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Background: Chronic hand eczema (CHE) is a very common skin disease among the European population. It causes itch and pain and, in more severe cases, seriously impairs hand functioning at work and in private life.Objectives: To explore perspectives of people with lived experience on CHE-related problems, wishes and goals.Methods: Following a qualitative approach, we conducted topic-guided interviews in five European countries and applied template analysis to identify recurrent themes among patients with CHE.Results: We interviewed 60 patients in seven outpatient dermatological and occupa-tional medicine clinics in Croatia, Denmark, Germany, the Netherlands and Spain. Five main themes were identified: (1) knowledge about the disease and its course, (2) preventive behaviour, (3) hand eczema therapy, (4) impact on everyday life and (5) attitudes towards CHE and healthcare. Participants did not feel well informed about CHE, especially about causes, triggers and treatment options. Preventive measures were experienced as more or less effective but also cumbersome. Experiences with therapy were diverse. Treatment satisfaction depended on the results and on the per-ceived support from the treatment teams. Participants found it important to be taken seriously, to receive practical advice, to try out additional treatments or examina-tions, find new hope and have occupational perspectives. They wished that others could better understand the physical and emotional burden of CHE. Patient support groups were not mentioned. Participants found it important to learn to take care of themselves and accept life with CHE.Conclusions: Due to its annoying symptoms, high visibility and impaired function-ing at work and in private life, CHE has a high emotional and social impact. Some people may require support to learn coping with CHE and its prevention. Patients wish for information about causes and triggers. They value physicians who listen to them and keep looking for solutions.

Background Healthcare workers (HCWs) are at high risk of developing hand eczema (HE). This can be exacerbated by hygiene measures related to the coronavirus disease (COVID-19). Using mild skin cleansers and emollients or moisturizers is central in the prevention of HE—especially with increased COVID-19 hygiene regimes. Aims This study aimed to assess parameters important for the acceptance of a skincare concept in HCWs. Methods In this proof-of-concept user trial, HCWs were provided ad libitum with hand wash oil and hand cream during the 6-month period, when occupationally acquired COVID-19 infections among HCWs were peaking in Germany and then surveyed about acceptance of the products using questionnaires. Results Of 135 HCWs, 115 (85%) responded. Skin tolerance of the hand wash oil and the hand cream was rated very good by 63% and 52% of the 115 participants, respectively. Of the 115 participants, 58% and 57% were very satisfied with the hand wash oil and the hand cream, respectively. Conclusions Acceptance of skin cleansing and skincare products in HCWs seems influenced by parameters such as self-assessed skin tolerance and self-reported overall satisfaction. It must be assumed that products are only used as recommended if they are well-accepted. Employers might survey employees about acceptance of products using the parameters identified to adjust concepts if necessary to sustainably contribute to the prevention of HE.

ZusammenfassungDas im Jahr 2004 eingeführte „Verfahren Haut“ der Deutschen Gesetzlichen Unfallversicherung (DGUV) sieht bei schweren, ambulant therapieresistenten berufsbedingten Hauterkrankungen vor, im Rahmen eines gestuft gegliederten Präventionskonzeptes eine Individualpräventionsmaßnahme durchzuführen, die sich aus einem dreiwöchigen stationären Aufenthalt mit einem interdisziplinären medizinischen und pädagogischen Interventionsprogramm und einer engmaschigen nachstationären ambulanten hautärztlichen Betreuung zusammensetzt. Diese Maßnahme (Tertiäre Individual-Prävention, TIP) wurde u. a. maßgeblich im Institut für interdisziplinäre Dermatologische Prävention und Rehabilitation (iDerm) an der Universität Osnabrück konzipiert und evaluiert und stellt hier einen Schwerpunkt des täglichen Wirkens dar. Mittels Langzeitevaluation der Verläufe nach TIP über einen Zeitraum von 5 Jahren konnte gezeigt werden, dass das Maßnahmenprogramm effektiv ist und der deutlichen Mehrheit der Teilnehmer erlaubt, trotz ursprünglich schwerer Berufsdermatose die berufliche Tätigkeit dauerhaft auszuüben bei gleichzeitig langfristig signifikanter Besserung des Hautbefundes und der Lebensqualität. Die im iDerm an der Universität Osnabrück angebotene stationäre Rehabilitationsmaßnahme TIP steht allen Versicherten der Unfallversicherungsträger in der Bundesrepublik Deutschland zur Verfügung; die Indikation hierfür kann problemlos durch die behandelnden Hautärztinnen und Hautärzte im Hautarztberichtsformular gestellt werden.

Palmoplantar pustulosis (PPP) is a chronic inflammatory skin disease. Its classification as a variant of psoriasis is controversial. Exogenous factors may affect PPP.Occupational aspects of PPP based on a retrospective evaluation of patient data are discussed.Data from 1518 patients who took part in a tertiary prevention program (TIP) for occupational skin diseases in our department between January 2015 and June 2019 were evaluated.PPP was diagnosed in 30 patients (1.98%). The hands were affected in all of them, while concomitant feet involvement was found in 83.3%. The majority was female (70.0%) and reported tobacco smoking (83.3%). Systemic treatment was continued or initiated in one third of patients. In only 8 patients (26.7%) was PPP considered to be work-related.PPP is an endogenous disease which is influenced by nonoccupational factors (e.g., tobacco smoking). Therefore, a thorough investigation is mandatory when assessing whether occupational factors are legally essential and exceed aggravation by everyday life. For this purpose, a well-documented course of the disease and a critical appraisal of occupational and nonoccupational factors are crucial. Only if occupational causality is probable can preventive measures be provided by the statutory accident insurance and PPP can be legally recognized as an occupational disease.

Additional file 1: Table S1. Association of UV exposure and risk for BCC in cases with histopathological subtype nodular and matched controls (n = 403 in each group). Table S2. Association of UV exposure and risk for BCC in cases with histopathological subtype sclerodermiform and matched controls (n = 145 in each group). Table S3. Association of UV exposure and risk for BCC in cases with histopathological subtype superficial and matched controls (n = 28 in each group).

Berufsdermatologie – Hautkrankheiten – Allergologie – Epikutantestung – Gebuhrenordnung – UV-GOA, Iontophorese – lokale PUVATherapie – Pravention

Health care of patients with occupational dermatitis (OD) in the sense of suspected "BK 5101" is carried out in Germany within the optimized dermatologist's procedure and the "dermal intervention" (formerly: hierarchical multistep intervention approach) of the statutory accident insurance (UVT), respectively.Dermatologists and UVT administrators are obliged to improve OD patient care by continuous quality management measures. Essential quality management elements include the research projects EVA_Haut and VVH, the clearing procedure of the Task Force on Occupational and Environmental Dermatology (ABD), training of dermatologists to receive the CME certificate "Occupational Dermatology (ABD)", the establishment of processing standards for administrators and optimized dermatologist's report forms (based on the results of all the above steps taken).It was shown that the optimized dermatologist's procedure and "dermal intervention" are established in Germany. Also, the available preventive and therapeutic measures for OD patients are effective. Despite the increase of cases with suspected OD, the number of cases in which a career change was required is almost constant (3 %); at the same time the percentage of notified cases which, as a result, are covered within the dermatologist's procedure by the UVT is rising (86 %). The measures recently taken have continuously increased quality of health care in occupational dermatology.

In the past years, more than 300 hairdressers have been reported to the mandatory accident insurance carriers as being suspected of having developed hairdressers asthma. Between 2001 and 2003, only 68 to 85 cases were confirmed as being caused or worsened by working as a hairdresser. Our study of more than 100 hairdressers from 2001 - 2005 has shown two age peaks for suspected cases. The first one in mostly young atopic hairdressers lies between 18 and 22 years. The second peak was determined to be between 3 8 and 45, comprising almost exclusively smokers with chronic bronchitis. Our results show that in most cases working in a salon does not cause asthma but that the inhalative exposure to numerous chemical substances increases symptoms and in a few cases leads to a progression of pre-existing bronchial hyperreactivity and asthma.

In Germany, responsibility for treatment of occupational diseases lies with the public statutory employers' liability insurances (SELI). According to their legal obligation SELI have to ascertain cure--wherever possible--"with all suitable means". Thus, dermatologists treating patients with occupational dermatoses are required to deliver the best possible therapy, which, according to the current scientific knowledge, may in some cases be off-label. For example, in occupational contact dermatitis a number of scientifically promising topical and systemic drugs are not yet licensed for this indication. Off-label prescribing is not prohibited and there are no laws limiting physician flexibility in such prescribing. SELI also allows the use of off-label drugs. The goals of optimal treatment or effective prevention of occupational disease determine the measures which can be employed. Off-label use is approved for occupational skin diseases when the medication is required for cure or prevention and its use meets generally accepted medical standards. In these cases, SELI will cover off-label drug prescriptions. However, detailed patient counseling and informed consent are mandatory.

Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP).To investigate the reasons for this development, we--on behalf of the DGP--sent a questionnaire to 120 German Departments of Dermatology in autumn 2012.In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments.Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available.

Upon skin contact to irritants, interleukin-1 alpha (IL-1α) is released in the stratum corneum as a primary step of skin inflammation. Variations in the IL-1A gene have been shown to alter the expression of IL-1α. This may influence the susceptibility to skin inflammation and the development of irritant contact dermatitis (ICD).To determine effects of an IL1A-889 C/T polymorphism in view of susceptibility to develop irritant contact dermatitis.In a case-control study, 478 Caucasian patients with occupational ICD of the hands were genotyped for an IL1A-889 C/T polymorphism. Results were compared to 393 apprentices from the same high risk occupations (controls).Trends of a protective effect of the C → T transition at position IL1A-889 were seen (OR = 0.81; 95% CI: 0.65-1.00). The genotype distribution for IL1A-889 was 52.2% wild type (C/C), 39.2% heterozygous (C/T) and 8.6% homozygous for variant allele (T/T) in patients and 46.0%, 42.7% and 11.4% in controls. Subgroup analysis, which took into account atopy status and exposure, did not reveal a significant effect of this polymorphism for an aberrant risk to acquire for ICD.Our study indicates a possible protective effect of the IL1A-889 C/T polymorphism regarding the development of ICD.

Numerous cases of work-related air-borne contact dermatitis of the face were encountered in a waste collection facility. Potential allergens contained in the dust at the facility could be identified. In 5 of 7 symptomatic workers a type-IV sensitization to p-aminodiphenylamine could be documented. Since there is no commercial patch test preparation for p-aminodiphenylamine available, it had to be prepared for each patient individually. After identifying the allergen, a change in the work routine led to a reduction of dust emissions and afterwards no cases of air-borne contact dermatitis of the face recurred.

Tetrazepam, a benzodiazepine, is a frequently used muscle relaxant. The most common adverse reactions are neurological and gastrointestinal. Cutaneous reactions to tetrazepam are rare and occur predominantly after systemic administration. To present 10 health care professionals who developed airborne contact dermatitis to tetrazepam due to occupational exposure to tetrazepam dusts. We report a series of 10 cases observed in our department between January 2006 and March 2011 where tetrazepam was identified to cause allergic airborne contact dermatitis. Affected individuals were employed as (geriatric) nursing staff, exposed to tetrazepam on a regular occupational basis when crushing tablets for their patients. Upon investigation, patients were patch tested with commercial and customized allergens. This included tetrazepam and in five cases diazepam. Tetrazepam revealed strong positive reactions in all patients. Additional diazepam sensitization was observed in three subjects. Following local treatment and occupational preventive action, patients recovered from their skin symptoms. Allergic contact sensitization to tetrazepam and cross-sensitization to diazepam seems to be underestimated and not appropriately diagnosed in patch test clinics, as it is so far insufficiently patch tested. They should be considered when allergic contact dermatitis is suspected, particularly in professionally exposed staff, and tested as supplemental allergens.

Parallel to the introduction of the optimized dermatologist's report in 2006, a hierarchical multi-step intervention approach to occupational dermatitis (OD) was launched within the statutory accident insurance bodies. It is aimed at ensuring that OD patients can be allocated to dermatological consultations and preventive measures quickly and in a manner appropriate to the severity of their OD. At present, a study ("EVA Haut") is being conducted at the University of Osnabrueck in which about 10% of the annually reported cases in Germany with suspected OD in 2007 have been selected at random (N=1,600). All randomized notifications are reviewed by occupational dermatologists; in parallel, the implementation of the hierarchical multi-step intervention scheme by the insurance-administrations is evaluated. Main criteria are the course of OD, job loss and costs of the procedures (follow-up 1 year). The random quota sample reveals the number of cases in which dermatological and/or preventive intervention were initiated by the administrations ("dermatologist's procedure"; N=995), in these cases patients and dermatologists involved are interviewed by a standardized questionnaire. In the remaining N=556 cases, no intervention has taken place so far; these cases are also analyzed. The study offers the unique opportunity to analyze the quality and interaction of dermatological and administrative procedures in the management of occupational dermatoses in Germany and to define criteria for further improvement.

Preventive measures in occupational dermatology have proven to be very effective in recent years, especially measures of primary and secondary prevention as components of a complex hierarchical prevention concept. For those cases of occupational dermatoses in which these outpatient prevention measures are not successful, interdisciplinary inpatient rehabilitation measures have been developed ("tertiary individual prevention" [TIP]). TIP comprises 3 weeks inpatient treatment including intensive disease-oriented teaching and psychological counseling, followed by outpatient treatment by the local dermatologist. In 2005, a German prospective cohort multicenter study ("Medizinisch-Berufliches Rehabilitationsverfahren Haut--Optimierung und Qualitätssicherung des Heilverfahrens" [ROQ]) started which will further standardize TIP and evaluate long-term success and scientific sustainability in depth. This integrated concept of an inpatient/outpatient disease management reveals remarkable pertinent options for patients with severe occupational dermatoses in all high-risk professions.

Occupational dermatoses (OD) are the most frequent occupational diseases in Germany and amount to more than 25% of all suspected occupational diseases. Preventive measures have proven to be very effective in recent years, especially measures of primary and secondary prevention as components of a complex hierarchical prevention concept in wet work occupations. If employees are in danger of loosing their job due to a severe OD, intensive interdisciplinary measures of tertiary individual prevention (TIP) are required. TIP comprises 2-3 weeks of in-patient treatment plus intensive health-pedagogic counselling, followed by 3 consecutive weeks (or longer) of out-patient treatment by the local dermatologists ("Osnabrueck model"). Each patient will stay off work for a total of at least 6 weeks to allow full barrier-recovery. It could be shown that 2/3 of the patients successfully remained in their workplaces because of TIP. TIP reveals remarkable pertinent options for interdisciplinary disease management in severe OD in all risk professions. In Germany recently, a multi-centre study was started which will further standardise such preventive measures and evaluate their long-term success.

The dermatologist's procedure was introduced in 1972 by employers' liability insurance funds in the industrial, agricultural, and public sectors of Germany's statutory occupational accident insurance as a "procedure for early detection of occupational skin diseases." So far, it is still the most relevant tool for secondary prevention in occupational dermatology in Germany. According to the intention of this procedure, insured persons with a skin disease in which an occupational etiology is suspected must be offered preventive measures and, if necessary, given appropriate treatment to avoid job-loss. To improve the efficiency of the "classic" dermatologist's procedure, in 1999, on the initiative of the Central Federation of Industrial Professional Associations, a study group was founded in cooperation with the Task Force on Occupational and Environmental Dermatology of the German Dermatological Society and the Professional Organisation of German Dermatologists. In October 2002, a controlled intervention study started in North-western Germany to scientifically evaluate the "optimised" dermatologist's procedure, which was proposed by the study group and compare it to the standard ("classic") procedure. The study results should allow detailed suggestions for an improved dermatologist's procedure before it is introduced nationwide.

Gegenstand der Epidemiologieist es, die Verbreitung von Krankheiten in der Bevolkerungi­In -untersuchen. untersuchen. Gerade im Bereich berufsbedingter, Hauterkrankun! gen erfullen epidemiologische Daten besonderem Mase nicht nur Aufgaben der;. Dokumentation,Poltunientation, des Erkrankuncgsgesche he,’sondern stellen zugleich die rationa le Bnsasis ~rdie ldent fizierung gefahrdeter’ Berufsgruppen und fur gezielte Praventi-onsat atr eigenen dar (Schnuch 1994;Schnuch, %e 2000). Der ‘Epi e iolvgk kommt hier; auch. deshalb eine besondere’ Bedeutung zu„.da Hautkrankheten in fast.a alten westlichen iaIndustrienationen seit Jahren an der Spitze aller berufsbedingten Erkrankungen stehen und erhebliche volkswirtschaftliche Folgekosten verursa’ hen (Dipgen, t oenra ds 2000). Nach Schatzungen sind etwa 30-40% aller !be’ rufsbedingten Erkrankungen in der indust; rialisierten. Welt Hautkrankheiten, wobei Inzidenzratei von 5-19 Erkrankungsfallen pro 100003 Vollarbeitern jahrlich angege lien werden (Coenraads, Smit 1992; Diep. gen, Coenraads 1999; Dickel et al. 2001) 90-95% berufsbedingter Hauterkrankun gen manifestieren ! sich als Ekzernerkran’ kungen (Diepgen et al. 1992, 1994; Rycroft 1995; Frosch, Rustemeyer, Schnuch 1996; Coenraads, Diepgen, Smit 2001; Dickel et al. 2002 a). Auf diese soll deshalb im Fol genden Bezug genommen werden. Berufs bedingte Fkieme:betreffen im Allgemei nen pripait den Ort der Einwirkung, dies sind in uber 90% die Hande (Diepgen et al, 1994; Rycroft 1995; Uter 1999; Diepgen, Coenraads 2000; Dickel et al. 2001)

Das Hautarztverfahren greift im Vorfeld von Berufskrankheiten der Haut, wo es sinnvoll seiner Zweckbestimmung, der Entwicklung berufsbedingter Hauterkrankungen vorzubeugen, gerecht werden kann. Falls bereits ein „begrndeter Verdacht auf das Vorliegen einerBerufskrankheit“ gegeben ist, muss eine „Arztliche Anzeige uber eine Berufskrankheit“ (Vordruck F 6000, Abb. 4.1) gemas § 202 SGB VII erstattet werden. In der Praxis herrschen gelegentlich Zweifel, welches der beiden Formulare zu verwenden ist

Das,,Verfahren zur Fruherfassung ber~abedingter tHauterkrarlkurtgen“ (Hautart verfahren) stellt das, €ur’die Berufsderma r tologie wichtigste praventive Instrument: in der gesetzlichen Unfallversicherung dar’keiner anderen beruflich bedingten Erkrankung kommen dieUnfalversiche rungstrager ihrem gesetzlich verankerten’’ Pr¨¢vutrag derart weitreichend nach. Das Hautarztvef rfahren konnte des,halb alsentionsa Modell fair die P~eavention auc anderer Berufskrankheiten dienen. Die Rahmen des Hautarztverfahrens erstattete Iautarztberichte bilden vielfach, wichtige Entscheidungsgrundlage fier s,1 tere Begutachtungen.

A 59-year-old woman with a single cuff-like plaque, consisting of multiple skin-coloured to bluish cysts and comedones on her right forearm is reported. The solitary lesion resembled, morphologically and histologically, the Favre-Racouchot syndrome. The above condition is another case of the previously described actinic comedonal plaque, which seems to be a rare entity within the spectrum of disease caused by actinic damage to the skin.

The aim of this study is to provide awareness of the common causes of death and their associated trends in the very aged. Forensic autopsies on patients aged >90 years were reviewed. The study lasted from January 1, 1988 to December 11, 1998 and was done in Auckland, New Zealand, the population of which is 1.3 million. Cases were divided into natural or unnatural deaths. Of the total of 319 cases, 272 (85%) deaths were natural. Of those, only 13 (5%) were "written off" as being attributed to old age or senile debility. The most common causes of death were ischemic heart disease (IHD), 74 cases (23%); bronchopneumonia, 37 cases (12%); fractures, 28 cases (9%); acute myocardial infarction, 25 cases (8%); cerebrovascular accident, 19 cases (6%); and ruptured aneurysm, 17 cases (5%); 61 (19%) deaths were multifactorial. Fractures, either as the primary cause of death or as a complicating factor, accounted for 29 cases, third only to IHD and bronchopneumonia. Forty-seven deaths (15%) were unnatural; of those, 43 were accidents, 3 were suicides, and 1 was a homicide. From these results it is clear that the very elderly succumb to disease; they do not often die of old age.

Elastosis perforans serpiginosa (EPS) is a rare entity belonging to the group of primary perforating dermatoses. A 13-year-old male patient with Down's syndrome developed reddish hyperkeratotic papules in a serpiginous and ellipsoid configuration on the face. Histological examination revealed transepidermal elimination of thick coarse elastic fibres from the papillary dermis. The dermal infiltrate showed an immunohistological pattern consistent with an acute cell-mediated immune response. It consisted mainly of activated T-lymphocytes, with a predominance of CD4-positive cells. Considerable numbers of CD1-positive cells were also present. Inflammatory macrophages of the 27E10 phenotype were found in considerable numbers, whereas 25F9-positive resident macrophages were almost completely absent. The role of a cell-mediated immune response in the mechanism of transepithelial elimination is discussed.

A "divided naevus" (or "kissing naevus") is defined as a congenital melanocytic naevus that occurs on adjacent parts of the upper and lower eyelid and may give the appearance of a single lesion when the eye is closed. We report on four cases of this rare naevus. Two of these were examined histologically and showed the features of compound naevi. The unique occurrence in nature of the divided naevus allows conclusions on the site and time of origin not only of the divided naevus, but possibly also of other congenital melanocytic naevi. The divided naevus must originate at the latest during the period of lid fusion, between the 9th and 20th week of gestation. The fact that the fusion involves only epithelial tissue suggests an epithelial origin of congenital melanocytic naevi, which may later develop secondarily into compound or intradermal naevi by way of "dropping-off".

Certain drugs used to treat the elderly are known to precipitate hypothermia. In this study, the effects of chlormethiazole and thioridazine in producing postural hypotension were compared. In a study of hypothermia in the elderly the effects of chlormethiazole, thioridazine and lormetazepam were examined. Only three patients showed a postural drop following chlormethiazole, while 11 showed a postural drop following thioridazine. Chlormethiazole showed little variation from the control group in the hypothermia study, while thioridazine and lormetazepam caused a fall in temperature. For behaviour control in the elderly and for a short course as a hypnotic, chlormethiazole seems to be safer than thioridazine or lormetazepam.

Eine direkte (infiltrative) Beteiligung des Zentralnervensystems ist eine bekannte Komplikation bei Hodgkin- und Non-Hodgkin-Lymphomen und kann in 10–25% der Falle nachgewiesen werden. Hingegen sind in der Literatur unseres Wissens insgesamt nur 12 Falle berichtet worden, bei denen sich eine kortikale Kleinhirnatrophie im Verlauf eines M. Hodgkin auf paraneoplastischer Grundlage entwickelte [1–12]. Trotz ihrer Seltenheit konnten wir diese Komplikation im Krankengut unserer Klinik in den letzten 5 Jahren in 3 Fallen nachweisen. Nach kombinierter Radio-und Chemotherapie sind alle 3 Patienten bis heute in der Remissionsphase. Auch die zerebellare Symptomatik zeigt eine zumindest partielle Besserung. Im folgenden werden Klinik, Therapie und Verlauf im einzelnen dargestellt.

Phlebologic diseases have become extremely common and have major socio-economic impact. However, the percentage of dermatologists working in phlebology appears to be decreasing according to the data of the German Society of Phlebology (DGP). To investigate the reasons for this development, we-on behalf of the DGP-sent a questionnaire to 120 German Departments of Dermatology in autumn 2012. In 76 returned questionnaires, the number of physicians with additional fellowship training in phlebology averaged 1.5; the average number of those who fulfill the criteria for training fellows in phlebology was 0.9. In 71.1 % of the departments there was a phlebologist. A special phlebologic outpatient clinic existed in 73.7 % of the departments. Sonography with Doppler (89.5 %) and duplex (86.8 %) was used as the most frequent diagnostic tool. For therapy, compression (94.7 %), sclerotherapy (liquid 78.9 %, foam 63.2 %, catheter 18.4 %), endoluminal thermic procedures (radio wave 28.9 %, laser 17.1 %) and surgery (especially crossectomy and stripping 67.1 %, phlebectomy of tributaries 75 %) were used. The average number of treatments was very heterogenous in the different departments. Phlebology definitely plays an important role in dermatology. Most departments fulfill the formal criteria for the license to conduct advanced training in phlebology. A wide spectrum of phlebological diagnostic and therapeutic procedures is available., Hintergrund Venenleiden sind eine Volkskrankheit und haben eine enorme sozioökonomische Bedeutung. Dennoch scheint der Anteil der phlebologisch tätigen Dermatologen entsprechend den Zahlen der Deutschen Gesellschaft für Phlebologie (DGP) abzunehmen. Methoden Um die Ursachen dieser Entwicklung zu untersuchen, führten wir im Herbst 2012 im Auftrag der DGP eine Befragungsstudie zur Phlebologie an 120 deutschen Hautkliniken durch. Ergebnisse In 76 antwortenden Klinien gab es im Mittel 1,5 Phlebologen und 0,9 Ärzte mit Voraussetzungen zur Weiterbildungsermächtigung Phlebologie. In 71,1 % der Kliniken gab es einen Phlebologen, in 73,7 % eine phlebologische Sprechstunde. Zur Diagnostik wurden besonders die Doppler- (89,5 %) und Duplexsonographie (86,8 %) eingesetzt. In der Therapie führte die Kompressionstherapie (94,7 %), gefolgt von Sklerosierungstherapien (flüssig 78,9 %, Schaum 63,2 %, Katheter 18,4 %), den endoluminalen thermischen Verfahren (Radiowelle 28,9 %, Laser 17,1 %) und den operativen Eingriffen (vor allem Cross- und Saphenektomie 67,1 %, Seitenastexhairese 75 %). Die durchschnittlichen Behandlungszahlen waren sehr heterogen. Schlussfolgerung Die Phlebologie spielt in der Dermatologie weiterhin eine wichtige Rolle. Mehrheitlich sind in den Kliniken die Möglichkeiten zur Weiterbildung Phlebologie gegeben. Es wird ein breites Spektrum an phlebologischen Techniken zur Diagnostik und Therapie angeboten.