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Anal cancer risk is increased in certain risk groups including people living with HIV (PLWH), especially in men who have sex with men, but also in organ transplant recipients and women with a history of cervical or vulva dysplasia or cancer. High-resolution anoscopy (HRA) is a tool to diagnose anal high-grade squamous intraepithelial lesions (HSIL), and HRA-guided treatment of anal HSIL has been shown to reduce the risk of anal cancer in PLWH. The purpose of this review is to increase the awareness of HRA but also of tertiary prevention by digital anal rectal examination.

Rhinophyma is a disfiguring skin condition characterised by progressive hyperplasia of the nasal sebaceous glands and proliferation of blood vessels and connective tissue. It is considered the end stage of rosacea and affects primarily older males of Northern European descent. Several surgical and laser treatment options are available. None of these has been compared in randomised, controlled prospective trials. In this review, we provide an overview of the different treatment modalities and account for their respective strengths and limitations.

In this article we give an overview of which skin conditions that are currently treated with laser and explains the basic principles of treatment. In addition, we summarize recommendations of the Danish Dermatological Society for demarcation of medical treatments which can be provided free of charge from cosmetic self-payment treatments.

Congenital melanocytic naevi (CMN) appear in approximately 2.6% of Caucasians. There is a major demand for treatment but no vital indication. Laser therapy, curettage and excision are available treatment modalities, but there is no ideal treatment with documented long-term effect and without side effects, and the level of evidence for the treatment options is generally low. The risk of malignancy has probably been overestimated, and furthermore new research shows that untreated CMN often show spontaneous lightening. We review the literature for pros and cons of different treatments.

Many patients struggle with tender, rigid and erythematous scars. Various modalities are used to treat cutaneous scars and in recent years, laser treatments are emerging as promising procedures. This article describes laser systems used for scar treatment according to scar type, evaluates the highest available level of evidence from randomized controlled trials (RCTs) and introduces a guideline for laser treatment of scars. Twelve RCTs documented effect on acne, burn and surgical scars. It is recommended that laser- and light-based treatments are considered according to the scar type.

The risk of non-melanoma skin cancer (NMSC) and in particular squamous cell carcinoma is significantly increased in organ transplant recipients due to long-term treatment with immunosuppressives. Dermatologic management in the form of a multidisciplinary approach, including patient education, skin surveillance and early treatment of premalignant and malignant lesions is recommended. Field-directed rather than lesional therapy is preferred for actinic keratosis in field-cancerized skin; and high-efficacy therapies are recommended in NMSC due to an increased risk of recurrences and metastases.

Introduction: Laser and IPL treatment by non-physicians raises professional concern. The purpose of this investigation is to evaluate laser and IPL treatment carried out by non-physicians and to assess the level of pre-treatment information given to patients., Material and Methods: Approached clinics were found by internet-searches and from advertisements in telephone directories and national newspapers. The target group was clinics in Zealand that offer laser or IPL treatment of pigmented lesions, pigmented nevi, sun-damaged skin, acne and/or unwanted hair growth. The investigation did not include specialised clinics run by dermatologists and plastic surgeons. By means of anonymous telephone calls the clinics were presented for standardized questions under the pretext of being a potential client., Results: Of 28 clinics investigated, 93% offered treatment for unwanted hair growth, 75% for pigmented lesions, 50% for acne, 36% for possible actinic keratoses and 29% for pigmented nevi. Medical examination was an exception (11%). In none of the clinics were medical examinations performed by specialists in dermatology or plastic surgery. Cosmeticians or nurses generally gave the laser and IPL treatments. In 57% of the clinics patients were informed that the treatment did not have any risks. In June treatment was offered in 79% of the clinics, 18% of which mentioned that no special precautions were necessary when treating in sunny periods., Conclusion: Laser and IPL treatment of skin diseases, including potential malignant diseases, is carried out by non-physicians and pre-treatment information contains major errors and shortcomings.

Lasers and light sources are increasingly used by non-physicians, which raises major concern due to the potentially increased risk of errors and complications. Safe treatments depend on optimal preoperative information, examination, and patient selection; optimal performance of the treatments; and optimal postoperative care of wounds and possible complications. Non-physicians do not normally possess these required skills. There is a need for quality assurance in cutaneous laser surgery. This report was initiated by the Danish National Board of Health.

Lasers and light sources are increasingly used in dermatology. Due to the limited financial resources of the public health care system, the Danish Dermatological Society has developed recommendations for distinguishing medical laser treatments to be provided free of charge from cosmetic self-payment treatments. Several considerations underlie the recommendations: present legislation; the diagnosis, etiology, severity, and anatomical location of the disease; and the availability of evidence-based treatments. It is suggested that the recommendations constitute the basis for referring patients to dermatological treatment involving laser and intense pulsed light in Denmark.

We report a case of congenital organoid nevus with an excessive number of apocrine glands. A one-year-old boy presented with a slowly enlarging keratotic element in the left temporal region, and biopsy showed hyperkeratosis, acanthosis, follicular plugging and multiple transverse sections of mature apocrine glands filling the reticular dermis. The lesion was benign and treatment was therefore conservative. In rare cases, various types of adnexal neoplasms may develop, but malignant tumours occur very seldom.

Background: About 15% of the population have fungal infections of the feet (tinea pedis or athlete's foot). Whilst there are many clinical presentations of tinea pedis the most common are between the toes (interdigital) and on the soles, heels and sides of the foot (plantar) which is known as moccasin foot. Once acquired the infection can spread to other sites including the nails, which can be a source of reinfection. Oral therapy is usually used for chronic conditions or when topical treatment has failed., Objectives: To assess the effects and costs of oral treatments for fungal infections of the skin of the foot (tinea pedis)., Search Strategy: Randomised controlled trials were identified from MEDLINE, EMBASE and CINAHL from the beginning of these databases to January 2000. We also searched the Cochrane Controlled trials Register (Cochrane Library issue 1, 2000) the Science Citation Index, BIOSIS, CAB-Health, Health star and Economic databases. Bibliographies were searched, podiatry journals hand searched and the pharmaceutical industry and schools of podiatry contacted., Selection Criteria: Randomised controlled trials including participants who have a clinically diagnosed tinea pedis, confirmed by microscopy and growth of dermatophytes in culture., Data Collection and Analysis: Study selection was done by two independent reviewers. Methodological quality assessment and data collection was also assessed by two independent reviewers., Main Results: Twelve trials, involving 700 participants, were included. The two trials comparing terbinafine and griseofulvin produced a pooled risk difference of 52% (95% confidence intervals 33% to 71%) in favour of terbinafine's ability to cure infection. No significant difference was detected between terbinafine and itraconazole; fluconazole and either itraconazole and ketoconazole; or between griseofulvin and ketoconazole, although the trials were generally small. Two trials showed that terbinafine and itraconazole were effective compared with placebo. Adverse effects were reported for all drugs, with gastrointestinal effects most commonly reported., Reviewers' Conclusions: The evidence suggests that terbinafine is more effective than griseofulvin and that terbinafine and itraconazole are more effective than no treatment.

We describe an outbreak of tinea capitis in a kindergarten. Individuals with relation to the institution were examined clinically and mycologically (n = 98). Microsporum audouinii was cultured from 12 people, out of whom eight patients had tinea capitis and seven patients had tinea corporis. Three patients had both tinea capitis and tinea corporis. The problems with spread of anthropophilic infections and the difficulties with treatment of Microsporum dermatophytes are discussed.

Unwanted hair growth remains a therapeutic challenge and an effective treatment modality without side effects is needed. Today, hair removal is offered with lasers and light sources and patients may expect long-lasting or permanent hair removal. Evidence-based clinical results have been considerably examined for ruby and alexandrite lasers, whereas there is little documentation on Nd:YAG and diode lasers. The results with the diode laser are, however, promising. No controlled clinical studies have been published with intense pulsed light sources. We conclude that there is scientific evidence of a short-term effect after hair removal with ruby, alexandrite, Nd:YAG, and diode lasers (three, six months). Ruby and diode lasers may have a long-lasting effect (one year), but this, however, must be further clarified. No studies have examined whether laser hair removal may be permanent. The occurrence of postoperative side effects is reported to be low for all laser systems. From this review of the literature, we conclude that laser hair removal does not at the moment have a permanent or convincing long-lasting effectiveness.

Laser light is monochromatic light that is delivered either in order to perform a precise thermal destruction of specific skin components or in order to ablate skin in an unspecific, but highly controlled way. Optimal dermatological laser treatment requires carefully selected laser wavelengths for specific indications. It is recommended that laser treatment of vascular lesions such as naevus flammeus and haemangiomas is carried out in early childhood. In laser treatment of benign, pigmented lesions it is important to distinguish between epidermal and dermal lesions, since treatment response as well as optimal laser wavelengths depend on this subclassification. The treatment of tattoos is undertaken by different laser types, of which the most optimal can be selected by skin reflectance measurements. Novel fields of indications for dermatological laser therapy are verrucae vulgares, erythematous hypertrophic scars, undesired hair growth, and wrinkled, photoaged facial skin.