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Daniel Ebrahimi‐Fakhari Sascha Meyer Thomas Vogt Claudia Pföhler Cornelia Sigrid Lissi Müller 《Journal der Deutschen Dermatologischen Gesellschaft》2017,15(7):695-700
Tuberous sclerosis complex (TSC) is a genetic multisystem disorder with prominent skin involvement that frequently occurs in early childhood. Dermatologic manifestations include facial angiofibromas, hypomelanotic macules, fibrous cephalic plaques, shagreen patches, and ungual fibromas. The International TSC Consensus Conference in 2012 provided guidelines for standardized baseline evaluation and follow‐up. Detailed clinical dermatological evaluation at the time of diagnosis and annual skin examination is recommended for both pediatric and adult populations. The onset of dermatological manifestations is clearly age‐related. However, dermatologists also have to assess for clinical manifestations beyond their own specialty. With advances in genetics and the advent of mTORC1 inhibitors, new specific therapeutic options have become available for TSC patients with skin manifestations. Early intervention is commonly recommended for symptomatic, rapidly evolving, disfiguring, or debilitating lesions. The consensus guidelines recommend “treatment as appropriate for the lesion and clinical context” and suggest the use of surgical excision, laser therapy, or topical mTORC1 inhibitors. Topical mTORC1 inhibitors present a useful option for TSC‐associated skin lesions, particularly in medically complex patients. They may prevent or reduce the risks of subsequent surgeries and permanent scarring. 相似文献
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S2k Guidelines for the diagnosis and treatment of chronic pruritus – update – short version
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Sonja Ständer Claudia Zeidler Matthias Augustin Gudrun Bayer Andreas E. Kremer Franz J. Legat Peter Maisel Thomas Mettang Martin Metz Alexander Nast Volker Niemeier Ulrike Raap Gudrun Schneider Hartmut F. Ständer Petra Staubach Markus Streit Elke Weisshaar 《Journal der Deutschen Dermatologischen Gesellschaft》2017,15(8):860-872
Associated with a host of different diseases, pruritus is a cardinal symptom that poses an interdisciplinary diagnostic and therapeutic challenge. Over time, that symptom may progress independently of the initial cause, thus losing its function as a warning sign and turning into a clinically relevant disease of its own. In Germany, approximately 13.5 % of the general population are affected by chronic pruritus, with an incidence of 7 %. All forms of chronic pruritus require targeted treatment consisting of (a) diagnosis and management of the underlying disease, (b) dermatological treatment of primary or secondary (for example, dry skin, scratch lesions) symptoms, (c) symptomatic antipruritic treatment, and (d) psychological/psychotherapeutic treatment in case of an underlying or associated psychological or psychosomatic condition. Medical care of patients with chronic pruritus should therefore include an interdisciplinary approach, in particular with respect to diagnosis and therapy of the underlying disease as well as in terms of the management of treatment and adverse events. The objective of the present interdisciplinary guidelines is to define and standardize diagnostic and therapeutic procedures in patients with chronic pruritus. This is a short version of the current S2 guidelines on chronic pruritus. The long version may be found at www.awmf.org . 相似文献
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Sigrun Vehling Claudia Lehmann Karin Oechsle Carsten Bokemeyer Andreas Kr��ll Uwe Koch Anja Mehnert 《Supportive care in cancer》2011,19(4):513-520