[Care for skin cancer in Germany : Provision and providers]. / Versorgung des Hautkrebses in Deutschland : Leistungsvolumina und -erbringer.

BACKGROUND: Treatment for skin cancer is a major component of dermatological care in western countries. OBJECTIVE: The purpose of this work is to analyze health care provision and providers for skin cancer care in Germany. METHODS: From the complete claims data set from 2007-2009 of the German statutory health insurance DAK (approximately 6.1 million insured persons), insurees with skin cancer and melanocytic naevi were extracted by ICD-10 codes. Surgical procedures and physician specialties were identified by specific codes. Data from the German statistical agency (Destatis) were derived from public domain for the years 2008-2010. RESULTS: Among the annual ambulatory surgical treatments (n = 6695) for melanoma, 83.6 % were conducted by dermatologists, followed by general surgeons (11.1 %), and facial surgeons (3.0 %). In melanocytic naevi (n = 51,659), 79.1 % were treated by dermatologists, followed by general surgeons (15.5 %), facial surgeons (3.6 %), and general practitioners (1.1 %), while in epithelial cancers (ICD-10 C44), 76.4 % were operated by dermatologists, followed by general surgeons (12.7 %) and facial surgeons (7.9 %). Overall, related to Germany, about 830,000 ambulatory operations for skin cancer were conducted in 2009 which is about 40 % more than in 2007. In hospitalized patients, 79,448 out of 195,558 inpatient cases (45.5 %) were treated in dermatological departments in the year 2012. Average annual growth rates of the inpatient cases in the DAK between 2007 and 2010 were 8.9 % for MM and 11.1 % for SCC/BCC. CONCLUSION: Skin cancer is associated with a significant and still growing need for surgical care in which dermatology has a leading role in Germany. Thus, there is an increasing need for dermato-surgical specialist training.

Participation and health care provision of statutory skin cancer screening in Germany - a secondary data analysis.

BACKGROUND: In Germany, skin cancer screening was introduced nationwide in July 2008. From the age of 35 years, members of the statutory health insurance are eligible for screening every 2 years. OBJECTIVE: The aim of this study is to calculate the participation rates and the proportions of health care providers of statutory skin cancer screening in Germany on a population-based level. METHODS: Data were provided by a nationwide German statutory health insurance, approximately 6.1 million members, covering the years 2008/2009. Participation rates were calculated per yearly quarter and were adjusted for age, gender and federal state. RESULTS: Approximately 920,000 insurants were screened from the third quarter of 2008 until the last quarter of 2009. Mean participation rate of skin cancer screening was 30.8%. Women had higher participation rates (31.9%) than men (29.7%). After adjusting for gender and federal state, high rates for pensioners at the age of 65-74 were confirmed at 39.4% on average for all yearly quarters. One of the highest gender- and age-adjusted rates was observed in the state of Schleswig-Holstein, where a population based pilot project had been implemented before the start of the nationwide screening programme. In general, without taking into account Berlin, former East Germany had a much lower gender- and age-adjusted participation rate (23.9%) than West Germany (33.3%). At the first quarter after implementation of screening, 58.5% of the screenings were provided by dermatologists and 41.5% by general practitioners. CONCLUSION: Participation rates and health care providers of skin cancer screening can be calculated from secondary data and contribute to identify group- and region-specific participation patterns in order to improve early detection of skin cancer.

Topical treatment of tinea pedis using 6% coriander oil in unguentum leniens: a randomized, controlled, comparative pilot study.

BACKGROUND: The antifungal activity of coriander oil has already been demonstrated in vitro. OBJECTIVE: Evaluation of the efficacy and tolerability of 6% coriander oil in unguentum leniens in the treatment of interdigital tinea pedis. METHODS: Half-side comparative pilot study on subjects with symmetric, bilateral interdigital tinea pedis. Active drug and placebo control were applied twice daily on the affected areas, and follow-up visits were performed on days 14 and 28. RESULTS: 40 participants (mean age 52.5 years, 60% male) were included in the study. For 6% coriander oil in unguentum leniens, a highly significant improvement of the clinical signs (p < 0.0001) was observed during the entire observation period; the number of positive fungal cultures also tended to decrease (p = 0.0654). The tolerability of the tested substances was good. CONCLUSION: Coriander oil is effective and well tolerated in the treatment of interdigital tinea pedis.