Der Hautarzt; Zeitschrift für Dermatologie, Venerologie, und verwandte Gebiete
-
Anaphylaxis, the maximal manifestation of an immediate allergic reaction, is a life-threatening systemic reaction. The immediate therapy is chosen according to the clinical manifestations and new German guidelines are in preparation. Required measures include immediate removal of allergen, adequate positioning, assessment of severity and organ involvement and activation of emergency medical services. ⋯ In patients with anaphylaxis, the elicitor of the reaction has to be diagnosed by allergy testing. Patients with sustained risk for anaphylaxis should receive a self-medication kit and should be educated about behavioral patterns needed for prophylaxis and therapy of anaphylactic reactions. Patient educational intervention increases knowledge about anaphylaxis, and practical competence and thus, is a basis of a successful management of anaphylaxis.
-
This review summarizes the epidemiology, clinical aspects, diagnosis and new therapeutic options of the superficial venous thrombosis. An important new finding is, that the thrombophlebitis is actually a thrombosis, which occurs in an intra- or epifascial vein. ⋯ New placebo-controlled studies show a clear benefit for low molecular weight heparin or the pentasaccharide fondaparinux. In addition to the medical treatment, compression is recommended for superficial venous thrombosis in varicose veins, but not in normal veins.
-
Chronic pruritus and chronic pain are frequent symptoms of a variety of underlying diseases. Painful sensations usually suppress acute itching. ⋯ The early detection of (neuropathic) pain in patients with chronic pruritus can be done using the PainDetect questionnaire. In general, patients suffering from both itch and pain have a highly impaired quality of life, high degree of objective health burden, need a more intensive health care and a complex analgetic and antipruritic therapy.
-
Many patients and their companions who present daily in dermatological clinics and private practices may have numerous non-dermatological comorbidities, which can cause medical emergencies. Additionally several dermatologic diagnostic or therapeutic procedures which are commonly performed can cause life-threatening complications. Therefore dermatologists can be confronted with acute medical emergencies at any time. ⋯ Therefore dermatologists must have the basic emergency medical knowledge; emergency situations should be practiced regularly and this training documented for quality control measures. Every practice must be able to deliver life-saving care until trained emergency medical personnel arrive. The general emergency procedures are presented below and the practical approach is illustrated at different cardinal symptoms such as impaired consciousness, respiratory disorders or cardiocirculatory disorders.