Peter Elsner

Universitätsklinikum Jena, Jena, Thuringia, Germany

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Publications (539)1041.13 Total impact

  • P Elsner, S Schliemann
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    ABSTRACT: The different definitions of skin disease in medicine and in law are frequently confusing for dermatologists. While a skin disease may be defined medically referring to the definition of health by the WHO as a pathological condition of the skin leading to a disruption of the physical, mental and social well-being of the individual, legal definitions vary depending on the field of insurance law that is referred to. In the law of private health insurance, a skin disease is defined as an anomalous condition of the skin requiring medical treatment that exists independently of the subjective judgement of the insured person and needs to be objectively confirmed by a medical evaluation. In contrast, in the law of the social health insurance, the Federal Court of Social Justice defines disease as irregular physical or mental condition, deviating from the perception of a healthy human being that requires medical treatment or leads to inability to work. Substantial bodily disfigurement may be regarded as an irregular physical condition. In the law of the statutory accident insurance, occupational skin diseases are defined under clause 5101 of the occupational disease regulation as serious or repeatedly relapsing skin diseases that have forced a person to refrain from any work activities causal for the development, the aggravation or the recurrence of the disease. The Federal Court of Social Justice interprets the term "skin disease" from the protective purpose of the law, i.e. the protection against the economic and health consequences of the exposure to harmful agents and a thereby forced change of profession. This broad interpretation of the term "skin disease" leads to the recognition of diseases of the conjunctiva of the eye or diseases of the blood vessels of the skin due to cold damage as skin diseases according to clause 5101. For the correct treatment and possibly notification of occupational skin diseases in collaboration with various insurance carriers, dermatologists should be familiar not only with the medical definition, but also with these different legal definitions of skin disease.
    02/2015;
  • J Lukács, S Schliemann, P Elsner
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    ABSTRACT: Scabies is an infectious skin disease caused by the human itch mite (Sarcoptes scabiei var. hominis). It is mainly transmitted by direct skin-to-skin contact. The spread of scabies can cause major difficulties in healthcare institutions, particularly in residential homes for the elderly. The disease is characterized by intense nocturnal itching, erythematous papules arranged in a linear order, and scratching resulting in excoriations. The diagnosis is confirmed by identification of the mite or by finding one or more mite tunnels in the skin. An individually occurring case does not need to be reported. If two or more cases occur in the same institution, the company physician and the appropriate public health department are to be informed in Germany. In case of a suspected scabies infection in medical personnel due to exposure in their work setting, medical notification to the statutory occupational accidents' insurance (Nr. 3101) is to be issued in accordance with § 202, Volume VII of the German Social Code. First line treatment is topical therapy with 5 % permethrin. If scabies control is required in an institution, systemic treatment with ivermectin may be considered. In the case of a scabies outbreak, all patients, contact persons, and staff must be treated simultaneously.
    02/2015;
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    ABSTRACT: Tobacco smoking is known to influence various inflammatory skin diseases. A systematic review with a meta-analysis was conducted to analyse a possible association between the lifestyle factor tobacco smoking and hand dermatitis. We performed a systematic review using the MEDLINE, Embase and Cochrane Central Register databases. Our search was limited to English and German language, human-subject studies published between January 1, 1980 and December 31, 2013. A total of 43 articles were identified from the initial search, and after taking into account exclusion criteria, only three studies remained investigating the risk factors for hand eczema in the general and in high-risk populations (e.g. bakers, hairdressers, dental technicians). The extracted data were pooled and analysed by standard statistical methods. The studies meeting inclusion criteria consisted of one cohort study and two cross-sectional studies based on a total of 4.113 subjects with hand dermatitis and 34.875 subjects without hand dermatitis. While one of the studies had reported a significant association between hand dermatitis and smoking, the meta-analysis did not confirm this finding (OR 0.99; 95% CI 0.88–1.11). However, heterogeneity across studies was high (I2 = 72%). Our meta-analysis did not show tobacco smoking to be a risk factor for hand dermatitis. However, these results depend mainly on two large studies from one country. From present data, it cannot be excluded that smoking may influence the course of hand dermatitis. Even though smoking does not seem to be associated with hand dermatitis, it may still negatively influence the course of the disease.
    Journal of the European Academy of Dermatology and Venereology 02/2015; · 2.69 Impact Factor
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    ABSTRACT: Granuloma annulare (GA) is a benign inflammatory skin disease. Localized GA is likely to resolve spontaneously, while generalized GA (GGA) is rare and may persist for decades. GGA usually is resistant to a variety of therapeutic modalities and takes a chronic course. The objective of this study was to summarize all reported treatments of generalized granuloma annulare. This is a systematic review based on MEDLINE, Embase and Cochrane Central Register search of articles in English and German and a manual search, between 1980 and 2013, to summarize the treatment of generalized granuloma annulare. Most medical literature on treatment of GGA is limited to individual case reports and small series of patients treated without a control group. Randomized controlled clinical studies are missing. Multiple treatment modalities for GGA were reported including topical and systemic steroids, PUVA, isotretinoin, dapsone, pentoxifylline, hydroxychloroquine, cyclosporine, IFN-γ, potassium iodide, nicotinamide, niacinamide, salicylic acid, dipyridamole, PDT, fumaric acid ester, etanercept, infliximab, adalimumab. While there are numerous case reports of successful treatments in the literature including surgical, medical and phototherapy options, well-designed, randomized, controlled clinical trials are required for an evidence-based treatment of GGA.
    Journal of the European Academy of Dermatology and Venereology 02/2015; · 2.69 Impact Factor
  • Journal of the European Academy of Dermatology and Venereology 01/2015; · 2.69 Impact Factor
  • Source
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    ABSTRACT: The guidelines aim to provide advice on the management of hand eczema (HE), using an evidence- and consensus-based approach. The guidelines consider a systematic Cochrane review on interventions for HE, which is based on a systematic search of the published literature (including hand-searching). In addition to the evidence- and consensus-based recommendation on the treatment of HE, the guidelines cover mainly consensus-based diagnostic aspects and preventive measures (primary and secondary prevention). Treatment recommendations include non-pharmacological interventions, topical, physical and systemic treatments. Topical corticosteroids are recommended as first line treatment in the management of HE, however continuous long-term treatment beyond six weeks only when necessary and under careful medical supervision. Alitretinoin is recommended as a second line treatment (relative to topical corticosteroids) for patients with severe chronic HE. Randomized control trials (RCT) are missing for other used systemic treatments and comparison of systemic drugs in “head-to-head” RCTs are needed.The guidelines development group is a working group of the European Society of Contact Dermatitis (ESCD) and has carefully tried to reconcile opposite views, define current optimal practice and provide specific recommendations, and meetings have been chaired by a professional moderator of the AWMF (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; Association of the Scientific Medical Societies in Germany).No financial support was given by any medical company. The guidelines are expected to be valid until December 2017 at the latest.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). · 1.40 Impact Factor
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    ABSTRACT: Antibacterial activity of dressings containing antimicrobials is mostly evaluated using in vitro tests. However, the various methods available differ significantly in their properties and results obtained are influenced by the method selected, micro-organisms used, and extraction method, the degree of solubility or the diffusability of the test-compounds. Here, results on antimicrobial activity of silver-containing dressings obtained by agar diffusion test (ADT), challenge tests (JIS L 1902, AATCC 100), and extraction-based methods (microplate laser nephelometry (MLN), luminescent quantification of bacterial ATP (LQbATP)) using Staphylococcus aureus and Pseudomonas aeruginosa were evaluated. Furthermore, the effect of the pH on antibacterial efficacy of these dressings was investigated. All silver-containing dressings exerted antimicrobial activity in all in vitro tests and results correlated considerably well. Differences were observed testing the agent-free basic materials. They did not exhibit any antimicrobial effects in the ADT, MLN or LQbATP, since these methods depend on diffusion/extraction of an active agent. However, they showed a strong antimicrobial effect in the challenge tests as they possess a high absorptive capacity, and are able to bind and sequester micro-organisms present. Therefore, it seems recommendable to choose several tests to distinguish whether a material conveys an active effect or a passive mechanism. In addition, it could be shown that release of silver and its antimicrobial efficacy is partially pH-dependent, and that dressings themselves affect the pH. It can further be speculated that dressings' effects on pH and release of silver ions act synergistically for antimicrobial efficacy.
    Journal of Materials Science Materials in Medicine 01/2015; 26(1):5343. · 2.14 Impact Factor
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    ABSTRACT: ZusammenfassungDie Leitlinie gibt evidenz- und konsensbasierte Empfehlungen zum Management von Handekzemen. Sie berücksichtigt einen systematischen Cochrane-Review „Intervention for hand eczema“, der auf einer systematischen Literatursuche (einschließlich Handsuche) basiert. Zusätzlich zu den evidenz- und konsensbasierten Empfehlungen zur Therapie von Handekzemen (HE) werden auch überwiegend konsensbasierte Empfehlungen zur Diagnostik und Prävention (primäre und sekundäre Prävention) gegeben. Die Therapieempfehlungen umfassen nichtmedikamentöse, topische, physikalische und systemische Behandlungsmöglichkeiten.Topische Glukokortikosteroide sind Therapie der ersten Wahl, jedoch wird eine Anwendung über einen Zeitraum länger als sechs Wochen nur in Ausnahmefällen und unter sorgfältiger ärztlicher Kontrolle empfohlen. Alitretinoin wird als Therapie der zweiten Wahl (nach topischen Glukokortikosteroiden) für Patienten mit schweren chronischen Handekzemen empfohlen. Für andere systemische Therapieverfahren fehlen derzeit randomisierte klinische Studien (RCTs). Ein direkter Therapievergleich der unterschiedlichen systemischen Medikamente in RCTs wird gefordert.Die Leitlinie wurde von einer Arbeitsgruppe der European Contact Dermatitis Society (ESCD) in einem öffentlichen Prozess mit dem Ziel entwickelt, aufgrund des derzeitigen Erkenntnistandes evidenz- und konsensbasierte Empfehlungen zu geben. Die Konsenskonferenzen wurden von einer professionellen Moderatorin der AWMF (Arbeitsgemeinschaft der medizinischen Wissenschaften) geleitet.Eine finanzielle Unterstützung durch die pharmazeutische Industrie erfolgte nicht. Die Leitlinie ist bis Dezember 2017 gültig.
    Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). · 1.40 Impact Factor
  • Journal der Deutschen Dermatologischen Gesellschaft 01/2015; 13(1). · 1.40 Impact Factor
  • M Peckruhn, P Elsner
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    ABSTRACT: Vulvar diseases might cause problems in the differential diagnosis, because the clinical presentation of inflammatory, infectious and neoplastic disorders may be quite similar. Itching and pain as well as dysuria and dyspareunia are the most common symptoms of vulvar diseases. Inflammatory dermatoses like atopic and contact dermatitis, lichen planus, lichen sclerosus and atrophic vulvitis account for the majority of cases in specialized clinics. Furthermore, neoplastic conditions such as vulvar carcinoma, vulvar intraepithelial neoplasia (VIN) and vulvar Paget's disease have to be considered. Another frequent group are infections. Candida spp., herpes simplex viruses and human papilloma viruses are common pathogens. Additionally, vulvodynia is a typical problem that is sometimes difficult to treat. Because of the wide spectrum of clinical symptoms, cooperation with gynaecologists and psychosomatic specialists should be considered in difficult cases. The typical clinical presentations, their specific signs and symptoms, and pitfalls in the dermatological consultation are discussed.
    12/2014;
  • 12/2014; 12(12):1102-6.
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    ABSTRACT: In Germany over 2.5 million employees have an increased risk of skin cancer due to their occupational exposure to natural UV-irradiation. The medical consultation board “Occupational diseases” of the Ministry of Labor and Social affairs has investigated the association between occupational UV-irradiation and skin cancer risk and recommends to add the following new occupational disease into the appendix1 of the German ordinance on occupational diseases: “Squamous cell carcinoma and multiple actinic keratosis due to natural UV-irradiation”.In this article we report in the view of the German Society of Occupational and Environmental Dermatology (ABD) and the German Statutory accident insurance (DGUV), whose criteria have to be fulfilled for the notification and recognition of an occupational skin cancer due to natural UV-irradiation.
    Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). · 1.40 Impact Factor
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    ABSTRACT: ZusammenfassungIn Deutschland sind über 2,5 Millionen Arbeitnehmer aufgrund ihrer beruflichen Tätigkeit als Outdoor-Worker im besonderen Maße gegenüber natürlicher UV-Strahlung exponiert. Der Ärztliche Sachverständigenbeirat „Berufskrankheiten“ beim Bundesministerium für Arbeit und Soziales hat den Zusammenhang zwischen beruflicher UV-Strahlung und Hautkrebs geprüft und empfohlen, in die Anlage1 zur Berufskrankheiten-Verordnung folgende neue Berufskrankheit aufzunehmen: „Plattenepithelkarzinome oder multiple aktinische Keratosen der Haut durch natürliche UV-Strahlung“.Es wird aus Sicht der Arbeitsgemeinschaft für Berufs- und Umweltdermatologie (ABD) in der Deutschen Dermatologischen Gesellschaft (DDG) und der Deutschen Gesetzlichen Unfallversicherung (DGUV) dargestellt, welche Voraussetzungen für eine Meldung und Anerkennung einer beruflichen Hautkrebserkrankung durch natürliche UV-Strahlung erfüllt sein müssen.
    Journal der Deutschen Dermatologischen Gesellschaft 12/2014; 12(12). · 1.40 Impact Factor
  • F Räßler, S Goetze, P Elsner
    Journal of the European Academy of Dermatology and Venereology 11/2014; · 2.69 Impact Factor
  • Thomas Ludwig Diepgen, Peter Elsner
    Journal der Deutschen Dermatologischen Gesellschaft 11/2014; 12(s4). · 1.40 Impact Factor
  • M. Gina, S. Schliemann, P. Elsner
    Journal of the European Academy of Dermatology and Venereology 11/2014; · 2.69 Impact Factor
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    ABSTRACT: Background The Occupational Contact Dermatitis Disease Severity Index (ODDI) was designed in Australia to measure severity and functional disability in patients with occupational contact dermatitis (OCD) of the hands. The ODDI was translated into the German language with a linguistic validation process. The psychometric properties of the German version of the ODDI are still unclear.Objectives To report the linguistic validation procedure and to perform a psychometric validation by investigating the validity and reliability of the German ODDI version in a sample of patients with OCD.Methods Data were drawn from the baseline assessment (T0) and first follow-up (T1) of the German chronic hand eczema (CHE) registry (CARPE). Spearman correlations of the ODDI with reference measures were computed to assess validity. Cronbach's alpha was calculated as a measure of internal consistency, and the intraclass correlation coefficient (ICC) was calculated to assess retest reliability. The smallest real difference (SRD) and minimal clinically important difference (MCID) were calculated to assess sensitivity to change. Physician Global Assessment (PGA) was used as an anchor for the MCID.ResultsFour hundred and twenty-two patients (54.5% female, mean age 45.1 years) were included for analysis. Cronbach's alpha was found to be 0.73. The ICC was 0.79. Correlations between the ODDI total and the Dermatology Life Quality Index (rho = 0.36), and between PGA (rho = 0.48) and patient-assessed disease severity (rho = 0.40), were of moderate strength. The MCID (1.29) was found to be smaller than the SRD (1.87).Conclusions The German ODDI version is reliable and valid for the measurement of functional impairment and disease severity in patients suffering from OCD.
    Contact Dermatitis 11/2014; · 3.62 Impact Factor
  • Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 10/2014;
  • 10/2014; 12(10):915-7.

Publication Stats

5k Citations
1,041.13 Total Impact Points

Institutions

  • 2002–2014
    • Universitätsklinikum Jena
      • Klinik für Hautkrankheiten
      Jena, Thuringia, Germany
  • 1998–2014
    • Friedrich-Schiller-University Jena
      • • Clinic of Dermatology
      • • Institute of Medical Statistics, Computer Sciences and Documentation
      Jena, Thuringia, Germany
  • 2009–2012
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      Erlangen, Bavaria, Germany
    • Universität des Saarlandes
      Saarbrücken, Saarland, Germany
    • Unfallkrankenhaus Hamburg
      Hamburg, Hamburg, Germany
  • 2007–2012
    • Universität zu Lübeck
      Lübeck Hansestadt, Schleswig-Holstein, Germany
  • 2011
    • Universität Heidelberg
      Heidelburg, Baden-Württemberg, Germany
    • Charité Universitätsmedizin Berlin
      • Institute of Microbiology and Hygiene
      Berlín, Berlin, Germany
  • 2008–2011
    • Universität Osnabrück
      Osnabrück, Lower Saxony, Germany
  • 2010
    • University of Leipzig
      • Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie
      Leipzig, Saxony, Germany
  • 2006
    • Medical University of Sofia
      • Department of Dermatology and Venereology
      Ulpia Serdica, Sofia-Capital, Bulgaria
  • 2005
    • Procter & Gamble
      Cincinnati, Ohio, United States
  • 2004
    • University of Liège
      Luik, Walloon Region, Belgium
    • Northwestern University
      Evanston, Illinois, United States
    • Universität Ulm
      Ulm, Baden-Württemberg, Germany
  • 2003–2004
    • University of Freiburg
      • Department of Pneumology
      Freiburg, Lower Saxony, Germany
    • University of Geneva
      • Division of Dermatology
      Genève, GE, Switzerland
  • 2000
    • Hôpital Bichat - Claude-Bernard (Hôpitaux Universitaires Paris Nord Val de Seine)
      Lutetia Parisorum, Île-de-France, France
  • 1992–1999
    • University of Zurich
      • Dermatologische Klinik und Poliklinik
      Zürich, Zurich, Switzerland
  • 1993–1998
    • Schulthess Klinik, Zürich
      Zürich, Zurich, Switzerland
  • 1988–1991
    • University of Wuerzburg
      • Department of Dermatology, Venereology and Allergology
      Würzburg, Bavaria, Germany