Dermatologie (Heidelberg, Germany)最新文献

Porokeratosis ptychotropica is a very rare subtype of porokeratosis, which is a heterogeneous group of inherited keratinization disorders. It is associated with verrucous, extensive hyperkeratotic plaques in the perigenital, gluteal, and inguinal regions. Histologically, porokeratosis exhibits the pathognomonic hallmark known as cornoid lamellae. Treatment results are generally disappointing and recurrence rates are high.

In dermatologic surgery, surgical success depends not only on selecting an appropriate defect closure method but also on the postoperative course. The most common complications include local wound infections, followed by postoperative bleeding. In addition, venous stasis, wound dehiscence, as well as flap and scar hypertrophy may occur, potentially impairing functional and aesthetic outcomes. The primary goal is the early recognition and targeted management of complications to ensure patient satisfaction and optimal surgical results. An overview of the most common postoperative complications in dermatological surgery and their management is provided.

Background and objective: Historical three-dimensional (3D) reconstructions of skin diseases, known as "moulages," were once indispensable in medical education but diminished in importance with the advent of photography. However, 3D characteristics that cannot be conveyed through two-dimensional (2D) photographs are essential in dermatology for the accurate diagnosis of skin diseases. The aim of this study was to test the use of a moulage created with modern 3D technologies in dermatological education and training, and to evaluate its benefit for teaching primary skin lesions (efflorescences) compared to established teaching media.

Materials and methods: A 3D scan of a face was digitally augmented with five dermatological primary lesions: plaque, macule, nodules, scars, and pustules. Using 3D printing polyjet technology, a full-color, 3D model in a flexible photopolymer material was generated in original size. This model was evaluated through a cross-sectional survey at a German university dermatology department, involving 214 medical students in the second clinical year, 22 dermatology residents, and 9 board-certified dermatologists. The model was compared to 2D and virtual 3D representations of skin findings using structured questionnaires completed by the participants.

Results: Subjectively, participants believed that conventional photographs were the least effective means of correctly identifying skin eruptions. Higher scores for perceived diagnostic confidence were observed with virtual 3D models, with the highest scores achieved using the 3D moulage. Participants supported the integration of modern moulages into medical education and the potential use of 3D models for surgical training. Medical students in particular found 3D moulages helpful for learning dermatological efflorescences.

Conclusion: This study aimed to evaluate the usefulness of 3D technologies in modern dermatological education. Conventional 2D photography lacks the haptic information required for confident identification of primary skin lesions. Furthermore, 3D technologies enhance understanding and improve confidence in recognizing skin lesions. Modern 3D technologies offer an opportunity to enrich dermatological education through multisensory learning.

Background: The therapeutic effects of medical compression devices is determined not only by the resting pressure exerted at the ankle, which determines the compression classes I-IV, but also to a large extent by the elastic properties of the material during movement. These dynamic properties of compression stockings affect the massage effect on the lower extremity during movement and can be assessed using the stiffness of the compression material. Stiffness describes the increase in compression pressure under load due to the increase in circumference of the lower leg and can be determined using various methods both in vitro and in vivo.

Aim: The aim of our review is to shed light on the various aspects of the stiffness of compression devices in order to raise awareness of this therapeutically relevant influencing factor.

Materials and methods: From July 2024 to September 2024, a web-based literature search was conducted on the topic of stiffness, compression therapy and compression materials in PubMed, as well as in online journals and printed literature.

Results and conclusion: Stiffness is a separate predictor for the effectiveness of compression therapy and can be used specifically in everyday clinical practice to select the optimum compression garment for different indications and patients. In the future, it would be desirable for manufacturers of compression products to clearly define stiffness in the product information in order to close the current information gap in the market.

Background: Occasionally, tinea is a differential diagnostic option in lesions of nummular atopic eczema. Mycological diagnostics can yield quite unexpected results.

Objectives: Evaluation of the detection of rare geophilic dermatophytes on atopic eczema, using mycological data and its clinical interpretation.

Methods: Detailed conventional and genetic mycological work-up of scales collected from atopic eczema; correlation of the findings with the clinical context and the pertinent literature.

Results: On a lesion of nummular atopic dermatitis two rare geophilic dermatophytes were detected synchronously: Arthroderma (A.) onychocola and A. quadrifidum. This was only the third isolation of A. onychocola ever and the first one on glabrous skin and in Germany. The strain grew on human stratum corneum and perforated hair. A. quadrifidum did not show unusual features. No pathogenetic relevance of this twofold colonization was noted regarding the atopic eczema.

Conclusion: Obviously, A. onychocola is more prevalent than has been assumed up to now. Geophilic dermatophytes detected on atopic dermatitis are not necessarily pathogenetically relevant for eczema-such a colonization needs to be critically interpreted in relation to its clinical context. The determinants that allow geophilic dermatophytes to persist on human skin are still not understood.