TY - JOUR AB - BACKGROUND: Efficient staging and management of cutaneous melanoma, one of today's deadliest skin cancers, requires non-invasive determination of tumour depth (Breslow depth). However, current imaging technologies lack the necessary contrast or penetration to measure Breslow depth. OBJECTIVES: To determine if raster-scanning optoacoustic mesoscopy (RSOM) can fill this gap in dermatology. METHODS: We used phantoms to optimize RSOM for melanoma imaging and demonstrated its capability to image melanocytes at single-cell resolution in deep tissue. We then compared RSOM's ability to measure Breslow depth against the clinical standard in a pilot study. For the phantoms studies, we compared the ability of an optimized RSOM system to measure the concentration and diameter of single melanoma cells against gold-standard microscopy methods. For the pilot clinical study, we used linear regression to compare RSOM's Breslow depth against the clinical standard, obtaining the goodness of fit (R2) and the p-value. For the pilot clinical study, we imaged nine lesions: 7 superficially spreading melanomas, 1 benign dysplastic nevus and 1 blue nevus. The average age of the patients was 56.2 ± 12.5 years. We also imaged 10 non-lesional skin areas from healthy volunteers. RESULTS: By utilizing ultra-wideband frequency detection and optimized illumination wavelength, we show that RSOM achieves non-invasive imaging of melanoma at the resolution of single melanocytes, penetrating more than 3 mm into the skin. The agreement between RSOM and the standard-of-care histological assessment was R2 = 0.886 (p = 0.0002) for Breslow depth determination. CONCLUSIONS: RSOM provides non-invasive imaging performance that correlates with the Breslow depth determination. Further work is needed to confirm these findings and to test RSOM against other non-invasive methods. AU - Aguirre Bueno, J. AU - Gasteiger, C. AU - Hindelang, B. AU - Seeger, M. AU - Berezhnoi, A. AU - Weidenfeld, I. AU - Darsow, U.* AU - Stiel, A.-C. AU - Steimle-Grauer, S.A.* AU - Posch, C.* AU - Biedermann, T.* AU - Ntziachristos, V. C1 - 75064 C2 - 57786 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Non-invasive characterization of melanoma depth at single-cell resolution. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2025 SN - 0926-9959 ER - TY - JOUR AU - Aguirre Bueno, J. AU - Ntziachristos, V. C1 - 75735 C2 - 57938 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Response to letter to editor (doi: 10.1111/jdv.20888) on UWB-RSOM in melanoma depth assessment. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2025 SN - 0926-9959 ER - TY - JOUR AB - The skin barrier can be divided into at least four functional units: chemical, microbial, physical and immunological barriers. The chemical and microbial barriers have previously been shown to exhibit different characteristics in topographically distinct skin regions. There is increasing evidence that the physical and immunological barriers also show marked variability in different areas of the skin. Here, we review recent data on the topographical variations of skin barrier components, the contribution of these variations to the homeostatic function of the skin and their impact on the pathogenesis of specific immune-mediated skin diseases (such as atopic dermatitis and papulopustular rosacea). Recognition of these topographical barrier differences will improve our understanding of skin homeostasis and disease pathogenesis and provide a basis for body site-specific targeted therapies. AU - Dajnoki, Z.* AU - Kapitány, A.* AU - Eyerich, K.* AU - Eyerich, S. AU - Törőcsik, D.* AU - Szegedi, A.* C1 - 72564 C2 - 56650 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Topographical variations in the skin barrier and their role in disease pathogenesis. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2024 SN - 0926-9959 ER - TY - JOUR AU - Eyerich, S. AU - Eyerich, K.* C1 - 68902 C2 - 53754 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 2401-2402 TI - Iatrogenic switch from psoriasis to eczema: What does it mean and is it predictable? JO - J. Eur. Acad. Dermatol. Venereol. VL - 37 IS - 12 PB - Wiley PY - 2023 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Cutaneous bacterial dysbiosis is a characteristic hallmark of atopic dermatitis (AD) and it decisively influences the severity of the disease. Despite this, frequently used murine models of AD have not been characterized regarding the changes in skin microbiome communities. OBJECTIVE: To analyze the skin microbiome of two frequently used murine models for AD for assessing their applicability in translational research. METHODS: AD was induced in mice by topical application of calcipotriol, or oxazolone. Following comparable elicitation of AD-like dermatitis, including IgE induction, the skin microbial communities were analyzed and compared with human AD. RESULTS: We detected critical differences in the microbiota composition of diseased skin. In contrast to calcipotriol treatment, application of oxazolone induced significant changes of the cutaneous microbiota and a drastic drop of bacterial richness. Furthermore, an expansion of Staphylococci, particularly S. xylosus was observed in the oxazolone group, also displaying positive correlations with AD key markers including pH, TEWL, IL-4, TSLP and IL-33. CONCLUSIONS: In this article we show that i) the model of choice to investigate AD needs to be characterized for the cutaneous microbiota if applicable and ii) the oxazolone-mediated mixed Th1-Th2 immune response triggers microbiota-induced alterations which share similarities to dysbiosis in human AD and represents therefore a suitable model for translational research on AD if alterations of the microbiome are in the focus of the investigation. AU - Amar, Y.* AU - Schneider, E. AU - Köberle, M.* AU - Seeholzer, T. AU - Musiol, S. AU - Hölge, I.M.* AU - Gschwendtner, S. AU - Krappmann, D. AU - Steiger, K.* AU - Biedermann, T.* AU - Schmidt-Weber, C.B. AU - Alessandrini, F. C1 - 63985 C2 - 52037 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 705-716 TI - Microbial dysbiosis in a mouse model of atopic dermatitis mimics shifts in human microbiome and correlates with the key pro-inflammatory cytokines IL-4, IL-33 and TSLP. JO - J. Eur. Acad. Dermatol. Venereol. VL - 36 IS - 5 PB - Wiley PY - 2022 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Atopic dermatitis (AD) is a heterogeneous, chronic inflammatory skin disease linked to skin microbiome dysbiosis with reduced bacterial diversity and elevated relative abundance of Staphylococcus aureus (S. aureus). OBJECTIVES: We aimed to characterize the yet-incompletely understood association between the skin microbiome and patients' demographic and clinical cofactors in relation to AD severity. METHODS: The skin microbiome in 48 adult moderate-to-severe AD patients was investigated using next-generation deep sequencing (16S rRNA gene, V1-V3 region) followed by denoising (DADA2) to obtain amplicon sequence variant (ASV) composition. RESULTS: In lesional skin, AD severity was associated with S. aureus relative abundance (rS =0.53, p<0.001) and slightly better with the microbiome diversity measure Evenness (rS =-0.58, p<0.001), but not with Richness. Multiple regression confirmed the association of AD severity with microbiome diversity, including Shannon (in lesional skin, p<0.001), Evenness (in non-lesional skin, p=0.015), or S. aureus relative abundance (p<0.012), and with patient's IgE levels (p<0.001), race (p<0.032), age (p<0.034) and sex (p=0.012). The lesional model explained 62% of the variation in AD severity, and the non-lesional model 50% of the variation. CONCLUSIONS: Our results specify the frequently reported "reduced diversity" of the AD-related skin microbiome to reduced Evenness, which was in turn mainly driven by S. aureus relative abundance, rather than to a reduced microbiome Richness. Finding associations between AD severity, the skin microbiome and patient's cofactors is a key aspect in developing new personalized AD treatments, particularly those targeting the AD microbiome. AU - Rauer, L. AU - Reiger, M. AU - Bhattacharyya, M.* AU - Brunner, P.M.* AU - Krueger, J.G.* AU - Guttman-Yassky, E.* AU - Traidl-Hoffmann, C. AU - Neumann, A.U. C1 - 66857 C2 - 53328 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 772-782 TI - Skin microbiome and its association with host cofactors in determining atopic dermatitis severity. JO - J. Eur. Acad. Dermatol. Venereol. VL - 37 IS - 4 PB - Wiley PY - 2022 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Chronic inflammatory skin diseases such as atopic dermatitis (AD) and psoriasis (PSO) present major challenges in health care. Thus, biomarkers to identify disease trajectories and response to treatments to improve the lives of affected individuals warrant great research consideration. The requirements that these biomarkers must fulfill for use as practical clinical tools have not yet been adequately investigated. AIM: To identify the core elements of high-quality AD and PSO biomarkers to prepare recommendations for current biomarker research. METHOD: A cross-sectional two-round Delphi survey was conducted from August to October 2019 and October to November 2020. All participants were members of the BIOMAP project, an EU-funded consortium of clinicians, researchers, patient organizations and pharmaceutical industry partners. The first round consisted of three open-ended questions. Responses were qualitatively analyzed, and 26 closed statements were developed. For the second round, 'agreement' was assumed when the responses of ≥70% of the participants were ≥5 points on a 7-point Likert scale for each statement. Priority classification was based on mean scores (<20th-percentile=low, 20th-60th-percentile=medium, >60th-percentile=high). RESULTS: Twenty-one and twenty-six individuals participated in round one and two, respectively. From 26 statements that were included in round 2, 18 achieved agreement (8 concerning the performance, 8 for the purpose, and 2 on current obstacles). Seven statements were classified as high priority, e.g., those concerning reliability, clinical validity, a high positive predictive value, prediction of the therapeutic response, and disease progression. Another seven statements were assigned medium priority, e.g., those about analytical validity, prediction of comorbidities, and therapeutic algorithm. Low priority included four statements, like those concerning cost-effectiveness and prediction of disease flares. CONCLUSION: The core requirements that experts agreed on being essential for high-quality AD and PSO biomarkers, require rapid validation. Biomarkers can therefore be assessed based on these prioritized requirements. AU - Ziehfreund, S.* AU - Tizek, L.* AU - Hangel, N.* AU - Fritzsche, M.C.* AU - Weidinger, S.* AU - Smith, C.* AU - Bryce, P.J.* AU - Greco, D.* AU - van den Bogaard, E.H.* AU - Flohr, C.* AU - Rastrick, J.* AU - Eyerich, S. AU - Buyx, A.* AU - Conrad, C.* AU - Eyerich, K.* AU - Zink, A.* C1 - 64862 C2 - 52523 SP - 1467-1476 TI - Requirements and expectations of high-quality biomarkers for atopic dermatitis and psoriasis in 2021 - a two-round Delphi survey among international experts. JO - J. Eur. Acad. Dermatol. Venereol. VL - 36 IS - 9 PY - 2022 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease affecting apocrine gland-bearing skin in the axilla, groin and under the breasts. Mutations of the gamma-secretase gene complex, which is essential in the activation of Notch signalling pathways were shown in some families with HS and in a few sporadic cases. Although an imbalance in Notch signalling is implicated in the pathogenesis, the exact mechanism of HS development is yet unknown. OBJECTIVES: We aim to investigate the genetic basis of HS by determining the presence of mutations of gamma-secretase gene complex in a cohort of HS patients and by searching for a disease-causing pathogenic variant in a multi-generational HS family using parametric linkage analysis. METHODS: Thirty-eight patients clinically diagnosed with HS were included in this study. All exons and exon-intron boundaries of the genes encoding gamma-secretase complex consisting of six genes: APH1A, APH1B, PSENEN, NCSTN, PSEN1 and PSEN2 were sequenced by Sanger technique. Genetic mapping with parametric linkage analysis for the patients in the family was performed with eight affected and four healthy individuals. The logarithm of odds was calculated. RESULTS: In a sporadic patient with early-onset, severe lesions in axilla and groin, a novel single nucleotide deletion causing frameshift in exon 1 of the NCSTN gene was identified ((NM_015331.3): c.38delG, p.(Gly13Glufs*15)). The LOD score of 1.5 was never exceeded in any region of the genome, pointing towards intricate multigenic inheritance pattern within the affected family. CONCLUSIONS: The gamma-secretase gene complex mutations were rare in our cohort (3.2%). Besides, our analysis indicates a possible complex multigenic inheritance in a seemingly autosomal dominantly inherited large HS family. Genetics of both familial and sporadic HS may be complicated in most cases, and the role of other potential genes such as autoinflammatory and modifier genes as well as environmental factors may influence the pathogenesis. AU - Vural, S.* AU - Baumgartner, M.* AU - Lichtner, P. AU - Eckstein, G.N. AU - Hariry, H.* AU - Chen, W.* AU - Ruzicka, T.* AU - Melnik, B.* AU - Plewig, G.* AU - Wagner, M. AU - Giehl, K.A.* C1 - 61324 C2 - 50153 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 1386-1392 TI - Investigation of gamma secretase gene complex mutations in German population with Hidradenitis suppurativa designate a complex polygenic heritage. JO - J. Eur. Acad. Dermatol. Venereol. VL - 35 IS - 6 PB - Wiley PY - 2021 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Hand eczema is a common inflammatory skin disorder in both adolescence and adulthood. OBJECTIVES: We sought to assess the lifetime prevalence of hand eczema and associated exogenous and endogenous risk factors among adolescents in Germany. METHODS: This was a cross-sectional study embedded into a prospective population-based birth cohort in four regions of Germany, which recruited healthy neonates born between November 1997 and January 1999. We included 1,736 participants who had completed the 15-year follow-up from birth cohort and 84.6% (1,468/1,736) had clearly reported whether they have ever had hand eczema. All the data was based on questionnaires and blood tests (immunoglobulin E). Multivariable logistic regression analysis was used to examine endogenous and exogenous factors in relation to the lifetime prevalence of hand eczema among adolescents. RESULTS: 1,468 adolescents (715 girls, 48.7%) were included in the final analysis. The lifetime prevalence of hand eczema among adolescents at the age of 15 was 10.4% (95% confidence interval [CI]: 8.9%-12.1%), with a significantly higher lifetime prevalence among girls than boys (12.7% vs. 8.2%, P = 0.005). Multivariable logistic regression analysis indicated statistically significant associations between the lifetime prevalence of hand eczema and having ever been diagnosed with atopic dermatitis (aOR = 1.8, 95% CI: 1.1-2.8) or having ever had dry skin (aOR=1.9, 95% CI: 1.1-3.1), respectively. No statistically significant independent associations were found between asthma, hay fever, allergy-related clinical symptoms, immunoglobulin E positivity and other exogenous factors in relation to hand eczema. CONCLUSION: Our study fills a research gap on the epidemiological burden of hand eczema among adolescents. One out of ten ever suffered from hand eczema until age 15 years indicating that hand eczema constitutes a significant burden in pediatric populations. The role of atopic dermatitis in hand eczema reinforces previous findings. Exogenous risk factors warrant further investigation. AU - Wang, J.* AU - Tischer, C.* AU - Standl, M. AU - Weidinger, S.* AU - von Berg, A.* AU - Herberth, G.* AU - Yew, Y.W.* AU - Heinrich, J.* AU - Schmitt, J.* AU - Apfelbacher, C.* C1 - 63655 C2 - 51743 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Lifetime prevalence and determinants of hand eczema in an adolescent population in Germany: 15-year follow-up of the LISA cohort study. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2021 SN - 0926-9959 ER - TY - JOUR AB - Social and psychosocial factors are thought to have an effect on the course of atopic eczema. The aim of this scoping review was to search for and summarize observational studies that investigated the effects of (psycho-)social factors on symptoms in atopic eczema and to identify research gaps. We searched PubMed and PsycINFO for literature published between 1 January 1989 and 31 December 2019 using a systematic search strategy. We included observational studies that analysed the effect of (psycho-)social factors on symptom severity in atopic eczema patients. Reviews and non-observational studies, articles with research on animals, and articles with languages other than English or German were excluded. We identified 17 observational studies that met the inclusion criteria. Several studies found significant results for an exacerbating effect of stress on atopic eczema severity. Although coping and social support does not seem to moderate the effect of stress, coping strategies might mediate the impact that stress has on symptoms. Depression is associated with atopic eczema severity. The effect of depression as a consequence of atopic eczema severity is stronger than the effect as an exacerbating factor. Illness identity, anger, frustration and psychosomatic states have been found to affect atopic eczema symptoms. For attachment security, anxiety and social status, contradictory results were found. Statistically non-significant results were reported for personality, being in a partnership, satisfaction with the partnership, childhood experiences and body consciousness. Only the association between psychosocial stress and atopic eczema symptom severity seems robust. To date, other (psycho-)social factors, especially protective and health-promoting factors, were analysed only in a few studies, mostly with low sample sizes and cross-sectional design. Biopsychosocial interactions between stress, protective factors and the course of atopic eczema as well as the psycho-neuroimmunological mechanisms underlying those interactions are considered fields for future research contributions. AU - Zeiser, K. AU - Hammel, G. AU - Kirchberger, I. AU - Traidl-Hoffmann, C. C1 - 60668 C2 - 49580 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Social and psychosocial effects on atopic eczema symptom severity - a scoping review of observational studies published from 1989 to 2019. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2021 SN - 0926-9959 ER - TY - JOUR AB - Background: Key pathogenic events of psoriasis and atopic eczema (AE) are misguided immune reactions of the skin. IL-17C is an epithelial-derived cytokine, whose impact on skin inflammation is unclear. Objective: We sought to characterize the role of IL-17C in human ISD. Methods: IL-17C gene and protein expression was assessed by immunohistochemistry and transcriptome analysis. Primary human keratinocytes were stimulated and expression of cytokines chemokines was determined by qRT-PCR and luminex assay. Neutrophil migration towards supernatant of stimulated keratinocytes was assessed. IL-17C was depleted using a new IL-17C-specific antibody (MOR106) in murine models of psoriasis (IL-23 injection model) and AE (MC903 model) as well as in human skin biopsies of psoriasis and AE. Effects on cell influx (mouse models) and gene expression (human explant cultures) were determined. Results: Expression of IL-17C mRNA and protein was elevated in various ISD. We demonstrate that IL-17C potentiates the expression of innate cytokines, antimicrobial peptides (IL-36G, S100A7 and HBD2) and chemokines (CXCL8, CXCL10, CCL5 and VEGF) and the autocrine induction of IL-17C in keratinocytes. Cell-free supernatant of keratinocytes stimulated with IL-17C was strongly chemotactic for neutrophils, thus demonstrating a critical role for IL-17C in immune cell recruitment. IL-17C depletion significantly reduced cell numbers of T cells, neutrophils and eosinophils in murine models of psoriasis and AE and led to a significant downregulation of inflammatory mediators in human skin biopsies of psoriasis and AE ex vivo. Conclusion: IL-17C amplifies epithelial inflammation in Th2 and Th17 dominated skin inflammation and represents a promising target for the treatment of ISD. AU - Lauffer, F.* AU - Jargosch, M.* AU - Baghin, V.* AU - Krause, L. AU - Kempf, W.* AU - Absmaier-Kijak, M.* AU - Morelli, M.* AU - Madonna, S.* AU - Marsais, F.* AU - Lepescheux, L.* AU - Albanesi, C.* AU - Müller, N.S. AU - Theis, F.J. AU - Schmidt-Weber, C.B. AU - Eyerich, S. AU - Biedermann, T.* AU - Vandeghinste, N.* AU - Steidl, S.* AU - Eyerich, K.* C1 - 57496 C2 - 47818 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 800-809 TI - IL-17C amplifies epithelial inflammation in human psoriasis and atopic eczema. JO - J. Eur. Acad. Dermatol. Venereol. VL - 34 IS - 4 PB - Wiley PY - 2020 SN - 0926-9959 ER - TY - JOUR AB - The 2019 Interactive Derma Academy (IDeA) meeting was held in Lisbon, Portugal, 10–12 May, bringing together leading dermatology experts from across Europe, the Middle East and Asia. Over three days, the latest developments and challenges in relation to the pathophysiology, diagnosis, evaluation and management of dermatological conditions were presented, with a particular focus on acne, atopic dermatitis (AD) and actinic keratosis (AK). Interesting clinical case studies relating to these key topics were discussed with attendees to establish current evidence-based best practices. Presentations reviewed current treatments, potential therapeutic approaches and key considerations in the management of acne, AK and AD, and discussed the importance of the microbiome in these conditions, as well as the provision of patient education/support. It was highlighted that active treatment is not always required for AK, depending on patient preferences and clinical circumstances. In addition to presentations, two interactive workshops on the diagnosis and treatment of sexually transmitted infections/diseases (STIs/STDs) presenting to the dermatology clinic, and current and future dermocosmetics were conducted. The potential for misdiagnosis of STIs/STDs was discussed, with dermoscopy and/or reflectance confocal microscopy suggested as useful diagnostic techniques. In addition, botulinum toxin was introduced as a potential dermocosmetic, and the possibility of microbiome alteration in the treatment of dermatological conditions emphasized. Furthermore, several challenges in dermatology, including the use of lasers, the complexity of atopic dermatitis, wound care, use of biosimilars and application of non-invasive techniques in skin cancer diagnosis were reviewed. In this supplement, we provide an overview of the presentations and discussions from the fourth successful IDeA meeting, summarizing the key insights shared by dermatologists from across the globe. AU - Luger, T.* AU - Dirschka, T.* AU - Eyerich, K.* AU - Gollnick, H.* AU - Gupta, G.* AU - Lambert, J.* AU - Micali, G.* AU - Ochsendorf, F.* AU - Ständer, S.* AU - Traidl-Hoffmann, C. C1 - 60838 C2 - 49647 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 3-18 TI - Developments and challenges in dermatology: An update from the Interactive Derma Academy (IDeA) 2019. JO - J. Eur. Acad. Dermatol. Venereol. VL - 34 IS - S7 PB - Wiley PY - 2020 SN - 0926-9959 ER - TY - JOUR AB - Participation of patients is key to establishing successful prevention programs in health care. Unfortunately, the attendance of follow-up appointments in our study was low due to various reasons. In general, our impression during the study was that anal Pap smear screening was well-tolerated by study participants and low patient acceptance of the examination was not the main reason for a low rate of follow-up appointments1 . AU - Schwierzeck, V. AU - Todorova, A. AU - Traidl-Hoffmann, C. C1 - 57852 C2 - 48106 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Response to ‘Anal cancer screening and Pap testing acceptability among HIV-positive men who have sex with men populations’. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2020 SN - 0926-9959 ER - TY - JOUR AB - Background The Atopic Dermatitis (AD) TREATgermany registry was initiated by the German Society for Dermatology (DDG) in 2011 to evaluate the 'real-life' situation of health care for patients with AD.Objectives Interim data analysis on baseline characteristics as well as current and prescribed systemic treatments of the TREATgermany registry patients.Methods Patients (>= 18 years) with moderate-to-severe AD [objective (o)SCORAD > 20], or with current or previous anti-inflammatory systemic treatment for AD within 24 months, were included and are followed up over at least 24 months. To assess clinical signs, the eczema area severity index (EASI, 0-72), the oSCORAD (0-83) and the Investigator Global Assessment (IGA; 6-point scale) were used. The disease severity was globally scored by the patients [Patient Global Assessment (PGA); six-step Likert scale]. Disease symptoms were assessed by the patient-oriented eczema measure (POEM, 0-28) and numeric rating scales (NRS, 0-10). Health-related quality of life was measured using the dermatological life quality index (DLQI, 0-30).Results A total of 612 patients were recruited across 32 sites between 06/2016 and 01/2019 (mean age: 42.6 +/- 14.2 years; mean oSCORAD: 40.8 +/- 16.3). The mean POEM score was 16.3 +/- 7.5. Pruritus was rated highest among subjective symptoms (NRS: 5.4 +/- 2.7). The mean DLQI value was 11.3 +/- 7.5. The frequency of arterial hypertension was lower (20.8%) compared with the general population, whilst this was higher for depression (10%). More than 60% of the patients had received systemic glucocorticosteroids, and 36.8% had received cyclosporine A prior to inclusion. Dupilumab was the leading substance documented as either 'current' (12.1%) or 'prescribed' (31.4%) at baseline.Conclusions These 'real-life' data clearly demonstrate the substantial disease burden. Most of TREATgermany patients were already treated with or prescribed dupilumab at baseline. Moreover, current findings indicate the urgent need for further alternative agents in order to achieve a perceptible improvement of quality of life of patients with moderate-to-severe AD. AU - Heratizadeh, A.* AU - Haufe, E.* AU - Stölzl, D.* AU - Abraham, S.* AU - Heinrich, L.* AU - Kleinheinz, A.* AU - Wollenberg, A.* AU - Weisshaar, E.* AU - Augustin, M.* AU - Wiemers, F.* AU - Zink, A. AU - von Kiedrowski, R.* AU - Hilgers, M.* AU - Worm, M.* AU - Pawlak, M.* AU - Sticherling, M.* AU - Fell, I.* AU - Handrick, C.* AU - Schäkel, K.* AU - Staubach-Renz, P.* AU - Asmussen, A.* AU - Schwarz, B.* AU - Bell, M.* AU - Effendy, I.* AU - Bieber, T.* AU - Homey, B.* AU - Gerlach, B.* AU - Tchitcherina, E.* AU - Stahl, M.* AU - Schwichtenberg, U.* AU - Rossbacher, J.* AU - Buck, P.* AU - Mempel, M.* AU - Beissert, S.* AU - Biedermann, T. AU - Weidinger, S.* AU - Schmitt, J.* AU - Werfel, T.* C1 - 57791 C2 - 47890 CY - 111 River St, Hoboken 07030-5774, Nj Usa TI - Baseline characteristics, disease severity and treatment history of patients with atopic dermatitis included in the German AD Registry TREATgermany. JO - J. Eur. Acad. Dermatol. Venereol. PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - In recent years, several non-invasive imaging methods have been introduced to facilitate diagnostics and therapy monitoring in dermatology. The microscopic imaging methods are restricted in their penetration depth, while the mesoscopic methods probe deeper but provide only morphological, not functional, information. 'Raster-scan optoacoustic mesoscopy' (RSOM), an emerging new imaging technique, combines deep penetration with contrast based on light absorption, which provides morphological, molecular and functional information. Here, we compare the capabilities and limitations of currently available dermatological imaging methods and highlight the principles and unique abilities of RSOM. We illustrate the clinical potential of RSOM, in particular for non-invasive diagnosis and monitoring of inflammatory and oncological skin diseases. AU - Hindelang, B. AU - Aguirre Bueno, J. AU - Schwarz, M. AU - Berezhnoi, A. AU - Eyerich, K.* AU - Ntziachristos, V. AU - Biedermann, T.* AU - Darsow, U.* C1 - 54719 C2 - 45811 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 1051-1061 TI - Non-invasive imaging in dermatology and the unique potential of raster-scan optoacoustic mesoscopy. JO - J. Eur. Acad. Dermatol. Venereol. VL - 33 IS - 6 PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - Background Imbalances of T-cell subsets are hallmarks of disease-specific inflammation in psoriasis. However, the relevance of B cells for psoriasis remains poorly investigated. Objective To analyse the role of B cells and immunoglobulins for the disease-specific immunology of psoriasis. Methods We characterized B-cell subsets and immunoglobulin levels in untreated psoriasis patients (n = 37) and compared them to healthy controls (n = 20) as well as to psoriasis patients under disease-controlling systemic treatment (n = 28). B-cell subsets were analysed following the flow cytometric gating strategy based on the surface markers CD24, CD38 and CD138. Moreover, immunofluorescence stainings were used to detect IgA in psoriatic skin. Results We found significantly increased levels of IgA in the serum of treatment-naive psoriasis patients correlating with disease score. However, IgA was only observed in dermal vessels of skin sections. Concerning B-cell subsets, we only found a moderately positive correlation of CD138(+) plasma cells with IgA levels and disease score in treatment-naive psoriasis patients. Confirming our hypothesis that psoriasis can develop in the absence of functional humoral immunity, we investigated a patient who suffered concomitantly from both psoriasis and a hereditary common variable immune defect (CVID) characterized by a lack of B cells and immunoglobulins. We detected variants in three of the 13 described genes of CVID and a so far undescribed variant in the ligand of the TNFRSF13B receptor leading to disturbed B-cell maturation and antibody production. However, this patient showed typical psoriasis regarding clinical presentation, histology or T-cell infiltrate. Finally, in a group of psoriasis patients under systemic treatment, neither did IgA levels drop nor did plasma cells correlate with IgA levels and disease score. Conclusion B-cell alterations might rather be an epiphenomenal finding in psoriasis with a clear dominance of T cells over shifts in B-cell subsets. AU - Thomas, J. AU - Küpper, M.* AU - Batra, R. AU - Jargosch, M.* AU - Atenhan, A. AU - Baghin, V.* AU - Krause, L. AU - Lauffer, F.* AU - Biedermann, T.* AU - Theis, F.J. AU - Eyerich, K.* AU - Eyerich, S. AU - Garzorz-Stark, N.* C1 - 53593 C2 - 44927 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 115-122 TI - Is the humoral immunity dispensable for the pathogenesis of psoriasis? JO - J. Eur. Acad. Dermatol. Venereol. VL - 33 IS - 1 PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - Authorship correction on Is the humoral immunity dispensable for the pathogenesis of psoriasis? Thomas J, Küpper M, Batra R, Jargosch M, Atenhan A, Baghin V, Krause L, Lauffer F, Biedermann T, Theis FJ, Eyerich K, Eyerich S, Garzorz-Stark N. J Eur Acad Dermatol Venereol. 2019 Jan; 33(1): 115–122. https://doi.org/10.1111/jdv.15101. Epub 2018 Jul 2. This corrigendum is to note that the name of Prof. Carsten Schmidt-Weber was inadvertently omitted as an author in the initial version of the paper. Schmidt-Weber CB has been added for his participation and contributions in this project. AU - Thomas, J. AU - Küpper, M.* AU - Batra, R. AU - Jargosch, M.* AU - Atenhan, A. AU - Baghin, V.* AU - Krause, L.* AU - Lauffer, F.* AU - Biedermann, T.* AU - Theis, F.J. AU - Eyerich, K.* AU - Schmidt-Weber, C.B. AU - Eyerich, S. AU - Garzorz-Stark, N.* C1 - 57448 C2 - 47799 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 2380-2380 TI - Is the humoral immunity dispensable for the pathogenesis of psoriasis? (vol 33, pg 115, 2019). JO - J. Eur. Acad. Dermatol. Venereol. VL - 33 IS - 12 PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - Background Conjunctivitis is common in patients with atopic dermatitis (AD) in general and a commonly reported adverse event in AD clinical trials with dupilumab. Objective To survey opinions and experience about conjunctivitis occurring in AD, including those during dupilumab treatment in a group of AD experts from the International Eczema Council (IEC). Methods Electronic survey and in-person discussion of management strategies. Results Forty-six (53.5%) IEC members from 19 countries responded to the survey. Consensus was reached for several statements regarding diagnostic workup, referral and treatment. IEC members suggest that patients with AD should (i) routinely be asked about ocular complaints or symptoms, (ii) obtain information about the potential for conjunctivitis before starting dupilumab therapy and (iii) if indicated, be treated with dupilumab despite previous or current conjunctivitis. In cases of new-onset conjunctivitis, there was consensus that dupilumab treatment should be continued when possible, with appropriate referral to an ophthalmologist. Limitations The study relies on expert opinion from dermatologists. Responses from few dermatologists without dupilumab access were not excluded from the survey. Conclusion The IEC recommends that dermatologists address conjunctivitis in patients with AD, especially during treatment with dupilumab. AU - Thyssen, J.P.* AU - de Bruin-Weller, M.S.* AU - Paller, A.S.* AU - Leshem, Y.A.* AU - Vestergaard, C.* AU - Deleuran, M.* AU - Drucker, A.M.* AU - Foelster-Holst, R.* AU - Traidl-Hoffmann, C. AU - Eyerich, K.* AU - Taïeb, A.* AU - Su, J.C.* AU - Bieber, T.* AU - Cork, M.J.* AU - Eichenfield, L.F.* AU - Guttman-Yassky, E.* AU - Wollenberg, A.* C1 - 55983 C2 - 46735 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 1224-1231 TI - Conjunctivitis in atopic dermatitis patients with and without dupilumab therapy - international eczema council survey and opinion. JO - J. Eur. Acad. Dermatol. Venereol. VL - 33 IS - 7 PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - Background Incidence of anal carcinoma is increased in people living with HIV (PLWH). Due to the improved life expectancy in PLWH, identifying appropriate prevention strategies for non-AIDS-defining cancer types such as anal carcinoma has become a priority in managing PLWH today. Objective We aimed to evaluate anal cytology assessment as screening tool for anal dysplasia and/or carcinoma in PLWH, regardless of gender or sexual orientation. Additionally, we investigated the correlation between cancer risk factors and abnormal screening results in our patient cohort. Methods People living with HIV from the Interdisciplinary HIV Centre of the University Hospital rechts der Isar in Munich, Germany (IZAR), were screened for anal carcinoma by single cytobrush examination and anal Papanicolaou (PAP) smear assessment from 2013 to 2015. Patients with abnormal PAP smear result were offered a follow-up examination after 12 months. Differences between two groups were tested for statistical significance using Student's t-test and Mann-Whitney U-test, as appropriate. Results In total, 101 PLWH were included. 26.7% of subjects (n = 27) were PAP IIID, and 9.9% (n = 10) were PAP IVa. Seven female subjects had an abnormal finding at screening. Smoking was significantly associated with abnormal findings at screening (P = 0.005). In addition, our study found an association between sexually transmitted infections (STI) and anal dysplasia. Condylomata acuminata were increased in subjects with PAP IIID/PAP IVa (P = 0.045). Reactive syphilis serology was found to be significantly associated with abnormal screening results (P = 0.016), respectively. Conclusion Our results demonstrate that smoking and two common STIs, condylomata acuminata and syphilis, are risk factors associated with advanced anal intraepithelial neoplasia (AIN) stages in our PLWH cohort. While further analysis is needed to determine diagnostic guidelines concerning AIN in PLWH, these results suggest that interdisciplinary lifestyle prevention strategies are required to reduce the risk factors for AIN in PLWH in an outpatient setting. AU - Todorova, A. AU - Schwierzeck, V. AU - Turek, D. AU - Zink, A.* AU - Schwerdtfeger, C.* AU - Kaliebe, K.* AU - Spinner, C.D.* AU - Traidl-Hoffmann, C. C1 - 56037 C2 - 46771 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 1595-1601 TI - Evaluation of anal carcinoma screening in male and female HIV patients at an interdisciplinary HIV therapy centre. JO - J. Eur. Acad. Dermatol. Venereol. VL - 33 IS - 8 PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - Linked article: R. Launois et al. J Eur Acad Dermatol Venereol 2019; 33: 1921-1927. . AU - Zink, A. C1 - 57129 C2 - 47563 CY - 111 River St, Hoboken 07030-5774, Nj Usa SP - 1817-1817 TI - The financial impact of atopic eczema paid out-of-pocket by affected patients in France. JO - J. Eur. Acad. Dermatol. Venereol. VL - 33 IS - 10 PB - Wiley PY - 2019 SN - 0926-9959 ER - TY - JOUR AB - Skin affections after sulfur mustard (SM) exposure include erythema, blister formation and severe inflammation. An antidote or specific therapy does not exist. Anti-inflammatory compounds as well as substances counteracting SM-induced cell death are under investigation. In this study, we investigated the benzylisoquinoline alkaloide berberine (BER), a metabolite in plants like berberis vulgaris, which is used as herbal pharmaceutical in Asian countries, against SM toxicity using a well-established in vitro approach. Keratinocyte (HaCaT) mono-cultures (MoC) or HaCaT/THP-1 co-cultures (CoC) were challenged with 100, 200 or 300 mM SM for 1 h. Post-exposure, both MoC and CoC were treated with 10, 30 or 50 mu M BER for 24 h. At that time, supernatants were collected and analyzed both for interleukine (IL) 6 and 8 levels and for content of adenylate-kinase (AK) as surrogate marker for cell necrosis. Cells were lysed and nucleosome formation as marker for late apoptosis was assessed. In parallel, AK in cells was determined for normalization purposes. BER treatment did not influence necrosis, but significantly decreased apoptosis. Anti-inflammatory effects were moderate, but also significant, primarily in CoC. Overall, BER has protective effects against SM toxicity in vitro. Whether this holds true should be evaluated in future in vivo studies. AU - Schielein, M.C.* AU - Tizek, L.* AU - Rotter, M. AU - Konstantinow, A.* AU - Biedermann, T.* AU - Zink, A.* C1 - 52982 C2 - 44688 CY - Elsevier House, Brookvale Plaza, East Park Shannon, Co, Clare, 00000, Ireland SP - 978-984 TI - Guideline-compliant prescription of biologicals and possible barriers in dermatological practices in Bavaria. JO - J. Eur. Acad. Dermatol. Venereol. VL - 32 IS - 6 PB - Elsevier Ireland Ltd PY - 2018 SN - 0926-9959 ER - TY - JOUR AB - European Academy of Dermatology and Venereology. Non-communicable inflammatory skin diseases (ncISD) such as psoriasis or atopic eczema are a major cause of global disease burden. Due to their impact and complexity, ncISD represent a major challenge of modern medicine. Dermatology textbooks describe more than 100 different ncISD based on clinical phenotype and histological architecture. In the last decades, this historical description was complemented by increasing molecular knowledge - and this knowledge is now being translated into specific therapeutics. Combining the enormous advances made in lymphocyte immunology and molecular genetics with clinical and histological phenotyping reveals six immune response patterns of the skin - type I immune cells cause the lichenoid pattern characterized by immune-mediated cell death of keratinocytes; type II immune cells underlie the eczematous pattern with impaired epidermal barrier, infection and eosinophils as well as the bullous pattern with loss of epithelial integrity; Th17 cells and ILC3 mediate the psoriatic pattern characterized by acanthosis, high metabolic activity and neutrophils; dysbalance of regulatory T cells causes either the fibrogenic pattern with rarefication of cells and dermal thickening or the granulomatous pattern defined by formation of granulomas. With more and more specific therapeutic agents approved, classifying ncISD also according to their immune response pattern will become highly relevant. This review defines the six immune response patterns of ncISD and highlights therapeutic strategies targeting key lymphocyte mediators. AU - Eyerich, K.* AU - Eyerich, S. C1 - 52297 C2 - 43896 SP - 692-703 TI - Immune response patterns in non-communicable inflammatory skin diseases. JO - J. Eur. Acad. Dermatol. Venereol. VL - 32 IS - 5 PY - 2017 SN - 0926-9959 ER - TY - JOUR AB - A 66-year old male patient was known being HIV-positive for more than 10 years at CDC stage C3. At regularly presentation, a transient viremia with HIV PCR of 322 cps/ml and CD4=120/μl was detected under therapy with Tenofovirdisaproxil fumarate, Emtricitabine and Norvir-boosted Atazanavir. However, the general condition of the patient was stable for years. Additionally, he demonstrated a skin lesion on his left lower leg, which occurred few weeks prior to consultation without any further symptoms. Dermatological clinical examination showed a single 10 x 7 centimeters large erythematous-brownish infiltrated plaque on the left lower leg (Fig. 1). Under the clinical diagnosis of cutaneous lymphoma a punch biopsy was taken from the affected area. AU - Todorova, A. AU - Zink, A.* AU - Spinner, C.D.* AU - Schielein, M.* AU - Vogelmann, R.* AU - Weirich, G.* AU - Rudelius, M.* AU - Andres, C.* AU - Traidl-Hoffmann, C. C1 - 51206 C2 - 42699 CY - Hoboken SP - E428-E429 TI - Primary skin manifestation of plasmoblastic lymphoma in an AIDS patient with long term survival. JO - J. Eur. Acad. Dermatol. Venereol. VL - 31 IS - 10 PB - Wiley PY - 2017 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Non-melanoma skin cancer (NMSC) was officially recognized in 2015 as an occupational disease for outdoor workers in Germany. Together with the enormous socioeconomic impact of NMSC, this has led to the continuous demand of evidence-based prevention. However, studies assessing the perceptions and beliefs along with risk behavior of outdoor workers as an essential prerequisite for prevention are rare. OBJECTIVE: To assess perceptions, beliefs, barriers, risk and preventive behavior towards non-melanoma skin cancer among different outdoor groups as a basis for the development of sustainable prevention programs. PATIENTS AND METHODS: Cross-sectional study among outdoor workers of three different occupational groups (farmer, gardener, roofer) using a 20-question online survey on NMSC awareness, risk and preventive behavior. RESULTS: Between March and April 2016, 353 outdoor workers participated in the study. Of these, 153 (43.4%) reported never to use sunscreen during work. Wearing headgear and long pants were the most common sun protection measures. Poor use of sunscreen was more likely in males and farmers. A low perceived skin cancer risk was significantly associated with poor use of sunscreen, long-sleeved shirts, sunglasses and headgear. CONCLUSIONS: Despite great evidence on NMSC risk in outdoor professions throughout the literature, high risk groups in fact are not yet aware of the topic. Sustainable target group oriented awareness prevention programs are needed to lower the immense burden of NMSC. AU - Zink, A.* AU - Wurstbauer, D.* AU - Rotter, M. AU - Wildner, M.* AU - Biedermann, T.* C1 - 50939 C2 - 42646 CY - Hoboken SP - 1649-1654 TI - Do outdoor workers know their risk of NMSC? Perceptions, beliefs and preventive behaviour among farmers, roofers and gardeners. JO - J. Eur. Acad. Dermatol. Venereol. VL - 31 IS - 10 PB - Wiley PY - 2017 SN - 0926-9959 ER - TY - JOUR AU - Garzorz-Stark, N.* AU - Papanagiotou, V.* AU - Atenhan, A. AU - Andres, C.* AU - Eyerich, S. AU - Eyerich, K.* AU - Ring, J.* AU - Brockow, K.* C1 - 31899 C2 - 34855 SP - 141–143 TI - Pyoderma gangrenosum, Acne, Psoriasis, Arthritis and Suppurative Hidradenitis (PAPASH)-syndrome: A new entity within the spectrum of autoinflammatory syndromes? JO - J. Eur. Acad. Dermatol. Venereol. VL - 30 IS - 1 PY - 2016 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: The phenomenon of allergy transfer from an allergic donor to a non-allergic recipient via hematopoietic cell transplantation has been described by several reports. However, it could not yet been conclusively shown that allergic reaction of the recipient is elicited by the donor's cells. OBJECTIVES: In the case of a 46-year-old male patient who - for the first time in his life - had two episodes of oral allergic syndrome upon kiwi consumption after having received myeloablative hematopoietic stem cell transplantation (HCT) from his kiwi-allergic sister, we aimed to clarify the origin of allergen reactive cells in the donor. We not only intended to demonstrate if allergy was transferred by HCT but also to present an experimental workup for the analysis of allergy transfer by HCT. METHODS: Allergic sensitization to kiwi in recipient and donor was proven by ImmunoCAP. Furthermore, origin of peripheral blood mononuclear cells (PBMCs) was analyzed by chromosomal fluorescence in situ hybridization (FISH). To confirm allergic reaction and activation of hematopoietic cells by customized kiwi extract, we performed basophil activation test from whole blood as well as T cell proliferation assays from purified PBMCs of both recipient and donor. RESULTS: Basophil activation upon kiwi extract was demonstrated in both recipient and donor. Besides, we showed proliferation of CD4(+) T cells after incubation with kiwi extract. FISH analysis proved that hematopoietic cells of the male recipient completely originated from the female donor. CONCLUSION: Exemplified in this patient, we show for the first time that allergy transfer is mediated by the donor's cells. Moreover, our experimental approach using customized kiwi extract to prove contribution of kiwi-specific T and B cells in both kiwi-allergic recipient and donor could serve as a model approach for future studies. AU - Garzorz-Stark, N.* AU - Thomas, J. AU - Eberlein, B.* AU - Haferlach, C.* AU - Ring, J.* AU - Biedermann, T.* AU - Schmidt-Weber, C.B. AU - Eyerich, K.* AU - Seifert, F.* AU - Eyerich, S. C1 - 48151 C2 - 39951 CY - Hoboken SP - 1136-1139 TI - Newly acquired kiwi fruit allergy after bone marrow transplantation from a kiwi-allergic donor. JO - J. Eur. Acad. Dermatol. Venereol. VL - 30 IS - 7 PB - Wiley-blackwell PY - 2016 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: Alopecia areata (AA) is a T-cell-driven autoimmune disease of the hair follicle and frequently reported to be associated with inflammatory skin diseases (ISD) such as atopic eczema (AE) or psoriasis. Interestingly, AA on the one hand and both AE and psoriasis on the other hand are believed to be driven by mutually antagonistic T-cell subsets. OBJECTIVE: To characterize AA-specific T-cell profiles and inflammatory pattern by intra-individual comparison of AA and coexistent ISD. METHODS: 112 patients with AA were recruited and investigated for coexisting ISD. In-depth analyses were performed in patients with AA and AE (n = 2), AA and psoriasis (n = 1), AA and psoriasis and AE (n = 1) and AA and lichen planus (n = 1), using histology, immunohistochemistry and cytokine staining of T cells isolated from lesional skin. RESULTS: Of 112 AA patients investigated, 23 suffered from an ISD. The prevalence of AE, vitiligo, psoriasis and lichen planus was higher in the investigated AA cohort than in the normal population. The clinical as well as histological phenotype of AA the coexistent ISD were unequivocal. In line with this, T-cell infiltrates were found to be disease-characteristics with AA and lichen planus dominated by CD8+ and IFN-γ+ TNF-α+ producing T cells while psoriasis lesions in the same patients were dominated by IL-17+ and AE by IL-4+ T cells. CONCLUSION: AA patients have a higher incidence of various T-cell-driven inflammatory skin diseases than the normal population, a phenomenon which might relate to over-activation of skin-homing T cells and to specific immune triggers as the primary cause of inflammation. More importantly, we showed that by using AA as a model disease, our approach of intra-individual comparison of distinct inflammatory responses in the same patient is feasible and offers the unique possibility to gain insights into disease pathogenesis independent from genetic susceptibilities. AU - Garzorz-Stark, N.* AU - Alsisi, M.* AU - Todorova, A.* AU - Atenhan, A. AU - Thomas, J. AU - Lauffer, F.* AU - Ring, J.* AU - Schmidt-Weber, C.B. AU - Biedermann, T.* AU - Eyerich, S. AU - Eyerich, K.* C1 - 46928 C2 - 39041 SP - 2429–2435 TI - Dissecting susceptibility from exogenous triggers: The model of Alopecia areata and associated inflammatory skin diseases. JO - J. Eur. Acad. Dermatol. Venereol. VL - 29 IS - 12 PY - 2015 SN - 0926-9959 ER - TY - JOUR AB - Background  Polymorphous light eruption (PLE) is the most common chronic and idiopathic photodermatosis. PLE is assumed to represent an immunological hypersensitivity reaction to a radiation-induced cutaneous antigen involving reactive oxygen species (ROS) on the basis of a genetic predisposition. Among others, cellular protection against ROS is provided by glutathione S-transferases (GSTs). Different variants of the GST enzymes may influence the activity and efficiency of detoxification and biotransformation of unknown UV-induced skin-antigens and other factors that may play an important role in the pathogenesis of PLE. Methods  In this study the relationship between isoenzymes of the GST genes GSTM1, GSTT1 and GSTP1 and possible protective or predisposing effects on PLE was examined in 29 patients and 144 controls. Diagnosis of PLE was based on the presence of characteristic clinical features. Results  No association between the functional polymorphisms of the GST gene family and PLE was found. Prevalence of certain GST isoenzymes or polymorphisms in patients with PLE did not differ from healthy controls. Conclusion  Our data do not support prevalence of GST isoenzymes or polymorphisms as a protective effect against PLE. Especially a higher carrier frequency of GSTP1 Val(105) as a protective factor against PLE which has been published before could not be proved. The GST genotypes GSTM1, GSTT1 and GSTP1 (including SNPs) seem to have no relevant association with PLE. AU - Zirbs, M.* AU - Pürner, C.* AU - Buters, J.T.M. AU - Effner, R. AU - Weidinger, S.* AU - Ring, J.* AU - Eberlein, B.* C1 - 11284 C2 - 30584 SP - 157-162 TI - GSTM1, GSTT1 and GSTP1 gene polymorphism in polymorphous light eruption. JO - J. Eur. Acad. Dermatol. Venereol. VL - 27 IS - 2 PB - Wiley-Blackwell PY - 2013 SN - 0926-9959 ER - TY - JOUR AB - The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune-suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. Eczema school educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies. AU - Ring, J. AU - Alomar, A.* AU - Bieber, T.* AU - Deleuran, M.* AU - Fink-Wagner, A.* AU - Gelmetti, C.* AU - Gieler, U.* AU - Lipozencic, J.* AU - Luger, T.* AU - Oranje, A.P.* AU - Schäfer, T.* AU - Schwennesen, T.* AU - Seidenari, S.* AU - Simon, D.* AU - Ständer, S.* AU - Stingl, G.* AU - Szalai, S.* AU - Szepietowski, J.C.* AU - Taïeb, A.* AU - Werfel, T.* AU - Wollenberg, A.* AU - Darsow, U. AU - European Dermatology Forum (EDF) (*) AU - European Academy of Dermatology and Venereology (EADV) (*) AU - European Federation of Allergy (EFA) (*) AU - European Task Force on Atopic Dermatitis (ETFAD) (*) AU - European Society of Pediatric Dermatology (ESPD) (*) AU - GA²LEN Study Group (*) C1 - 8310 C2 - 30104 SP - 1045-1060 TI - Guidelines for treatment of atopic eczema (atopic dermatitis) Part I. JO - J. Eur. Acad. Dermatol. Venereol. VL - 26 IS - 8 PB - Wiley-Blackwell PY - 2012 SN - 0926-9959 ER - TY - JOUR AB - The existing evidence for treatment of atopic eczema (atopic dermatitis, AE) is evaluated using the national standard Appraisal of Guidelines Research and Evaluation. The consensus process consisted of a nominal group process and a DELPHI procedure. Management of AE must consider the individual symptomatic variability of the disease. Basic therapy is focused on hydrating topical treatment, and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin inhibitors (TCI) is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the TCI tacrolimus and pimecrolimus are preferred in certain locations. Systemic immune-suppressive treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial treatment. Adjuvant therapy includes UV irradiation preferably with UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. Eczema school educational programs have been proven to be helpful. Pruritus is targeted with the majority of the recommended therapies, but some patients need additional antipruritic therapies. AU - Ring, J. AU - Alomar, A.* AU - Bieber, T.* AU - Deleuran, M.* AU - Fink-Wagner, A.* AU - Gelmetti, C.* AU - Gieler, U.* AU - Lipozencic, J.* AU - Luger, T.* AU - Oranje, A.P.* AU - Schäfer, T.* AU - Schwennesen, T.* AU - Seidenari, S.* AU - Simon, D.* AU - Ständer, S.* AU - Stingl, G.* AU - Szalai, S.* AU - Szepietowski, J.C.* AU - Taïeb, A.* AU - Werfel, T.* AU - Wollenberg, A.* AU - Darsow, U. C1 - 8560 C2 - 30179 SP - 1176-1193 TI - Guidelines for treatment of atopic eczema (atopic dermatitis) Part II. JO - J. Eur. Acad. Dermatol. Venereol. VL - 26 IS - 9 PB - Elsevier PY - 2012 SN - 0926-9959 ER - TY - JOUR AB - Gender differences in medicine have been recognized in anatomy, physiology, as well as in epidemiology and manifestations of various diseases. With respect to skin disorders, males are generally more commonly afflicted with infectious diseases while women are more susceptible to psychosomatic problems, pigmentary disorders, certain hair diseases, and particularly autoimmune as well as allergic diseases. Significantly, more female sex-associated dermatoses can be identified than the male sex-associated dermatoses. Dermatoses in the genital area differ between men and women. Gender differences also exist in the occurrence and prognosis of certain skin malignancies. The mechanisms underlying gender differences in skin diseases remain largely unknown. Differences in the skin structure and physiology, effect of sex hormones, ethnic background, sociocultural behaviour and environmental factors may interact to exert the influences. A better understanding of gender differences in human health and diseases will allow the development of novel concepts for prevention, diagnosis and therapy of skin diseases. AU - Chen, W.* AU - Mempel, M.* AU - Traidl-Hoffmann, C. AU - Al Khusaei, S.* AU - Ring, J. C1 - 3372 C2 - 27881 SP - 1378-1385 TI - Gender aspects in skin diseases. JO - J. Eur. Acad. Dermatol. Venereol. VL - 24 IS - 12 PB - Elsevier Science Publishers PY - 2010 SN - 0926-9959 ER - TY - JOUR AB - The diagnosis of atopic dermatitis (AD) is made using evaluated clinical criteria. Management of AD must consider the symptomatic variability of the disease. EADV eczema task force developed its guideline for atopic dermatitis diagnosis and treatment based on literature review and repeated consenting group discussions. Basic therapy relies on hydrating topical treatment and avoidance of specific and unspecific provocation factors. Anti-inflammatory treatment based on topical glucocorticosteroids and topical calcineurin antagonists is used for exacerbation management and more recently for proactive therapy in selected cases. Topical corticosteroids remain the mainstay of therapy, but the topical calcineurin inhibitors, tacrolimus and pimecrolimus are preferred in certain locations. Systemic anti-inflammatory treatment is an option for severe refractory cases. Microbial colonization and superinfection may induce disease exacerbation and can justify additional antimicrobial/antiseptic treatment. Systemic antihistamines (H1) can relieve pruritus, but do not have sufficient effect on eczema. Adjuvant therapy includes UV irradiation preferably of UVA1 wavelength or UVB 311 nm. Dietary recommendations should be specific and given only in diagnosed individual food allergy. Allergen-specific immunotherapy to aeroallergens may be useful in selected cases. Stress-induced exacerbations may make psychosomatic counselling recommendable. 'Eczema school' educational programmes have been proven to be helpful. AU - Darsow, U. AU - Wollenberg, A.* AU - Simon, D.* AU - Taïeb, A.* AU - Werfel, T.* AU - Oranje, A.* AU - Gelmetti, C.* AU - Svensson, A.* AU - Deleuran, M.* AU - Calza, A.M.* AU - Giusti, F.* AU - Lübbe, J.* AU - Seidenari, S.* AU - Ring, J. C1 - 3099 C2 - 27889 SP - 317-328 TI - ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis. JO - J. Eur. Acad. Dermatol. Venereol. VL - 340 IS - 7742 PB - Elsevier Science Publishers PY - 2010 SN - 0926-9959 ER - TY - JOUR AU - Kerzl, R.* AU - Eyerich, K.* AU - Eberlein, B. AU - Hein, R.* AU - Weichenmeier, I. AU - Behrendt, H. AU - Clemm, C.* AU - Fend, F.* AU - Mempel, S.* AU - Waldt, S.* AU - Ring, J. AU - Mempel, M. C1 - 4421 C2 - 25591 SP - 224-226 TI - Parallel occurrence of Erdheim-Chester disease and eosinophilic granuloma in the same patient. JO - J. Eur. Acad. Dermatol. Venereol. VL - 23 IS - 2 PB - Blackwell PY - 2009 SN - 0926-9959 ER - TY - JOUR AB - BACKGROUND: A pathogenic role of serine protease inhibitor lymphoepithelial Kazal type-related inhibitor (LEKTI) in atopic dermatitis (AD) is currently in intense debate. Analyses of an association between genetic polymorphisms of SPINK5 and atopic diseases revealed contradictory results. Herein, we assessed the role of LEKTI in AD at an expressional and functional level. METHODS: The expression of LEKTI and its inhibitory capacity was measured by real-time polymerase chain reaction and hydrolytic activity assay, respectively, in keratinocyte cell cultures of three AD patients in comparison to cultures of healthy individuals (5x) and Netherton (NS) patients (3x). RESULTS: Expression of LEKTI was significantly decreased in AD vs. healthy volunteers. Due to reduced protease inhibition, trypsin-like hydrolytic activity in AD was slightly increased, although not significantly. CONCLUSIONS: Even though the number of investigated subjects was small and hydrolytic activity was only slightly increased, the results denote that LEKTI might be diminished in AD. The study also disclosed the necessity of functional analyses in addition to genetic investigations to gain further and more detailed insights into the role of LEKTI in AD. AU - Roedl, D. AU - Traidl-Hoffmann, C. AU - Ring, J. AU - Behrendt, H. AU - Braun-Falco, M.* C1 - 48568 C2 - 41189 SP - 1263-1266 TI - Serine protease inhibitor lymphoepithelial Kazal type-related inhibitor tends to be decreased in atopic dermatitis. JO - J. Eur. Acad. Dermatol. Venereol. VL - 23 IS - 11 PY - 2009 SN - 0926-9959 ER - TY - JOUR AB - Background Lysosomal storage disorders may impair intracellular lysosomal processing of antigen with consequences for antibody production [e.g. immunoglobulin E (IgE)] and atopic disease status. Aims Serum concentration of total IgE as well as clinical symptoms of atopic disorders as an indirect consequence of lysosomal impairment of antigen processing were studied in male and female Fabry disease (FD) patients with and without replacement of the missing lysosomal enzyme, alpha-galactosidase A (alpha-Gal A). Methods Observational study in 31 adult FD patients with measurements of total serum IgE concentration. Questionnaire-derived data were obtained for atopic eczema (AE) skin lesions, allergic rhinoconjunctivitis (RCA) and allergic asthma (AA) at present or in the past. Results Among 12 FD males under enzyme replacement therapy (ERT), 2 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 2, RCA and AE in 1, respectively. Among 10 FD females under ERT, 4 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 4, RCA in 2 and AE in 2. Among 9 females without ERT, 2 showed total IgE concentrations above 100 kU/L. Clinical symptoms for AA were found in 2, RCA in 2 and AE in none. Conclusions FD patients may demonstrate an increased total serum IgE concentration and may show symptoms of atopic disorders (AA, RCA, AE) in a prevalence rate comparable to international experience for individuals without FD. There was no difference between patients with and without ERT. Lack of detection of AE in females without ERT is suggested to be caused by the small sample size. FD patients without any alpha-Gal A activity prior to initiation of ERT should be in the focus of future studies. AU - Möhrenschlager, M. AU - Ollert, M.* AU - Ring, J. C1 - 200 C2 - 27943 CY - Oxford SP - 692-695 TI - A study on serum IgE and clinical symptomatology of atopy in patients suffering from the lysosomal storage disorder Fabry disease. JO - J. Eur. Acad. Dermatol. Venereol. VL - 22 IS - 6 PB - Blackwell Publishing PY - 2008 SN - 0926-9959 ER - TY - JOUR AU - Gutermuth, J. AU - Hein, R. AU - Fend, F. AU - Ring, J. AU - Jakob, T. C1 - 1198 C2 - 24723 SP - 566-567 TI - Cutaneous pseudolymphoma arising after tattoo placement. JO - J. Eur. Acad. Dermatol. Venereol. VL - 21 IS - 4 PB - Elsevier PY - 2007 SN - 0926-9959 ER - TY - JOUR AU - Darsow, U. AU - Lübbe, J.* AU - Taïeb, A.* AU - Seidenari, S.* AU - Wollenberg, A.* AU - Calza, A.M.* AU - Giusti, F.* AU - Ring, J. C1 - 3501 C2 - 22951 SP - 286-295 TI - Position paper on diagnosis and treatment of atopic dermatitis. JO - J. Eur. Acad. Dermatol. Venereol. VL - 19 PY - 2005 SN - 0926-9959 ER - TY - JOUR AU - Gutermuth, J. AU - Audring, H.* AU - Voit, C.* AU - Haas, N.* C1 - 1208 C2 - 24228 SP - 217-221 TI - Primary carcinoma of ectopic axillary breast tissue. JO - J. Eur. Acad. Dermatol. Venereol. VL - 20 PY - 2005 SN - 0926-9959 ER - TY - JOUR AU - Gutermuth, J. AU - Audring, H.* AU - Voit, C.* AU - Trefzer, U.* AU - Haas, N.* C1 - 115 C2 - 22556 SP - 477-479 TI - Antitumour activity of paclitaxel and interferon-alpha in a case of metastatic eccrine porocarcinoma. JO - J. Eur. Acad. Dermatol. Venereol. VL - 18 PY - 2004 SN - 0926-9959 ER -