Dermatologie (Heidelberg, Germany)最新文献

Treatment of diabetic foot is challenging due to the complex pathophysiological mechanisms, various clinical manifestations, severe complications with considerable impairment of quality of life, and the need for special, individualized treatment strategies. Particularly in the case of diabetic foot ulcers, conventional therapies are not always effective, so new treatment strategies are needed. This review aims to present alternative therapies with current efficacy data for diabetic foot ulcers that may be suitable for treatment-refractory ulcers. Platelet-rich plasma and stem cells have regenerative and anti-inflammatory effects and show good results in the treatment of diabetic ulcers, while ozone therapy improves local circulation and antioxidant levels. Wearable devices could become crucial for the long-term monitoring of patients with diabetic foot as they allow early identification of ulcers or infections. There are also literature reports of alternative treatments (e.g., maggot debridement, honey dressings, acupuncture) that have been used successfully for treatment-refractory ulcers, demonstrating how diverse the management of the diabetic foot can be.

Diabetes may have an impact on aesthetic medicine, influencing both the safety and efficacy of various aesthetic procedures. Key aspects of the impact of diabetes on aesthetic medicine are summarized. Individuals with diabetes often experience dry skin, a condition known as xerosis, which may affect the overall texture and appearance of the skin. Diabetes can compromise the immune system, making individuals more susceptible to skin infections. Aesthetic procedures involve the introduction of foreign substances, and compromised skin integrity may heighten the risk of infection. This underscores the importance of strict hygiene and postprocedure care to minimize the risk of complications. Delayed wound healing can be a significant concern in aesthetic procedures where incisions, injections, or other manipulations are made, as impaired healing may affect the final outcome and increase the risk of complications. Collagen metabolism, affecting the elasticity and structural integrity of the skin, may influence the long-term results of procedures such as dermal fillers, where collagen plays a crucial role in maintaining skin volume and firmness. Diabetes is linked to vascular complications, including poor blood circulation, which may have implications for procedures like laser treatments or other interventions that rely on adequate blood supply for optimal results.

Erythema nodosum (EN) is the most frequently occurring form of acute panniculitis. It is characterized by painful red to livid raised nodules or bumps that typically occur symmetrically in the shin area. The cause of EN is often a reaction of the immune system to various triggers including infections, inflammatory diseases or medications. In approximately half of the cases no trigger can be identified. After treatment of the underlying pathology EN is typically self-limiting.

Diabetes mellitus (DM) is a debilitating, life-limiting disease. According to recent estimates, 415 million adults currently suffer from the disease. This number is expected to rise to 642 million by 2040. Skin disorders can often predict the onset of this metabolic disorder. Uncontrolled hyperglycemia impairs the overall immunity of patients with DM, involving various mechanistic pathways, resulting in the diabetic skin being immunocompromised and prone to bacterial infections. Among others, diabetic foot infections are very common. In this article, we have focused on the association of DM with different types of bacterial skin infections and resistance patterns to antimicrobial agents commonly used in the treatment of diabetes-associated infections.

Background and objectives: Granuloma annulare (GA) is a noninfectious, granulomatous dermatosis that is generally localized and self-limiting. In 15% of cases, the disease disseminates with protracted trajectories. This study aims to characterise the patient population with disseminated GA at a German university hospital and to explore treatment modalities.

Materials and methods: A retrospective monocentric evaluation was conducted at the University Hospital Regensburg between 2021 and 2023 with descriptive statistical analysis of the patient population and the treatment modalities used.

Results: During the specified period, 239 patients with GA were identified, 33 of whom had histologically confirmed disseminated GA. Of the patients, 25 (76%) were women. Average age was 57.4 ± 14.4 years. Furthermore 17 patients (53%) denied symptoms. Common symptoms included dysesthesia, itching and pain. Frequent concomitant diseases were diabetes mellitus, thyroid disease, atopic dermatitis and coronary heart disease. Topical glucocorticoids, systemic glucocorticoids, phototherapy, topical calcineurin inhibitors and dimethyl fumarate were used therapeutically in descending frequency. Only 6 patients (18%) showed partial or complete remission.

Conclusion: Due to the lack of approved therapies, disseminated GA is treated with inadequately effective regimens. Prospective randomized placebo-controlled trials are needed to investigate the efficacy of novel targeted therapies.