Dermatologie (Heidelberg, Germany)最新文献

The thyroid gland is a key endocrine organ that influences whole-body physiology. The skin, as the largest organ, provides a visible window into internal processes and offers valuable diagnostic clues during clinical examination. This article highlights the secondary cutaneous manifestations of thyroid dysfunction and explores associations between thyroid disorders and dermatological diseases.

A deaf-mute patient suffering from erythrokeratodermia progressiva (keratitis-ichthyosis-deafness syndrome) presented to our clinic with mycotic and bacterial superinfection. An overview of the clinical, aetiopathogenetic and therapeutic aspects of this rare clinical condition is presented in the context of the patient's case.

Background: Neuromodulator treatments are widely accepted, highly popular and represent a hallmark of every aesthetic-oriented minimally invasive practice. Despite its limited adverse events profile, some unexpected negative clinical outcomes have been reported.

Objective: The goal of this work is to better understand the relationship between underlying anatomy and the occurrence of adverse events.

Methods: This article is designed as a narrative anatomic review summarizing the current anatomic literature and comparing it to the most frequently observed adverse events following treatment with neuromodulators.

Results: Eyebrow ptosis occurs most frequently when the injections are performed too far caudal, whereas eyelid ptosis can occur when the product is injected too deep. Asymmetric lip position can occur when the risorius or the depressor labii inferioris muscle are inadvertently targeted. Difficulties during swallowing or head anteflexion is most likely related to the administration of product into the deep layers of the neck (instead of the subdermal layer), thereby affecting the muscles deep to the platysma.

Conclusion: Knowledge of the three-dimensional facial anatomy is crucial when it comes to treatment with neuromodulators and should replace the previous concepts of two dimensions. Knowing that facial muscles are three- and not two-dimensional will guide practitioners toward safer procedures with less collateral damage and an increased safety profile when reducing facial rhytids with neuromodulators.

We report the case of a 22-year-old man who developed multiple flesh-colored papules during antiepileptic treatment with lamotrigine. Histopathological examination confirmed the diagnosis of lichen nitidus, showing a sharply demarcated lymphohistiocytic infiltrate in a typical "ball-and-claw" configuration. Despite discontinuation of lamotrigine, the lesions persisted, while topical corticosteroid therapy resulted in moderate improvement. This case highlights a rare possible association between lamotrigine and lichen nitidus and contributes to the discussion of drug-induced lichenoid dermatoses.

Tumescent local anesthesia (TLA) offers many advantages in major and minor dermatosurgical procedures, especially in elderly and multimorbid patients in whom general anesthesia is sometimes associated with major risks. LA intolerances are rare. In our experience, TLA is a safe method despite the mixture of different LA. Monitoring of the patient during TLA is necessary. Clarification of a history of LA intolerance prior to surgical treatment is useful; however, a negative test does not reliably rule out an allergic reaction.

Dermatosurgery plays a pivotal role in the management of cutaneous neoplasms, aiming not only at complete tumor removal but also at preserving functional and esthetic integrity. While conventional histopathology ensures high diagnostic accuracy, it is limited by processing time, artifacts, and restricted intraoperative availability. Novel imaging techniques such as confocal laser microscopy (CLM), optical coherence tomography (OCT), and line-field confocal OCT (LC-OCT) provide new opportunities for preoperative mapping, intraoperative margin assessment, and postoperative surveillance. Ex vivo confocal microscopy further allows rapid tissue analysis with minimal specimen loss. The synergistic use of multiple imaging modalities, together with artificial intelligence-assisted image interpretation, holds significant potential to refine dermatosurgical practice. These advances may contribute to more precise, patient-centered surgical care and reduce unnecessary re-operations.