A reference guide of cutaneous metastases is given; the clinical spectrum is adjusted to an actual status; state of the art of the treatment is accomplished. An epidemiological, improved registration and diagnostic work-up for targeted therapies in conjunction with dermatologists are favoured.

Compression bandaging is a major cornerstone in the treatment of chronic venous insufficiency. Its efficacy considerably depends on the applied pressure and it is therefore largely dependent on the individual applying the system. The sub-bandage pressure was measured under three consecutive compression bandages applied by 21 nurses before and after training and the introduction of a pressure monitor (Kikuhime, MediTrade, Denmark). A questionnaire was used to evaluate the self-rating before and after the intervention. Before intervention, a questionnaire showed the confidence of the nurses in reaching sufficient sub-bandage pressure levels. However, 34.9% of all bandages were shown to be insufficient before intervention (< 20 or > or = 60 mmHg) and only 17.5% after intervention, representing a statistically significant improvement through intervention. Of the insufficient bandages, 77.3% were applied by nurses with more than 10 years of working experience. Furthermore, the mean sub-bandage pressure in active standing position, a marker for the working pressure, was improved form 38.7 to 64.3 mmHg after intervention. Continuous awareness and training are necessary to maintain sufficient compression bandaging. The availability of a pressure monitor was helpful to reach this goal. Long work experience and self-rating alone is not sufficient to maintain adequate quality in compression bandaging.

Here, we report on the first systematic long-term study of fibroblast therapy in a mouse model for recessive dystrophic epidermolysis bullosa (RDEB), a severe skin-blistering disorder caused by loss-of-function of collagen VII. Intradermal injection of wild-type (WT) fibroblasts in >50 mice increased the collagen VII content at the dermal-epidermal junction 3.5- to 4.7-fold. Although the active biosynthesis lasted <28 days, collagen VII remained stable and dramatically improved skin integrity and resistance to mechanical forces for at least 100 days, as measured with a digital 3D-skin sensor for shear forces. Experiments using species-specific antibodies, collagen VII-deficient fibroblasts, gene expression analyses, and cytokine arrays demonstrated that the injected fibroblasts are the major source of newly deposited collagen VII. Apart from transitory mild inflammation, no adverse effects were observed. The cells remained within an area

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Taken together, the results suggest that the MMP1 SNP is not the sole disease modifier in different forms of DEB, and other genetic and environmental factors contribute to the clinical phenotype.

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