[Useful knowledge regarding tattoos]. / Nützliches Wissen zu Tätowierungen.

The number of people with tattoos has continued to increase in recent years. In the USA about 23% and in Europe 9-12% of the population have tattoos. In the German media (2019) and by the infoportal Statista (2017), it is assumed that 21-25% of citizens have tattoos and that the trend is increasing (Statista 2018: 36%). Men and women wear tattoos equally. The age group 20-29 years dominates with almost 50% having tattoos. The following article describes the new regulations especially the REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) regulation, legal basis, and governmental controls on the subject of "tattoos". The composition of tattooing agents and testing options relevant for the user before and for the performance of tattooing are presented. Dermatologically associated diseases and testing procedures are listed. Since 70% of the population denies knowledge of this information even when they have tattoos themselves, this update is written as an overview for treating physicians and users.

Chemoimmunotherapy for cutaneous melanoma with dacarbazine and epifocal contact sensitizers: results of a nationwide survey of the German Dermatologic Co-operative Oncology Group.

PURPOSE: To scrutinize published data from small mono-centric studies and case reports which implicated high response rates and promising survival times for a combination therapy consisting of epifocal dinitrochlorobenzene (DNCB) and dacarbazine (DTIC) for metastasized melanoma. This therapy merges the effects of an allergic contact dermatitis elicited at the site of a cutaneous metastasis, and systemic chemotherapy. METHODS: We performed a retrospective survey with nine German centers and evaluated 72 patients treated from 1993 to 2005. RESULTS: The objective response rate in stage III melanoma (n = 39) was 62%. In contrast, only 9% objective responses were observed in 33 stage IV patients. Interestingly, more than half of patients with objective remissions remained progression-free for more than 1 year irrespective of the stage of disease. CONCLUSIONS: Epifocal DNCB combined with DTIC is effective in patients with regionally metastasized melanoma not amenable to surgery or isolated limb perfusion, whereas in stage IV disease in spite of few durable remissions the addition of DNCB does not improve the therapeutic efficacy of DTIC.

[Imiquimod, pegylated interferon-alpha-2b and interleukin-2 in the treatment of cutaneous melanoma metastases]. / Imiquimod, pegyliertes Interferon-alpha-2b und Interleukin-2 in der Behandlung kutaner Melanommetastasen.

The immune system plays an important role in the defense against malignant melanoma. Interferon-alpha (IFN-alpha) and interleukin-2 (IL-2) are therapeutically used for unspecific stimulation of the immune system. After intralesional injections of these cytokines into cutaneous melanoma metastases, regression has been observed. In view of its immunomodulating effects, imiquimod appears as an additional promising therapeutic option for treatment of malignant tumors. In a case report, we present combined therapy with intralesional IL-2, pegylated IFN-alpha-2b and topical imiquimod 5% cream for disseminated cutaneous metastatic malignant melanoma stage IIIa. This therapy achieved an almost complete remission. In a treatment period of eight months, side effects remained tolerable. Histologically, both fibrosis and inflammation were found in the regressing lesions. After the end of therapy, no disease progression occurred during 11 months follow-up.

[Sentinel lymph node excision (SLNE) and positron emission tomography in the staging of stage I-II melanoma patients]. / Schildwächterlymphknotenexzision (SLKE) und Positronenemissionstomographie (PET).Staginguntersuchungen bei Melanompatienten in den klinischen Stadien I-II (nach DDG): Erfahrungen aus der Hautklinik Dortmund.

BACKGROUND AND OBJECTIVE: Sentinel lymph node excision (SLNE) and positron emission tomography (PET) were evaluated in the staging of 51 Stage I and II melanoma patients (staged according to the guidelines of the German Dermatological Society). PATIENTS/METHODS AND RESULTS: Tumor thickness ranged from 1.0 mm to 6.0 mm (median: 1.5 mm; mean: 2.07 mm). At least one sentinel lymph node (SLN) was excised in all patients; 80 SLN were excised from 69 lymphatic drainage areas. Positive SLN were detected in 6 patients (11.8%). Additional positive lymph nodes were not detected in any of these patients in the following complete lymph node dissection of the affected lymph node basin. Preoperative PET was performed in 40 patients and did not detect any of the micrometastases that were subsequently found by SLNE. During the follow up of 7-40 months (mean 21.9 months) 3 patients experienced tumor progression; 2 of 3 had a positive SLN. CONCLUSIONS: According to the current literature SLNE is recommended in primary tumors greater than 1 mm thickness. PET cannot be expected to give additional information in the staging of stage I-II patients.

[Papular mucinosis--successful therapy with plasmapheresis]. / Papulöse Muzinose--Erfolgreiche Therapie mit Plasmapherese.

A 23-year old female patient presented with a 14 year history of cutaneous mucinosis. Her hands showed indurated edema with acrocyanosis and severe reduction in motility, while her face was red, edematous and revealed numerous small angiomas. In the sacral region, she had a large elevated skin colored plaque. On the basis of clinical findings, histology and further laboratory tests the disease was classified as papular mucinosis (lichen myxoedematosus). In view of the severe suffering of the young patient and an unsuccessful previous therapy with chloroquine, we decided to employ plasmapheresis as a single therapy. After the first treatment course there was an improvement in her skin condition. After a total of four plasmapheresis courses over a period of 18 months (total exchange volume of 38.4 l) there was an objective flattening of the plaques and reduction of the finger swelling. This case demonstrates that monotherapy of plasmapheresis is an effective mode of treatment for cutaneous mucinosis, a disease which is extremely difficult to treat.

[Adjuvant therapy of primary malignant melanoma with natural human interferon-beta. Significant survival advantage in 96 treated patients in comparison with 288 untreated symptomatic controls]. / Adjuvante Therapie des primären malignen Melanoms mit natürlichem humanen Interferon-beta. Signifikanter Uberlebensvorteil bei 96 behandelten Patienten im Vergleich zu 288 unbehandelten Symptomenzwillingen.

In the dermatological department of Dortmund's Municipal Medical Centre, between May 1986 and April 1991 a total of 105 patients with primary malignant melanoma (stage I) underwent adjuvant treatment with 5 million IU natural interferon beta as a 30-min i.v. infusion three times weekly for 6 months. During follow-up the patients were examined at short intervals and all recurrences and disease-related cases of death were documented up to September 1992. We evaluated the outcome of patients treated with interferon beta (n = 96 with valid notes of tumour thickness) compared with untreated historical controls (n = 288) matched for tumour thickness, localization, and sex, taken from the Central Malignant Melanoma Registry (CMMR) of the German Dermatological Society. Therefore, the main prognostic factors were identical between cases and controls. A computerized randomization was used to fit three control patients to each treated patient. Survival rate and recurrence-free survival were estimated in both groups for a period of 5 years. During the follow-up 3 patients died in the interferon beta group and the 5-year survival rate was 95%, as against 89% in the control group (P < 0.05 for difference between survival curves). Recurrence-free survival curves were also more favourable for interferon-treated patients than for the control group (P = 0.06). A detailed analysis of high-risk patients with tumour thickness of over 1.5 mm also demonstrated obviously better survival (5 years: 95% vs 77%; P = 0.012) and recurrence-free survival rates (5 years: 75% vs 53%; P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

[Contact allergy of the immediate type to topical use of lidocaine]. / Kontaktallergie vom Sofort-Typ auf topische Anwendung von Lidocain.

While undergoing urinary bladder catheterization using a lidocaine lubricant, a seven year old boy developed an anaphylactic reaction. Diagnosis of contact sensitization of type I variety following topical application of lidocaine was confirmed by appropriate testing.