Search

Summary: Background: Seborrhoeic dermatitis is a common but epidemiologically poorly researched chronic skin disease. Objectives: To characterize the prevalence and dermatological comorbidity of seborrhoeic dermatitis in Germany. Methods: In the course of voluntary company skin checks, full‐body examinations were carried out in more than 500 companies by experienced dermatologists and documented electronically. Results: In total, 161 269 participants were included (men 55·5%, mean age 43·2 ± 10·9 years). Seborrhoeic dermatitis was identified in 3·2% (men 4·6%, women 1·4%). A significant difference was found between age groups (2·0% in < 35; 3·6% in 35–64; 4·4% ≥ 65 years). The most frequent concomitant skin conditions were: folliculitis [17·0%, 95% confidence interval (CI) 15·9–18·1], onychomycosis (9·1%, 95% CI 8·3–10·0), tinea pedis (7·1%, 95% CI 6·3–7·8), rosacea (4·1%, 95% CI 3·6–4·7), acne (4·0%, 95% CI 3·4–4·5) and psoriasis (2·7%, 95% CI 2·3–3·2). Regression analysis revealed the following relative dermatological comorbidities when controlling for age and sex: folliculitis [odds ratio (OR) 2·1, 95% CI 2·0–2·3], contact dermatitis (OR 1·8, 95% CI 1·1–2·8), intertriginous dermatitis (OR 1·8, 95% CI 1·4–2·2), rosacea (OR 1·6, 95% CI 1·4–1·8), acne (OR 1·4, 95% CI 1·2–1·7), pyoderma (OR 1·4, 95% CI 1·1–1·8), tinea corporis (OR 1·4, 95% CI 1·0–2·0), pityriasis versicolor (OR 1·3, 95% CI 1·0–1·7) and psoriasis (OR 1·2, 95% CI 1·0–1·5). Conclusions: Seborrhoeic dermatitis is a common disease, which is more prevalent in men and older people, and it has an increased rate of dermatological comorbidity. However, absolute differences in the prevalence of comorbidities are small and negligible. Nevertheless, the findings underline the need for integrated, complete dermatological diagnostics and therapy. What's already known about this topic? Seborrhoeic dermatitis is a multifactorial skin disease with endogenous and exogenous predisposing factors.It is one of the more common skin diseases, and is estimated to affect between 1% and 8% of the general adult population.The prevalence of seborrhoeic dermatitis is higher among men and elderly people.Seborrhoeic dermatitis is associated with systemic diseases. What does this study add? Robust data on the epidemiology of seborrhoeic dermatitis on a population‐based level.Data on dermatological comorbidity; seborrhoeic dermatitis seems to be strongly associated with fungal and bacterial diseases and is a possible pathogenetic cofactor in the development of infectious skin diseases.Integrated, complete dermatological diagnostics and therapy are recommended. Linked Comment: Andersen and Egeberg. Br J Dermatol 2019; 181:659. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]

Summary: This study from research workers in Switzerland and Germany provides new information on the skin condition seborrheic dermatitis, more specifically how common it is and whether those with the condition have other diseases (co‐morbidities). Seborrhoeic dermatitis is a common disease which shows as redness, scaling and some irritation on areas of the head such as the eyebrows, around the nostrils, behind the ears and in the scalp. The work was based on voluntary skin health checks carried out in workplaces in Germany, involving more than 160,000 individuals. Seborrhoeic dermatitis was found in 4.6% of males and 1.4% of females and was commoner in those above the age of 35. Seborrhoeic dermatitis was commoner in those who had the following other skin conditions: folliculitis, fungal nail infections or tinea pedis (athlete's foot), rosacea, acne and psoriasis. The authors conclude that many of the other skin infections or conditions such as acne with which seborrheic dermatitis is associated, are those in which there are changes in the microbes (tiny organisms) in the skin (microbiome) and/or the production of fats or sebum on the skin surface. Linked Article: Zander et al. Br J Dermatol 2019; 181:743–748 [ABSTRACT FROM AUTHOR]

Background: With the help of specialized outpatient palliative care teams (German abbreviation: SAPV), seriously ill and dying patients in Germany can be adequately cared for in their home environment until the end of their lives; however, there are no uniform standards or guidelines for well-executed pain management right now., Objective: This approach serves as basic research in the field of public health research. This is intended to present which methods (use of different professional groups, use of pain medications, alternative medical treatment etc.) the individual SAPV teams use for pain management. From this it can be deduced which procedures can be considered particularly effective., Material and Methods: This cross-sectional study was conducted in May 2021. All German SAPV teams (n = 307) listed on the homepage of the German Association for Palliative Medicine (DGP) were contacted by post and invited to participate. A total of 175 teams (57%) responded to the request and were included in the evaluation. A descriptive data analysis was performed., Results: Pain management in the German outpatient care of palliative patients is based on several components. All common pain medications are used, but primarily metamizole (99.4%) as a non-opioid analgesic, morphine (98.3%) from the opiate series and pregabalin (96.6%) as a co-analgesic are mainly prescribed. If pain therapy fails, 22.5% of the SAPV teams perform palliative sedation for symptom control on a regular basis., Conclusion: This cross-sectional study is the first of its kind to provide a general overview of the treatment options for pain management in German outpatient palliative care. In comparison with international studies, the question arises as to whether uniform therapy schemes and a reduction in the medication available in the individual SAPV teams could lead to an improvement in patient care., (© 2023. The Author(s).)

Background: Early diagnosis is key to prevent bowel damage in inflammatory bowel disease (IBD). Risk factor analyses linked with delayed diagnosis in European IBD patients are scarce and no data in German IBD patients exists., Aim: To identify risk factors leading to prolonged diagnostic time in a German IBD cohort., Methods: Between 2012 and 2022, 430 IBD patients from four Berlin hospitals were enrolled in a prospective study and asked to complete a 16-item questionnaire to determine features of the path leading to IBD diagnosis. Total diagnostic time was defined as the time from symptom onset to consulting a physician (patient waiting time) and from first consultation to IBD diagnosis (physician diagnostic time). Univariate and multivariate analyses were performed to identify risk factors for each time period., Results: The total diagnostic time was significantly longer in Crohn's disease (CD) compared to ulcerative colitis (UC) patients (12.0 vs 4.0 mo; P < 0.001), mainly due to increased physician diagnostic time (5.5 vs 1.0 mo; P < 0.001). In a multivariate analysis, the predominant symptoms diarrhea ( P = 0.012) and skin lesions ( P = 0.028) as well as performed gastroscopy ( P = 0.042) were associated with longer physician diagnostic time in CD patients. In UC, fever was correlated ( P = 0.020) with shorter physician diagnostic time, while fatigue ( P = 0.011) and positive family history ( P = 0.046) were correlated with longer physician diagnostic time., Conclusion: We demonstrated that CD patients compared to UC are at risk of long diagnostic delay. Future efforts should focus on shortening the diagnostic delay for a better outcome in these patients., Competing Interests: Conflict-of-interest statement: All authors declare that they have no conflicts of interest related to this paper., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Introduction: Physical therapy (PT) and occupational therapy (OT) as supportive forms of treatment in palliative care, together with other treatment measures, can create participation for seriously ill patients in the form of a life that is as autonomous as possible until the end of life. However, specially trained staff are needed for the care of palliative patients in order to do justice to the clients' special life situation. In Germany, no corresponding survey on the subject has so far been conducted. So it is unclear to what extent PT and OT are offered in palliative care structures in this country, which tasks are assigned to the respective professional groups, and what the level of knowledge is that caregivers have about treatment options., Aim: Compilation of an overview of the provision, need and use of PT and OT in the various areas of palliative care in Germany. If there is a lack of provision, the reasons for this will be identified., Methods: In this cross-sectional survey, a self-designed 9-item questionnaire was sent out to a total of 260 hospices, 323 palliative care units and 304 specialized outpatient palliative care services (SOPC) listed on the homepage of the German Society for Palliative Medicine (DGP). The respondents' answers were analysed using a purely descriptive approach., Results: The response rate was 439 (49.5%). A total of 434 questionnaires (49%) were included in the analysis. A heterogeneous distribution of PT and OT offers between outpatient, inpatient, and hospice palliative care can be seen, with the outpatient area showing a significantly fewer offerings. 29% of the SOPC teams can offer neither PT nor OT. This is mostly due to a shortage of skilled workers or a lack of funding opportunities. The different areas of responsibility of physiotherapists and occupational therapists are known to the majority of respondents (hospice 87%, palliative care unit 83%, SOPC 81%) and are also reflected in the distribution of tasks between the two professional groups. Especially palliative care units and SOPC teams state that they would like to offer more PT and OT (palliative care units 42% more PT and 58% more OT; SOPC 65% more PT and 50% more OT)., Discussion: This cross-sectional survey is the first of its kind to provide an overview of the PT and OT offerings in the different sectors of German palliative care. In a comparison of the two forms of therapy, occupational therapists are used less frequently than physiotherapists. An international comparison of the study situation also shows that the use of OT in palliative care, in particular, has not yet been implemented satisfactorily. Outside Germany, the main reasons for this are a shortage of specialists and a lack of knowledge about the tasks of OT., Conclusion: PT and OT are frequently used treatment options in all areas of German palliative care. In order to better classify structural problems in care, further differentiated surveys should be conducted. Furthermore, a better knowledge base should be created through research and information activities of both professional groups in palliative care., (Copyright © 2022. Published by Elsevier GmbH.)

Background: Though patient needs are key drivers of treatment decisions, they are rarely systematically investigated in routine care., Objective: This study aimed at analysing needs and expectations from the patient perspective in the German and Swiss psoriasis registries PsoBest and Swiss Dermatology Network of Targeted Therapies (SDNTT) with respect to treatment choice, age and gender., Methods: The German and Swiss psoriasis registries observe patients recruited at first-time use of systemic drugs. Within 10 years, clinical [Psoriasis Area Severity Index (PASI), Body Surface Area (BSA)] and patient-reported outcomes are documented, including the Dermatology Quality of Life Index (DLQI) and the Patient Benefit Index (PBI), characterizing patient needs for treatment. The analysis data set includes n = 4894 patients from PsoBest and n = 449 from SDNTT with mean follow-up time of 7.5 months., Results: A total of 5343 patients registered between 2008 and 2016 were included in the analyses (at baseline: 59.6% male, mean age 47.6 years ± 14.5, PASI 14.2 ± 9.7, BSA 22.7 ± 19.7, DLQI 11.3 ± 7.2). The most important patient needs were to 'get better skin quickly' and to 'be healed of all skin defects'. Subgroup analyses by age revealed significant differences in needs, especially higher needs regarding social impairments in patients younger than 65 years. Patients 65 years or older attributed more importance to sleep quality, less dependency on medical visits, fewer side-effects and confidence in the therapy. Out of 25 items reflecting patient needs, 20 items were rated significantly more important by women than men, with the greatest differences regarding feeling of depression, sleep quality and everyday productivity. Divided by treatment, needs were rated differently, recommending individualized and targeted choice of therapy., Conclusion: Age and gender stratify patient needs. Women showed higher expectations and rated specific needs in psoriasis treatment higher than men. Analysing the patient needs on an individual level will facilitate shared decisions by patient and physician in finding the optimal personalized treatment., (© 2018 European Academy of Dermatology and Venereology.)

Background: Dry skin is a frequent and multifaceted condition which can be associated with skin irritation, itch, patient discomfort and manifest skin disease. In spite of being frequent, little is known about the epidemiology of dry skin in the population., Objective: To determine the prevalence of dry skin in the German adult population., Methods: Data of 48 630 employed persons were assessed on a cross-sectional level in whole-body examinations by experienced dermatologists during company-based skin screenings conducted in 343 German companies. Next to the current dermatologic findings, age, gender, allergies, atopic diseases and the skin type were assessed., Results: In total, n = 14 300 persons (29.4%) were rated as having xerotic skin. Older age but not gender was associated with xerosis. In the regression analyses controlling for age and gender, dry skin was a significant predictor for: axillary dermatitis (OR: 4.51; CI 2.70-7.54), atopic eczema (OR: 3.99; CI 3.42-4.65), exsiccation eczema (OR: 2.96; CI 2.40-3.65), psoriasis (OR: 1.57; CI 1.38-1.78), plantar warts (OR: 1.42; CI 1.26-1.60), seborrhoeic dermatitis (OR: 1.28; CI 1.16-1.42) and atopic disposition (OR: 1.17; CI 1.12-1.22)., Conclusion: Dry skin is a frequent condition in the adult general population and needs special attention. Known risk factors may facilitate identifying patients at risk for deterioration., (© 2018 European Academy of Dermatology and Venereology.)