BACKGROUND AND OBJECTIVES: Chronic pruritus (CP) significantly impairs quality of life (QoL), but existing patient-reported QoL tools are either not specific for CP or are very extensive. PATIENTS AND METHODS: The 5-item...BACKGROUND AND OBJECTIVES: Chronic pruritus (CP) significantly impairs quality of life (QoL), but existing patient-reported QoL tools are either not specific for CP or are very extensive. PATIENTS AND METHODS: The 5-item pruritus life quality (5PLQ, range: 5-25, 7-day recall) was developed to assess key itch-related QoL domains (sensory symptoms, impact on daily life, social interactions, sleep and psychological well-being). Adult patients with CP across nine European centers (n = 471) completed the 5PLQ twice, 60 minutes apart, and itch intensity (numerical rating scale/visual analogue scale) and QoL (Dermatology Life Quality Index/ItchyQol) scales. Construct and structural validity, internal consistency, convergent and external validity and test-retest reliability were analyzed. ROC analysis evaluated discrimination across QoL impairment levels. RESULTS: Mean 5PLQ scores were 15.0 ± 4.8 and 14.8 ± 5.0. The scale revealed good internal consistency reliability (Cronbach α: 0.816), weak to strong correlations across items (r = 0.343-0.619, p < 0.001) and strong to very strong correlations between single items and total score (r = 0.640-0.809, p < 0.001), strong correlations with QoL (r = 0.706-0.745, p < 0.001) and itch intensity (r = 0.407-0.608, p < 0.001), and high test-retest reliability (interclass correlation for single measures: 0.669). A cut-off of 13 best discriminated none/mild from moderate/severe impairment. CONCLUSIONS: The 5PLQ is a brief, validated, reliable and user-friendly tool for assessing itch-related QoL in CP.
BACKGROUND: The Psoriasis Area and Severity Index (PASI) is the standard measure for psoriasis severity but reflects only a single time point and may underestimate long-term disease burden. To assess whether the highest-...BACKGROUND: The Psoriasis Area and Severity Index (PASI) is the standard measure for psoriasis severity but reflects only a single time point and may underestimate long-term disease burden. To assess whether the highest-ever recorded PASI (PeakPASI) can serve as a marker of historical disease severity and correlate with treatment burden and comorbidities. PATIENTS AND METHODS: A cross-sectional analysis of 308 psoriasis patients from a German university hospital was conducted. Data on PASI, PeakPASI, therapies, and comorbidities were obtained from self-report and medical records. Group comparisons used non-parametric tests; Poisson regression assessed PeakPASI as a predictor of systemic therapy use and comorbidity burden. RESULTS: Median PeakPASI (11.4 [IQR 5.9-17.0]) exceeded current PASI (2.0 [IQR 1.0-5.1]). PeakPASI ≥ 10 was associated with more systemic therapies (p < 0.001), phototherapy (p < 0.001), smoking (p = 0.021), and diabetes (p = 0.020). PeakPASI correlated with number of systemic (ρ = 0.296), topical therapies (ρ = 0.367), and hospital visits (ρ = 0.186). It significantly predicted systemic therapy use (β = 0.355, p < 0.001), but not comorbidity burden. CONCLUSIONS: PeakPASI may complement current measures by reflecting historical severity and informing treatment. While not a cumulative burden marker, it may prevent underestimation of long-term disease impact. Prospective validation is warranted.
Beta-blockers have been proven to be safe and effective treatments for various medical conditions, but their full potential in dermatology remains to be fully understood. We conducted a comprehensive review of clinical t...Beta-blockers have been proven to be safe and effective treatments for various medical conditions, but their full potential in dermatology remains to be fully understood. We conducted a comprehensive review of clinical trials published between January 2000 and August 2025. 41 studies were included, exploring the use of beta-blockers for any dermatological conditions, involving over 4,000 people worldwide. Our findings show strong evidence that beta-blockers are the first-line treatment for infantile hemangiomas. Additionally, they reduce mortality in patients with burns, accelerate wound healing in chronic venous and diabetic ulcers, and improve skin graft donor sites. Emerging data suggest benefits in rosacea, pyogenic granulomas, post‑procedural erythema, and as an adjunct to immune checkpoint inhibitors in melanoma, alongside a favorable safety profile in clinical trials. However, beta‑blockers can exacerbate inflammatory dermatoses, may interfere with the management of anaphylaxis, and exert complex effects on cutaneous immunity. Overall, beta‑blockers are evolving into versatile dermatologic tools whose expanding indications must be balanced against their immunologic and cardiovascular risks, and further high‑quality trials are needed to standardize their use in these emerging applications.
BACKGROUND AND OBJECTIVES: Despite receiving similar information about outpatient dermatologic surgical procedures, some patients still hold misconceptions about the nature of their lesions and the treatment. No studies...BACKGROUND AND OBJECTIVES: Despite receiving similar information about outpatient dermatologic surgical procedures, some patients still hold misconceptions about the nature of their lesions and the treatment. No studies have been done to understand this difference in the perception of surgery. Therefore, this study aimed to assess patients' perceptions of their condition and the planned surgical intervention, to identify potential influencing factors, and to evaluate the concordance between preoperative information and postoperative experience. PATIENTS AND METHODS: A single-center descriptive observational study was conducted using surveys provided to patients who underwent dermatologic surgery between September 2023 and August 2024. RESULTS: A total of 302 patients were enrolled. Significant differences were found when evaluating disease perception based on the nature of the lesion, emotional responses depending on sex and previous surgical history. Differences were also observed in patients' perceptions of the surgery based on the operative technique used in terms of duration and complexity. Finally, wound care perception also showed significant differences depending on the surgical technique used. CONCLUSIONS: Patients' perceptions of dermatologic surgery are primarily shaped by the information provided and their own expectations. Several factors may influence and explain the differences and misconceptions observed among patients.
Solid organ transplant (SOT) recipients have a higher chance of developing cancers due to immunosuppressive therapy. Among post-SOT skin cancers, the most common is squamous cell carcinoma, while post-transplant cutaneou...Solid organ transplant (SOT) recipients have a higher chance of developing cancers due to immunosuppressive therapy. Among post-SOT skin cancers, the most common is squamous cell carcinoma, while post-transplant cutaneous T-cell lymphoma (PT-CTCL) is less known because of its rare prevalence. Understanding PT-CTCL is important to improve therapeutic approaches and aftercare in these patients. To evaluate manifestations, characteristics, management strategies, and outcomes of PT-PTCL in SOT patients, a systematic search was conducted through PubMed/Medline, Scopus, Web of Science, and Embase until July 28th, 2024. Inclusion criteria were centered around the new onset of CTCL after organ transplantation. Following PRISMA guidelines, 50 studies including 111 patients were included. Most patients who developed PT-PTCL were males (79.3%), and the mean age was 51.9. Kidney transplantation was the most frequent transplant type among patients who developed PT-CTCL (60.4%). This was followed by the heart (17.1%), liver (17.1%), and lung (2.7%). Among 105 patients with available data, complete remission was achieved for 42 (39.6%), and partial response was observed in 13 (12.3%). PT-PTCL is associated with prolonged immunosuppressive therapy. Personalized treatment and modifications to immunosuppression regimens are critical. Further research into immunological and molecular pathways is essential to achieve better management approaches.
BACKGROUND AND OBJECTIVES: Closed venereology wards existed in both Western and Eastern European dictatorships. These institutions isolated, disciplined, and "educated" individuals with Sexually Transmitted Infections (S...BACKGROUND AND OBJECTIVES: Closed venereology wards existed in both Western and Eastern European dictatorships. These institutions isolated, disciplined, and "educated" individuals with Sexually Transmitted Infections (STI) or suspected infections. In 2024, 220 patient records from the closed venereology ward of Dresden-Friedrichstadt Hospital were discovered in the Dresden City Archive. The records were analyzed to gain insight into the care of girls and women admitted under coercion. PATIENTS AND METHODS: The patient records were critically reviewed and descriptively analyzed. Data collected included: referring institution, reason for admission, type of treatment, and admission/discharge dates. RESULTS: Most records date from 1969. A total of 84 women were admitted with a diagnosed STI, 70 for a "social indication" (vagrancy), and 77 for a dermatological condition. Patients with an STI or a "social indication" underwent daily gynecological smear tests. They also received three to four provocation procedures intended to activate latent infections for diagnostic detection. Confirmed STIs were treated with penicillin. CONCLUSIONS: The Dresden ward reflects the GDR system of closed venereology wards: underage girls and women were forcibly admitted, disciplined, and isolated. Many admissions were unlawful. The closed venereology ward of Dresden-Friedrichstadt Hospital represents a chapter in Europe's history of politicized medicine.
BACKGROUND: Full-thickness nasal defects of the tip, soft triangle, and ala are commonly reconstructed using a paramedian forehead flap with cartilage grafts or an epithesis. However, these approaches may be associated w...BACKGROUND: Full-thickness nasal defects of the tip, soft triangle, and ala are commonly reconstructed using a paramedian forehead flap with cartilage grafts or an epithesis. However, these approaches may be associated with donor-site morbidity and psychological burden. Cartilage grafts are generally considered necessary to prevent nostril collapse during inspiration. The aim of this study was to assess whether cartilage grafting is required to prevent nasal collapse and to evaluate patient satisfaction, complications, and functional and aesthetic outcomes. PATIENTS AND METHODS: This case series analysed postoperative outcomes in 10 patients following two-stage folded paramedian forehead flap reconstruction without cartilage grafts. Median follow-up was 14 months. Outcomes included patient satisfaction as well as functional and aesthetic results. RESULTS: All patients reported being satisfied or very satisfied with their long-term postoperative outcomes. Nasal airflow on the reconstructed side was preserved without impairment. No cases of nostril collapse during inhalation were observed. Additionally, no hypertrophic scarring or tissue necrosis occurred. CONCLUSIONS: Two-stage reconstruction of full-thickness nasal defects using a folded paramedian forehead flap without cartilage grafts provides good functional and aesthetic outcomes with high patient satisfaction. In most cases, additional cartilage grafting appears unnecessary.
BACKGROUND AND OBJECTIVES: Melanocytic nevi show distinct age-related dermoscopic patterns. However, data on age-related patterns of melanomas are lacking. This study aimed to identify age-related static and dynamic derm...BACKGROUND AND OBJECTIVES: Melanocytic nevi show distinct age-related dermoscopic patterns. However, data on age-related patterns of melanomas are lacking. This study aimed to identify age-related static and dynamic dermoscopic patterns of melanomas. PATIENTS AND METHODS: Explorative cross-sectional cohort study between October 1996 and May 2012, including 832 patients at increased melanoma risk monitored by total body photography (TBP) and sequential digital dermoscopy (SDD). Patients were categorized into age groups I: < 31 years (n = 308), II: 31-50 years (n = 340), and III: > 50 years (n = 184). Dermoscopic features of melanoma-suspicious lesions were prospectively characterized before excision. RESULTS: During the study, 1,770 of 14,896 monitored lesions were excised. Histopathology confirmed 190 (10.7%) melanomas. In comparison to melanomas of other age groups, we found "signature features" for age group I: "blue whitish veil" and "symmetrical enlargement without globules", age group II: appearance of "irregular pigmentation" and "irregular dots/globules", and age group III: "regression structures" and appearance of "atypical pigment network", "atypical vascular pattern", and "blue whitish veil". In contrast, unique age-related features of excised nevi were "symmetrical enlargement with globules" in age group I, and "no enlargement" in age group III. CONCLUSIONS: Our explorative study identified a number of age-related static and dynamic dermoscopic features that might be helpful to detect melanomas.