Background: Due to demographic change and increased UV exposure, the number of dermatosurgical procedures in the elderly is increasing. Data on the occurrence of systemic side effects during and after treatment with tumescent local anaesthesia are limited and do not refer to details such as volume and composition of local anaesthetics or epinephrine additive. Objectives:The aim of this study was to investigate the risk of systemic side effects in elderly patients undergoing skin tumour surgery with tumescent local anaesthesia.Methods: Investigation of systemic complications in patients (≥75 years) who underwent head and neck skin tumour surgery under tumescent local anaesthesia at the

The increasing number of melanoma patients makes it necessary to develop best possible strategies for prognosis assessment in order to recommend appropriate therapy and follow‐up. The prognostic significance of tumor cell pigmentation has not been fully elucidated. Hematoxylin and eosin (H&E)‐stained sections of 775 melanomas diagnosed between 2012 and 2015 were independently assessed for melanin pigment abundance by two investigators, and the impact on melanoma‐specific survival was calculated. Unpigmented melanomas (n = 99) had a melanoma‐specific survival of 67.7%, melanomas with moderate pigmentation (n = 384) had a melanoma‐specific survival of 85.9%, and strongly pigmented melanomas (n = 292) had a melanoma‐specific survival of 91.4% (p < .001). In an analysis of melanoma‐specific survival adjusted for pT stage and pigmentation, we found a nonsignificant impact of pigmentation abundance with a hazard ratio of 1.277 (p = .74). The study presented here provides evidence in a German cohort that patients with pigmented melanomas have a more favorable prognosis than those diagnosed with nonpigmented melanomas. Moreover, the abundance of pigmentation already seems to provide a first prognostic estimate. However, it does not appear to provide significant additional value for prognostic assessment according to the AJCC 2017 pT classification.

ZusammenfassungEin 59-jähriger Patient stellte sich mit einem seit 1 Jahr wachsenden Tumor an der Glans penis vor, den wir exzidierten. Histologisch zeigte sich eine akanthotische Epidermis, unter der die Papillarkörper prall angefüllt waren mit zahlreichen schaumigen Histiozyten. Der Befund entspricht einem verruziformen Xanthom. Die Differenzialdiagnose eines Peniskarzinoms erfordert eine deutlich radikalere Therapie. Da mutilierende Penisoperationen mit erheblichen psychosexuellen Belastungen für die Patienten einhergehen, kann die Kenntnis dieser gutartigen Diagnose einem vorschnell aggressiven Vorgehen bei ähnlichen Tumoren vorbeugen und zu bedachtem Vorgehen anregen.

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