may serve as a foundation for further integrating diversity-sensitive teaching into medical education.