Traditional models of medical education are increasingly challenged by structural and logistical constraints. In Dermato-Venereology, there is marked heterogeneity in undergraduate training across Europe, including substantial variation in curriculum structure and the perceived importance of the speciality. The aim of this study was to develop harmonized, structured and scalable educational tools for blended learning within an interactive “flipped classroom” framework. Within an EU-funded Erasmus+ project, supported by the European Dermatology Forum, key structural gaps in current training were identified, and a conceptual framework for restructuring undergraduate Dermato-Venereology education was developed. This framework emphasizes harmonization and standardization, scalability and integration into clinical practice. The development process incorporated iterative feedback from participating centres and alignment with existing European educational standards. The e-learning platform Cyberderm was expanded, revised and harmonized, and complemented by a more detailed PDF-based version (“webbook”), accessible electronically, to provide standardized educational content across European training settings. In addition, an artificial intelligence-based feature was implemented, enabling query-driven navigation and facilitating intuitive access to content. This functionality supports individualized learning pathways and enhances adaptability to different levels of training and educational needs. These results provide the first set of recommendations for a harmonized European undergraduate training programme in Dermato-Venereology.
A distinct proportion of patients with atopic dermatitis and dupilumab treatment does not reach the primary endpoint of an eczema area severity index (EASI)-75 or investigator global assessment 0/1 after 16 weeks. Little is known about poor responders to dupilumab in real life scenarios. The study objective was to identify the percentage and characteristics of patients with insufficient treatment response to dupilumab based on “TREATgermany” registry data from dermatological routine care. Between 06/2016 and 12/2024, 476 patients matched the study criteria. In total, 4% of patients (n=19) were identified as dupilumab poor responders, i.e. reduction in EASI ≤40% at the 1st follow-up visit after 8 to 20 weeks and a consecutive 2nd follow-up visit up to 52 weeks of treatment. 44% (n=209) were classified as stable responders, i.e. decrease in EASI≥75% at both follow-up visits. Poor responders were significantly more often male, more frequently exhibited smoking, arterial hypertension and a higher body mass index. This TREATgermany data analysis demonstrates a proportion of 4% dupilumab poor responders within the first year of treatment. Male sex, smoking, arterial hypertension and increased body mass index were identified as potential risk factors. Further translational research is needed to confirm these clinical findings.
Poliosis in vitiligo is closely linked to loss or dysfunction of melanocytes within hair follicles, but the contribution of adrenergic stress signalling remains poorly understood. We first compared β2-adrenergic receptor immunoreactivity in vitiligo-associated poliosis hair follicles and normally pigmented hair follicles. We then used cultured human scalp hair follicles to examine the temporal effects of 5 μmol/L norepinephrine, with or without the selective β2-adrenergic receptor antagonist ICI-118551, over 1–7 days. Acute norepinephrine exposure (1 day) increased malondialdehyde levels, reduced superoxide dismutase activity, depolarized the mitochondrial membrane, increased 8-hydroxy-2′-deoxyguanosine and reduced B-cell lymphoma 2 immunoreactivity. Longer exposure (5–7 days) increased gamma histone 2 AX and terminal deoxy-nucleotidyl transferase dUTP nick end labelling signals and produced progressive melanocyte ultrastructural injury. Norepinephrine also reduced tyrosinase-related protein 2 and glycoprotein 100 (premelanosome protein, gp100) immunoreactivity, shortened gp100-positive melanocyte dendrites and produced a biphasic change in Masson–Fontana-stained melanin, with an early increase followed by a decline. ICI-118551 attenuated these effects. These findings show that sustained norepinephrine exposure damages the pigmentation of healthy human scalp hair follicles through a pathway involving β2-adrenergic receptor, oxidative stress, DNA damage and apoptosis. Because functional experiments were not performed in vitiligo hair follicles, the relevance of this pathway to vitiligo-associated poliosis remains to be further researched.
