Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
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The working methods of the Standing Committee on Vaccination (STIKO) and its recommendations are only partially known by medical professionals and the public. ⋯ The STIKO vaccination recommendations are considered as the medical standard. The published current instructions for vaccination of immunodeficient patients and the recently published recommendation for COVID-19 vaccination, together with their scientific backgrounds and reasons, represent a valuable basis for medical action in the field of vaccination against infectious diseases.
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Pigmentation disorders are a frequent skin problem and incorporate a broad spectrum of diseases, caused by an abnormal melanin pigmentation or also non-melanin pigmentation of the skin. Both hypermelanosis and hypomelanosis can be hereditary or acquired. This article summarizes the treatment approaches that are used in the majority of acquired pigmentation disorders of the skin. ⋯ For every disorder the specific dermatological treatment is presented even when some pigmentation alterations that occur in association with systemic diseases, are cured by the treatment of the primary disease. Most diseases are exacerbated by exposure to UV light. Therefore, sun protection is recommended and a cosmetic coverage is indicated.
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Pigmentation disorders are among the most common cutaneous changes and occur in up to 60% of all people. They can be genetic or acquired, functionally or cosmetically disturbing, or the expression of a medical disorder. ⋯ A correct diagnosis is therefore essential, taking into account the skin type, the type of pigmentation and how deep the pigmentation is located in the skin. The most common indications for which laser treatment is recommended include genetically predisposed nevi (Becker, Ota, Hora, Ito, acquired bilateral nevus of Ota-like macules [ABNOM]), pigmentation (e.g., lentigines, postinflammatory hyperpigmentation, ephelides, café au lait, nevus spilus, linear and whorled hypermelanosis [LWNH]), nevus cell nevi, exogenous pigments, tattoos and cosmetic pigments.
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Esthetically unattractive hyperpigmentation can occur post-inflammatory or as a result of genetic or hormonal influences, UV exposure or medication. Important parameters for the quality of topical treatments are evidence-based in vivo and in vitro efficacy as well as scientifically verified wanted and unwanted effects. ⋯ Hydroquinone is still the gold standard for the treatment of hyperpigmentation, along with the triple therapy of hydrochinon, tretinoin, and steroids in different modifications. In summary, hyperpigmentation is best treated using a combination therapy of different approaches that includes consequent UV protection.
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Artificial intelligence (AI) is increasingly being used in medical practice. Especially in the image-based diagnosis of skin cancer, AI shows great potential. However, there is a significant discrepancy between expectations and true relevance of AI in current dermatological practice. ⋯ In numerous studies, computer algorithms were able to detect pigmented and nonpigmented neoplasms of the skin with high precision, comparable to that of dermatologists. The combination of the physician's assessment and AI showed the best results. Computer-based diagnostic systems are widely accepted among patients and physicians. However, they are still not applicable in daily practice, since computer-based diagnostic systems have only been tested in an experimental environment. In addition, many digital diagnostic criteria that help AI to classify skin lesions remain unclear. This lack of transparency still needs to be addressed. Moreover, clinical studies on the use of AI-based assistance systems are needed in order to prove its applicability in daily dermatologic practice.