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Complete lymph node dissection (CLND) following positive sentinel lymph node (SLN) biopsy has been the standard of care for decades. We aimed to study melanoma patients with an emphasis on the outcome of patients with versus without CLND following positive SLN biopsy. SLN-positive patients with or without CLND were compared regarding important prognostic clinical and histological characteristics. Ten-year and 20-year survival curves for melanoma relapse and melanoma-specific survival (MSS) were determined by the Kaplan-Meier method and Cox proportional-hazards regression. We studied 258 patients who had micrometastases in their SLN biopsy. CLND was performed in 209 of 258 patients (81%). Hence, in 49 of 258 patients (19%) with SLN micrometastases, CLND was not performed. These patients did not significantly (p &gt, 0.05) differ from patients with CLND in regard to age, gender, tumor thickness, tumor ulceration, capsule infiltration of SLN, or invasion level of SLN. On 10-year analysis, we did not observe a significantly increased risk for melanoma relapse and worse in MSS in patients who did not undergo CLND (hazard ratio: 1.1 (95% CI 0.67 to 1.7) and 1.1 (95% CI 0.67 to 1.9), respectively). On 20-year survival analysis, we confirmed that the risk of melanoma relapse and impaired MSS does not significantly increase in patients without CLND (hazard ratio: 1.2 (95% CI 0.8 to 1.9) and 1.3 (95% CI 0.8 to 2.3), respectively). On 10-year as well as 20-year multivariable follow-up analysis (including several important prognostic factors), Cox proportional-hazards regression showed that the status of CLND did not remain in the regression model (p &gt, 0.1). Our 10-year data give conclusive support to previous investigations indicating that waiving CLND in patients with SLN micrometastases does not affect MSS. More importantly, our long-term follow-up data confirm for the first time the 10-year survival data of previous investigations.

Die Hidradenitis suppurativa/Acne inversa (HS/AI) ist eine chronisch rezidivierende inflammatorische Hauterkrankung. Erhebungen zeigen, dass bevorzugt Männer einen perianalen, perinealen und glutealen Befall aufweisen, wohingegen bei Frauen die Axillen sowie die submammäre und inguinale Region vermehrt betroffen sind. Der Befall der Genitoanalregion ist mit einer stärkeren Einschränkung der Lebensqualität und einer größeren Belastung der sexuellen Gesundheit assoziiert als andere Lokalisationen. Darüber hinaus kann die HS/AI in der Genitoanalregion zu schwerwiegenden Komplikationen führen. Die perianale Fistelbildung, das pubogenitale Lymphödem und das Plattenepithelkarzinom zählen zu den 3 schwersten Komplikationen, deren Kenntnis entscheidend für ein adäquates Therapiemanagement ist. Hidradenitis suppurativa/acne inversa (HS/AI) is a chronic inflammatory skin disease. Several studies showed that perianal, perineal and gluteal involvement is more common in men. Axillary, submammary and inguinal localizations seem to be more prevalent in women. Involvement of the genitoanal region is associated with a higher reduced quality of live and sexual health compared to other locations. Moreover HS/AI in the genitoanal region can lead to serious complications. The knowledge of perianal fistula formation, pubogenital lymphedema and squamous cell carcinoma, which are three of the most severe complications, is critical for adequate treatment.

\(\it Background:\) The pathogenesis of hidradenitis suppurativa (HS), with its complex inflammatory network, is still elusive. Imbalances in DNA methylation can lead to genome destabilization and have been assumed to play a role in inflammatory diseases. Global DNA methylation and hydroxymethylation have not been studied in HS yet. \(\it Objective:\) We conducted this study to investigate the global DNA methylation and hydroxymethylation status in lesional and perilesional HS skin compared to healthy controls. \(\it Methods:\) Immunohistochemical analysis was performed for 5-methylcytosine (5-mC) and 5-hydroxymethylcytosine (5-hmC) in 30 lesional and 30 corresponding healthy-appearing perilesional HS tissue samples. We included 30 healthy subjects as an interindividual control group. \(\it Results:\) 5-hmC levels were significantly lower in healthy-appearing perilesional (\(\it {p}\) < 0.0001) and lesional HS skin (\(\it {p}\) < 0.0001) when compared to healthy controls. There was no significant difference between lesional HS skin and perilesional HS skin regarding 5-hmC levels (\(\it {p}\) = 0.6654). In contrast to 5-hmC, 5-mC staining showed no significant changes between the 3 groups. Univariate analysis revealed no significant association between patients’ characteristics, disease severity, and the levels of 5-mC and 5-hmC. \(\it Conclusion:\) Our findings indicate that imbalances in DNA hydroxymethylation may play a role in the pathogenesis of HS rather than DNA methylation. Further studies are warranted to investigate the significance of DNA hydroxymethylation and the regulating enzymes in HS in order to advance our knowledge of the inflammatory network in this disease.

Haut- und Haarproben von Moorleichen wurden histologisch, elektronenmikroskopisch, immunhistologisch und IR-spektroskopisch untersucht. Histologisch konnten bei allen Hautproben die Kollagenbündel des Koriums nachgewiesen werden. Epidermis war nicht erhalten. Elektronenoptisch waren bei allen Moorleichen Kollagenfasern mit einem Durchmesser von 45 - 110 nm und der typischen Periodizität zu erkennen. Bakteriensporen mit einem Durchmesser von 0,83 \(\pm\) 0,051 \(\mu\)m waren sichtbar. Keine der Hautproben zeigte eine Reaktivität mit den verwendeten Antikörpern. Spektroskopisch konnten Kollagen Typ-I und Typ-III in den Hautproben nachgewiesen werden. Anhand der IR-Spektren wurden äußerliche Veränderungen an Haut und Haaren der Moorleichen dokumentiert. Histologie, Elektronenmikroskopie und IR-Spektroskopie demonstrieren die guten Konservierungseigenschaften des Moores für den Kollagen-Anteil der Haut. Nur der äußere Teil von Haut und Haaren wurde durch Gerbungsprozesse verändert.