Adel Sammain

European Evidence‐based (S3) Guidelines for the Treatment of Acne

Subcommittee Members: Dr. Alexander Nast, Berlin (Germany) Dr. Cristina Oprica, Stockholm (Sweden) Prof. Dr. Brigitte Dreno, Nantes (France) Mrs. Stefanie Rosumeck, Berlin (Germany) Dr. Vincenzo Bettoli, Ferrara (Italy) Prof. Dr. Berthold Rzany, Berlin (Germany) Prof. Dr. Klaus Degitz, Munich (Germany) Dr. Adel Sammain, Berlin (Germany) Mr. Ricardo Erdmann, Berlin (Germany) Dr. Thierry Simonart, Brussels (Belgium) Prof. Dr. Andrew Finlay, Cardiff (United Kingdom) Dr. Niels Kren Veien, Aalborg (Denmark) Prof. Dr. Ruta Ganceviciene, Vilnius (Lithuania) Dr. Maja Vurnek fivkovi , Zagreb (Croatia) Dr. Alison Layton, Harrogate (United Kingdom) Prof. Dr. Christos Zouboulis, Dessau (Germany) Dr. Jose Luis Lopez Estebaranz, Madrid (Spain) Prof. Dr. Falk Ochsendorf, Frankfurt (Germany) Prof. Dr. med. Harald Gollnick, Magdeburg (Germany)

S3 – Guidelines on the treatment of psoriasis vulgaris (English version). Update

Psoriasis vulgaris is a common and often chronic inflammatory skin disease. The incidence of psoriasis in Western industrialized countries ranges from 1.5% to 2%. Patients afflicted with severe psoriasis vulgaris may experience a significant reduction in quality of life. Despite the large variety of treatment options available, surveys have shown that patients still do not received optimal treatments. To optimize the treatment of psoriasis in Germany, the Deutsche Dermatologi sche Gesellschaft (DDG) and the Berufsverband Deutscher Dermatologen (BVDD) have initiated a project to develop evidence‐based guidelines for the management of psoriasis. They were first published in 2006 and updated in 2011. The Guidelines focus on induction therapy in cases of mild, moderate and severe plaque‐type psoriasis in adults including systemic therapy, UV therapy and topical therapies.

German S3-guidelines on the treatment of psoriasis vulgaris (short version)

Psoriasis vulgaris is a common and often chronic inflammatory skin disease. The incidence of psoriasis in Western industrialized countries ranges from 1.5 to 2%. Patients afflicted with severe psoriasis vulgaris may experience a significant reduction in quality of life. Despite the large variety of treatment options available, patient surveys have revealed insufficient satisfaction with the efficacy of available treatments and a high rate of medication non-compliance (Richards et al. in J Am Acad Dermatol 41(4):581–583, 1999). To optimize the treatment of psoriasis in Germany, the Deutsche Dermatologische Gesellschaft (DDG) and the Berufsverband Deutscher Dermatologen (BVDD) have initiated a project to develop evidence-based guidelines for the management of psoriasis first published in 2006 and now updated in 2011. The Guidelines focus on induction therapy in cases of mild, moderate, and severe plaque-type psoriasis in adults. This short version of the guidelines presents the resulting series of therapeutic recommendations, which were based on a systematic literature search and discussed and approved by a team of dermatology experts. In addition to the therapeutic recommendations provided in this short version, the full version of the guidelines includes information on contraindications, adverse events, drug interactions, practicality, and costs, as well as detailed information on how best to apply the treatments described (for full version please see Nast et al. in JDDG Suppl 2:S1–S104, 2011 or http://www.psoriasis-leitlinie.de).

Efficacy of systemic therapies for moderate‐to‐severe psoriasis: a systematic review and meta‐analysis of long‐term treatment

Background  Despite the chronicity of psoriasis, most systematic reviews focus on short‐term treatment.

S2k-Leitlinie zur Therapie der Akne

To optimize the treatment of acne in Germany, the German Society of Dermatology (DDG) and the Association of German Dermatologists (BVDD) initiated a project to develop consensus-based guidelines for the management of acne. The Acne Guidelines focus on induction therapy, maintenance therapy and treatment of post-acne scarring. They include an evaluation of the most commonly used therapeutic options in Germany. In addition, they offer detailed information on how to administer the various treatments and on contraindications, adverse drug reactions, and drug interactions, taking into account gender and special conditions such as pregnancy and lactation. The Acne Guidelines were developed following the recommendations of the Association of Scientific Medical Societies in Germany (AWMF). The treatment recommendations were developed by an expert group and finalized by an interdisciplinary consensus conference. The first choice treatments for acute acne according to acne type are as follows: 1) comedonal acne: topical retinoids; 2) mild papular/pustular acne: fixed or sequential combinations of BPO and topical retinoids or of BPO and topical antibiotics; 3) moderate papular/pustular acne: oral antibiotic plus BPO or plus topical retinoid, or in a fixed combination 4) acne papulo-pustulosa nodosa and acne conglobata: oral antibiotic plus topical retinoid plus BPO or oral isotretinoin. For maintenance treatment: topical retinoid or its combination with BPO. Particular attention should be paid to compliance and quality of life. Additional treatment options are discussed in the main body of the text.

S3-Leitlinie zur Therapie der Psoriasis vulgaris Update 2011

Alexander Nast, Wolf-Henning Boehncke, Ulrich Mrowietz, Hans-Michael Ockenfels, Sandra Philipp, Kristian Reich, Thomas Rosenbach, Adel Sammain, Martin Schlaeger, Michael Sebastian, Wolfram Sterry, Volker Streit, Matthias Augustin, Ricardo Erdmann, Joachim Klaus, Joachim Koza, Siegrid Müller, Hans-Dieter Orzechowski, Stefanie Rosumeck, Gerhard Schmid-Ott, Tobias Weberschock, Berthold Rzany (1) Division of Evidence Based Medicine (dEBM), Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin (2) Zentrum der Dermatologie und Venerologie, Klinikum der Johann Wolfgang Goethe Universität, Frankfurt/M. (3) Klinik für Dermatologie, Venerologie, Allergologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel (4) Hautund Allergieklinik, Klinikum Hanau (5) Psoriasisstudienzentrum, Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin (6) Dermatologikum Hamburg (7) Niedergelassener Dermatologe, Osnabrück (8) Niedergelassener Dermatologe, Oldenburg (9) Niedergelassener Dermatologe, Mahlow (10) Klinik für Dermatologie, Venerologie und Allergologie, Charité – Universitätsmedizin Berlin (11) Niedergelassener Dermatologe, Buchholz (12) Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Dermatologie und Venerologie, Hamburg (13) Deutscher Psoriasis Bund e.V. (14) Pflegevertreterin, Ravenstein (15) Institut für Klinische Pharmakologie und Toxikologie, Charité – Universitätsmedizin Berlin (16) Berolina Klinik, Löhne

S3-Leitlinie zur Therapie der Psoriasis vulgaris – Methodenreport

BACKGROUND This methods report summarizes the methodology used to update the German Psoriasis Guidelines. METHODS The guidelines were developed following the recommendations of the Association of the Scientific Medical Societies in Germany. Medline, Cochrane Library and Embase were searched to generate new evidence. In addition, the results from the literature search from the EU Psoriasis Guidelines were used. The recommendations were discussed during a consensus conference using nominal group technique and were voted on during the Delphi procedure. An extensive internal and external review (open) was performed. RESULTS Due to changes in drug licensing efalizumab was excluded from the guidelines and adalimumab and ustekinumab were added. 97 new studies were included to serve as a basis for the recommendations. The level of evidence improved for calcineurin inhibitors from level 4 to level 2/3 and for MTX and systemic retinoids from level 3 to level 2. A lack of evidence still exists for coal tar (level of evidence 4). All other described interventions have a level of evidence of 2 or 1. CONCLUSIONS The field of psoriasis therapy is in constant transition. A lack of head to head trials makes direct comparisons still a challenging task. Continuous updating will be necessary to respond to the further changes expected in the field of psoriasis.

S2k - Guideline on the Therapy of Acne

Alexander Nast, Christiane Bayerl, Claudia Borelli, Klaus Degitz, Thomas Dirschka, Ricardo Erdmann, Joachim Fluhr, Uwe Gieler, Roland Hartwig, Eva-Maria Meigel, Siegfried Möller, Falk Ochsendorf, Maurizio Podda, Thomas Rabe, Berthold Rzany, Adel Sammain, Susanne Schink, Christos Zouboulis, Harald Gollnick (1) Division of Evidence Based Medicine (dEBM), Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin, Berlin (2) Department of Dermatology and Allergology, Wilhelm Fresenius Klinik, Wiesbaden (3) Department of Dermatology and Allergology, Ludwig-Maximilians University Munich, Munich (4) Dermatologist in private practice, Munich (5) Dermatologist in private practice, Wuppertal (6) Department of Dermatology, Venerology and Allergology, Charité – Universitätsmedizin Berlin, Berlin (7) Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Giessen, Giessen (8) Dermatologist in private practice, Cuxhaven (9) Dermatologist in private practice, Hamburg (10) Dermatologist in private practice, Wiesbaden (11) Department of Dermatology and Venerology, Johann Wolfgang Goethe University, Frankfurt / Main (12) Department of Dermatology, Darmstadt City Hospital, Darmstadt. (13) Department of Gynecologic Endocrinology and Reproductive Medicine, Heidelberg University Womens Hospital, Heidelberg (14) Patient representative, medical student, Charité – University Medical School Berlin, Berlin (15) Department of Dermatology, Venerology and Allergology / Immunological Center, Dessau City Hospital, Dessau / Laboratory for Biogerontology, Dermatopharmacology and Dermatoendocrinology, Institute of Clinical Pharmacology and Toxicology, Benjamin Franklin Campus, Charité – University Medical School Berlin, Berlin (16) Department of Dermatology and Venerology, Otto-von-Guericke University, Magdeburg

Lupus vulgaris : ein Verlauf über mehr als 20 Jahre bis zur Diagnosestellung

A 47-year-old Turkish woman developed an erythematous scaly plaque on her thigh over 20 years. Cutaneous sarcoidosis had been diagnosed eight years previously on a skin biopsy. We confirmed Mycobacterium tuberculosis infection by polymerase chain reaction and cultivation of the causative organism from lesional skin. After several months of antituberculous treatment with isoniazid, rifampicin, ethambutol and pyrazinamide, the skin lesions resolved.