Prevalence and risk factors of actinic keratoses in Germany--analysis of multisource data.

BACKGROUND: In Europe, only few and inconsistent data on the prevalence and treatment of actinic keratoses (AK) are available. OBJECTIVES: To determine the prevalence of AK in Germany, to identify potential predictors and to estimate the number of AK cases treated in dermatological practices. METHODS: In a multiple-source approach, prevalence was assessed from whole-body examinations in a cohort of 90 800 employees and from nationwide statutory health insurance (SHI) data of 2008. The number of cases documented in dermatological offices was estimated from statistics of a SHI Physicians Association. RESULTS: Standardized prevalence of AK from dermatological examinations was 2.7%; the rate increased with age (11.5% in the group 60-70 years) and was higher for men (3.9%) than for women (1.5%). Significant associations were also identified for skin phototype I, sunburns in childhood and solar lentigines. Vitiligo and a history of melanoma were also, but not significantly, associated with AK. In the SHI data analysis, standardized AK prevalence was 1.8%. Age-specific rates were below 1.5% up to 60 years and rose to 8.2% (13.2% in men) in the group 80-89 years. The prevalence from these large data sets--which is at the lower limit of studies from other countries--suggests about 1.7 million estimated AK cases in Germany. In 2011, AK accounted for 8.3% of the hundred most frequently treated dermatological outpatient diagnoses. The proportion of AK cases has risen almost continuously over the last 10 years, compared to other dermatological conditions. Estimated annual number of AK cases documented by dermatologists in Germany is about 1.7 million. CONCLUSIONS: Actinic keratosis is a frequent condition in higher age groups and more prevalent in men; a relevant need for health care is evident. Predictors and risk factors for AK are easy to identify in the population, which could also help to detect groups with special need for preventive measures.

Willingness to pay and quality of life in patients with atopic dermatitis.

Atopic dermatitis (AD) is a frequent and burdensome disease. The objectives of this study were (1) to assess the willingness to pay (WTP) and quality of life (Qol) in AD patients and (2) to compare the results with data on other chronic skin diseases. To collect data, a non-interventional, cross-sectional nationwide postal survey on adult patients with clinically diagnosed AD was performed; socio-demographic data, clinical features/symptoms, WTP and QoL were recorded. WTP was assessed in three different approaches, including relative and absolute figures. Data from n = 384 AD patients (mean age 42.0, range 18-92, 69.8 % female) were analyzed. WTP for complete healing was on median 1,000 (average 11,884) and exceeded WTP in rosacea (median 500) but not in vitiligo (median 3,000). Mean Dermatology Life Quality Index (DLQI) was 8.5 (vitiligo 7.0; psoriasis 6.7; rosacea 4.3) and correlated with pruritus, xerosis and disturbed sleep. WTP and DLQI correlated only marginally (r s = 0.134, p = 0.01). In conclusion, AD patients show high WTP and markedly reduced QoL compared to other chronic skin diseases.

Prevalence and disease burden of hyperhidrosis in the adult population.

BACKGROUND: Although hyperhidrosis is a common and burdensome condition, little is known about the population-based prevalence. OBJECTIVE: To evaluate the epidemiology, disease burden and medical care of hyperhidrosis in German adults. METHODS: Employees of fifty-two companies underwent skin screenings and interviews including hyperhidrosis questions. RESULTS: 14,336 individuals were investigated (36% women, mean age 42 years) of whom 2,340 (16.3%) reported hyperhidrosis, including 869 (6.1%) with frequent or continuous disturbing sweating. 28% showed focal hyperhidrosis, whilst 68% had a generalized condition. Predictors of hyperhidrosis were male gender and concomitant drug medication. Moreover, persons with psoriasis and with metabolic comorbidity were at increased risk. Only 27% of those with focal hyperhidrosis had consulted a physician, and only 28% used prescribed medication or self-medication. CONCLUSION: Hyperhidrosis is a frequent skin condition predicted by medical and personal factors. In spite of the disease burden, few individuals utilize medical care. Affected individuals should be encouraged to refer to a dermatologist.

[Giant papillomas of the tongue and pharynx in focal dermal hypoplasia: a case report]. / Riesenpapillome der Zunge und des Rachens bei fokal dermaler Hypoplasie: Ein Fallbericht.

Focal dermal hypoplasia is a rare congenital syndrome with dominant X-linked mode of inheritance characterized by a wide range of meso-ectodermal anomalies. The clinical variation is great, as explained by the Lyon hypothesis and mosaicism. Findings include skin atrophy along the lines of Blaschko and papillomas. Our case is striking with rapidly-growing giant pharyngeal papillomas which caused dysphagia and required resection.

[Calcipotriol plus betamethasone dipropionate gel in the treatment of scalp psoriasis. A review]. / Calcipotriol plus Betamethasondipropionat-Gel in der Behandlung der Kopfhautpsoriasis. Eine Ubersicht.

Scalp psoriasis has a significant psychosocial impact on individuals affecting their quality of life. It occurs in 50-80% of patients with psoriasis and may be the only affected area of the body. Current topical therapies for scalp psoriasis are difficult or unpleasant to apply, resulting in decreased adherence and efficacy. A combination of calcipotriol and betamethasone dipropionate in a gel formulation has been developed and approved in Germany for the treatment of scalp psoriasis. Multiple randomized controlled clinical trials have confirmed the efficacy and safety of the new formulation. After two weeks, 60% of patients showed significant improvement; this climbed to 70%, after eight weeks. It may be safely used for up to 52 weeks. No cases of atrophy, striae, or steroid purpura were noted in two 52-week studies. Although scalp psoriasis can often be adequately treated with topical therapy, there is a need for treatment recommendations and algorithms for severe forms and for patients with extended body involvement, taking the combination of systemic and topical treatment and the presence of comorbidities into account.