How can I identify an atypical or suspicious cutaneous lesion ?
Basically there are 5 golden rules that can help us sort out different cutaneous lesions like birth marks, warts or moles.

A Stands for asymmetric, meaning the lesion has different colours, shapes or structures

B stands for borders, if these are unregular, illshaped, a medical advice is recommended

C stands for colour being that most of us know, that more the lesion is darker more it is wise to have it checked.

D stand for diameter and is looking at the size of the lesion. Being over 5 mm in diameter, the lesion clearly should be regularly looked after.

E stands for evolution and means, in case the lesion is changing in whatever aspect, colour, size, shape or eventually causes symptoms like itching or pain, it should be checked.

All of this is just a basic guideline. Generally speaking everybody concerned over some pigmented lesion or worried something might be wrong, always should be seek professional advice.

Most of the health care providers cover the costs for a check up every 2 years. One is clearly advised to make use of that offer to prevent major trouble and should get checked from head to toe.

Acne is considered physiological ( normal ) in the age between 10 an d 20. Most of the times it has hormonal causes and basically needs care and patience.

Some sub-types are somewhat more intense and in these cases a good option is an early systemic treatment.

Generally it is important to clarify what type of skin is present before going to the pharmacy and buy some kind of treatment. Is it dry, or fatty, is it sensitive or rough. Most of the cleaning lotions do dry out your skin and can cause irritation that might worsen the situation.

Apart from a balanced nutrition your dermatologist knows a series of options to ameliorate your skin condition.

In no way you should manipulate the lesions, do not squeeze, pop or punction the lesion, for this might spread the infection and leave behind unfavorable pigments or even scars.

Most of the times rashes go along with itching that might tempt  you to scratching, which you should try to avoid. Many diseases like for instance psoriasis will get worse by scratching, the lesion might get bigger and develop dandruff or scales

When bacteria is involved, like sometime in cases of neurodermitis, scratching might provoke a spread of bacteria and by this means enhance infection and irritation of the skin

Also when parasites are involved as in scabies, scratching does deteriorate the clinical situation. As a basic rule, in case of rashes it is wise to have it looked after by a dermatologist.

Especially  In case of long term presence of rashes, chronic rashes,  it is important to analyze the possible causes, that can range from neurodermitis, psoriasis, even allergies or in the worst cases cancerous disease should be professionally ruled out.

In most cases however, rashes can be treated with basic ointments of which there are innumerable in common drug stores. In case of persistence or when refractory to basic treatment a dermatologist should be asked for counseling.

Nowadays it is not unavoidable to suffer the consequences of hay fever. There are modern and rapid diagnostic tests. They allow us to determine what the causing agents are so that we can initiate a very specific and tailored therapy

The most important one is the so called prick test. In this test several allergens are injected into the skin, mostly of the forearm. Shortly thereafter it is possible to evaluate the intensity if the reaction. If necessary one can as well determine the causing agent in a blood test.

Mild or moderate symptoms can be treated with oral medication like for instance antihistamicas.

In case of severe symptoms like for instance respiratory distress it might be recommended to initiate a systemic treatment called hyposensibilisation. This can be done either by regular injections or via a sublingual therapy, both of which have to be continued for a period of three years.

Today, probably every second person in Germany is affected by nail fungus. Therefore it can clearly be called a mass disease, that can be tricky and difficult to get rid of.

On the one side there is the risk of spreading to other nails or the surrounding skin and in immune suppressed people ( with low defenses) can even cause severe infections.

Treatment can be local  for instance with special nail polishes which can be bothersome because they require up to 2 years of treatment, or systemic, with oral drugs, that have to be used for up to 6 to 12 month and have to be regularly controlled by a blood work up to make sure there are no unwanted side effects.

Best option clearly is the laser therapy, that has shown to be effective in up to 99 percent of the patients and only shows very few and mild side effects.

Most of the cutaneous ( skin) lesions, specifically if they are long known and unchanged ( for instance existing since childhood) are benign ( not cancerous). In any case of doubts it is recommended ro have it looked after by a dermatologist. This counts even more, if the lesion is painful, itching or changing shape and size.

If your dermatologist recommends excision ( removal) of the lesion, several options will be brought forward and explained to you. In most cases, before the complete removal of the lesion, a biopsy will be performed in order to get a precise diagnosis, which will help to define by what means the lesion  has to be treated. Options range from superficial abrasion, knife excision, cryotherapy , or laser based therapy.

In any case, your dermatologist will explain the options as well as the potential side effects and risks of the therapy of choice and sometimes will have you sign a written informed consent to make sure have understood what you are up to.