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Background: Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP)., Methods: To investigate the reasons for this development, we--on behalf of the DGP--sent a questionnaire to 120 German Departments of Dermatology in autumn 2012., Results: In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments., Conclusions: Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available.

For some time now, there have been reports of acral necrosis as a paraneoplasia that may occur in association with a number of different malignant tumours. There have also been a series of reports about acral necrosis associated with chemotherapy with various cytostatics. The treatment of choice if these lesions occur is plasmapheresis. Ultimately, the occurrence of thrombotic microangiopathy (TMA) can only be prevented by close monitoring through regular laboratory controls before each new cycle of chemotherapy. In the differential diagnosis, Raynaud's syndrome should be considered as a premonitory paraneoplasia, a risk factor for the occurrence of acral necrosis in patients with a malignant tumour undergoing chemotherapy, particularly patients with ovarian carcinoma receiving gemcitabine treatment.

The profession of masseur or bath attendant involves intense contact with multiple potential allergens and irritants. There is a complete lack of epidemiological studies for this professional group in spite of the general agreement that sensitization to ingredients of beauty and healthcare products such as fragrances is common. In this review, we critically review the relevant literature, and present own results from recently performed analyses of the German Information Network of Departments of Dermatology (IVDK). Fragrances, preservatives, emulsifiers, and antioxidants are relevant from the allergological perspective. In order to evaluate the particular importance of these and other potentially important allergens for occupational dermatology, further systematic research in allergology as well as epidemiological studies are needed.

There are at least two classic photoprotective DNA damage responses that can be elicited by UV exposure: induction of melanogenesis (tanning) and enhancement of DNA repair. Both mechanisms are mediated, at least in part, by the tumor-suppressor protein and transcription factor p53. Both of these responses can be induced in vitro as well as in vivo by small DNA fragments of specific sequences, without prior induction of actual DNA damage. The topical application of such fragments onto human skin might enhance photoprotection in human skin, as typically elicited by gradual sun exposure. The induction of photoprotection by this means, however, would not bear the mutagenic and carcinogenic risk of exposure to natural sunlight.

Unilateral laterothoracic exanthem (ULE) developed in a 4-year-old-boy on maintenance therapy for acute lymphatic leukemia (ALL). This is the second reported case of an association between ULE and leukemia. The etiology of ULE is unknown. Endemic cases, frequently associated signs of upper respiratory infections, and the occurrence of ULE in immunocompromised hosts are suggestive of an infectious process.

Freshly isolated keratinocytes were used for the treatment of non-healing leg ulcers (21 cases). For application, keratinocytes were suspended in fibrin (Tissucol Duo S). One or more applications of keratinocytes initiated granulation and reepithelialization of nearly all leg ulcers (20 cases). The method is compared with the established therapy entailing transplantation of allogenic keratinocyte sheets onto leg ulcers. Our method shows the advantages: autologous cells that are immediately and easily available, freedom from pain, and short-time immobilization (48 h) after application.

We present a 68-year-old male patient, who had had longitudinal melanonychia with Hutchinson sign for 4 years. Melanocytic proliferation was ruled out by biopsy. Friction and pressure had been acting on this patient's nails during boxing for the past 40 years. These mechanical factors are discussed under the entity of "frictional longitudinal melanonychia". In addition, cellular and non-cellular mechanisms for longitudinal melanonychia are reviewed.

The development of a method to cultivate and expand human keratinocytes in vitro by Rheinwald and Green in the mid-1970s can be considered a milestone in the search for the ideal biological skin substitute. For more than 10 years, cultured keratinocytes have now been used for the treatment of various wounds. In this paper the present status knowledge and the authors own experience after treating 29 patients are discussed.

We present a 59-year old male patient, who had small plant cylinders 1-2 mm in length adhering to the hair shafts and easily moved up and down along them. We found hair casts together with lichen ruber follicularis and pseudopelade of the Brocq type. The presence of hair casts is often misdiagnosed as pediculosis capitis, piedra alba or trichorrhexis nodosa. The case report and the literature are discussed.

The epidermis, the outermost layer of all individuals, is a point of contact between individuals and their surroundings, especially insofar as it mediates sensory stimuli, but it also has the function of separating them from their surroundings and providing protection from harmful environmental influences. This paper traces the adaptation of the epidermis of vertebrates to these multiple functions via various methods of differentiation. In the human, epidermal differentiation is divided into synthesis, transformation, and terminal stages, and the stratum corneum is the final product of this differentiation. The differentiation products (tonofilaments, keratohyalin granules, membrane coating granules, cornified envelopes) are discussed with reference to their molecular bases (especially cytokeratin polypeptides, filaggrin, involucrin, lipids). The importance of these new cell-biological results for the pathogenesis of disorders of keratinization is discussed.

The hereditary forms of ichthyosis can be considered to be models of impaired terminal epidermal differentiation. Analysis of the cytokeratin polypeptide pattern represents a new attempt at elucidating the mechanisms of keratinization mechanisms which are still unclear. We therefore studied the cytokeratin expression of the following types of ichthyosis: autosomal dominant ichthyosis vulgaris (n = 4), X-linked recessive ichthyosis vulgaris (n = 4), recessive non-bullous congenital ichthyosiform erythroderma (n = 1), recessive classical lamellar ichthyosis (n = 2), autosomal dominant lamellar ichthyosis (n = 1), and Netherton syndrome (n = 1). After dissection of frozen sections of the interfollicular epidermis, two-dimensional gel electrophoresis was performed. For immunofluorescence microscopy a panel of monoclonal cytokeratin antibodies (KG8.13, KK8.60, KA5 and AE1) was used. Cytokeratin polypeptide expression was basically unchanged compared with normal epidermis. In contrast, however, the antibody AE1 did not stain the basal cell layer in most types of ichthyosis, regardless of their genetic type. The cytokeratin polypeptides nos. 6 and 16, which are generally considered markers of hyperproliferation, were not expressed in either type of ichthyosis vulgaris (XRI or ADI), but were detected in trace amounts in various types of congenital ichthyosis.