Blume-Peytavi U, Constantinou A, Tomova-Simitchieva T
… +11 more, Tanew A, Sticherling M, Girschick H, Vogt A, Schwichtenberg U, Gieler U, Märtens A, Zienert K, Stenders C, Werner RN, Wilborn D
In the project funded by the Innovation Committee at the G-BA, the S3 guideline for the diagnosis and treatment of AA was developed between 2023 and 2025. The interdisciplinary expert panel consisted of representatives f...In the project funded by the Innovation Committee at the G-BA, the S3 guideline for the diagnosis and treatment of AA was developed between 2023 and 2025. The interdisciplinary expert panel consisted of representatives from the German Dermatological Society, in particular from the Pediatric Dermatology Working Group, the Professional Association of German Dermatologists, the German Society for Psychosomatic Medicine and Psychotherapy, the German Society for Pediatrics and Adolescent Medicine, the Austrian Society for Dermatology and Venereology, a hairdresser as an external consultant and two patient representatives. In the first of two parts, we present the key statements on epidemiology and the recommendations for diagnosis. Data from Germany show a population-based prevalence of AA of 0.22% (95% CI 0.21-0.22) for 2016 and 0.21% (95% CI 0.20-0.22) for 2020. This means that 170,000 people in Germany were diagnosed with alopecia areata (AA) in 2020. International data show a pooled prevalence of 2.1%, but with large regional differences. Data on the incidence of AA from Germany show that 72 patients per 100,000 were newly diagnosed with AA in 2020 (RR 0.072%; 95% CI 0.07-0.08). Extrapolated to the German population, this means that around 70,000 people were newly diagnosed with AA in 2020.
BACKGROUND: The teaching of elementary skin lesions and the ABCDE rule are central components of undergraduate medical education in dermatology. This content is typically taught using photographs, moulages, or patient ex...BACKGROUND: The teaching of elementary skin lesions and the ABCDE rule are central components of undergraduate medical education in dermatology. This content is typically taught using photographs, moulages, or patient examples. Independent practice under supervision, however, is often difficult to implement in everyday clinical work. Standardized patients (SPs) equipped with moulages offer an opportunity to link technical content with communication skills. PATIENTS AND METHODS: Using temporary, two-dimensional transfer tattoos or three-dimensional moulages, a wide range of common skin and nail changes can be realistically depicted on standardized patients and integrated into medical student teaching. Questionnaire-based evaluations and the results of a clinical, practical exam (Objective Structured Clinical Examination, OSCE) were used to assess the benefit and compare the required level of complexity. RESULTS: Eighty-six medical students in Leipzig participated in a voluntary small-group dermatology examination course to improve lesion description and skin cancer screening skills. Two-dimensional transfer tattoos specifically highlighted often-overlooked skin areas and supported training in conveying clinical findings. A total of 83.7 % of students reported a benefit from using two-dimensional tattoos. In the OSCE exam, no significant difference was observed between two- and three-dimensional depictions (p = 0.082; mean scores 22.54 vs. 23.28). CONCLUSIONS: Transfer tattoos provide a simple and effective means of creating realistic dermatology teaching and examination scenarios. Two-dimensional tattoos are not inferior to more complex three-dimensional moulages when used with standardized patients in an examination context.
BACKGROUND AND OBJECTIVES: Atopic dermatitis and psoriasis are chronic inflammatory skin diseases often linked to psychological stress. Integrative care models are lacking. This randomized pilot study aimed to develop an...BACKGROUND AND OBJECTIVES: Atopic dermatitis and psoriasis are chronic inflammatory skin diseases often linked to psychological stress. Integrative care models are lacking. This randomized pilot study aimed to develop and test a psychoeducational intervention for dermatology patients. PATIENTS AND METHODS: Patients with a PHQ-2 score ≥ 3 at an outpatient inflammation center were randomized into an intervention or control group. The intervention group received three standardized educational sessions focusing on maladaptive schemas, coping strategies, psychoeducation, and emotion-focused techniques (e.g. chair-dialogues, imaginary rescripting). RESULTS: 19 patients received the intervention; 13 were in the control group. Post-intervention, significant improvements were observed in dermatological quality of life (DLQI), subjective well-being (WHO-5), and depressive symptoms (PHQ-9, BDI-II). Psychological benefits were largely independent of disease severity (PASI, EASI). Qualitative feedback highlighted usability, learning specific techniques, and a trusting therapeutic relationship. CONCLUSIONS: A brief psychoeducational intervention significantly reduced psychological stress in dermatology outpatients. Further studies are needed to evaluate long-term effects and broader implementation.
Gina M, Fartasch M, Bauer A
… +14 more, Drexler H, Elsner P, Geier J, John SM, Schliemann S, Altenburg C, Brans R, Lunter DJ, Nast A, Pieper B, Schlieter A, Staubach P, Thielitz A, Zeyen C
J Dtsch Dermatol Ges
· 2026 May · PMID 41838028
·
Full text
The AWMF S1 guideline 013/056 "Occupational Skin Products: Protective Creams, Skin Cleansers and Skin Care Products" from 2014 has been revised and upgraded to S2K level. The aim was to develop a decision aid for the opt...The AWMF S1 guideline 013/056 "Occupational Skin Products: Protective Creams, Skin Cleansers and Skin Care Products" from 2014 has been revised and upgraded to S2K level. The aim was to develop a decision aid for the optimal use of occupational skin products for the prevention of hand eczema in the workplace. The multidisciplinary expert commission included representatives from dermatology, occupational medicine and dermopharmaceutical societies, as well as from German Social Accident Insurance. The update was conducted through a non-systematic review of current (inter)national scientific literature, focusing on randomized controlled clinical trials. The revised guideline integrates: (1) epidemiological studies demonstrating the effectiveness of skin protection and care, (2) results from the Cochrane Review on the primary prevention of occupational hand eczema, (3) skin physiological multicenter studies on the application and benefits of skin protection creams and the tolerability of skin cleansing products, (4) specific investigations on wet work, and (5) current positions on aluminum chlorohydrate and contact allergens based on opinions of the Scientific Committee on Consumer Safety (SCCS) and data from the Information Network of Departments of Dermatology (IVDK). The recommendations and key statements were agreed upon in a structured consensus conference using a nominal group process under professional moderation. The S2K guideline aims to improve the prevention of occupational hand eczema and promote the health of employees.
Hummel T, Papapostolou G, Broermann M
… +9 more, Dresler C, Flessenkämper I, Jünger M, Stenger D, Mühlberger D, Sidhwa Y, Falkenstein T, Stücker M, Mumme A
BACKGROUND: Same-site recurrence at the sapheno-femoral junction (SFJ) takes up a large amount of the daily practice of phlebologists. Follow-up data for high-ligation and stripping (HL/S) of the great saphenous vein (GS...BACKGROUND: Same-site recurrence at the sapheno-femoral junction (SFJ) takes up a large amount of the daily practice of phlebologists. Follow-up data for high-ligation and stripping (HL/S) of the great saphenous vein (GSV) are quite heterogenous and incoherent. This prospective multicentric study was designed to elucidate the outcome after standardized HL/S with special focus on same site groin recurrences. PATIENTS AND METHODS: A standardized HL/S of the GSV, including closure of the cribriform fascia, was performed. The primary endpoint was same-site groin recurrence, assessed by clinical examination and duplex ultrasonography. Secondary endpoints were recurrences at different sites. RESULTS: 405 patients (519 legs) from six German vein centers were included. 225 patients (287 legs, 55.56%) were available for the five-year follow up examination. 21 legs (7.32%) suffered from clinically apparent varicosis. Same site groin recurrences were detected in five (1.74%) cases, of which only two were clinically relevant. Most clinically apparent varicose veins were caused by perforator insufficiencies. CONCLUSIONS: The standardized technique of HL/S including ligation of small tributaries of the common femoral vein near the SFJ as well as the closure of the cribriform fascia as an anatomical barrier shows excellent results after five years.
BACKGROUND AND OBJECTIVES: Outpatient care of venous leg ulcers (VLU) is a problem of high medical and health economic relevance. Treatment is often inconsistent and not guideline-compliant. The project Ulcus Cruris Care...BACKGROUND AND OBJECTIVES: Outpatient care of venous leg ulcers (VLU) is a problem of high medical and health economic relevance. Treatment is often inconsistent and not guideline-compliant. The project Ulcus Cruris Care investigated the VLU outpatient care situation in Germany. PATIENTS AND METHODS: Reimbursement data of 40,046 patient cases (2015-2019) with VLU diagnosis from a statutory health insurer (AOK Baden-Wuerttemberg, Germany) were retrospectively analyzed. Outcome assessment was based on prescriptions, medical aids, nursing care, use of compression devices, surgical procedures and treatment costs. RESULTS: 47.3% (n = 7,581) of patients without contraindication received a compression device within 90 days. 2.3% (n = 135) received surgical truncal vein interventions. 14.1% (n = 771) received consistent compression therapy associated with faster wound healing (121.6 ± 86.2 vs. 188.1 ± 164.2 days, p < 0.001), lower total costs (4,280 ± 5,326 € vs. 5,683 ± 9,657 €, p < 0.001) and lower disease-specific costs (2,498 ± 2,785 € vs. 2,797 ± 5,145 €, p = 0.017) versus no or unsteady treatment. CONCLUSIONS: In outpatient VLU care around 80% of patients do not receive consistent compression therapy and are therefore not adequately treated. There is an urgent need for action to improve treatment of patients with VLU in Germany.
OBJECTIVE: To investigate the variants of the CYLD gene in Chinese patients with multiple familial trichoepithelioma (MFT), aiming to provide a scientific basis for genetic counseling and prenatal diagnosis, thereby crea...OBJECTIVE: To investigate the variants of the CYLD gene in Chinese patients with multiple familial trichoepithelioma (MFT), aiming to provide a scientific basis for genetic counseling and prenatal diagnosis, thereby creating favorable conditions for intervention treatment and improving the prognosis of patients. PATIENTS AND METHODS: Whole-exome sequencing (WES) was performed in patients from eleven families to identify candidate variants, which were subsequently confirmed by Sanger sequencing. The minigene technique was used to perform functional analyses of the variants c.2342-8C>G and c.1685-9T>G. Whole-genome sequencing (WGS) was applied in patients with negative WES results. RESULTS: All 41 patients presented with multiple papules or nodules on the nose. We identified six novel pathogenic variants and three recurrent pathogenic variants. Conversely, no gene variants were detected in four patients. The c.1685-9T>G variant caused aberrant mRNA splicing, resulting in the insertion of an 8-base intronic sequence into the mRNA and subsequent premature termination, while the variant c.2342-8C>G led to premature mRNA splicing seven bases upstream of the canonical splice site. CONCLUSIONS: This study identified six novel and three recurrent pathogenic variants in the CYLD gene among 41 patients with MFT. Comprising the largest sample size report in this field to date, this work considerably expands the mutational spectrum of the CYLD gene (currently comprising 144 variants) and carries important implications for genetic counseling.