Impact of off-label use regulations on patient care in dermatology - a prospective study of cost-coverage applications filed by tertiary dermatology clinics throughout Germany.

Background: In dermatology, a medical speciality with a relatively high number of rare diseases, physicians often have to resort to off-label treatment options. To avoid claims, physicians in Germany can file a cost-coverage request (off-label application, OL-A).

Objectives: Our aim was to investigate the extent to which the current regulations affect patient care.

Adaptation of to the Human Skin Environment Identified Using an Tissue Model.

The healthy human epidermis provides physical protection and is impenetrable for pathogenic microbes. Nevertheless, commensal and pathogen bacteria such as are able to colonize the skin surface, which may subsequently lead to infection. To identify and characterize regulatory elements facilitating adaptation of to the human skin environment we used tissue explants and quantified gene transcription during co-culture.

The CD63 basophil activation test as a diagnostic tool for assessing autoimmunity in patients with chronic spontaneous urticaria.

Background: Over the past years, it has become widely recognized that a proportion of chronic spontaneous urticaria (CSU) cases is of autoimmune origin, however, the search for reliable diagnostic tools to confirm underlying autoimmune pathophysiology is ongoing. The CD63 basophil activation test (CD63 BAT) has recently become useful for diagnosing autoimmune CSU.

Objectives: To analyse the correlation between positive CD63 BAT results, total IgE antibody levels, and the presence of autoimmune thyroiditis as a comorbidity in patients diagnosed with CSU.

[Anaphylaxis to PR-10 proteins (Bet v1 homologues)].

Secondary food allergies to PR-10 proteins (Bet v1 homologues) are the most common food allergies in Germany. Clinically they present with an oral allergy syndrome (intraoral pruritus and perhaps swelling). When drinks containing PR-10 proteins are rapidly consumed, for example after sporting activities, large concentrations of allergen can be reached without any intraoral symptoms and then lead to anaphylaxis.