Die Dermatologie in der BG Klinik Falkenstein

Zusammenfassung

Das stationäre Heilverfahren im Rahmen der tertiären Individualprävention wurde für schwere, therapieresistente Berufsdermatosen entwickelt, wenn das ambulante Management nicht ausreichend ist. Das Heilverfahren ist mittlerweile gut etabliert und wird in 5 Kliniken deutschlandweit angeboten. Die BG Klinik Falkenstein liegt im Herzen des Vogtlandes umgegeben von einem Naturschutzgebiet. Hier können durch Schulungen, multidisziplinäre Diagnostik und Behandlung sowie Optimierung der Präventionsmaßnahmen eine Steigerung der Motivation und bei ca. ⅔ der Betroffenen ein weiterer Berufsverbleib ermöglicht werden.

Abstract

Outpatient management of occupational skin diseases may be difficult. A tertiary individual prevention programme is offered to patients with severe occupational skin diseases in Germany. This concept is currently well established in five specialised dermatological centres. One of them is the BG Klinik Falkenstein. It is situated in a protected landscape in the middle of Vogtland, Saxony. Due to interdisciplinary diagnostic procedures, dermatological treatment, patient education (health and psychological) about ⅔ of patients are able to continue their occupation.

• Literatur

• 1 Skudlik C, Weisshaar E, Scheidt R. et al. Multicenter study “Medical-Occupational Rehabilitation Procedure Skin – optimizing and quality assurance of inpatient-management (ROQ)”. J Dtsch Dermatol Ges 2009; 7: 122-126
• 2 Skudlik C, Weisshaar E, Scheidt R. et al. First results from the multicentre study rehabilitation of occupational skin diseases – optimization and quality assurance of inpatient management (ROQ). Contact Dermatitis 2012; 66: 140-147
• 3 Weisshaar E, Skudlik C, Scheidt R. et al. Multicentre study ‘rehabilitation of occupational skin diseases – optimization and quality assurance of inpatient management (ROQ)’ – results from 12-month follow-up. Contact Dermatitis 2013; 68: 169-174
• 4 Brans R, Skudlik C, Weisshaar E. et al. Multicentre cohort study ‘Rehabilitation of Occupational Skin Diseases – Optimization and Quality Assurance of Inpatient Management (ROQ)’: results from a 3-year follow-up. Contact Dermatitis 2016; 75: 205-212
• 5 Diepgen T, Krohn S, Bauer A. et al. Empfehlung zur Begutachtung von arbeitsbedingten Hauterkrankungen und Hautkrebserkrankungen-Bamberger Empfehlung. Dermatologie in Beruf und Umwelt 2016; 64: 89
• 6 Brasch J, Becker D, Aberer W. et al. Guideline contact dermatitis: S1-Guidelines of the German Contact Allergy Group (DKG) of the German Dermatology Society (DDG), the Information Network of Dermatological Clinics (IVDK), the German Society for Allergology and Clinical Immunology (DGAKI), the Working Group for Occupational and Environmental Dermatology (ABD) of the DDG, the Medical Association of German Allergologists (AeDA), the Professional Association of German Dermatologists (BVDD) and the DDG. Allergo J Int 2014; 23: 126-138
• 7 Frosch PJ, Schnuch A, Uter W. Kontaktdermatitis: ein Leitfaden für die Praxis unter besonderer Berücksichtigung von Berufsdermatosen. Feistle: Dustri-Verlag; 2014
• 8 Johansen JD, Bruze M, Andersen KE. et al. The repeated open application test: suggestions for a scale of evaluation. Contact Dermatitis 1998; 39: 95-96
• 9 Brancaccio RR, Alvarez MS. Contact allergy to food. Dermatol Ther 2004; 17: 302-313
• 10 Bauer A, Schubert S, Geier J. et al. Type IV contact allergies in the food processing industry: an update. Hautarzt 2018; 69: 443-448
• 11 Przybilla B, Ruëff F, Walker A. et al. Diagnose und Therapie der Bienen-und Wespengiftallergie. Allergo J 2011; 20: 318-339
• 12 de Weck AL, Sanz ML. Cellular allergen stimulation test (CAST) 2003, a review. J Investig Allergol Clin Immunol 2004; 14: 253-273
• 13 Allmers H, Schmengler J, John SM. Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. J Allergy Clin Immunol 2004; 114: 347-351
• 14 Vandenplas O, Raulf M. Occupational Latex Allergy: the Current State of Affairs. Curr Allergy Asthma Rep 2017; 17: 14
• 15 Wu M, McIntosh J, Liu J. Current prevalence rate of latex allergy: Why it remains a problem?. J Occup Health 2016; 58: 138-144
• 16 Diepgen TL, Fartasch M, Hornstein OP. Evaluation and relevance of atopic basic and minor features in patients with atopic dermatitis and in the general population. Acta Derm Venereol Suppl (Stockh) 1989; 144: 50-54
• 17 Schurer NY, Schwanitz HJ. Prevention and regeneration of barrier disturbances in occupational dermatology. J Dtsch Dermatol Ges 2004; 2: 895-904
• 18 Diepgen TL, Agner T, Aberer W. et al. Management of chronic hand eczema. Contact Dermatitis 2007; 57: 203-210
• 19 Nast A, Augustin M, Boehncke WH. et al. S3-Leitlinie zur Therapie der Psoriasis vulgaris – Update: „Übersicht der Therapieoptionen“ und „Efalizumab“: evidence-based (s3) guideline for the treatment of psoriasis vulgaris – Update: „therapeutic options“ and „efalizumab“. Journal der Deutschen Dermatologischen Gesellschaft 2010; 8: 65-66
• 20 Nast A, Spuls P, van der Kraaij G. et al. European S3‐Guideline on the systemic treatment of psoriasis vulgaris – Update Apremilast and Secukinumab – EDF in cooperation with EADV and IPC. J Eur Acad Dermatol Venereol 2017; 31: 1951-1963
• 21 Diepgen TL, Andersen KE, Chosidow O. et al. Guidelines for diagnosis, prevention and treatment of hand eczema. J Dtsch Dermatol Ges 2015; 13: e1-22
• 22 Bauer A, Ronsch H, Elsner P. et al. Interventions for preventing occupational irritant hand dermatitis. Cochrane Database Syst Rev 2018; 4: CD004414
• 23 Wohlrab J. Topical preparations and their use in dermatology. J Dtsch Dermatol Ges 2016; 14: 1061-1070
• 24 Wollenberg A, Barbarot S, Bieber T. et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I. J Eur Acad Dermatol Venereol 2018; 32: 657-682
• 25 Lindelof B, Sigurgeirsson B, Gabel H. et al. Incidence of skin cancer in 5356 patients following organ transplantation. Br J Dermatol 2000; 143: 513-519
• 26 Euvrard S, Kanitakis J, Claudy A. Skin cancers after organ transplantation. N Engl J Med 2003; 348: 1681-1691
• 27 Stege H. Ultraviolet therapy in patients with chronic hand eczema. Hautarzt 2008; 59: 696-702
• 28 Molin S, Ruzicka T. Alitretinoin: a new treatment option for chronic refractory hand eczema. Hautarzt 2008; 59: 703-704 706 – 709
• 29 Diepgen TL. Chronic hand eczema: epidemiology and therapeutic evidence. Hautarzt 2008; 59: 683-684 686 – 689
• 30 Wollenberg A, Barbarot S, Bieber T. et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol 2018; 32: 850-878
• 31 Lee N, Chipalkatti N, Zancanaro P. et al. A Retrospective Review of Dupilumab for Hand Dermatitis. Dermatology 2019; 235: 187-188
• 32 Garzorz-Stark N, Krause L, Lauffer F. et al. A novel molecular disease classifier for psoriasis and eczema. Exp Dermatol 2016; 25: 767-774
• 33 Weisshaar E, Gazorz-Stark N, Eyerich K. Ekzem oder Psoriasis? Eine spezielle Herausforderung in der Berufsdermatologie. Dermatologie in Beruf und Umwelt 2018; 66: 113-119
• 34 Wehrmann J, Scheewe S, Weyergraf A. et al. S1 Leitlinie 013/083: Stationäre dermatologische Rehabilitation. 5: 2015 Stand 2015