Publications by authors named "Michael Flaig"

Actinic keratosis (AK) are common lesions in light-skinned individuals that can potentially progress to cutaneous squamous cell carcinoma (cSCC). Both conditions may be associated with significant morbidity and constitute a major disease burden, especially among the elderly. To establish an evidence-based framework for clinical decision making, the guideline "actinic keratosis and cutaneous squamous cell carcinoma" was updated and expanded by the topics cutaneous squamous cell carcinoma in situ (Bowen's disease) and actinic cheilitis.

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Rosacea is a common chronic inflammatory dermatosis of the face, clinically characterized by erythema, telangiectasia, papules, pustules, and rhinophyma. In January 2022, the updated guideline on rosacea was published. Groundbreaking innovations include the new clinical classification according to phenotypes, extended diagnostic and therapeutic recommendations for ocular rosacea and implications of the gut microbiome on rosacea.

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With an incidence of more than > 1,000,000/day, sexually transmitted diseases remain a major challenge for health care systems worldwide. To reduce disease burden, complications, and spread, rapid diagnosis permitting early therapy is pivotal. The range of pathogens is wide and co-infections are common.

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  • Bullous pemphigoid (BP) and pemphigus vulgaris (PV) are autoimmune skin diseases, with BP characterized by intense itching which may involve the cytokine IL-31.
  • Research compared the expression of IL-31 and its receptor IL-31RA in skin samples from BP and PV patients, revealing significantly higher levels in BP, especially in advanced lesions.
  • The findings suggest that IL-31/IL-31RA signaling could contribute to the difference in pruritus and inflammation between BP and PV, indicating potential for targeted therapies in BP patients.
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Merkel cell carcinoma (MCC, ICD-O M8247/3) is a rare, malignant, primary skin tumor with epithelial and neuroendocrine differentiation. The tumor cells share many morphologic, immunohistochemical, and ultrastructural features with cutaneous Merkel cells. Nevertheless, the cell of origin of MCC is unclear.

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  • The updated S2k guideline focuses on the diagnosis and treatment of rosacea, a common chronic skin disease primarily affecting the face, with symptoms evolving from flushing to severe inflammatory lesions.
  • Treatment recommendations include avoiding triggers and using topical treatments like metronidazole, azelaic acid, and ivermectin; vasoconstrictors for persistent redness; and systemic therapy for severe cases, primarily low-dose doxycycline.
  • Additional care for ocular rosacea involves lid hygiene and treatments such as ciclosporin eye drops and azithromycin.
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Ex vivo confocal laser scanning microscopy (ex vivo CLSM) is a novel diagnostic tool for a quick bedside evaluation of freshly excised tissue, comparable to histology. We aimed to assess the sensitivity and specificity of ex vivo CLSM in detecting malignant features, to validate its reliability in identifying various skin tumours based on a combination of confocal features and to evaluate the digital staining mode (DS). One-hundred twenty freshly excised skin samples from 91 patients were evaluated.

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  • - Mycosis fungoides (MF) is the most common type of primary cutaneous T-cell lymphoma, usually progressing slowly and rarely affecting organs beyond the skin.
  • - A 42-year-old male with follicular MF exhibited unusual symptoms like hair loss, lipoatrophy, and progressive leg weakness, which led to significant muscle infiltration as shown by biopsies and MRIs.
  • - Despite treatment with steroids and chemotherapy, the patient's condition worsened rapidly, resulting in cachexia, muscular atrophy, and eventually death 2.5 years after the onset of skin lesions, marking a rare and severe case of muscular involvement in MF.
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Lichen planus pigmentosus inversus (LPPI) is a rare subvariant of Lichen planus pigmentosus (LPP), presenting with sharply defined brown to gray macules, papules, and plaques limited to the intertriginous areas, with only a few cases reported in the medical literature so far. While LPP mostly affects patients with Fitzpatrick skin type III-IV in sun-exposed areas such as the neck, LPPI is seen in Caucasians and spares sun-exposed areas. Skin lesions tend to be very refractory to treatment attempts including potent topical steroids and oral corticosteroids.

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