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The article discusses the inter-rater reliability of the International Hidradenitis Suppurativa Severity Scoring System (IHS4) as a primary outcome measurement instrument for large clinical studies in hidradenitis suppurativa (HS). The study involved 31 dermatology residents from 16 countries who evaluated 10 HS patients with varying disease severity. The results showed that the IHS4 had excellent inter-rater reliability among the raters, indicating its suitability for use in large clinical studies. However, the evaluation of HS lesions without weighting and the evaluation of inflammatory nodules and abscesses only led to reduced reliability. The article concludes that the IHS4 is a reliable instrument for assessing HS in clinical studies. [Extracted from the article]

This article discusses a study conducted at the European Academy of Dermatology and Venereology (EADV) Schools on hidradenitis suppurativa (HS). The study aimed to assess the baseline knowledge of dermatology specialists and residents on HS and evaluate their learning outcomes after participating in the EADV School. The study found that there was a significant improvement in participants' knowledge of epidemiology and treatment of HS after the school. However, there was no significant improvement in knowledge of pathogenesis. The study highlights the educational value of the EADV School in increasing knowledge levels among dermatology residents and specialists. [Extracted from the article]

Dear editor, Cryosurgery, a safe physical regimen with only a few adverse effects and contraindications, provides satisfactory results in the generally frustrating treatment of keloids.1 Contact cryosurgery has mostly been applied,2 whereas intralesional cryosurgery3 is a relatively new, safe, therapeutic modality with a still limited level of evidence (15 evidence-relevant studies from 105 publications).4 The fact that intralesional cryosurgery induces only low temperatures and achieves a long freezing time in the deep scar core, causing minimal damage and hypopigmentation to the superficial skin, is of paramount importance in keloid treatment.5,6 In addition, marked efficacy of a single intralesional cryosurgery session has been recorded even in voluminous keloids, which is an additional major advantage compared with the repeated sessions required in classical contact cryosurgery.4,5 In order to assess the expected reduction of keloid volume after a single session and the required optimum keloid treatment hold time (duration) with intralesional cryosurgery, a monocentric retrospective study was conducted using a review of hospital records, which randomly included a maximum of two keloids per patient. There was an overall volume reduction of 52-2 ± 28-1% 6 months after a single treatment (total freezing of the lesion including a 5-mm margin of healthy-appearing perilesional tissue).3,7 Sternum keloid volume was reduced by 41-5 ± 26-8%, ear keloid volume was reduced by 59-1 ± 28-7% and shoulder keloid volume was reduced by 59-1 ± 28-7% (not significant). [Extracted from the article]

Background: Intralesional cryosurgery is effective in the treatment of keloids; however, clinical studies have presented diversified results., Objective: A novel, reproducible model for biophysical studies on intralesional cryosurgery of keloids is presented., Methods: Triplicate studies with a cryosurgical needle on 37°C-heated potatoes, which exhibit identical specific heat and similar heat conductivity with human skin, were performed., Results: No complete potato freezing resulted through a cryosurgical needle. The limited tissue damage achieved had a double concave form. The needle induced lower temperature and stronger tissue damage at the distal exit than the proximal entrance site. The concave form of tissue damage flattened with time at the area under the needle. Needle freezing with puncture distances of 0.5, 1.0 and 1.5 cm from the potato surface only revealed freezing temperatures within the 0.5 cm range. At any needle depth, tissue damage was detected at only an area to about 1 cm under the needle., Conclusion: Clinical extrapolation of these experimental findings indicates a proper needle positioning towards the keloid basis, shows keloid volume freezing limitations by a single needle and corroborates the observations of minor epidermal and deep dermal damage induced by intralesional cryosurgery., (© 2020 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)