[Seborrheic dermatitis]. / Seborrhoisches Ekzem.

Seborrheic dermatitis is a frequent skin disorder in infancy and adulthood. It also often occurs in patients with HIV or neurologic disorders like Parkinson disease or mood disorders. It is characterized by greasy, yellow flakes or scales in areas of high sebaceous gland activity like the scalp, face, chest and upper back. Additionally, erythema and itching can be present. The etiology and pathogenesis of seborrheic dermatitis is unknown; however, the focus lies on the involvement of Malassezia yeasts or fatty acid metabolites of Malassezia, on hormones and immunologic factors. The diagnosis is usually a clinical one, based on history and the appearance and site of lesions. The therapy consists mainly of antifungal agents, corticosteroids, immunomodulators, and keratolytics. Because of the chronicity of the illness with frequent relapses, a treatment strategy in which effectiveness and potential side effects are weighed should be used.

[Therapy-resistant "psoriasis vulgaris"]. / Therapierefraktäre "Psoriasis vulgaris".

A 61-year-old patient had a 25-year history of erythematous scaling lesions, diagnosed and treated as psoriasis vulgaris. He presented with a growing nodule within the erythematous plaque. Biopsy shows epithelioid cell granulomas with prominent Langhans giant cells. There was no sign of a squamous cell carcinoma. The tuberculin test was strongly positive and M. tuberculosis complex was detected in the biopsy material by PCR. He was diagnosed with lupus vulgaris, the most frequent form of cutaneous tuberculosis. Other types include tuberculosis verrucosa cutis, tuberculosis cutis orificialis and disseminated military tuberculosis. The patient was treated with rifampicin, isoniazid, pyrazinamide and ethambutol for two months, following a four month treatment with rifampicin and isoniazid. The skin lesions rapidly resolved under antituberculotic treatment.

Intranasal trigeminal function in children.

The aim of the study was to investigate trigeminal function in children compared with that of adults. Trigeminal sensitivity was assessed using a lateralization task where participants were requested to identify the side of the nose to which an odorous stimulus was presented. The ability to localize the sensation is largely based on trigeminal function. A total of 344 people participated (191 females, 153 males; mean age 12 y [SD 7 y 9 mo], range 5-54 y). Eucalyptol (EUC) was administered as a mixed olfactory-trigeminal stimulant; phenylethyl alcohol (PEA) was used as a control stimulant with minimal trigeminal impact. In addition, sensitivity to vibration was assessed as a somatosensory control. With regard to all age groups, PEA could not be localized whereas this was easily possible for EUC. However, the ability to localize EUC increased with age, which was not the case for PEA. No sex-related difference was found for odour localization. These results provide data for normal intranasal trigeminal function in children. They also indicate that trigeminal sensitivity is already well-developed in children.