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Dirr MA, Ahmed A, Schlessinger DI, Haq M, Shi V, Koza E, Ma M, Christensen RE, Ibrahim SA, Schmitt J, Johannsen L, Asai Y, Baldwin HE, Berardesca E, Berman B, Vieira AC, Chien AL, Cohen DE, Del Rosso JQ, Dosal J, Drake LA, Feldman SR, Fleischer AB, Friedman A, Graber E, Harper JC, Helfrich YR, Jemec GB, Johnson SM, Katta R, Lio P, Maier LE, Martin G, Nagler AR, Neuhaus IM, Palamar M, Parish LC, Rosen T, Shumack SP, Solomon JA, Tanghetti EA, Webster GF, Weinkle A, Weiss JS, Wladis EJ, Maher IA, Sobanko JF, Cartee TV, Cahn BA, Alam M, Kang BY, Iyengar S, Anvery N, Alpsoy E, Bewley A, Dessinioti C, Egeberg A, Engin B, Gollnick HPM, Ioannides D, Kim HS, Lazaridou E, Li J, Lim HG, Micali G, de Oliveira CMM, Noguera-Morel L, Parodi A, Reinholz M, Suh DH, Sun Q, van Zuuren EJ, Wollina U, Zhou Y, Zip C, Poon E, Pearlman R. Rosacea Core Domain Set for Clinical Trials and Practice: A Consensus Statement. JAMA Dermatol 2024:2817890. [PMID: 38656294 DOI: 10.1001/jamadermatol.2024.0636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Importance Inconsistent reporting of outcomes in clinical trials of rosacea is impeding and likely preventing accurate data pooling and meta-analyses. There is a need for standardization of outcomes assessed during intervention trials of rosacea. Objective To develop a rosacea core outcome set (COS) based on key domains that are globally relevant and applicable to all demographic groups to be used as a minimum list of outcomes for reporting by rosacea clinical trials, and when appropriate, in clinical practice. Evidence Review A systematic literature review of rosacea clinical trials was conducted. Discrete outcomes were extracted and augmented through discussions and focus groups with key stakeholders. The initial list of 192 outcomes was refined to identify 50 unique outcomes that were rated through the Delphi process Round 1 by 88 panelists (63 physicians from 17 countries and 25 patients with rosacea in the US) on 9-point Likert scale. Based on feedback, an additional 11 outcomes were added in Round 2. Outcomes deemed to be critical for inclusion (rated 7-9 by ≥70% of both groups) were discussed in consensus meetings. The outcomes deemed to be most important for inclusion by at least 85% of the participants were incorporated into the final core domain set. Findings The Delphi process and consensus-building meetings identified a final core set of 8 domains for rosacea clinical trials: ocular signs and symptoms; skin signs of disease; skin symptoms; overall severity; patient satisfaction; quality of life; degree of improvement; and presence and severity of treatment-related adverse events. Recommendations were also made for application in the clinical setting. Conclusions and Relevance This core domain set for rosacea research is now available; its adoption by researchers may improve the usefulness of future trials of rosacea therapies by enabling meta-analyses and other comparisons across studies. This core domain set may also be useful in clinical practice.
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Affiliation(s)
- McKenzie A Dirr
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Areeba Ahmed
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Misha Haq
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Victoria Shi
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Eric Koza
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Melissa Ma
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Rachel E Christensen
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sarah A Ibrahim
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Lena Johannsen
- Center for Evidence-Based Healthcare, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Yuka Asai
- Division of Dermatology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | | | - Enzo Berardesca
- Phillip Frost Department of Dermatology and Cutaneous Surgery Miller School of Medicine, University of Miami, Miami, Florida
| | - Brian Berman
- Dermatology and Cutaneous Surgery, University of Miami, Miami, Florida
| | - Ana Carolina Vieira
- Ophthalmology Department, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - David E Cohen
- The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | | | | | - Lynn A Drake
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Steven R Feldman
- Pathology and Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | | | - Adam Friedman
- Department of Dermatology, George Washington School of Medicine and Health Science, Washington, DC
- Universitätsklinik für Dermatologie und Venerologie, Innsbruck, Austria
| | - Emmy Graber
- The Dermatology Institute of Boston Affiliate, Northeastern University, Boston, Massachusetts
| | - Julie C Harper
- The Dermatology and Skin Care Center of Birmingham, Birmingham, Alabama
| | | | - Gregor B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
| | | | - Rajani Katta
- McGovern Medical School at UTHealth, Houston, Texas
| | - Peter Lio
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Lisa E Maier
- Department of Dermatology, University of Washington, Seattle
| | - George Martin
- Dr George Martin Dermatology Associates, Kihei, Hawaii
| | - Arielle R Nagler
- Ambulatory Quality and Network Integration, The Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Isaac M Neuhaus
- Department of Dermatology, University of California, San Francisco
| | - Melis Palamar
- Department of Ophthalmology, Faculty of Medicine, Ege University, Bornova, Turkey
| | - Lawrence C Parish
- Jefferson Center for International Dermatology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Stephen P Shumack
- Royal North Shore Hospital of Sydney, St Leonards, New South Wales, Australia
| | - James A Solomon
- University of Central Florida College of Medicine, Florida State College of Medicine, Tallahassee
- Department of Dermatology, Carle-Illinois College of Medicine, Urbana
| | - Emil A Tanghetti
- Center for Dermatology and Laser Surgery, Sacramento, California
| | - Guy F Webster
- Department of Dermatology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | | | - Edward J Wladis
- Department of Ophthalmology, Lions Eye Institute, Albany Medical College, Albany, New York
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Joseph F Sobanko
- Department of Dermatology, University of Pennsylvania, Philadelphia
| | - Todd V Cartee
- Department of Dermatology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Brian A Cahn
- Department of Dermatology, University of Illinois, Chicago
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Bianca Y Kang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sanjana Iyengar
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Noor Anvery
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Anthony Bewley
- Barts Health National Health Service Trust and Queen Mary University, London, United Kingdom
| | - Clio Dessinioti
- Department of Dermatology, Andreas Sygros Hospital, University of Athens, Athens, Greece
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Burhan Engin
- Dermatology Department, Cerrahpaşa Medical Faculty, İstanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Harald P M Gollnick
- Dermatology Department, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Dimitrios Ioannides
- First Department of Dermatology-Venereology, Aristotle University Medical School Hospital for Skin and Venereal Diseases, Thessaloniki, Greece
| | - Hei Sung Kim
- Department of Dermatology, Incheon St Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Elizabeth Lazaridou
- Second Department of Dermatology-Venereology, Aristotle University School of Medicine, Thessaloniki, Greece
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha Shi, China
| | | | | | | | - Lucero Noguera-Morel
- Department of Dermatology, Hospital Infantil, Universidad Niño Jesús, Madrid, Spain
| | - Aurora Parodi
- Department of Health Sciences, University of Genoa, Ospedale-Policlinico San Martino, IRCCS Genova, Italy
| | | | - Dae Hun Suh
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Shuaifuyuan, Beijing, China
| | - Esther J van Zuuren
- Department of Dermatology B1-Q, Leiden University Medical Centre, RC Leiden, the Netherlands
| | - Uwe Wollina
- Department of Dermatology and Allergology, StädtischesKlinikum Dresden, Friedrichstr, Dresden, Germany
| | - Youwen Zhou
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine Zip
- Department of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ross Pearlman
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Guertler A, Fiedler T, Lill D, Kuna AC, Volsky A, Wallmichrath J, Kämmerer T, French LE, Reinholz M. Deficit of Omega-3 Fatty Acids in Acne Patients-A Cross-Sectional Pilot Study in a German Cohort. Life (Basel) 2024; 14:519. [PMID: 38672789 PMCID: PMC11050840 DOI: 10.3390/life14040519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Omega-3 fatty acids (ω-3 FAs) exert anti-inflammatory effects, including the downregulation of pro-inflammatory cytokines, eicosanoids, and insulin-like growth factor-1. Therefore, they may improve acne severity as an adjunct treatment. However, there is a paucity of data regarding patients' existing deficits. The aim of this study was to determine ω-3 FA levels in acne patients in correlation with self-reported dietary preferences and clinical severity. A single-center, cross-sectional study of 100 acne patients was conducted. Patients' blood parameters, including ω-3 FAs levels, were assessed using the HS-omega-3 Index® in erythrocytes (Omegametrix® GmbH, Martinsried, Germany). Dietary preferences were assessed using a standardized food frequency questionnaire. Clinical dermatologic evaluation was performed using the Investigator Global Assessment (IGA) of acne. The values of the HS-omega-3 Index® were outside the recommended range of 8-11% in 96 patients (mean 5.15%), independent of the clinical severity or affected anatomic sites. A severe deficit (HS-omega-3 Index® < 4%) was seen more commonly in men than in women (p = 0.021). The regular consumption of legumes was significantly associated with higher ω-3 FA levels (p = 0.003), as was oral ω-3 FA supplementation (p = 0.006) and the lack of sunflower oil intake (p = 0.008). This pilot study demonstrated a deficit of ω-3 FAs in a German acne cohort. Higher ω-3 FAs levels were observed in patients with regular legume intake and oral ω-3 FAs supplementation. Further prospective studies are needed to investigate whether the clinical severity of acne improves in patients with normal HS-omega-3 Index®.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Tobias Fiedler
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Diana Lill
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Anne-Charlotte Kuna
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Arina Volsky
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Jens Wallmichrath
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Till Kämmerer
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
| | - Lars E. French
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, LMU University Hospital, 80539 Munich, Germany (M.R.)
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Kaemmerer T, Clanner-Engelshofen BM, Lesmeister T, French LE, Reinholz M. Cannabinoids in hyperhidrosis. J DERMATOL TREAT 2023; 34:2127308. [PMID: 36200741 DOI: 10.1080/09546634.2022.2127308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Hyperhidrosis can significantly curtail patient quality of life, from debilitating physical symptoms to social stigmatization and reduced life opportunities. Current treatments often prove unsatisfactory, especially in sufferers of generalized hyperhidrosis. In this open trial, we present the case of a refractory generalized hyperhidrosis treated with cannabinoids. We found a remarkable reduction in the volume of sweat and an improvement to the patient's quality of life using this novel low-cost and low-impact approach.
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Affiliation(s)
- Till Kaemmerer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | | | - Tony Lesmeister
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA.,Department of Oral, Maxillofacial and Facial Plastic Surgery, University Medical Centre Mainz, Mainz, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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Kaemmerer T, Guertler A, Clanner-Engelshofen BM, Fuchs C, French LE, Reinholz M. Cutaneous T-cell Lymphomas: A Single-center Retrospective Analysis. Acta Dermatovenerol Croat 2023; 31:184-190. [PMID: 38651844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Cutaneous T-cell lymphomas (CTCLs) are rare diseases characterized by infiltration of malignant T-cells into the skin. We evaluated the prevalence, epidemiology, and therapy of CTCLs, focusing on its most well-known subtypes, namely mycosis fungoides (MF) and Sézary syndrome (SS). PATIENTS AND METHODS We retrospectively analyzed the medical data of patients with a histologically confirmed diagnosis of CTCL presenting to our outpatient department during a 5-year period from January 2015 to December 2019. RESULTS We evaluated the files of 102 patients, of whom 67% were men and 33% women. The overall mean age was 59.1±14.1 (24-86) years. Ninety-two patients (90%) were diagnosed with MF and ten patients (10%) with SS. According to ISCL/EORTC, the majority of patients initially classified as stage IA (34%) and IB (45%). Disease frequency decreased at advanced stages (II: 4%; III: 7%; IV: 10%). Forty-five patients (44.1%) received only skin-directed therapy (SDT). Twenty patients (19.6%) progressed from SDT to systemic therapy (ST). Thirty-seven patients (36.3%) received ST combined with SDT (TS) from the start of treatment. Overall, fifty different therapeutic approaches of TS were initiated due to lack of response to therapy or disease progression. CONCLUSION Management of CTCLs aims to maintain patient quality of life while minimizing side-effects. As CTCLs are usually incurable diseases, the focus of treatment is on symptom control and prevention of disease progression. Due to the large patient group and the long observation period, our study allows for a valid evaluation of the frequency and therapy of MF and SS in a university outpatient clinic in Germany. We favor topical therapies in early stages with more invasive therapies in advanced stages.
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Affiliation(s)
- Till Kaemmerer
- Till Kämmerer, MD, Department of Dermatology and Allergy University Hospital, LMU Munich, Frauenlobstr. 9-11,
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Guertler A, Volsky A, Eijkenboom Q, Fiedler T, French LE, Reinholz M. Dietary Patterns in Acne and Rosacea Patients-A Controlled Study and Comprehensive Analysis. Nutrients 2023; 15:4405. [PMID: 37892480 PMCID: PMC10609993 DOI: 10.3390/nu15204405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/23/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
As the relationship between exposome factors and inflammatory skin diseases is gaining increasing attention, the objective of this study was to investigate dietary patterns among acne and rosacea patients and to establish the disease risk attributable to nutrition. In this cross-sectional, controlled study, patients' dietary habits were assessed via subjective ratings of beneficial and trigger foods, followed by standardized food frequency surveys (FFS). Scores for disease-specific risk stratification based on dietary habits were proposed. Clinical assessments, dermatologic examinations, and laboratory analyses were performed. A total of 296 patients (acne group (AG) n = 120, control group (ACG) n = 32; rosacea group (RG) n = 105, control group (RCG) n = 39) were included. The significant impact of diet on disease severity was self-reported by 80.8% of the AG and 70.5% of the RG. Leading dietary triggers were found in both groups, while beneficial food items were identified more clearly by the AG. FFS revealed significant dietary differences between the AG, RG, and control groups. Disease-specific scores showed greater precision for acne (odds ratio 14.5 AG, 5.5 RG). The AG had higher insulin-like growth factor (IGF)-1 levels correlating with dairy intake (p = 0.006). Overall, this study underlines the influence of diet on acne and rosacea, providing valuable disease-specific scores for dietary risk stratification. Consuming vegetables, legumes, oily fish, olive oil, and nuts, and limiting meat, cheese, and alcohol appear to be beneficial for both acne and rosacea. Future studies can build on these data to further improve preventive and therapeutic strategies.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Arina Volsky
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Quirine Eijkenboom
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Tobias Fiedler
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
| | - Lars E. French
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, LMU University Hospital, LMU Munich, 80539 Munich, Germany
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Srour J, Marsela E, Fiocco Z, Kendziora B, Gürtler A, French LE, Reinholz M. Serum levels of serum amyloid A, interleukin-6 and C-reactive protein correlate with severity of hidradenitis suppurativa. Ital J Dermatol Venerol 2023:S2784-8671.23.07442-X. [PMID: 37404192 DOI: 10.23736/s2784-8671.23.07442-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND Validated biomarkers enabling an objective, dynamic assessment of hidradenitis suppurativa (HS) disease severity do not exist. The aim of our study was to determine the serum concentration of four potential biomarkers with respect to HS disease severity. METHODS We recruited 50 patients with hidradenitis suppurativa. After obtaining informed consent, patients were requested to fill out multiple questionnaires. Severity of HS was determined based on Hurley and Sartorius scores by an experienced dermatologist. Blood sampling included Serum Amyloid A (SAA), Interleukin-6 (IL-6), C-reactive protein (CRP) and S100 protein (S100) in a certified laboratory. RESULTS Moderate and statistically significant correlations of SAA, IL-6 and CRP with the clinical scores Hurley and Sartorius were observed. The respective Spearman's correlation coefficients (r) were: Hurley 0.38, 0.46, 0.35 and Sartorius 0.51, 0.48, 0.48. No relevant changes were detected when comparing S100 to both Hurley (r=0.06) and Sartorius (r=0.09). CONCLUSIONS Our data suggest that an association between SAA, IL-6, CRP and HS disease severity could exist. Further research is needed to define their potential as biomarkers for quantifying and monitoring disease activity and response to treatment.
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Affiliation(s)
- Jerome Srour
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany -
| | - Enklajd Marsela
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany
| | - Zeno Fiocco
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany
| | - Benjamin Kendziora
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany
| | - Anne Gürtler
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany
- Miller School of Medicine, Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, Ludwig-Maximilian University (LUM) Hospital, LMU Munich, Munich, Germany
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Nellessen T, Ebner B, Pyrgidis N, Ledderose S, Kretschmer A, Marcon J, Teupser D, Mayr D, Faihs V, Stief CG, French LE, Herlemann A, Reinholz M. Characterization of Human Papilloma Virus in Prostate Cancer Patients Undergoing Radical Prostatectomy-A Prospective Study of 140 Patients. Viruses 2023; 15:1264. [PMID: 37376564 DOI: 10.3390/v15061264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/21/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The association between human papilloma virus (HPV) and the pathogenesis of prostate cancer (PCa) is still controversial. Existing studies often lack information about clinical risk factors, are limited by their retrospective design or only use a single detection method for HPV. MATERIAL AND METHODS A total of 140 patients undergoing radical prostatectomy (RP) for PCa at the Department of Urology, Ludwig Maximilian University of Munich, Germany, were prospectively enrolled. Knowledge of HPV and sociodemographic parameters were assessed with questionnaires. The following methods were used for HPV detection: RP specimens were tested for HPV DNA by PCR. If HPV DNA was detected, an LCD-Array hybridization technique was used for HPV subtyping, and immunohistochemical staining for p16 was performed as a surrogate marker for HPV infection. Serological titers of HPV-16 L1 antibodies were measured using an HPV-16-specific immunoassay. RESULTS HPV DNA was detected in 9.3% (13/140) of RP specimens, with HPV-16 being the most predominantly detected subtype (5/13 = 39%). HPV-16 L1 antibody levels were below the limit of detection in 98% of patients (137/140). We found no significant difference between HPV PCR-positive (HPV+) and -negative (HPV-) patients in terms of HPV-16 antibody levels, history of HPV-associated diseases, level of education or marital status. Seventy-five percent of all PCa patients had never heard of HPV before. An acinar adenocarcinoma of the prostate was the most frequently detected histologic type in both HPV+ (100%) and HPV- (98%) patients (p = 0.86). HPV+ patients had fewer positive biopsy cores (3.5 vs. 5.8; p = 0.01) and a lower maximal tumor infiltration rate per core (37% vs. 57%; p = 0.03) compared to HPV- patients. However, when analyzing the whole prostate and the lymph nodes after RP, there were no significant differences in TNM stage, Gleason score or tumor volume between both groups. In a subgroup analysis of all high-risk HPV patients (n = 6), we found no significant differences in sociodemographic, clinical or histopathological parameters compared to HPV- or low-risk HPV+ patients. CONCLUSION In our prospective study, we were not able to prove a clinically significant impact of HPV status on tumor characteristics in RP specimens. Most men with PCa had never heard of HPV, despite its proven causal association with other tumor entities.
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Affiliation(s)
- Tobias Nellessen
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
- Department of Dermatology and Allergy, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Benedikt Ebner
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Nikolaos Pyrgidis
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Stephan Ledderose
- Institute of Pathology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Alexander Kretschmer
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Julian Marcon
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Daniel Teupser
- Institute of Laboratory Medicine, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Doris Mayr
- Institute of Pathology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Valentina Faihs
- Department of Dermatology and Allergy Biederstein, Technical University of Munich, 80802 Munich, Germany
| | - Christian G Stief
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Annika Herlemann
- Department of Urology, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, Ludwig-Maximilians-University Munich, 81377 Munich, Germany
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Nellessen T, Aoki R, Kammerbauer C, Clanner-Engelshofen BM, French LE, Reinholz M. Relationship between α-genus human papillomavirus and non-genital seborrheic keratosis: Report of new cases and updated review. J Cosmet Dermatol 2023; 22:306-310. [PMID: 35066969 DOI: 10.1111/jocd.14759] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Seborrheic keratoses (SK) are the most common acquired benign tumor that affects middle-aged or older adults with great cosmetic concern. Clinical and histopathological similarities of SK and common warts have been addressed by investigating the possible presence of human papillomavirus (HPV) DNA in SK. Previous studies suggested the association between α-genus HPV and SK located on genital skin, whereas the causal relationship between α-HPV and non-genital SK remains controversial. AIM This study aimed to clarify the pathogenic involvement of α-HPV in the development of non-genital SK. METHODS We analyzed α-HPV DNA prevalence and HPV genotypes using a PCR-based microarray on 51 skin samples presenting with histologically confirmed SK without any malignant changes. Correlation between the histological subtype of SK and their HPV DNA-positive reactivity was also evaluated. RESULTS Of 51 non-genital SK, two (3.9%) skin samples were positive for α-HPV DNA; high-risk HPV 31 and low-risk HPV 42 were found. Evaluation of HPV prevalence in different histological types of SK showed that both HPV-positive cases were acanthotic type; 14.3% of acanthotic SK lesions were positive, while all of the other types were negative for α-HPV. CONCLUSIONS This study demonstrates that α-HPV positivity is very rare in common non-genital SK. The rare α-HPV-positive SK lesions histologically belonged to the acanthotic type, implying a potential impact of HPV infection on epidermal hyperproliferation. Although a possible association cannot be excluded, our findings suggest that α-HPV is not a major causative factor for non-genital SK.
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Affiliation(s)
- Tobias Nellessen
- The Department of Dermatology and Allergology, University Hospital of Munich LMU, Munich, Germany
| | - Rui Aoki
- The Department of Dermatology and Allergology, University Hospital of Munich LMU, Munich, Germany
| | - Claudia Kammerbauer
- The Department of Dermatology and Allergology, University Hospital of Munich LMU, Munich, Germany
| | | | - Lars E French
- The Department of Dermatology and Allergology, University Hospital of Munich LMU, Munich, Germany
| | - Markus Reinholz
- The Department of Dermatology and Allergology, University Hospital of Munich LMU, Munich, Germany
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Wei E, Li J, Anand P, French LE, Wattad A, Clanner-Engelshofen B, Reinholz M. "From molecular to clinic": The pivotal role of CDC42 in pathophysiology of human papilloma virus related cancers and a correlated sensitivity of afatinib. Front Immunol 2023; 14:1118458. [PMID: 36936942 PMCID: PMC10014535 DOI: 10.3389/fimmu.2023.1118458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
Background Human papilloma virus (HPV)-related cancers are global health challenge. Insufficient comprehension of these cancers has impeded the development of novel therapeutic interventions. Bioinformatics empowered us to investigate these cancers from new entry points. Methods DNA methylation data of cervical squamous cell carcinoma (CESC) and anal squamous cell carcinoma (ASCC) were analyzed to identify the significantly altered pathways. Through analyses integrated with RNA sequencing data of genes in these pathways, genes with strongest correlation to the TNM staging of CESC was identified and their correlations with overall survival in patients were assessed. To find a potential promising drug, correlation analysis of gene expression levels and compound sensitivity was performed. In vitro experiments were conducted to validate these findings. We further performed molecular docking experiments to explain our findings. Results Significantly altered pathways included immune, HPV infection, oxidative stress, ferroptosis and necroptosis. 10 hub genes in these pathways (PSMD11, RB1, SAE1, TAF15, TFDP1, CORO1C, JOSD1, CDC42, KPNA2 and NUP62) were identified, in which only CDC42 high expression was statistically significantly correlated with overall survival (Hazard Ratio: 1.6, P = 0.045). Afatinib was then screened out to be tested. In vitro experiments exhibited that the expression level of CDC42 was upregulated in HaCaT/A431 cells transfected with HPV E6 and E7, and the inhibitory effect of afatinib on proliferation was enhanced after transfection. CDC42-GTPase-effector interface-EGFR-afatinib was found to be a stable complex with a highest ZDOCK score of 1264.017. Conclusion We identified CDC42 as a pivotal gene in the pathophysiology of HPV-related cancers. The upregulation of CDC42 could be a signal for afatinib treatment and the mechanism in which may be an increased affinity of EGFR to afatinib, inferred from a high stability in the quaternary complex of CDC42-GTPase-effector interface-EGFR-afatinib.
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Affiliation(s)
- Erdong Wei
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
| | - Jiahua Li
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
- *Correspondence: Jiahua Li,
| | - Philipp Anand
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
| | - Lars E. French
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, United States
| | - Adam Wattad
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
| | - Benjamin Clanner-Engelshofen
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilians University of Munich (LMU) Munich, Munich, Germany
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Frommherz L, Hering P, Stadler PC, Clanner-Engelshofen BM, Reinholz M. Silicone Models for Dermatological Education: Assessment of a New Teaching Tool by Dermatologists. Dermatol Pract Concept 2023; 13:dpc.1301a49. [PMID: 36892340 PMCID: PMC9946078 DOI: 10.5826/dpc.1301a49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION The coronavirus pandemic forced universities to transfer academic curricula into the digital realm and calls for the introduction of new teaching methods to adequately compensate for the limited in-patient training. Especially in the field of dermatology, the use of 3D models presents an interesting opportunity to maintain the teaching of diagnostically essential sensory and haptic characteristics of primary lesions. OBJECTIVES We developed a prototype silicone model and presented it to the medical service of the Department of Dermatology of the Ludwig-Maximilians University for evaluation. METHODS Silicone models demonstrating primary skin lesions were produced by using negative 3D-printed molds and different types of silicone. An online survey obtained evaluations from a group of dermatologists regarding the quality of previously supplied silicone 3D models and their potential use in medical education. Data from 58 dermatologists were collected and analyzed. RESULTS The majority of the participants rated the models overall as positive and innovative, providing constructive feedback for additional modifications, and recommended further implementation into the regular curriculum as an additional tool after the end of the pandemic. CONCLUSIONS Our study underlined the possible advantages of using 3D models as a supplement in educational training even after the end of the SARS-CoV-2 pandemic.
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Affiliation(s)
- Leonie Frommherz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Pascal Hering
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | | | | | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
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Li J, Wei E, Reisinger A, French LE, Clanner-Engelshofen BM, Reinholz M. Comparison of Different Anti-Demodex Strategies: A Systematic Review and Meta-Analysis. Dermatology 2022; 239:12-31. [PMID: 36310014 DOI: 10.1159/000526296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/17/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Demodex mites are related to some inflammatory diseases such as rosacea and blepharitis and could be harmful in patients with immunodeficiency or immunosuppression, especially notable in patients using biologic like dupilumab. In order to have an objective observation of different anti-Demodex strategies, we conducted this study, based on interventional clinical evidence with quantified Demodex mite data. METHODS We used the PubMed, Embase, ClinicalTrials.gov, Medline, and International Clinical Trials Registry Platform (ICTRP) as databases. To assess the risk of bias, the RoB2 and ROBINS-I tools were used. The certainty of evidence was assessed following the GRADE guideline. Furthermore, the effect sizes (ESs) of different strategies were compared in different time periods (0-1, 1-2, 2-3, >3 months), as well as Demodex decrease rates. RESULTS 1,618 studies were identified in the databases, with 21 of which included in the final quantitative synthesis. Interventions in these studies included ivermectin, tea tree oil (TTO), permethrin, crotamiton, metronidazole, light therapies, combined therapies, and other therapies. During 0-1 month, the ES varied from 0.07 (cleanser) to 1.95 (systemic ivermectin-metronidazole). During 1-2 months, the ES varied from 0.88 (topical permethrin) to 4.40 (topical ivermectin). During 2-3 months, the ES varied from 0.79 (topical permethrin) to 8.37 (topical ivermectin). During the time of 3 months, the ES varied from 0.59 (topical permethrin) to 2.25 (intense pulsed light [IPL]). In terms of Demodex decrease rates, topical ivermectin, TTO, permethrin, IPL, and baby shampoo had achieved a nearly 100% decrease. The reported adverse events were mostly mild, without severe adverse events reported in any of the studies. CONCLUSIONS We found ivermectin (topical and systemic), ivermectin-metronidazole (topical), and TTO (topical) are promising anti-Demodex interventions. In addition to traditional pharmacotherapy, light therapies, especially IPL and skin cleansing, could also be considered as effective methods to control Demodex mite infestation.
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Affiliation(s)
- Jiahua Li
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany,
| | - Erdong Wei
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
| | - Amin Reisinger
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
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Frommherz L, Reinholz M, Gürtler A, Stadler PC, Kaemmerer T, French L, Clanner-Engelshofen BM. High-frequency devices effect in vitro: promissing approach in the treatment of acne vulgaris? An Bras Dermatol 2022; 97:729-734. [PMID: 36109271 DOI: 10.1016/j.abd.2021.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acne vulgaris is an inflammatory skin disorder leading to an impairment of quality of life and is therefore not only a cosmetic issue. Its pathogenesis is multifactorial - of particular importance is the colonization with the bacterium Propionibacterium acnes. A wide range of different treatment options exists including topical and systemic treatments depending on severity. High Frequency (HF) therapy, historically developed in the 19th century, claims antimicrobial effects on acne skin, but solid data on its efficacy and mechanism of action is lacking. OBJECTIVES The main objective of this study was to determine the efficacy of HF therapy on skin flora and P. acnes in vitro using a commercial device as well as to review studies on the mechanism of action. METHODS The plasma source was investigated regarding electrical settings, heat, and ozone development. Bacterial skin flora, fungal isolates, and P. acnes were exposed to HF in vitro and compared to unexposed controls by evaluating the number of colonies on agar plates. To further analyze bacterial species from normal skin flora, 16S-sequencing was performed. Statistical analyses were carried out using row analysis and unpaired t-test. RESULTS HF treatment led to a significant reduction of almost every bacterial and fungal species investigated in this study. Moreover, the number of colonies forming units was significantly decreased in P. acnes after HF treatment compared to controls in vitro. STUDY LIMITATIONS The experiments were performed in vitro only. To assess clinical effects further in vivo experiments are necessary. CONCLUSIONS The results collected in this study, although in vitro, provide a mechanistic basis for HF as a complementary treatment option for patients with acne. It might also have a beneficial effect on patients with superficial infectious skin of the skin.
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Affiliation(s)
- Leonie Frommherz
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.
| | - Anne Gürtler
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
| | - Pia-Charlotte Stadler
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
| | - Till Kaemmerer
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany
| | - Lars French
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany; Dr Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
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13
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Fuchs C, Teichert N, Neu K, Clanner-Engelshofen B, Zippel S, French LE, Reinholz M. The Sexual Behavior and Protective Conduct among University Students in Germany - Chances and Approaches to Tackle Spread of Sexually Transmitted Diseases. Indian J Dermatol 2022; 67:625. [PMID: 36865848 PMCID: PMC9971759 DOI: 10.4103/ijd.ijd_107_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background Current case numbers of sexually transmitted infections (STIs) in Germany are continuously increasing. Young adults aged 19-29 appear to be especially at risk and are therefore the demographic of ever-growing importance for future prevention work. Objective The aim of the survey was to analyze awareness and protective behavior regarding sexually transmitted infections with a major focus on condom-usage by university students in Germany. Method The collection of data was based on the conduction of a cross-sectional survey for students of Ludwig Maximilian University of Munich, the Technical University Munich, and the University of Bavarian Economy. The survey was distributed via the professional online survey tool "Soscy" and was thus performed completely anonymized. Results Within this study, a total of 1,020 questionnaires were collected and consecutively analyzed. In terms of knowledge about human immunodeficiency viruses (HIV), over 96.0% of participants were aware that vaginal intercourse can be a source of transmission for both sex partners and that condom use can be preventive. In contrast, 33.0% were unaware that smear infections constitute a crucial transmission route of human papillomaviruses (HPV). Concerning protective behavior, 25.2% either rarely or did not use a condom in their sexual history, even though 94.6% agreed that condoms protect against STIs. Conclusion This study outlines the importance of education and prevention work that focuses on STIs. Results might reflect effectiveness of previous education efforts made by several prevention campaigns targeting HIV. On the downside, knowledge of other pathogens that establish STIs appears worthy of improvement, especially considering the partially risky sexual behavior observed. Therefore, we see a strong need to reform education, guidance, and prevention strategies in a way that emphasizes not only all pathogens and connected STIs equally, but also a differentiated presentation of sexuality providing appropriate protection strategies for everyone.
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Affiliation(s)
- Corbinian Fuchs
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
| | - Niklas Teichert
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
| | - Katharina Neu
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
| | - Benjamin Clanner-Engelshofen
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
| | - Stefan Zippel
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
| | - Lars E. French
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
| | - Markus Reinholz
- From the Department of Dermatology and Allergology, University Hospital, LMU Munich Frauenlobstr, 9-11, 80337 Munich, Germany
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14
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Clanner-Engelshofen BM, Bernhard D, Dargatz S, Flaig MJ, Gieler U, Kinberger M, Klövekorn W, Kuna AC, Läuchli S, Lehmann P, Nast A, Pleyer U, Schaller M, Schöfer H, Steinhoff M, Schwennesen T, Werner RN, Zierhut M, Reinholz M. S2k guideline: Rosacea. J Dtsch Dermatol Ges 2022; 20:1147-1165. [PMID: 35929658 DOI: 10.1111/ddg.14849] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/10/2022] [Indexed: 12/01/2022]
Abstract
This updated and upgraded S2k guideline deals with the diagnosis and treatment of rosacea, which is a common, chronic inflammatory skin disease mostly affecting the face. Initially, rosacea is characterized by recurrent erythema, telangiectasia and flushing. Later, the inflammatory component predominates, with persistent erythema with follicular papules, papulopustules and pustules. The development of phyma, which usually occurs on the acral localizations, is the most severe manifestation. For the treatment of rosacea, the interdisciplinary guideline committee, with representatives of the German Dermatological Society (DDG), the Professional Association of German Dermatologists (BVDD), the German Opthalmological Society (DOG), the Society for Dermopharmacy (GD), the Swiss Society for Dermatology and Venereology (SGDV) and the German Rosacea Aid e. V., recommends the avoidance of trigger factors and topical applications of metronidazole, azelaic acid or ivermectin. For symptomatic treatment of persistent centrofacial erythema, the topical vasoconstrictors brimonidine or oxymetazoline can also be used. Systemic therapy is recommended for therapy-resistant and severe forms of rosacea papulopustulosa. The drug of choice is low-dose doxycycline. Alternatively, low-dose isotretinoin can be recommended. Ocular rosacea should be treated with lid margin hygiene. For topical treatment, ciclosporin eye drops, azithromycin, ivermectin or metronidazole are suggested.
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Affiliation(s)
| | - Dominik Bernhard
- Department and Clinic for Dermatology and Allergology, University Hospital Munich, LMU Munich, Germany
| | - Sonja Dargatz
- Deutsche Rosazea Hilfe e.V. (German Rosacea Aid), Hamburg, Germany
| | - Michael J Flaig
- Department and Clinic for Dermatology and Allergology, University Hospital Munich, LMU Munich, Germany
| | - Uwe Gieler
- Vitos Hospital for Psychosomatic Medicine, University Hospital Gießen - Dermatology, UKGM Gießen, Gießen, Germany
| | - Maria Kinberger
- Department of Dermatology, Venereology and Allergology, Division of Evidence- Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Anne-Charlotte Kuna
- Department and Clinic for Dermatology and Allergology, University Hospital Munich, LMU Munich, Germany
| | - Severin Läuchli
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Percy Lehmann
- Center for Dermatology, Allergology and Dermatosurgery, HELIOS University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence- Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Uwe Pleyer
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Martin Schaller
- Department of Dermatology, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Helmut Schöfer
- German Clinic for Diagnostics (DKD, Deutsche Klinik für Diagnostik) Dermatology, Helios Kliniken Wiesbaden, Wiesbaden, Germany
| | - Martin Steinhoff
- Weill Cornell Medicine-Qatar, Cornell University, Ar-Rayyan, Qatar
| | | | - Ricardo Niklas Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence- Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Manfred Zierhut
- Department of Ophthalmology, University Hospital Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Markus Reinholz
- Department and Clinic for Dermatology and Allergology, University Hospital Munich, LMU Munich, Germany
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15
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Clanner-Engelshofen BM, Bernhard D, Dargatz S, Flaig MJ, Gieler U, Kinberger M, Klövekorn W, Kuna AC, Läuchli S, Lehmann P, Nast A, Pleyer U, Schaller M, Schöfer H, Steinhoff M, Schwennesen T, Werner RN, Zierhut M, Reinholz M. S2k-Leitlinie: Rosazea. J Dtsch Dermatol Ges 2022; 20:1147-1167. [PMID: 35971589 DOI: 10.1111/ddg.14849_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 06/10/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Benjamin M Clanner-Engelshofen
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Dominik Bernhard
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | | | - Michael J Flaig
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Uwe Gieler
- Vitos-Klinik für Psychosomatik, Gießen - Universitäts-Hautklinik, UKGM Gießen, Gießen, Deutschland
| | - Maria Kinberger
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | | | - Anne-Charlotte Kuna
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Severin Läuchli
- Dermatologische Klinik, Universitätsspital Zürich, Zürich, Schweiz
| | - Percy Lehmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, HELIOS Universitätsklinikum Wuppertal, Universität Witten/Herdecke, Wuppertal, Deutschland
| | - Alexander Nast
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Uwe Pleyer
- Klinik für Augenheilkunde, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Martin Schaller
- Universitäts-Hautklinik, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Deutschland
| | - Helmut Schöfer
- Deutsche Klinik für Diagnostik (DKD) Dermatologie, Helios Kliniken Wiesbaden, Wiesbaden, Deutschland
| | - Martin Steinhoff
- Weill Cornell Medicine-Qatar, Cornell University, Ar-Rayyan, Qatar
| | | | - Ricardo Niklas Werner
- Department of Dermatology, Venereology and Allergology, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Manfred Zierhut
- Universitäts-Augenklinik, Universitätsklinikum Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Deutschland
| | - Markus Reinholz
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
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16
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Clanner-Engelshofen BM, Ständer LM, Steegmueller T, Kämmerer T, Frommherz LH, Stadler PC, Gürtler A, Reinholz M. First ex vivo cultivation of human Demodex mites and evaluation of different drugs on mite proliferation. J Eur Acad Dermatol Venereol 2022; 36:2499-2503. [PMID: 35881081 DOI: 10.1111/jdv.18468] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 06/24/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Demodex spp. mites are the most complex resident of the human skin microbiome. Although they are considered commensals, they can be pathophysiologically relevant in inflammatory skin diseases like rosacea. Until now, there is no culture system available for these mites except for using live vertebrate hosts. OBJECTIVES Our aim was to establish an ex vivo culture of human Demodex mites and to characterize the sebogenesis-dependent mite density. METHODS Demodex mites were cultivated in pilosebaceous units of human skin explants, called human organotypic skin explant culture (hOSEC). Furthermore, different sebogenesis-modifying additives were evaluated. Mites and mite survival were evaluated using light and fluorescence microscopy. RESULTS After 90 days of incubation, living Demodex mites - including eggs, larvae and nymphs - were detected in the dissected skin samples. Incubation for 30 days with anabolic steroids (testosterone and trenbolone) as well as retinol and retinoic acid (isotretinoin) yielded a reduced mite density. CONCLUSIONS With this technique, mites can be cultivated ex vivo for the first time, thereby establishing new ways to investigate Demodex spp. The sebostatic effect of isotretinoin might explain the mechanism of action in the off-label treatment of rosacea. We anticipate our findings to be the basis of an accelerated research on our most complex commensal, its life, biology and physiology.
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Affiliation(s)
- B M Clanner-Engelshofen
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - L M Ständer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - T Steegmueller
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - T Kämmerer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - L H Frommherz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - P C Stadler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - A Gürtler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - M Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
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17
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Guertler A, Neu K, Fiedler T, Kuna AC, Kämmerer T, Lill D, French LE, Reinholz M. Clinical effects of omega-3 fatty acids on acne vulgaris. J Dtsch Dermatol Ges 2022; 20:1023-1027. [PMID: 35798259 DOI: 10.1111/ddg.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Katharina Neu
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Tobias Fiedler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Anne-Charlotte Kuna
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Till Kämmerer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Diana Lill
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.,Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, FL, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
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18
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Guertler A, Neu K, Fiedler T, Kuna AC, Kämmerer T, Lill D, French LE, Reinholz M. Klinische Auswirkung oraler Omega-3-Fettsäure-Supplementation bei Akne vulgaris. J Dtsch Dermatol Ges 2022; 20:1023-1027. [PMID: 35881089 DOI: 10.1111/ddg.14779_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Anne Guertler
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Katharina Neu
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Tobias Fiedler
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Anne-Charlotte Kuna
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Till Kämmerer
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Diana Lill
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
| | - Lars E French
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland.,Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Markus Reinholz
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, München, Deutschland
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19
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Wei E, Reisinger A, Li J, French LE, Clanner-Engelshofen B, Reinholz M. Integration of scRNA-Seq and TCGA RNA-Seq to Analyze the Heterogeneity of HPV+ and HPV- Cervical Cancer Immune Cells and Establish Molecular Risk Models. Front Oncol 2022; 12:860900. [PMID: 35719936 PMCID: PMC9198569 DOI: 10.3389/fonc.2022.860900] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/02/2022] [Indexed: 12/12/2022] Open
Abstract
Background Numerous studies support that Human papillomavirus (HPV) can cause cervical cancer. However, few studies have surveyed the heterogeneity of HPV infected or uninfected (HPV+ and HPV-) cervical cancer (CESC) patients. Integration of scRNA-seq and TCGA data to analyze the heterogeneity of HPV+ and HPV- cervical cancer patients on a single-cell level could improve understanding of the cellular mechanisms during HPV-induced cervical cancer. Methods CESC scRNA-seq data obtained from the Gene Expression Omnibus (GEO) database and the Seurat, Monocle3 package were used for scRNA-seq data analysis. The ESTIMATE package was used for single-sample gene immune score, CIBERSORT package was used to identify immune scores of cells, and the “WGCNA” package for the weighted correlation network analysis. Univariate Cox and LASSO regression were performed to establish survival and relapse signatures. KEGG and GO analyses were performed for the signature gene. Gene Expression Profiling Interactive Analysis was used for Pan-cancer analysis. Results In the HPV+ CESC group, CD8+ T cells and B cells were down-regulated, whereas T reg cells, CD4+ T cells, and epithelial cells were up-regulated according to scRNA-seq data. Survival analysis of TCGA-CESC revealed that increased expression of naive B cells or CD8+ T cells favors the survival probability of CESC patients. WGCNA, univariate Cox, and LASSO Cox regression established a 9-genes survival signature and a 7-gene relapse model. Pan-cancer analysis identified IKZF3, FOXP3, and JAK3 had a similar distribution and effects in HPV-associated HNSC. Conclusion Analysis of scRNA-seq and bulk RNA-seq of HPV+ and HPV- CESC samples revealed heterogeneity from transcriptional state to immune infiltration. Survival and relapse models were adjusted according to the heterogeneity of HPV+ and HPV- CESC immune cells to assess the prognostic risk accurately. Hub genes represent similar protection in HPV- associated HNSC while showing irrelevant to other potential HPV-related cancers.
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Affiliation(s)
- Erdong Wei
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany
| | - Amin Reisinger
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany
| | - Jiahua Li
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery , Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Benjamin Clanner-Engelshofen
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, Ludwig-Maximilians-Universität München (LMU) Munich, University Hospital, Munich, Germany
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20
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Leibrock LB, Hofmann DM, Fuchs B, Birt A, Reinholz M, Guertler A, Frank K, Giunta RE, Egaña JT, Nickelsen J, Schenck TL, Moellhoff N. In vitro and in vivo detection of microbial gene expression in bioactivated scaffolds seeded with cyanobacteria. Lett Appl Microbiol 2022; 75:401-409. [PMID: 35587396 DOI: 10.1111/lam.13740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/30/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
Dermal replacement materials bioactivated with cyanobacteria have shown promising potential for wound regeneration. To date, extraction of cyanobacteria RNA from seeded scaffolds has not been described. Aim of this study was to develop a method to isolate total RNA from bioactivated scaffolds and to propose a new approach in determining living bacteria based on real-time PCR. Transgenic synechococcus sp. PCC 7002 (tSyn7002) were seeded in liquid cultures or in scaffolds for dermal regeneration in vitro and in vivo for 7 days. RNA was extracted with a 260/280 ratio of ≥ 2. The small subunit of the 30S ribosome in prokaryotes (16S) and RNAse P protein (rnpA) were validated as reference transcripts for PCR analysis. Gene expression patterns differed in vitro and in vivo. Expression of 16S was significantly upregulated in scaffolds in vitro, as compared to liquid cultures, while rnpA expression was comparable. In vivo, both 16S and rnpA showed reduced expression compared to in vitro (16S: in vivo Ct value 13.21±0.32, in vitro 12.44±0.42; rnpA in vivo Ct value 19.87±0.41, in vitro 17.75±1.41). Overall, the results demonstrate rnpA and 16S expression after 7 days of implantation in vitro and in vivo, proving presence of living bacteria embedded in scaffolds using qPCR.
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Affiliation(s)
- Lars B Leibrock
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - Daniel M Hofmann
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - Benedikt Fuchs
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - Alexandra Birt
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Germany
| | - Anne Guertler
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Germany
| | - Konstantin Frank
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - Riccardo E Giunta
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
| | - José T Egaña
- Institute for Biological and Medical Engineering, Schools of Engineering, Biological Sciences and Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Joerg Nickelsen
- Molecular Plant Science, Department Biology I, LMU Munich, Munich, Germany
| | - Thilo L Schenck
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany.,Frauenklinik Dr. Geisenhofer GmbH, 80538, Munich, Germany
| | - Nicholas Moellhoff
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU Munich, Germany
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21
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Zierl S, Hildebrand JA, Guertler A, Dietrich C, Clanner-Engelshofen BM, French LE, Reinholz M. Clinical clues to identify patients with ocular rosacea - a Germany-wide epidemiologic analysis. Int J Dermatol 2022; 61:880-885. [PMID: 35579395 DOI: 10.1111/ijd.16235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 01/18/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES Ocular rosacea is a special manifestation of rosacea with unknown etiology. Eye involvement in rosacea patients is surprisingly common; however, it is often underdiagnosed, resulting in inappropriate treatment. We aimed to provide an updated epidemiologic perspective on ocular rosacea in Germany to improve patient care. PATIENTS AND METHODS Data of 777 rosacea patients were assessed using a detailed online questionnaire regarding ocular and skin symptoms, previous dermatological and ophthalmological consults, presence of type 1 hypersensitivities, and Demodex testing. All data were statistically analyzed. RESULTS Most patients reported ocular symptoms (399/777, 51.4%), including red eyes (179/399, 44.9%), itching (187/399, 46.9%), sty or chalazion (309/399, 77.4%), and dryness (108/399, 27.1%). Ocular rosacea was confirmed in 149/309 cases who consulted an ophthalmologist (45.3%). A total of 159/399 (39.8%) had no pre-existing allergies. Eye involvement was significantly associated with the presence of skin symptoms (P < 0.05), impacting patients' general well-being and overall treatment satisfaction. About half of Demodex-positive patients (21/45, 46.7%) showed ocular symptoms. CONCLUSIONS Eye involvement in rosacea patients was common, often presenting with unspecific symptoms.
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Affiliation(s)
- Stephan Zierl
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
| | - Johannes A Hildebrand
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
| | - Anne Guertler
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
| | - Cecilia Dietrich
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
| | | | - Lars E French
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), Munich, Germany
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22
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Ecke S, Huber A, Hilfrich R, French L, Reinholz M. HPV16 L1 serological test shows high concordance with anal cytology in people living with HIV. JID Innovations 2022; 2:100124. [PMID: 35620706 PMCID: PMC9127411 DOI: 10.1016/j.xjidi.2022.100124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Sara Ecke
- Department of Dermatology and Allergy, University Hospital, Ludwig Maxmilian University of Munich, Munich, Germany
| | - Anna Huber
- Abviris Deutschland GmbH, Ahrensburg, Germany
| | | | - Lars French
- Department of Dermatology and Allergy, University Hospital, Ludwig Maxmilian University of Munich, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, Ludwig Maxmilian University of Munich, Munich, Germany
- Corresponding author
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23
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Rummel M, Clanner-Engelshofen BM, Nellessen T, Zippel S, Schuster B, French LE, Reinholz M. Kenntnisse bayerischer Schüler zu sexuell übertragbaren Infektionen: eine Querschnittsstudie. J Dtsch Dermatol Ges 2022; 20:169-176. [PMID: 35146879 DOI: 10.1111/ddg.14653_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 09/12/2021] [Indexed: 11/27/2022]
Abstract
HINTERGRUND UND ZIELE Trotz zahlreicher Informationsquellen und Kampagnen zu sexuell übertragbaren Infektionen (STI) haben diese Krankheiten in Deutschland in den letzten Jahren zugenommen. Ziel war es, das Bewusstsein und den Wissensstand junger Schüler in Bayern zu sexuell übertragbaren Krankheiten (STI) mit Schwerpunkt auf humane Papillomaviren (HPV) zu bewerten. METHODEN In einer vollständig irreversibel anonymisierten Querschnittsstudie wurden insgesamt 4100 bayerische Schüler im Alter zwischen 12 und 17 Jahren anhand eines Multiple-Choice-Fragebogens hierzu befragt. ERGEBNISSE Insgesamt wurden 3834 Fragebögen in die Datenanalyse einbezogen. Interessanterweise ist der Bekanntheitsgrad von HPV im Vergleich zu anderen STI bemerkenswert geringer. Mädchen und Jugendliche, die bereits vorbeugende Jugendgesundheitsuntersuchungen absolviert hatten, zeigten im Durchschnitt ein größeres Wissen über STI. Darüber hinaus konnten wir zeigen, dass Jugendliche mit geringerem Bildungsniveau, wie Realschüler, über die geringsten Kenntnisse verfügten. SCHLUSSFOLGERUNGEN Die Querschnittsstudie zeigt, dass viele junge Menschen noch unzureichend über STI informiert sind. Die Informationslücken unterstreichen die Notwendigkeit einer intensiven und langfristigen Aufklärungsarbeit.
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Affiliation(s)
- Marcel Rummel
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland
| | - Benjamin M Clanner-Engelshofen
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland
| | - Tobias Nellessen
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland
| | - Stefan Zippel
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland
| | - Barbara Schuster
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland
| | - Lars E French
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland.,Dr. Phillip Frost Klinik für Dermatologie und Hautchirurgie, Universität von Miami, Miller School of Medicine
| | - Markus Reinholz
- Klinik für Dermatologie und Allergie, Universitätsklinikum der LMU München, Frauenlobstr 9-11, München, 80337, Deutschland
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24
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Clanner-Engelshofen BM, Frommherz L, Mitwalli M, Stadler PC, French LE, Reinholz M. 3D‐Druck‐ und Silikonmodelle der Primäreffloreszenzen für die dermatologische Lehre im Fernstudium. J Dtsch Dermatol Ges 2022; 20:177-184. [PMID: 35146884 DOI: 10.1111/ddg.14656_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Hintergrund und Ziele: Die Corona-Pandemie betrifft eine Fülle von verschiedenen Lebensaspekten - Herausforderungen in der medizinischen Behandlung sind hier unzweifelhaft von höchster Wichtigkeit. Allerdings muss auch, um die Ausbildung von Studierenden zu gewährleisten, fortlaufende medizinische Lehre stattfinden. Während eines Semesters mit Lockdown-Phasen und eingeschränktem Patientenkontakt für die Studierenden schickten wir jedem Studierenden ein Silikonmodell zu und baten um die Evaluation dieses Lernwerkzeugs. Methoden: Mittels zweier vollständig und irreversibel anonymisierter Online-Fragebögen befragten wir Studierende des Dermatologie-Semesters (n = 222) an der Medizinischen Fakultät der Ludwig-Maximilians-Universität in München im Wintersemester 2020/2021 - anschließend an Online-Lehre - zu ihrem Verständnis und der Eigeneinschätzung zu Primäreffloreszenzen vor und nach Erhalt der Silikonübungsmodelle. Diese wurden durch Schichtung verschiedener Silikontypen in negative 3D-Polylactid-Formen hergestellt, um bestimmte Festigkeiten und Farben darzustellen. Ergebnisse: Insgesamt wurden Fragebögen von 211 (95,0 %) und 213 (95,9 %) der 222 Studierenden analysiert, jeweils vor und nach dem Erhalt der Silikonmodelle. Die Studierenden gaben eine statistisch signifikante Zunahme ihrer Fähigkeiten an (P < 0,001). Ein Großteil der Studierenden evaluierte die Silikonmodelle positiv und berichtete von einem besseren Verständnis und Lernen der Primäreffloreszenzen. Schlussfolgerungen: Diese Lehrstudie zeigt die Vorzüge der haptischen Erfahrung in der dermatologischen Lehre auf - nicht nur in Zeiten von COVID-19, sondern auch danach.
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Affiliation(s)
- Benjamin M Clanner-Engelshofen
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Leonie Frommherz
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Mohammed Mitwalli
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Pia-Charlotte Stadler
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
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25
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Fiocco Z, Kerl K, French LE, Reinholz M, Dietrich C. Disseminated tinea corporis under baricitinib therapy for atopic dermatitis. Dermatol Ther 2022; 35:e15351. [PMID: 35103361 DOI: 10.1111/dth.15351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Zeno Fiocco
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Katrin Kerl
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Cecilia Dietrich
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
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26
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Clanner‐ Engelshofen BM, Frommherz L, Mitwalli M, Stadler P, French LE, Reinholz M. 3D printing and silicone models of primary skin lesions for dermatological education as remote learning tool. J Dtsch Dermatol Ges 2022; 20:177-183. [DOI: 10.1111/ddg.14656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 09/12/2021] [Indexed: 01/31/2023]
Affiliation(s)
| | - Leonie Frommherz
- Department of Dermatology and Allergy University Hospital Ludwig Maximilian University of Munich (LMU) Munich Germany
| | - Mohammed Mitwalli
- Department of Dermatology and Allergy University Hospital Ludwig Maximilian University of Munich (LMU) Munich Germany
| | - Pia‐Charlotte Stadler
- Department of Dermatology and Allergy University Hospital Ludwig Maximilian University of Munich (LMU) Munich Germany
| | - Lars E. French
- Department of Dermatology and Allergy University Hospital Ludwig Maximilian University of Munich (LMU) Munich Germany
- Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery Miller School of Medicine University of Miami Miami USA
| | - Markus Reinholz
- Department of Dermatology and Allergy University Hospital Ludwig Maximilian University of Munich (LMU) Munich Germany
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27
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Niesert AC, Guertler A, Reinholz M. Short contact therapy with adapalen 0,3 % / benzoyl peroxide 2,5 % gel for maintenance after systemic isotretinoin treatment. Dermatol Ther 2022; 35:e15318. [PMID: 35019193 DOI: 10.1111/dth.15318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/30/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Anne-Charlotte Niesert
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstrasse 9-11, Munich, Germany
| | - Anne Guertler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstrasse 9-11, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstrasse 9-11, Munich, Germany
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28
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Rummel M, Clanner-Engelshofen BM, Nellessen T, Zippel S, Schuster B, French LE, Reinholz M. Evaluation of the knowledge of students concerning sexually transmitted infections in Bavaria/Germany (a cross-sectional study). J Dtsch Dermatol Ges 2022; 20:169-176. [PMID: 34997826 DOI: 10.1111/ddg.14653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 09/12/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Despite numerous information sources and campaigns on sexually transmitted infections (STIs), there has been an increase in STIs in Germany in recent years. The aim was to evaluate the awareness and knowledge level among young students in Bavaria/Germany for STIs with a focus on human papilloma viruses (HPV). METHODS In a cross-sectional survey rendered completely and irreversibly anonymous, a total of 4,100 students from Bavaria between the ages of 12 and 17 were interviewed using a multiple choice questionnaire about their knowledge and awareness of STI, on the basis of gender, school education and preventive youth health examinations that had taken place. RESULTS A total of 3,834 questionnaires were included in the data analysis. Interestingly, the awareness level for HPV is remarkably lower compared to other STIs. Girls and adolescents who had already taken preventive youth health examinations showed a higher knowledge of STIs on average. Additionally, we could show that adolescents of lower educational levels, such as secondary school students, had the least knowledge. CONCLUSIONS The cross-sectional study shows that many young people are still insufficiently informed about STIs. The gaps in information and lack of knowledge underline the necessity of intensive and long-term educational work.
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Affiliation(s)
- Marcel Rummel
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | | | - Tobias Nellessen
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Zippel
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Barbara Schuster
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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Fiocco Z, Kupf S, Patzak L, Kämmerer T, Pumnea T, French LE, Reinholz M. Quality of Life and Psychopathology in Lichen Planus: A Neglected Disease Burden. Acta Derm Venereol 2021; 101:adv00619. [PMID: 34698356 PMCID: PMC9472096 DOI: 10.2340/actadv.v101.442] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The disease burden of lichen planus and its impact on patients’ quality of life have not been well studied. The aim of this mono-centre cross-sectional study was to investigate these factors. From June to September 2020, an anonymous survey was posted to 253 patients, who were diagnosed with lichen planus in our outpatient clinic from January 2018 to June 2020. Quality of life was evaluated using the Dermatology Life Quality Index (DLQI), the EuroQol 5-dimension 3-level score, and further quality of life indicators. Beck Depression Inventory II was used to evaluate symptoms of depression. A total of 100 patients completed and returned the survey. Lichen planus affected quality of life in 78% of cases. DLQI was higher for multiple localizations (r = 0.454, p < 0.001). Patients with genital lichen planus had a significantly higher DLQI (mean ± standard deviation (SD) 8.68 ± 6.96) than patients who were not affected in the genital area (5.01 ± 5.49; p = 0.009). DLQI was also significantly higher for ungual lichen planus (9.83 ± 7.6; not affected: 5.65 ± 5.84; p-value 0.039), and for cutaneous LP (mean 8.1, SD 6.22; not affected: 5.63 ± 6.12; p-value 0.045). Twenty-nine percent of patients had mild to moderate symptoms of depression, and 6% had severe symptoms of depression. Depression and reduced quality of life are an undetected and relevant burden affecting patients with lichen planus.
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Affiliation(s)
- Zeno Fiocco
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Frauenlobstr. 9-11, DE-80337 Munich, Germany .
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Hiebeler M, Reinholz M, Flaig M, Schmidt C, Schoser B, Herzinger T, Abicht A, Reilich P. Cutaneous T-cell lymphoma mimicking myopathy with lipoatrophy. Neuromuscul Disord 2021; 32:65-70. [PMID: 34937683 DOI: 10.1016/j.nmd.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 10/23/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
Mycosis fungoides (MF) is the most common form of primary cutaneous T-cell lymphoma. Classic MF usually follows a rather benign course over many years or decades, rarely ever leading to fatal extracutaneous organ involvement. Single cases of muscular involvement have been reported. Here we describe a 42-year-old male patient with hair loss and lipoatrophy since six months diagnosed as follicular MF and with a two months history of progressive distal leg weakness. Muscle biopsy and whole body muscle MRI showed an extensive muscular and subcutaneous fatty tissue infiltration. After therapy with topical steroids and acitretin/PUVA, systemic chemotherapy (CHOP) was initiated. The patient suffered from a rapid disease progression with fatal outcome 2.5 years after the first skin lesions, displaying progressive cachexia, muscular atrophy and weakness with scapuloperoneal distribution and cardiac dysfunction. So far, extensive muscular involvement by MF mimicking a distinct muscular phenotype has not been reported.
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Affiliation(s)
- Miriam Hiebeler
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - Michael Flaig
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - Christian Schmidt
- Department of Internal Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Benedikt Schoser
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Herzinger
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - Angela Abicht
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, LMU Munich, Munich, Germany; Medical Genetics Center, MGZ, Munich, Germany
| | - Peter Reilich
- Friedrich-Baur-Institute, Department of Neurology, University Hospital, LMU Munich, Munich, Germany.
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31
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Stadler PC, Clanner-Engelshofen BM, Helbig D, Satoh T, Reinholz M, French LE. Necroptotic and apoptotic cell death in Toxic Epidermal Necrolysis. J Dermatol Sci 2021; 104:138-141. [PMID: 34656387 DOI: 10.1016/j.jdermsci.2021.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Doris Helbig
- Department of Dermatology, University Hospital Cologne, Germany
| | - Takashi Satoh
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany; Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami, Miller School of Medicine, Germany
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32
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Kämmerer T, Lesmeister T, Wollenberg A, French LE, Strobel E, Reinholz M. Rattenbissfieber, eine diagnostische Herausforderung: Fallbericht und Übersicht von 29 Fällen. J Dtsch Dermatol Ges 2021; 19:1283-1288. [PMID: 34541792 DOI: 10.1111/ddg.14526_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/26/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Till Kämmerer
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum, Ludwig-Maximilians-Universität (LMU) München
| | - Tony Lesmeister
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum, Ludwig-Maximilians-Universität (LMU) München
| | - Andreas Wollenberg
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum, Ludwig-Maximilians-Universität (LMU) München
| | - Lars Einar French
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum, Ludwig-Maximilians-Universität (LMU) München.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine (UMMSM), Miami (FL), USA
| | - Erwin Strobel
- Sektion Medizinische Mikrobiologie und Technische Hygiene, München Klinik, München
| | - Markus Reinholz
- Klinik und Poliklinik für Dermatologie und Allergologie, Universitätsklinikum, Ludwig-Maximilians-Universität (LMU) München
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Kaemmerer T, Stadler PC, Helene Frommherz L, Guertler A, Einar French L, Reinholz M. Alitretinoin in the treatment of cutaneous T-cell lymphoma. Cancer Med 2021; 10:7071-7078. [PMID: 34435474 PMCID: PMC8525105 DOI: 10.1002/cam4.4237] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/09/2021] [Accepted: 08/17/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION In this survey, we analyzed data from patients suffering from the most common cutaneous T-cell lymphomas (CTCLs) subtypes mycosis fungoides (MF) and Sézary syndrome (SS), treated with the retinoid alitretinoin during a 7-year period at our outpatient department between 2015 and 2020. MATERIALS AND METHODS We analyzed patient medical records including TNMB stage, side effects under therapy with alitretinoin, time to next treatment (TTNT), and previous photo documentation. RESULTS A total of 35 patients with MF (n = 28) and SS (n = 7) were included in the study, of whom 69% were male and 31% were female. The mean age of onset was 56 ± 15 years in MF and 65.4 ± 10.8 years in SS with 51.4% having early stage (IA-IIA) and 48.6% having advanced stage (IIB-IVA) CTCL. Of these patients 37.2% responded to alitretinoin, 28.6% had a stable course, and 34.3% experienced progression. Alitretinoin was administered as a monotherapy (25.7%) or combined with five concomitant therapies (74.2%), most frequently with ECP (31.4%) and PUVA (11.4%). 63% did not report any side effects, most often hypertriglyceridemia (20%) was described. CONCLUSION Considering that nearly two thirds of the CTCL patients treated with alitretinoin showed a response or stable disease, together with a low number of side effects and low cost compared to bexarotene, alitretinoin may be a potential alternative in the treatment of less advanced CTCLs. This survey represents the largest number of recorded therapies with the retinoid alitretinoin in CTCLs in a European patient collective.
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Affiliation(s)
- Till Kaemmerer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | | | | | - Anne Guertler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Germany
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Kämmerer T, Lesmeister T, Wollenberg A, French LE, Strobel E, Reinholz M. Rat bite fever, a diagnostic challenge: case report and review of 29 cases. J Dtsch Dermatol Ges 2021; 19:1283-1287. [PMID: 34323361 DOI: 10.1111/ddg.14526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/26/2021] [Indexed: 11/29/2022]
Abstract
Rats can transmit Streptobacillus moniliformis, which may cause rat-bite fever (RBF), a rare and potentially lethal zoonosis. Fastidious in vitro growth and unspecific symptoms, including fever, arthralgia, and polymorphous skin lesions, complicate the diagnosis. Rat-bite fever follows exposure to contaminated bodily fluids of infected rodents; however, reports on Streptobacillus moniliformis-related infections are few so far. A female patient presented with painful hemorrhagic pustules and purpuric lesions on hands and feet. She developed fever and migratory polyarthralgia. Blood culture yielded growth with Streptobacillus moniliformis. The patient owned rats and handled contaminated rat feces and urine, making this the most likely etiology of infection. We report a case of RBF due to Streptobacillus moniliformis in a rat handling-patient. Difficulties in clinical and microbiological diagnosis highlight the need for a thorough and complete history-taking and a greater understanding of this rare infectious disease.
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Affiliation(s)
- Till Kämmerer
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University (LMU) of Munich, Munich, Germany
| | - Tony Lesmeister
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University (LMU) of Munich, Munich, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University (LMU) of Munich, Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University (LMU) of Munich, Munich, Germany.,Dr. Phillip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine (UMMSM), Miami (FL), USA
| | - Erwin Strobel
- Department of Medical Microbiology and Technical Hygiene, Municipal Hospital of Munich, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University (LMU) of Munich, Munich, Germany
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35
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Niesert AC, Guertler A, Schutti O, Engels L, Flaig M, French LE, Schlaak M, Reinholz M. Ulcerated Lichen Planus after Adjuvant Use of Programmed Cell Death-1-Inhibitor: A Case Report and Systematic Review of the Literature. Acta Derm Venereol 2021; 101:adv00472. [PMID: 34043014 PMCID: PMC9380279 DOI: 10.2340/00015555-3840] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Anne-Charlotte Niesert
- Department of Dermatology and Allergy, University Hospital, LMU Munich, DE-80337 Munich, Germany. E-mail:
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36
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Reinholz M, Kendziora B, Frey S, Oppel EM, Ruëff F, Clanner-Engelshofen BM, Heppt MV, French LE, Wollenberg A. Increased prevalence of irritant hand eczema in health care workers in a dermatological clinic due to increased hygiene measures during the SARS-CoV-2 pandemic. Eur J Dermatol 2021; 31:392-395. [PMID: 34309523 PMCID: PMC8354833 DOI: 10.1684/ejd.2021.4046] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hand hygiene measures in the general population and in health care workers have increased considerably since the outbreak of the COVID-19 pandemic. OBJECTIVES To investigate the prevalence and symptoms of hand eczema, as well as hygiene measures and concepts of care, in German health care workers. MATERIALS & METHODS This was an observational questionnaire study to investigate hygiene and skin care habits, as well as the prevalence and symptoms of hand eczema in 66 nurses and doctors of our dermatology department before and during the SARS-CoV-2 pandemic. RESULTS Hand washing and hand disinfection procedures increased significantly during the COVID-19 pandemic. Self-diagnosed hand eczema was reported by 33% of the participants, with a median duration of 14 days. The majority of staff currently affected by hand eczema were free of eczema a month previously (82%) and would treat their skin condition with emollients (77%). Erythema, scaling, burning and fissures were reported by 66.1% of the participants and were classified as predominant signs of toxic-irritant hand dermatitis rather than contact allergy. CONCLUSION Overall, the SARS-CoV-2 pandemic has led to a significant increase in the incidence of signs of irritant hand eczema despite intensified emollient use as a preventive measure. Awareness of the prevalence of hand eczema in health care workers in Germany during the COVID-19 pandemic should be raised, and preventive measures should be intensified.
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Affiliation(s)
- Markus Reinholz
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
| | - Benjamin Kendziora
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
| | - Surina Frey
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
| | - Eva Maria Oppel
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
| | - Franziska Ruëff
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
| | | | - Markus V. Heppt
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
| | - Andreas Wollenberg
- Department of Dermatology and Allergy University Hospital, Ludwig Maximilian University of Munich, 80337 Munich, Germany
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37
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Pumnea T, Fiocco Z, Clanner-Engelshofen BM, Flaig M, French LE, Reinholz M. Non-itchy, Nodular Intermittently Healing Persistent Lesions on the Neck, Arms and Gluteus: A Quiz. Acta Derm Venereol 2021; 101:adv00432. [PMID: 33723617 PMCID: PMC9364255 DOI: 10.2340/00015555-3786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Teodora Pumnea
- Department of Dermatology and Allergy, University Hospital of Munich (LMU), DE-80337 Munich, Germany
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Guertler A, Niesert AC, Wilhelm KP, Knuhr K, Brandt M, French LE, Reinholz M. Efficacy and tolerability of a detergent and care component for rosacea patients: A split-face, vehicle-controlled, randomized trial. J Cosmet Dermatol 2021; 21:689-697. [PMID: 33825333 DOI: 10.1111/jocd.14130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The treatment of facial erythema and subjective symptoms of rosacea patients remains challenging in clinical practice. Cosmeceuticals, care components containing active ingredients such as phytochemicals, play a growing role in treatment plans. However, well-designed studies on their efficacy and limitations are widely missing. OBJECTIVE A foam and a cream for rosacea patients were assessed based on objective and subjective methodology. The tolerability of skin and eyes was evaluated. METHODS A randomized, double-blinded, split-face, and vehicle-controlled trial was conducted. At baseline and after four weeks of product use, dermatological and ophthalmological investigations were performed, employing image analysis of facial erythema, clinical assessments, and questionnaires. RESULTS The patient cohort comprised 33 females with persistent facial erythema due to rosacea. No significant differences were found between the vehicle and the verum. According to the analysis of facial erythema, a "less pronounced" or "much less pronounced" appearance was seen in two thirds of patients comparing V1 to V0. Especially, the dryness of the skin improved by the use of the vehicle and the verum. Adverse subjective skin sensations decreased by 61.3% for the verum side and by 58.6% for the vehicle side. Subjective and objective analysis of ocular manifestation differed, with subjective manifestations reported more frequently, thus highlighting underdiagnosis of ocular rosacea. CONCLUSIONS As no clear differences between the verum and the vehicle were found, an optimal skin care regime itself seems to have a superior effect in the relief of facial erythema and foremost of subjective symptoms, rather than certain active ingredients.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
| | - Anne Charlotte Niesert
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
| | - Klaus-Peter Wilhelm
- proDERM Institut für Dermatologische Forschung GmbH, Schenefeld/Hamburg, Germany
| | - Katrin Knuhr
- proDERM Institut für Dermatologische Forschung GmbH, Schenefeld/Hamburg, Germany
| | - Marianne Brandt
- proDERM Institut für Dermatologische Forschung GmbH, Schenefeld/Hamburg, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
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Reinholz M, French LE. Medical education and care in dermatology during the SARS-CoV2 pandemia: challenges and chances. J Eur Acad Dermatol Venereol 2021; 34:e214-e216. [PMID: 32219888 DOI: 10.1111/jdv.16391] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Affiliation(s)
- M Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - L E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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Stadler PC, Senner S, Frey S, Clanner-Engelshofen BM, H Frommherz L, French LE, Reinholz M. Teledermatology in times of COVID-19. J Dermatol 2021; 48:620-624. [PMID: 33715181 PMCID: PMC8250059 DOI: 10.1111/1346-8138.15812] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/28/2021] [Indexed: 12/25/2022]
Abstract
Remote consultations are likely to grow in importance in the following years, especially if the coronavirus disease 2019 (COVID‐19) pandemic continues. Patients’ opinions on teledermatology have already been analyzed, but a current analysis during the COVID‐19 pandemic is lacking. The purpose of this survey was to investigate the satisfaction of patients who had received dermatological advice via telephone during the COVID‐19 pandemic and to analyze their general opinion about eHealth as well as possible limitations for a broad implementation. Ninety‐one patients managed in the dermatology department using telephone consultation during the COVID‐19 pandemic were interviewed. An anonymous questionnaire, including the established quality of life questionnaire (Dermatology Life Quality Index [DLQI]), was used. It was found that men were more satisfied with telephone consultations than women (p = 0.029), educational level and age did not correlate with satisfaction (p = 0.186 and 388, respectively), and the longer the waiting time for a telephone consultation, the lower the satisfaction (p = 0.001). Grouped analysis of all participants showed that the majority (54.0% n = 38/71) were “very happy” with the telephone consultation. Higher disease burden (DLQI) was associated with lower satisfaction (p = 0.042). The main stated reasons for using telemedicine were shorter waiting times (51.6% n = 47/91) and no travel requirement (57.1% n = 47/91). Almost one‐quarter (23.1% n = 21/89) of patients would use teledermatology in the future, 17.6% (n = 16/89) would not, and 57.1% (n = 51/89) would only use it in addition to a traditional consultation with personal contact. In conclusion, most patients in the study group still preferred traditional face‐to‐face medical consultations to telephone consultations, but also desired an add‐on telemedical tool. Dermatological care using more modern telemedicine technologies than telephone conferencing is needed to better address patients’ desires, especially in times of the COVID‐19 pandemic.
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Affiliation(s)
- Pia-Charlotte Stadler
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Sonja Senner
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Surina Frey
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | | | - Leonie H Frommherz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany.,Dr Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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Schlager JG, Kendziora B, Patzak L, Kupf S, Rothenberger C, Fiocco Z, French LE, Reinholz M, Hartmann D. Impact of COVID-19 on wound care in Germany. Int Wound J 2021; 18:536-542. [PMID: 33554436 PMCID: PMC8014846 DOI: 10.1111/iwj.13553] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/07/2020] [Accepted: 01/15/2021] [Indexed: 01/18/2023] Open
Abstract
Recent studies showed that the COVID‐19 pandemic caused collateral damage in health care in terms of reduced hospital submissions or postponed treatment of other acute or chronic ill patients. An anonymous survey was sent out by mail to patients with chronic wounds in order to evaluate the impact of the pandemic on wound care. Sixty‐three patients returned the survey. In 14%, diagnostic workup or hospitalisation was cancelled or postponed. Thirty‐six percent could not seek consultation by their primary care physician as usual. The use of public transport or long travel time was not related to limited access to medical service (P = .583). In ambulatory care, there was neither a significant difference in the frequency of changing wound dressings (P = .67), nor in the person, who performed wound care (P = .39). There were no significant changes in wound‐specific quality of life (P = .505). No patient used telemedicine in order to avoid face‐to‐face contact or anticipate to pandemic‐related restrictions. The COVID‐19 pandemic impaired access to clinical management of chronic wounds in Germany. It had no significant impact on ambulatory care or wound‐related quality of life. Telemedicine still plays a negligible role in wound care.
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Affiliation(s)
| | - Benjamin Kendziora
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Leilah Patzak
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Sophie Kupf
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | | | - Zeno Fiocco
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Daniela Hartmann
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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Kaemmerer T, Clanner‐Engelshofen BM, Fiocco Z, French LE, Reinholz M. Cryoglobulinemic vasculitis associated with chronic hepatitis C: a case of skin lesions/purpura in a 49‐year‐old Caucasian male patient. Int J Dermatol 2020; 59:e440-e442. [DOI: 10.1111/ijd.15179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/09/2020] [Accepted: 08/17/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Till Kaemmerer
- Department of Dermatology and Allergology University Hospital of Munich (LMU) Munich Germany
| | | | - Zeno Fiocco
- Department of Dermatology and Allergology University Hospital of Munich (LMU) Munich Germany
| | - Lars E. French
- Department of Dermatology and Allergology University Hospital of Munich (LMU) Munich Germany
| | - M. Reinholz
- Department of Dermatology and Allergology University Hospital of Munich (LMU) Munich Germany
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Weiland T, Brcic L, Reinholz M, French LE, Thurnher D. Response to: "Study results and related evidence do not support use of HPV16 L1 DRH1 antibodies as a cancer screening test". EBioMedicine 2020; 62:103139. [PMID: 33254024 PMCID: PMC7701314 DOI: 10.1016/j.ebiom.2020.103139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/28/2022] Open
Affiliation(s)
- Thomas Weiland
- Department of Otorhinolaryngology-Head&Neck Surgery, Medical University of Graz, Graz, Austria.
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Dietmar Thurnher
- Department of Otorhinolaryngology-Head&Neck Surgery, Medical University of Graz, Graz, Austria
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Maron RC, Utikal JS, Hekler A, Hauschild A, Sattler E, Sondermann W, Haferkamp S, Schilling B, Heppt MV, Jansen P, Reinholz M, Franklin C, Schmitt L, Hartmann D, Krieghoff-Henning E, Schmitt M, Weichenthal M, von Kalle C, Fröhling S, Brinker TJ. Artificial Intelligence and Its Effect on Dermatologists' Accuracy in Dermoscopic Melanoma Image Classification: Web-Based Survey Study. J Med Internet Res 2020; 22:e18091. [PMID: 32915161 PMCID: PMC7519424 DOI: 10.2196/18091] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/28/2020] [Accepted: 05/14/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Early detection of melanoma can be lifesaving but this remains a challenge. Recent diagnostic studies have revealed the superiority of artificial intelligence (AI) in classifying dermoscopic images of melanoma and nevi, concluding that these algorithms should assist a dermatologist's diagnoses. OBJECTIVE The aim of this study was to investigate whether AI support improves the accuracy and overall diagnostic performance of dermatologists in the dichotomous image-based discrimination between melanoma and nevus. METHODS Twelve board-certified dermatologists were presented disjoint sets of 100 unique dermoscopic images of melanomas and nevi (total of 1200 unique images), and they had to classify the images based on personal experience alone (part I) and with the support of a trained convolutional neural network (CNN, part II). Additionally, dermatologists were asked to rate their confidence in their final decision for each image. RESULTS While the mean specificity of the dermatologists based on personal experience alone remained almost unchanged (70.6% vs 72.4%; P=.54) with AI support, the mean sensitivity and mean accuracy increased significantly (59.4% vs 74.6%; P=.003 and 65.0% vs 73.6%; P=.002, respectively) with AI support. Out of the 10% (10/94; 95% CI 8.4%-11.8%) of cases where dermatologists were correct and AI was incorrect, dermatologists on average changed to the incorrect answer for 39% (4/10; 95% CI 23.2%-55.6%) of cases. When dermatologists were incorrect and AI was correct (25/94, 27%; 95% CI 24.0%-30.1%), dermatologists changed their answers to the correct answer for 46% (11/25; 95% CI 33.1%-58.4%) of cases. Additionally, the dermatologists' average confidence in their decisions increased when the CNN confirmed their decision and decreased when the CNN disagreed, even when the dermatologists were correct. Reported values are based on the mean of all participants. Whenever absolute values are shown, the denominator and numerator are approximations as every dermatologist ended up rating a varying number of images due to a quality control step. CONCLUSIONS The findings of our study show that AI support can improve the overall accuracy of the dermatologists in the dichotomous image-based discrimination between melanoma and nevus. This supports the argument for AI-based tools to aid clinicians in skin lesion classification and provides a rationale for studies of such classifiers in real-life settings, wherein clinicians can integrate additional information such as patient age and medical history into their decisions.
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Affiliation(s)
- Roman C Maron
- Digital Biomarkers for Oncology Group (DBO), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jochen S Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Achim Hekler
- Digital Biomarkers for Oncology Group (DBO), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Axel Hauschild
- Department of Dermatology, University Hospital Kiel, University of Kiel, Kiel, Germany
| | - Elke Sattler
- Department of Dermatology, University Hospital Munich (LMU), Munich, Germany
| | - Wiebke Sondermann
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Sebastian Haferkamp
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Bastian Schilling
- Department of Dermatology, University Hospital Würzburg, University of Würzburg, Würzburg, Germany
| | - Markus V Heppt
- Department of Dermatology, University Hospital Erlangen, University of Erlangen, Erlangen, Germany
| | - Philipp Jansen
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Markus Reinholz
- Department of Dermatology, University Hospital Munich (LMU), Munich, Germany
| | - Cindy Franklin
- Department of Dermatology, University Hospital Cologne, Cologne, Germany
| | - Laurenz Schmitt
- Department of Dermatology, University Hospital Aachen, Aachen, Germany
| | - Daniela Hartmann
- Department of Dermatology, University Hospital Munich (LMU), Munich, Germany
| | - Eva Krieghoff-Henning
- Digital Biomarkers for Oncology Group (DBO), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Max Schmitt
- Digital Biomarkers for Oncology Group (DBO), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Weichenthal
- Department of Dermatology, University Hospital Kiel, University of Kiel, Kiel, Germany
| | - Christof von Kalle
- Department of Clinical-Translational Sciences, Charité University Medicine and Berlin Institute of Health (BIH), Berlin, Germany
| | - Stefan Fröhling
- National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany
| | - Titus J Brinker
- Digital Biomarkers for Oncology Group (DBO), National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany
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Ruini C, Clanner-Engelshofen BM, Heppt M, Herzinger T, Sárdy M, Ruzicka T, French LE, Reinholz M. Cantharidin as an Alternative Treatment for Genital Warts: A Case Monitored With Optical Coherence Tomography. Acta Derm Venereol 2020; 100:adv00259. [PMID: 32852561 PMCID: PMC9235030 DOI: 10.2340/00015555-3623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Cristel Ruini
- Department of Dermatology and Allergology, University Hospital, Ludwig Maximilian University, Frauenlobstr. 9-11, DE-80337 Munich, Germany
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Guertler A, Jøntvedt NM, Clanner‐Engelshofen BM, Cappello C, Sager A, Reinholz M. Efficacy and safety results of micellar water, cream and serum for rosacea in comparison to a control group. J Cosmet Dermatol 2020; 19:2627-2633. [DOI: 10.1111/jocd.13591] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/22/2020] [Accepted: 06/29/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy University Hospital of Munich (LMU) Munich Germany
| | - Nora Marie Jøntvedt
- Department of Dermatology and Allergy University Hospital of Munich (LMU) Munich Germany
| | | | | | | | - Markus Reinholz
- Department of Dermatology and Allergy University Hospital of Munich (LMU) Munich Germany
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47
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Steeb T, Wessely A, Drexler K, Salzmann M, Toussaint F, Heinzerling L, Reinholz M, Berking C, Heppt MV. The Quality of Practice Guidelines for Melanoma: A Methodologic Appraisal with the AGREE II and AGREE-REX Instruments. Cancers (Basel) 2020; 12:cancers12061613. [PMID: 32570843 PMCID: PMC7352745 DOI: 10.3390/cancers12061613] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 12/21/2022] Open
Abstract
Multiple guidelines on cutaneous melanoma (CM) are available from several consortia and countries. To provide up-to-date guidance in the rapidly changing field of melanoma treatment, guideline developers have to provide regular updates without compromises of quality. We performed a systematic search in guideline databases, Medline and Embase to identify guidelines on CM. The methodological quality of the identified guidelines was independently assessed by five reviewers using the instruments “Appraisal of Guidelines for Research and Evaluation” (AGREE II) and “Recommendation EXcellence” (AGREE-REX). We performed descriptive analysis, explored subgroup differences using the Kruskal–Wallis (H) test and examined the relationship between distinct domains and items of the instruments with Spearman’s correlation. Six guidelines by consortia from Australia, France, Germany, Scotland, Spain and the United States of America were included. The German guideline fulfilled 71%–98% of criteria in AGREE II and 78%–96% for AGREE-REX, obtaining the highest scores. Deficiencies in the domains of “applicability” and “values and preferences” were observed in all guidelines. The German and Spanish guidelines significantly differed from each other in most of the domains. The domains “applicability” and “values and preferences” were identified as methodological weaknesses requiring careful revision and improvement in the future.
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Affiliation(s)
- Theresa Steeb
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.S.); (A.W.); (F.T.); (L.H.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany
| | - Anja Wessely
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.S.); (A.W.); (F.T.); (L.H.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany
| | - Konstantin Drexler
- Department of Dermatology, University Hospital Regensburg, 93053 Regensburg, Germany;
| | - Martin Salzmann
- Department of Dermatology, University Hospital Heidelberg, 69120 Heidelberg, Germany;
| | - Frédéric Toussaint
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.S.); (A.W.); (F.T.); (L.H.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany
| | - Lucie Heinzerling
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.S.); (A.W.); (F.T.); (L.H.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian University, 80337 Munich, Germany;
| | - Carola Berking
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.S.); (A.W.); (F.T.); (L.H.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany
| | - Markus V. Heppt
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (T.S.); (A.W.); (F.T.); (L.H.); (C.B.)
- Comprehensive Cancer Center Erlangen-European Metropolitan Area of Nürnberg (CCC ER-EMN), 91054 Erlangen, Germany
- Correspondence: ; Tel.: +49-9131-85-35747
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Guertler A, Moellhoff N, Schenck TL, Hagen CS, Kendziora B, Giunta RE, French LE, Reinholz M. Onset of occupational hand eczema among healthcare workers during the SARS-CoV-2 pandemic: Comparing a single surgical site with a COVID-19 intensive care unit. Contact Dermatitis 2020; 83:108-114. [PMID: 32452036 PMCID: PMC7283680 DOI: 10.1111/cod.13618] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/18/2020] [Accepted: 05/24/2020] [Indexed: 12/25/2022]
Abstract
Background As a result of the COVID‐19 outbreak, hygiene regulations have been revised and hand sanitation has been intensified. Objective To investigate the onset of hand eczema during the COVID‐19 pandemic in healthcare workers (HCWs) directly involved in intensive care of COVID‐19 patients and HCWs without direct contact with COVID‐19 patients. Hereby, we aim at increasing awareness about occupational hand eczema and preventive measures that can be adopted. Method A survey was distributed amongst 114 HCWs at a single surgical centre and at a COVID‐19 intensive care unit of the university hospital Ludwig Maximilian University Munich, Germany. Participants were questioned about the daily frequency of hand hygiene prior to and during the pandemic. Participants self‐reported the onset of hand eczema and associated symptoms. Results Our study revealed a significant increase in hand washing, disinfection, and use of hand cream across all participants (P‐value <.001), regardless of having direct contact with COVID‐19 patients. A high prevalence of symptoms associated with acute hand dermatitis of 90.4% was found across all HCWs, whereas hand eczema itself was underreported (14.9%). Conclusion The increase in hand sanitation during the COVID‐19 pandemic impairs the skin of the hands across all HCWs, independent of direct intensive care of affected patients.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Nicholas Moellhoff
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| | - Thilo L Schenck
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| | - Christine S Hagen
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| | - Benjamin Kendziora
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Riccardo E Giunta
- Division of Hand, Plastic and Aesthetic Surgery, University Hospital, LMU, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
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Hoepfner A, Marsela E, Clanner‐Engelshofen BM, Horvath ON, Sardy M, French LE, Reinholz M. Rosazea und periorale Dermatitis: Eine monozentrische, retrospektive Analyse des klinischen Erscheinungsbildes von 1032 Patienten. J Dtsch Dermatol Ges 2020; 18:561-570. [DOI: 10.1111/ddg.14120_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Andreas Hoepfner
- Klinik und Poliklinik für Dermatologie und Allergologie LMU Klinikum, München, Deutschland
| | - Enklajd Marsela
- Klinik und Poliklinik für Dermatologie und Allergologie LMU Klinikum, München, Deutschland
| | | | - Orsolya N. Horvath
- Klinik und Poliklinik für Dermatologie und Allergologie LMU Klinikum, München, Deutschland
- Department of Dermatology Venerology and Dermato‐oncology Semmelweis University Budapest Ungarn
| | - Miklos Sardy
- Department of Dermatology Venerology and Dermato‐oncology Semmelweis University Budapest Ungarn
| | - Lars E. French
- Klinik und Poliklinik für Dermatologie und Allergologie LMU Klinikum, München, Deutschland
| | - Markus Reinholz
- Klinik und Poliklinik für Dermatologie und Allergologie LMU Klinikum, München, Deutschland
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Hoepfner A, Marsela E, Clanner‐Engelshofen BM, Horvath ON, Sardy M, French LE, Reinholz M. Rosacea and perioral dermatitis: a single‐center retrospective analysis of the clinical presentation of 1032 patients. J Dtsch Dermatol Ges 2020; 18:561-570. [DOI: 10.1111/ddg.14120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/01/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Andreas Hoepfner
- Department of Dermatology and Allergy Hospital of the Ludwig Maximilian University of Munich Munich Germany
| | - Enklajd Marsela
- Department of Dermatology and Allergy Hospital of the Ludwig Maximilian University of Munich Munich Germany
| | | | - Orsolya N. Horvath
- Department of Dermatology and Allergy Hospital of the Ludwig Maximilian University of Munich Munich Germany
- Department of Dermatology Venerology and Dermato‐oncology Semmelweis University Budapest Hungary
| | - Miklos Sardy
- Department of Dermatology Venerology and Dermato‐oncology Semmelweis University Budapest Hungary
| | - Lars E. French
- Department of Dermatology and Allergy Hospital of the Ludwig Maximilian University of Munich Munich Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy Hospital of the Ludwig Maximilian University of Munich Munich Germany
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