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Aktinische Keratose (AK) - epidermale dysplastische Läsionen nach chronischer Exposition gegenüber Sonneneinstrahlung - ist bei Personen mit hellerer Haut sehr verbreitet; die chronische Langzeit-UV-Exposition ist hierbei der Hauptrisikofaktor. Angesichts der Alterung der Bevölkerung ist zu erwarten, dass die Prävalenz der AK weiter steigen wird. AK kann zu nicht-melanomatösem Hautkrebs (NMSC) progredieren und stellt ein relevantes Problem der öffentlichen Gesundheit dar. Sechs führende Dermatologen aus Deutschland mit Spezialisierung auf AK und NMSC kamen zusammen, um über das Wesen der Erkrankung sowie die Präventions- und Behandlungsstrategien zu diskutieren, die dem Dermatologen heute zur Verfügung stehen. Während kosmetische Sonnenschutzmittel einen wesentlichen Bestandteil der Sonnenschutzstrategien darstellen, sind sie nicht ausreichend, wenn bereits Schädigung eingetreten ist. Neu entwickelte Produkte aus der Kategorie der Medizinprodukte bieten auch DNA-reparierende Eigenschaften zusätzlich zum UV-Schutz mit hohem Lichtschutzfaktor. Für die adjuvante Behandlung der AK in verschiedenen Risikostufen wurde ein Algorithmus entwickelt. Für Patienten mit niedrigem bis mittlerem Risiko wird reiner Sonnenschutz empfohlen. Für Patientengruppen mit hohem bis sehr hohem Risiko wird die ganzjährige Anwendung von Medizinprodukten empfohlen, die sehr hohen Lichtschutz mit Korrektur von Lichtschäden (durch DNA-Reparaturenzyme) kombinieren.

Actinic keratosis (AK) or lesions of epidermal dysplasia occurring in skin chronically exposed to solar radiation is very prevalent in lighter skin persons, with chronic long-term sun exposure being the major risk factor. With an aging population it is expected that the prevalence of AK will further increase. AK can progress to nonmelanoma skin cancer (NMSC) and is a public health concern. Six leading dermatologists with expertise in AK and NMSC from Germany met to discuss the nature of the disease and the prevention and treatment strategies available to dermatologists today. While cosmetic sunscreen products form an essential element of sun protection strategies, they are not adequate when damage has already been inflicted. Newly developed products of the medical device category offer DNA repair function paired with high sun protection factor (SPF) UV protection. An adjuvant treatment algorithm for various risk levels of AK was developed. For patients with low and moderate risk, sunscreen only is recommended. For patient groups with high and very high risk, a very high photoprotection and photorepair action (DNA repair enzymes) in medical device products all year round is recommended.

Background/Aims: Data on contact allergy to fragrances in the general population are limited. Data from allergological services suggest that the frequency of contact allergy to fragrances is increasing. The European Dermato-Epidemiology Network (EDEN) Fragrance Study aims to obtain reliable data on the prevalence of contact allergy to fragrances and other sensitizers of the European baseline series, in the general population of different geographical areas of Europe. We report the methodology and the reliability of instruments adopted and discuss the feasibility based on a pilot phase. Methods: Descriptive epidemiology survey. A random sample from the general population is selected and interviewed, and is offered patch testing in a randomized way. We specifically enquire about any skin rash reported during the previous year, and any history of reactions to products that may contain the sensitizer and/or a history of avoidance of the same products. Patch test data are linked to the questionnaire information to define clinical relevance. Results: The questionnaire showed high test-retest reliability in 94 individuals. Patch test reading also showed a high level of interrater reliability. During the pilot phase, a total of 589 participants were recruited. Conclusions: The EDEN Fragrance Study is feasible and able to provide useful data on fragrance allergy.

Background: The SCORing Atopic Dermatitis (SCORAD) index is used worldwide to assess the severity of atopic eczema. Patient involvement in the treatment process is of major current interest. There are very few validated patient self-assessment tools for atopic dermatitis (AD). Objective: To develop a self-assessment score for AD patients, the patient-oriented SCORAD (PO-SCORAD) based on the SCORAD index, and to assess its acceptability in a pilot study. Methods:A multicenter working group decided on the initial form of the PO-SCORAD. A prospective, single-center pilot study was then carried out to assess its acceptability and validity. A SCORAD and a PO-SCORAD were applied at baseline and after 18 days; the acceptability of the tool was assessed by questionnaire, its validity by comparing SCORAD and PO-SCORAD on both visits. Results: The study involved 15 children and 18 adults. 80% of the respondents found the questions clear and the form easy to fill in; 96% spent less than 10 min on it. A correlation was found between the SCORAD and the PO-SCORAD. Conclusion:This study shows that self-assessment is feasible in AD, and that there is a correlation between the physician and the patient scores. This study was the first step in validating the PO-SCORAD.

Some 30–50% of cases of atopic dermatitis (AD) are believed to be associated with autosomal dominant ichthyosis vulgaris (ADI). The diagnosis of ADI can be proved by the ultrastructural demonstration of fewer and abnormal keratohyalin (KH) granules in all ADI patients, even in clinically unaffected skin. To prove the suggested frequent association of ADI with AD, an ultrastructural investigation of dry skin of 49 AD patients was performed. Only in 2 (4%) patients ADI could be confirmed by electron microscopy. In 17 patients, including the 2 patients with abnormal KH, hyperlinear palms were clinically seen. The present study yields evidence that hyperlinear palms, if present, and dry skin are in most cases a phenotypic marker of AD and not a sign of concomitant ADI. A histologically absent stratum granulosum in AD does not signify by itself a manifestation of concomitant ADI.