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The making of wax moulages was an exclusive and sought-after art that was primarily used for teaching, but also to document clinical and laboratory research during the first half of the 20th century. Applying the technique of moulage-making to document a case of psoriasis improvement for posterity, a moulage of the trunk of a patient with psoriasis vulgaris was taken prior to treatment with biologics - adalimumab, a TNF-α antagonist - and again 3 month after adalimumab was first given. Our modern moulage shows in the most realistic way the science-driven improvement of psoriasis achievable nowadays with biologics. However, the real clinical picture of the disease is shrouded by showing only one detail of the patient - by accident the one with the best clinical improvement. All available techniques to document skin disease have advantages and limitations and nothing beats seeing live patients.

Studienaufenthalte an verschiedenen dermatologischen Kliniken und genetischen Instituten im In- und Ausland pragten schon fruh das besondere Interesse von Urs Walter Schnyder (◘ Abb. 2.1) an den Genodermatosen, insbesondere den Epidermolysen und Verhornungsstorungen.

In den letzten zehn Jahren haben sich zwei Schwerpunkte in unserer Klinik speziell etabliert: »Hautkrebs « und »Entzundliche Hautkrankheiten «.

Mithilfe der Publikationen aus der Klinik seit ihrer Grundung 1916 wird ein Uberblick uber die Forschungstatigkeit an der Dermatologischen Klinik fur den Zeitraum bis 1978 entworfen. Aspekte aus dem klinischen Alltag und die tatsachlich am Patienten praktizierte Dermatologie werden dabei ausgeklammert, ebenso wie Forschung, die nicht publiziert wurde. Dennoch lasst sich erkennen, in welcher Art medizinische Probleme wissenschaftlich angegangen und als translationale Forschung in die Praxis umgesetzt werden konnten. Im gedruckten Buchtext sind die wichtigsten Referenzpublikationen angegeben. Eine vollstandige Zusammenstellung aller vorhandenen Referenzen findet sich unter http://extras.springer.com/.

Der Unterricht macht nur Sinn, »wenn dem Studenten Gelegenheit geboten wird, moglichst viele Falle und diese moglichst grundlich und aus der Nahe zu studieren. Die Diagnostik hangt […] von der Ausbildung des visuellen Sehvermogens ab« (Bloch 1929).

Um 1840 publizieren die Dresdener Chirurgen Eduard Zeis und Friedrich August von Ammon Bucher zur plastischen Chirurgie und wahnten sich am Hohepunkt dieser Disziplin. Die grosen Errungenschaften, welche die Chirurgie grundsatzlich veranderten, die Anasthesie und Asepsis, wurden allerdings erst entdeckt, nachdem Zeis seine Ansichten uber „die Glanzperiode der plastischen Chirurgie” publiziert hatte. Dies deutet darauf hin, dass die fortschrittsgeschichtliche Darstellung Erganzungen benotigt. Insbesondere die sich wandelnden Krankheitskonzepte und die Bedeutung der Kosmetik verdienen eine grosere Beachtung, da sie einen direkten Einfluss auf den Denkstil der Chirurgen hatten. Abstract: In 1838 and 1842 Eduard Zeis and Friedrich August von Ammon, both practicing surgeons in Dresden, published their books about „plastic surgery”. They were convinced that they had reached the height of their discipline. But anesthesia and asepsis have not been discovered, yet. This indicates that the classical history of a (technical) progress needs to be completed with aspects of concepts of diseases and the social impact of cosmetic surgery, as they had a direct influence on the thought style of the surgeons.

Marion B. Sulzberger was one of the most famous American dermatologists. He had received his training in dermatology in Zurich (Switzerland) from 1926 to 1929. The collection of moulages in Zurich still preserves outstanding wax models of Sulzberger's scientific work. They are impressive examples of the purpose and value of moulages at the beginning of the 20th century being used as teaching aids but also as documents and illustrations in scientific articles and textbooks. Today, the wax models of Sulzberger's work belong to the most important examples of moulages used in medical historical research. They also have value for teaching dermatology to medical students.

Die dermatologische Wachsmoulage zieht heute nicht nur die Aufmerksamkeit der Medizinhistoriker, sondern auch wieder die der Dermatologen auf sich. Wiederentdeckte Bestande werden erfasst, besser gelagert und, wenn moglich, wieder ausgestellt. Dabei wird oft nach Moglichkeiten gesucht, die Wachsobjekte, an denen die Vergangenheit ihre Spuren hinterlassen hat, nicht nur zu konservieren, sondern auch zu restaurieren. Wie wichtig eine professionelle, vorsichtige und gut dokumentierende Herangehensweise ist, zeigt das Beispiel der Wachsmoulage Nr. 189 aus dem Zurcher Moulagenmuseum. Die dazugehorige Diagnose verandert die Bedeutung des Objektes und macht aus einem Lehrmittel ein Dokument eines eindrucklichen Patientenschicksals. Today, the medical wax moulages attract not only the attention of medical historians, but also dermatologists have rediscovered their value. Collections that were almost forgotten are classified, archived and if possible exhibited. The moulages are conserved and sometimes restored if the past has left its marks on the fragile wax objects. The story behind the wax moulage No. 189 illustrates the importance of a gapless documentation and conservative restoration. The old diagnosis attached with a plaque changes the meaning of the moulage that has been regarded as a teaching object into a research document with a moving story of the patient behind.

Zusammenfassung: Flecken der Haut, die seit der Geburt bestehen, werden auch Muttermale genannt, da sie „von der Mutter her” kommen. Als wichtige Ursache fur die Entstehung von Muttermalen wird seit der Antike das „Versehen” beschrieben und diskutiert. Erst im ausgehenden 19. Jahrhundert distanziert sich die naturwissenschaftliche Medizin von diesem Konzept. Parallel zu den sich entwickelnden Spezialisierungen entstehen anatomisch-embryologische und schlieslich genetische Theorien zur Navusgenese. Abstract: Congenital moles are also called mother's marks because they were said to originate „from the mother”. Since ancient times „maternal impression” was discussed as a possible cause for the development of moles. At the end of the 19th century, this concept was replaced by modern embryologic and finally by genetic theories.

With a focus on Zurich, a short synopsis over the formation of the therapy of skin diseases with x-rays focuses is lined out. Not only papers and books but also pictures and wax moulages help us to understand better how our ancestors were confronted with this very successful but also dangerous new treatment modality, promising amelioration of almost any skin disease.

Botulinumtoxin (BTX) is a neurotoxin produced from Clostridium botulinum under anaerobic conditions and is responsible for botulism, a notifiable, bacterial form of food poisoning. The first case of botulism is believed to have occurred in 1735. An epidemic in Southern Germany in 1793 claimed the death of over the half of those patients who had become ill through eating uncooked blood sausages. The term "pharmakon" is Greek and implicates that a drug originates from poison (potion, remedy). Theophrastus Bombast von Hohenheim known as Paracelsus (1493/94-1541) first described this duality with his dictum "alle ding sind gift und nichts on gift; alein die dosis macht das ein ding kein gift ist" (only the dose makes a remedy poisonous). In Baden-Wurttemberg in 1817, the poet and physician Dr. Justinus Christian Kerner described the symptoms of botulism, so that at this time botulism was also called Kerner disease. Until the turn of the century the reason for poisoning was not known. Van Ermengem succeeded in isolating the anaerobic bacterium causing botulism, but the specific mechanism of BTX was only established after the second World War. In the late seventies the ophthalmologist Dr. Alan Scott used BTX the first time in the treatment of strabismus. The drug was then used in the treatment of several muscle spasticities such as, for example, torticollis or hemifacial spasm. Only recently BTX has been successfully used for focal hyperhidrosis. We review the history of botulinum toxin from its discovery in the nineteenth century and the research into its effect in the middle of the 20th century up to its clinical use at the present time.

Background: The history of psoriasis, remains highly speculative for the time before Willan (1757-1812), and can be reliably assigned only for the last 200 years. Terms such as "Leprosy", "Impetigo" and "Psora" have been used in the centuries before. Hebra (1806-1880) gave a morphological and nosologic definition, in which also the histopathology appearance was taken into account. In the early 20th century, it was the biochemistry and histochemistry, which provided new insights. In the second half of the 20th century, immunocytochemistry and immunology shed some light on the pathogenetic processes of the disease. At the end of the 20th and at the beginning of the 21st century, it is the triumph of genetics and immunology, which have opened new therapeutic possibilities due to the interesting insights into the pathogenesis of psoriasis. However besides the new therapeutic modalities, which harbor some health and some economic threats, classical approaches still remain valuable tools.

In the 1950s, based on the theory of stimulating radiant energy published by Albert Einstein in 1916, the collaboration of physicists and electrical engineers, searching for monochromatic radiation to study the spectra of molecules, led to the invention of the first laser in 1960. Ophthalmologists and dermatologists were the first to study the biological effects and therapeutic possibilities of laser beams. The construction of new laser systems emitting energy at different wavelengths or with different durations, as well as the development of new concepts of the biomedical effects, led to its broad use in surgery in the treatment of vascular and pigmented lesions as well as cosmetic applications.

Seit mehr als zehn Jahren widmet sich die Arbeitsgemeinschaft fur Dermatologie und Venerologie e. V., kurz AGDV, der Einordnung aktueller Entwicklungen in der Dermatologie in den Kontext der Fachgeschichte [1]. Die Mitwirkung der Mitglieder an grosen Projekten legt international Zeugnis davon ab, wie aktiv die Fachgeschichte gewurdigt wird [2]. Jahrliche Arbeitstreffen dienen dem Austausch und der Darstellung von aktuellen Forschungsarbeiten. Diese Treffen finden alternierend im Rahmen der Fortbildungswoche in Munchen oder auf dem DDG-Kongress statt, zuletzt im Mai 2013 in Dresden. Diese Veranstaltung war zunachst gepragt vom Gedenken an den Grundungsprasidenten der AGDV, Herrn Professor Dr. Albrecht Scholz, der im Marz verstorben ist. Zwei Monate fruher verstarb mit Herrn Professor Dr. Karl Holubar ebenfalls ein Grundungsmitglied. Beide waren grose Personlichkeiten und auf ihre Art herausragende Vertreter der Medizinhistorie. Diese Ausgabe der Aktuellen Dermatologie ehrt ihr Andenken und wurdigt ihre Verdienste in zwei Nachrufen.

Background It has been proposed that the innate immune system plays a central role in driving the autoimmune T-cell cascade leading to psoriasis; however, there is no direct evidence for this. Observations We observed aggravation and spreading of a psoriatic plaque when treated topically with the toll-like receptor (TLR) 7 agonist imiquimod. The exacerbation of psoriasis was accompanied by a massive induction of lesional type I interferon activity, detected by MxA expression after imiquimod therapy. Since imiquimod induces large amounts of type I interferon production from TLR7-expressing plasmacytoid dendritic cell precursors (PDCs), the natural interferon-producing cells of the peripheral blood, we asked whether PDCs are present in psoriatic skin. We identified high numbers of PDCs in psoriatic skin lesions (up to 16% of the total dermal infiltrate) based on their coexpression of BDCA2 and CD123. By contrast, PDCs were present at very low levels in atopic dermatitis and not detected in normal human skin. Conclusions This study shows that psoriasis can be driven by the innate immune system through TLR ligation. Furthermore, our finding that large numbers of PDCs infiltrate psoriatic skin suggests a role of lesional PDCs as type I interferon-producing targets for the TLR7 agonist imiquimod.

Botulinumtoxin (BTX) is a neurotoxin produced from Clostridium botulinum under anaerobic conditions and is responsible for botulism, a notifiable, bacterial form of food poisoning. The first case of botulism is believed to have occurred in 1735. An epidemic in Southern Germany in 1793 claimed the death of over the half of those patients who had become ill through eating uncooked blood sausages. The term "pharmakon" is Greek and implicates that a drug originates from poison (potion, remedy). Theophrastus Bombast von Hohenheim known as Paracelsus (1493/94-1541) first described this duality with his dictum "alle ding sind gift und nichts on gift; alein die dosis macht das ein ding kein gift ist" (only the dose makes a remedy poisonous). In Baden-Württemberg in 1817, the poet and physician Dr. Justinus Christian Kerner described the symptoms of botulism, so that at this time botulism was also called Kerner disease. Until the turn of the century the reason for poisoning was not known. Van Ermengem succeeded in isolating the anaerobic bacterium causing botulism, but the specific mechanism of BTX was only established after the second World War. In the late seventies the ophthalmologist Dr. Alan Scott used BTX the first time in the treatment of strabismus. The drug was then used in the treatment of several muscle spasticities such as, for example, torticollis or hemifacial spasm. Only recently BTX has been successfully used for focal hyperhidrosis. We review the history of botulinum toxin from its discovery in the nineteenth century and the research into its effect in the middle of the 20th century up to its clinical use at the present time.