Non-biologic immunosuppressive drugs for inflammatory and autoimmune skin diseases.

Non-biologic immunosuppressive drugs, such as azathioprine, dapsone or methotrexate are fundamental treatment options for a wide range of autoimmune and chronic inflammatory skin diseases. Some of these drugs were initially used for malignancies (e.g., azathioprine or methotrexate) or infectious diseases (e.g., hydroxychloroquine or dapsone) but are nowadays mostly used for their immunosuppressive/immunomodulating action. Although dermatologists have years of clinical experience with these drugs, some of the mechanisms of action are not fully understood and are the subject of research. Although these drugs are commonly used, lack of experience or knowledge regarding their safety profiles and management leads to skepticism among physicians. Here, we summarize the mechanism of action and detailed management of adverse effects of the most commonly used immunosuppressive drugs for skin diseases. Furthermore, we discuss the management of these drugs during pregnancy and breastfeeding, as well as their interaction and handling during vaccination.

[How does the Degree of Acculturation Influence the Intention to Breastfeed, Breastfeeding Frequency, and Breastfeeding Duration in Migrant Women? A Review of the Publications from 2014-2018]. / Wie beeinflusst der Akkulturationsgrad Stillabsicht, Stillhäufigkeit und Stilldauer bei Migrantinnen? Ein Review der Publikationen der Jahre 2014­2018.

The breastfeeding behavior of women is influenced by social, demographic and cultural factors, yet little is known about the influence of migration and acculturation. A systematic search using the electronic databases LIVIVO and MEDLINE (PubMed) was conducted followed by a manual search in the bibliographies of all selected articles. Quantitative studies from industrialized countries, published from 01.01.2014 to 30.05.2018, in English or German were included. A total of 77 studies could be identified; 17 of them met the required inclusion criteria. Migrant mothers, excluding those from Southeast Asia, tended to have a higher breastfeeding prevalence than mothers without a migrant background. In addition, migrant women in Southern Europe, Ireland, and Taiwan were observed to have a longer breastfeeding period, whereas migrant women in Canada and women of non-Scandinavian origin in northern Europe showed shorter breastfeeding duration. With increasing acculturation, there was also a tendency of decreased breastfeeding apparent in women with a migrant background.