Nguyen L, Kimmig W, Hammes S
… +2 more, Schneider SW, Seeber N
J Dtsch Dermatol Ges
· 2026 Mar · PMID 41797616
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Laser and energy-based devices (EBDs) are firmly established in dermatology and widely used for both medical and aesthetic purposes. Even with advanced safety features such as integrated cooling and real-time monitoring,...Laser and energy-based devices (EBDs) are firmly established in dermatology and widely used for both medical and aesthetic purposes. Even with advanced safety features such as integrated cooling and real-time monitoring, these procedures still carry inherent risks. Complications may occur as a result of inappropriate device choice, suboptimal parameter settings, insufficient patient evaluation, or limited operator experience. This CME article provides an overview of the spectrum of adverse events associated with dermatologic laser and EBD treatments, ranging from expected short-term reactions to late complications, including pigmentary alterations, scarring, and ocular injury. Strategies for prevention and management are outlined, with particular attention to the importance of patient selection, treatment planning, and post-procedure care. In addition, regulatory frameworks in Germany, such as the Verordnung zum Schutz vor schädlichen Wirkungen nichtionisierender Strahlung bei der Anwendung am Menschen (NiSV), and initiatives like the complications registry of the German Dermatological Society of Laser Medicine are highlighted as important measures to enhance patient safety. A comprehensive understanding of potential risks and their mitigation is essential to ensure safe practice and optimize clinical outcomes in laser dermatology.
OBJECTIVE: This study investigates the association of melanoma risk with total-body nevus count and the presence of atypical nevi in younger (< 40 years) and older (> 60 years) individuals. METHODS: A pooled analysis was...OBJECTIVE: This study investigates the association of melanoma risk with total-body nevus count and the presence of atypical nevi in younger (< 40 years) and older (> 60 years) individuals. METHODS: A pooled analysis was conducted within the M-SKIP project, based on multiple melanoma case-control studies. Associations were assessed through study-specific odds ratios (ORs), adjusted for potential confounders. RESULTS: Nine case-control studies were included, analyzing common nevi (2,674 melanoma cases/2,343 controls) and atypical nevi (2,459 cases/1,740 controls). High common nevus count was associated with increased melanoma risk in both younger (summary [s]OR = 2.56; 95% CI 1.64-4.01; I = 31%) and older individuals (sOR = 2.06; 95% CI 1.06-4.00; I = 67%), with no significant age-group difference (p = 0.57). In contrast, younger individuals exhibited a markedly higher risk of melanoma associated with the presence of at least one atypical nevus (sOR = 4.84, 95% CI 2.18-10.76; I = 65%) compared to older individuals (sOR = 1.71 95%CI 1.07-2.74; I = 39%), with a p value for the difference of 0.02. CONCLUSIONS: These findings suggest age-specific differences in melanoma risk associated with nevus burden. Specifically, atypical nevi are a stronger risk factor in younger individuals. This could have significant implications for prevention strategies and clinical management, in particular for better identification of high-risk groups for targeted secondary prevention efforts.
BACKGROUND: Erythropoietic protoporphyria (EPP) is a rare genetic disorder characterized by severe phototoxic reactions that occur within minutes of light exposure. In clinical studies, afamelanotide has been shown to pr...BACKGROUND: Erythropoietic protoporphyria (EPP) is a rare genetic disorder characterized by severe phototoxic reactions that occur within minutes of light exposure. In clinical studies, afamelanotide has been shown to prolong pain-free sun exposure, improve quality of life, and reduce the frequency and severity of phototoxic reactions. OBJECTIVE: To present the real-world data of the Austrian EPP cohort treated with afamelanotide. PATIENTS AND METHODS: Data from all Austrian EPP patients treated with afamelanotide in 2023 (n = 20) were analyzed and compared to baseline data on quality of life, phototoxic burn tolerance time (PBTT), reported UV index on the day with the longest PBTT, and incidence and severity of phototoxic reactions. RESULTS: Before treatment, the EPP QoL score had a median of 11.11 (IQR 3.03-19.44) and increased to a median of 79.17 (IQR 75.00-97.22) under therapy. Phototoxic burn tolerance time (PBTT) increased from a median of 15 minutes (IQR 10-25) to a median of 250 minutes (IQR 120-300) under therapy. Before therapy 88% of patients had phototoxic reactions, while on therapy only 33% were affected. Treatment side effects were only mild and transient. CONCLUSIONS: The real-world data of the Austrian cohort confirm the effectiveness and safety of afamelanotide in EPP patients.
Lindemann H, Mauritz MD, Rehmann V
… +3 more, Paulussen M, Frank J, Aydin M
J Dtsch Dermatol Ges
· 2026 Apr · PMID 41786680
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Mycoplasma pneumoniae (MP) is a common pathogen responsible for diverse infections in children and adolescents, primarily affecting the respiratory tract. Besides causing atypical pneumonia, MP can also lead to extrapulm...Mycoplasma pneumoniae (MP) is a common pathogen responsible for diverse infections in children and adolescents, primarily affecting the respiratory tract. Besides causing atypical pneumonia, MP can also lead to extrapulmonary manifestations, including mucocutaneous, hematological, neurological, cardiac, and gastrointestinal symptoms. These extrapulmonary manifestations are often overlooked, complicating diagnosis and management. Here, we delineate the spectrum of cutaneous and non-cutaneous diseases caused by MP in children, focusing on the pathophysiology, clinical features, and treatment of mucocutaneous manifestations.
Kirtschig G, Woelber L, Günthert A
… +23 more, Becker K, Ciresa-König A, Fischer B, Fricke-Otto S, Günther C, Hirchenhain C, Köllmann NH, Kreuter A, Malisiewicz B, Neis F, Mon O'Dey D, Ott H, Promm M, Renner R, Schardt AR, Schweizer I, Stein R, Ter-Nedden J, Trutnovsky G, Wand A, Weyandt G, Werner RN, Kinberger M
J Dtsch Dermatol Ges
· 2026 Apr · PMID 41778748
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The German-language, consensus- and evidence-based S3 guideline on lichen sclerosus (LS) was developed based on the European "EuroGuiDerm Guideline on lichen sclerosus" under the leadership of the German Dermatological S...The German-language, consensus- and evidence-based S3 guideline on lichen sclerosus (LS) was developed based on the European "EuroGuiDerm Guideline on lichen sclerosus" under the leadership of the German Dermatological Society (DDG) and the German Society for Gynecology and Obstetrics (DGGG). Particular emphasis was placed on adapting the recommendations to the healthcare conditions in German-speaking countries. The interdisciplinary guideline development group consisted of 24 experts from 16 medical societies and actively included patient representatives in the development process. The guideline provides comprehensive recommendations on diagnosis, patient management, follow-up care, and patient education, as well as the treatment of both genital and extragenital LS in women, men, girls, and boys. Regardless of age or sex, ultrapotent or potent topical glucocorticosteroids in combination with emollients remain the standard therapy for genital LS. In male patients with LS-associated phimosis who do not respond sufficiently to standard therapy, circumcision with complete removal of the foreskin is indicated. For extragenital LS, phototherapy with UV light is recommended as an adjunct to topical treatment. Topical calcineurin inhibitors are second-line therapy.
BACKGROUND: The aim of this analysis was to assess the burden of hidradenitis suppurativa (HS) in Germany. PATIENTS AND METHODS: This was a retrospective German statutory health insurance claims data analysis covering th...BACKGROUND: The aim of this analysis was to assess the burden of hidradenitis suppurativa (HS) in Germany. PATIENTS AND METHODS: This was a retrospective German statutory health insurance claims data analysis covering the years 2020-2022 and 4.1 million individuals. An HS prevalence cohort and matched non-HS cohort representing the general population were analyzed regarding burden of disease indicators. An HS incidence cohort was analyzed regarding flare occurrences. RESULTS: Adult HS patients showed a significantly higher prevalence of comorbidities including a 3.58 (95% CI: 3.30; 3.85) higher prevalence for a mental/behavioral disorder due to tobacco, 2.72 (95% CI: 2.61; 2.83) for obesity, 2.56 (95% CI: 2.40; 2.73) for diabetes, 2.00 (95% CI: 1.86; 2.14) for pain and 1.69 (95% CI: 1.62; 1.76) for depression compared to matched non-HS individuals, respectively. HS patients aged ≥ 50 years had a numerically higher risk of death (risk ratio 1.57; 95% CI 0.96-2.17). Among deceased HS patients, the mean number of years of life lost ranged from 20.46 to 25.91 during the period 2020-2022. Finally, 24.4% experienced at least one HS flare requiring medical treatment within 24 months following their initial HS diagnosis. CONCLUSION: The results of this analysis reveal that HS patients experience a substantial burden of disease compared to non-HS patients.
Erosive pustular dermatosis of the lower legs (EPDL) is a rarely diagnosed, chronic inflammatory skin disease that occurs predominantly in elderly people. Predisposing factors include skin atrophy, chronic venous insuffi...Erosive pustular dermatosis of the lower legs (EPDL) is a rarely diagnosed, chronic inflammatory skin disease that occurs predominantly in elderly people. Predisposing factors include skin atrophy, chronic venous insufficiency, and trauma. Although the pathogenesis of EPDL has not yet been conclusively clarified, there are ongoing discussions on its nature as a neutrophilic dermatosis in which exogenous triggers lead to immunological dysregulation with local skin damage. Clinically, EPDL manifests with superficial, sterile pustules from which sharply defined erosions develop. The predilection sites are the middle third of the lower leg extensor sides. It is a diagnosis of exclusion, which makes diagnostic differentiation more difficult. Potent topical glucocorticoids with a high therapeutic index (TIX) and calcineurin inhibitors are used therapeutically. Systemic immunomodulating therapies are reserved for refractory courses. Optimization of wound care is also important. In the long term, education and skin care are at the forefront of the complex and often long-term treatment. Due to the chronic recurrent course and the risk of secondary ulcerations and superinfections, early diagnosis and individual treatment planning is important. Interdisciplinary and interprofessional collaboration can make a decisive contribution to improve quality of life of affected patients and reduce the risk of complications.
Aliu A, Wehry UP, Oellig F
… +8 more, Gambichler T, Burmann SN, Vidakovic M, Kionke J, Distler JHW, Györfi AH, Müller VL, Kreuter A
J Dtsch Dermatol Ges
· 2026 Jun · PMID 41762004
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Adult-onset dermatomyositis (DM) is frequently associated with underlying malignancies, especially in individuals with anti-TIF1-γ or anti-NXP-2 autoantibodies. This case series describes 10 cases of DM with periorbital...Adult-onset dermatomyositis (DM) is frequently associated with underlying malignancies, especially in individuals with anti-TIF1-γ or anti-NXP-2 autoantibodies. This case series describes 10 cases of DM with periorbital heliotropic erythema and eyelid edema (PHEEE), in which an underlying malignancy was confirmed by imaging in 9 patients. By incorporating additional serological markers and clinical characteristics described in the literature, a simple criteria list is provided to aid in the assessment of a paraneoplastic etiology in DM. The presence of PHEE appears to constitute a clinically relevant indicator of paraneoplastic DM and requires careful screening for malignancy.