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Recent progress in molecular engineering, digital imaging and artificial intelligence improve human modern medicine to levels never seen before. Digital pathology becomes the new standard of patient care in dermatology and personalized medicine. It is increasingly used for digital exchange of histological slides, personalized consultations, tumor boards, quantitative image analysis for research purposes and in education. Digital pathology allows automatization and quantification with greater consistency and accuracy than light microscopy. Personalized dermatology is focusing on tailoring therapy to the individual characteristics of each patient and allow to use genetic information in order to develop a treatment plan, uniquely suited to each patient, which in turn leads to improved quality of care and management of each individual., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article. Le laboratoire de DH profite d’un contrat scientifique de la part d’Unilabs.

Rare Vascular Diseases (RVD) encompass different types of vessel involvement. Some cause a dilation, others a weakening or tortuosity of the arterial wall, others an obstruction or excessive calcification of arterial walls. Clinical pathway of patients with RVD to diagnosis is often long and complex. Thus, in order to allow early diagnosis and coordinated multidisciplinary management and follow-up, a specialized RVD centre has been set-up at the CHUV, following the framework of the national concept of rare diseases., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêt en relation avec cet article.

The skin contains many commensal bacteria. For years, these microbes have been considered to be exploiters of the human host for nutrients. However, recent findings indicates that the skin microbiota is also used by the human host to protect himself against invading pathogens as the commensal bacteria have direct antimicrobial capacity and provide factors required to mount a protective immune responses in the skin. While the healthy skin microbiome functions as guardians of host defense, increased or decreased bacterial composition of the skin microbiome (called dysbiosis) leads to skin inflammation and disease. Here we will review the emerging data on the role of distinct types of dysbiosis in the pathogenesis skin diseases and illustrate how the new understanding of the role of the skin microbiome has implications in the clinical management of skin diseases.

Progress in paediatric dermatology is achieved in both research and therapeutic fields. In infectiology, scabies and bed bugs are a scourge for dermatologists, with an important recent outbreak. This article describes the fundamental clinical signs to look for, when suspecting such diagnosis. Hair dermatoscopy seems to be also very precious as a new tool for the diagnosis of ringworm. Regarding eczemas, atopic dermatitis is supported by S. Aureus's skin colonization, the target of eradication of new products in ongoing studies. We will also explain the role of Hemangiol, recently marketed in Switzerland for the treatment of haemangiomas. Alternative beta blockers have also a large number of ongoing projects in the dermatological vascular diseases field. Other various news is to be discovered....

The history of most cutaneous squamous cell carcinomas (CSCC) is limited to the skin. However, about 4% of these malignancies are at risk of metastasis and can be life-threatening. This risk is determined by clinical and histological elements which are individually recognized, but so far staging systems allow us neither to assess a risk score, nor to adopt a standardized therapeutical approach. This article reviews prognostic factors for CSCC, and underlines the need for the clinician to have all clinical and histological elements available, in order to try to define the best therapeutical strategy for each case, following up-to-date recommendations.

The diagnosis of melanoma is accompanied by numerous informations delivered in a systematic and synoptic histopathological report. Next to the ulceration and the tumor thickness, the clinician must know the significance of the number of mitosis, of the inflammation or of the lymphovascular invasion. We detail here each of the prognostic factor and present the last 7th edition of the TNM classification of the AJCC valid from January 2010. In therapy, concrete progresses have been done in metastatic melanoma. The explanation of the pathways involved in melanoma is of particular interest because it facilitates the comprehension of the different biological effects of these therapies. We present here briefly their molecular basis.

Many significant advances in dermatology were published during 2009, focussing on infectious diseases, inflammatory disorders and oncology. Molecular medicine, as a result of the human genome project, also modifies the field of dermatology. Bioinformatics and biotechnology revolutionize the daily clinical practice in dermatology. A change of paradigm occurs notably in infectious diseases.

Atopic dermatitis (AD) is a chronic disease frequent in childhood. The treatment is based on regular moisturizing of the skin, information to the parents on the chronic course with recurrent flares, topical anti-infectious therapy for superinfections and colonization of the skin by staphylococcus aureus, and topical steroids. The immuno-modulatory macrolides (tacrolimus and pimecrolimus) represent a new alternative to topical steroids. These molecules are well tolerated, but theirs effects on the long-term are unknown. A food allergy may be responsible for a AD flare in up to a third of the cases, but the presence of an allergy should be demonstrated before the prescription of an elimination diet. AD is often the first manifestation of atopy: the physician should be aware of the future occurence of respiratory symptoms.