Mohamed Badawy Abdel-Naser

A direct contact co‐culture of skin explants to SZ95 sebocytes (3D‐SeboSkin) has been shown to preserve the integrity of epidermal keratinocytes and dermis. In this study, the properties of epidermal melanocytes were evaluated in the same 3D SeboSkin ex vivo model. Skin explants (n = 6) were maintained in the 3D‐SeboSkin model, in direct contact to fibroblasts and alone in serum‐free medium (SFM). Histopathological, immunohistochemical, apoptosis and oil red staining evaluations were performed at Days 0 and 6 of incubation. Results revealed preservation and prominent proliferation of basal keratinocytes of the skin explants in addition to preservation of dermal collagen and vasculature at Day 6 in the 3D‐SeboSkin culture model and to a lesser extent in co‐culture with fibroblasts but not in SFM alone. Melan‐A+/Ki67‐ epidermal melanocytes remained attached to the dermis even at sites of epidermal detachment in the three skin explant models tested. However, the number of epidermal melanocytes was significantly conserved in 3D‐SeboSkin cultures in comparison with skin explants in SFM (p < 0.05), whereas no difference was found in comparison with the co‐culture with fibroblasts. Few DAPI/TUNEL+ apoptotic melanocytes could mostly be observed in SFM‐incubated skin explants. Furthermore, only SZ95 sebocytes in contact to skin explants in 3D‐SeboSkin exhibited increased lipogenesis with accumulation of abundant lipid droplets. These results denote that the 3D‐SeboSkin model yielded significant preservation of epidermal melanocytes and hence it is optimal for ex vivo studies of abnormalities of skin pigmentation, melanocyte neoplasms and effects of different hormones, cytokines, carcinogens and various therapeutics in a pattern that recapitulates the in vivo environment.

Schistosomiasis (bilharziasis) is an endemic parasitic disease of a major source of morbidity and mortality for developing countries. It is caused by different species of blood flukes (trematode worms) of the genus Schistosoma, the most important of which are S. haematobium which infests the genitourinary tract and S. mansoni and S. japonicum which infest the gastrointestinal tract. The incidence of schistosome‐induced male infertility is not known and probably underestimated being overshadowed by the more severe and often fatal urinary and gastrointestinal complications. Several causes may contribute to schistosomiasis‐induced male infertility, such as hormonal imbalance, testicular tissue damage and genital ductal system obstruction, in addition to decreased libido and erectile dysfunction due to associated hormonal imbalance and prostatic infestation. Demonstration of the schistosome ova in seminal plasma or testicular tissue confirms the diagnosis. Treatment of schistosomiasis‐induced male infertility depends on clinical evaluation and includes, besides anthelmintic treatment, hormonal replacement and assisted reproduction (IVF/ICSI) in cases of severe oligozoospermia and or obstructive and nonobstructive azoospermia.

The role of adipose tissue has long been underestimated in esthetic dermatology. With the development of liposculpture and lipolysis, subcutaneous adipose tissue has gained an increasing interest. Harvested tissue has been used for lipofilling. In recent years, a better understanding of adipocyte physiology and its role in aging opened a new road for targeted treatments. Subcutaneous adipose tissue is no longer an innocent bystander in the combat of aging and the correction in esthetics. Adipose tissue is of importance for metabolic function and thermoregulation. Adipose tissue is involved in inflammation. Adipose tissue is heterogeneous in sense of function, color and size of adipocytes. The tissue is an important source of somatic stem cells.

Congenital bilateral absence of vas deferens (CBAVD) results in obstructive azoospermia in which testicular function, such as spermatogenesis, is preserved. Bilateral testicular biopsy is not only diagnostic but also therapeutic as retrieved spermatozoa are usually cryopreserved for assisted reproduction. In this case report, CBAVD was confirmed in a 24‐year‐old azoospermic man on the basis of persistent azoospermia associated with low semen volume, absent fructose and normal hormonal levels, ultrasonographically (absent seminal vesicles) and histologically (intact spermatogenesis). Interestingly and incidentally, only the right testicular biopsy showed ova of two parasitic species of Schistosoma, namely Schistosoma haematobium which infests the genitourinary tract and Schistosoma mansoni which infests the gastrointestinal tract. Both species are rare causes of azoospermia, and the case should be further managed as CBAVD in which the left testicle is considered the preferred site of sperm retrieval for assisted reproduction.

Extramammary Paget’s disease (EMPD) is a rare, slow growing non-melanoma skin cancer. Diagnosis is often significantly delayed, since clinical presentation may resemble common benign dermatoses. Treatment is characterized by high recurrence rates. This is in part due to ill-defined margins and by frequent development of satellites. Improvement of outcome needs a better preoperative planning with fluorescence diagnostics or scouting biopsies. Mohs micrographic surgery has some advantages for patients, such as reduced relapse rates and prolonged relapse-free survival. Improved identification of Paget cells in cryosections by immunostainings or alternatively the use of delayed Mohs with formalin-fixed material reduces the rate of false-negative results. Surgery remains the cornerstone of treatment.

In der Weiterbildungsordnung zum Arzt für Dermatologie und Venerologie werden „Kenntnisse, Erfahrungen und Fertigkeiten in der Erkennung andrologischer Störungen und Indikationsstellung zur weiterführenden Behandlung“ gefordert. Damit wird eine „Überweisungskompetenz“ verlangt. Dieser Beitrag soll die dazu erforderlichen Grundkenntnisse vermitteln. In the dermatology practice patients attend with andrological aspects even though the treating physicians might not consider them at first sight. This concerns hypogonadism which may occur primarily in the context of genetic disorders (Klinefelter’s syndrome, rare genodermatoses) or later in life as a consequence of ageing or diseases (like infections, autoimmune disorders or chronic inflammatory diseases like psoriasis). The history should ask for sexual symptoms (lack of nocturnal erections, decrease of libido, erectile dysfunction). The physical examination could also reveal symptoms of hypogonadism. The investigation of testosterone and SHBG confirms the suspicion of hypogonadism. Erectile dysfunction due to skin diseases is uncommon (scleroderma, psoriasis). It is mostly caused by circulatory disorders, or of psychogenic origin or drug induced (such as finasteride). Treatment is primarily with phosphodiesterase type 5 inhibitors. Dermatological therapies can impair testicular function. Therefore patients should be asked whether they have a wish for a child. If a wish for a child is present, drug therapy has to take this into account. If immunomodulatory drugs are to be described cryopreservation of sperm should be offered. For the infertility workup a sperm analysis fulfilling certain quality criteria is mandatory but not sufficient. The counselling has to take into account aspects of history (e. g., age of the partner) and clinical aspects (e. g., varicocele). The decision for reproductive measures has to be made together with the treating gynecologist.

Age-dependent modification of the facial subcutaneous white adipose tissue (sWAT) connected with reduction of its volume, modification of collagen content and adhesion between dermal and adipose layers can significantly influence mechanical stability of the skin and cause the development of aging symptoms such as wrinkles. Typical aging appearance in facial skin is at least partly connected with special phenotypical features of facial preadipocytes and mature adipocytes. In this paper, we have discussed the possible roles of local inflammation, compartmental structure of facial sWAT and trans-differentiation processes such as beiging of white adipocytes and adipocyte-myofibroblast transition in facial skin aging.

Calcium and 1,25 dihydroxyvitamin D3 (1,25(OH)2D3) are promoters of epithelial cell functions; howev...