[Drug therapy of acne inversa]. / Medikamentöse Therapie der Acne inversa.

Acne inversa is a chronic inflammatory destructive skin disease that affects about 1% of the population. The therapy should be personalized and consists of surgical and conservative procedures. Antibiotics are administered either topically or systemically. Combination therapy with clindamycin and rifampicin for 10-12 weeks can be very effective. Furthermore, TNF-α inhibitors show adequate efficacy and can be recommended. Adalimumab is the only approved drug product for systemic treatment of acne inversa. The efficacy of retinoids is controversial. Isotretinoin cannot be recommended for the treatment of acne inversa; however, acitretin has been proven to be more effective. Immune-modulating substances, like dapsone, cyclosporine A, methotrexate, colchicine, or corticosteroids, can be considered; however, the study data are insufficient for recommendation. Hormonal therapies can influence the course of the disease. Antiseptics are applied independent of the stage of disease. Patients should be informed about triggering factors.

[Ulcerative angiosarcoma of the cranial vault masquerading as a pyoderma]. / Ulzeratives Angiosarkom der Schädelkalotte durch eine Pyodermie maskiert.

This is a report on a patient suffering from a progressive ulcerative tumour of the vault of the cranium with accompanying osteolytic destruction. The disease pattern was interpreted first after a biopsy from the marginal wall of the inflammation as a case of pyoderma. It was only on postmortem examination that an angiosarcoma of the ulcerative type was correctly diagnosed. The ulcerative type of angiosarcoma is sometimes difficult to differentiate from inflammatory skin diseases.