No other field in medicine has such a plethora of diagnoses as dermatology.
Working at the General Hospital Vienna (AKH Vienna) I am familiar with all fields of dermatology including dermatological emergencies. Skin diseases occur in all periods of life. Typical diseases of the infants are eczema, virus infections leading to exanthemas and atopic dermatitis. In adolescence, skin conditions like acne or psoriasis become more frequent; typical skin diseases of the elder population are non-melanoma skin cancer (basal cell carcinoma, squamous cell carcinoma) and herpes zoster (shingles).
Skin diseases, that occur in all periods of life are the aggressive melanoma, cellulitis, urticarial, warts, eczemas with different triggers as well as allergies.
In addition to all these, there is a plenty of unusual dermatoses ("zebra diagnoses") which are often driven by immunological disorders.
My field of specific expertise are connective tissue diseases.
In 2012 I spent a fellowship at the renowned US hospital Mayo Clinic, in Rochester, Minnesota, where I dealt with my focus, the connective tissue diseases. These belong to the so called auto-immune mediated diseases, which are lupus erythematosus, dermatomyositis, scleroderma (systemic sclerosis), sjögren syndrome and rheumatoid arthritis. Regularily, also vessels are involved ("vasculitis"). Connective tissue diseases are characterized by the potential of affecting multiple organs (joints, kidneys, lung, muscles, and others). They can be mild or life-threatening; therefore, regular check-ups are very important.
The skin of a pregnant woman often prettyfies: it becomes more fresh, sanguine and bright.
But there are also skin conditions that may lead to concern. Moles become darker and may rise the suspicion of melanoma. Frequently, the skin becomes more sensitive to light or eczemas arise. Most of these diseases are not dangerous and can be easily treated with local treatments that are harmless to the baby.
However, such skin conditions can sometimes be alarm signals for more serious diseases, such as cholestasis of pregnancy or pemphigoid gestationis, a bilstering skin disease. In particular in such diseases, it is important to have the medical experience for a thorough work-up.
The skin of the elderly needs specific care. On the one hand, over the years the skin lacks the capacity to sufficiently produce lipids and retain moisture. Intensive skin care adapted to the individual skin type is needed in ordert o stabilize the status. Often, intensive itch occurs which can be the result of chronic disorders of the liver and kidney, but also the result of a blistering skin diseases, the bullous pemhigoid. Last not least, seniority is characterized by a typical long-term effect of sun tanning: skin cancer, in particular the non-melanoma skin cancer ("white skin cancer" = basal cell carcinoma and squamaous cell carcinoma). Only if these are recognized in their preliminary phase, surgical procedures can be avoided.
One of the most complicated fields in dermatology are chronic, non-healing wounds. In ordert o satisfy such patients, I am member of an interdisciplinary wound managment team. Please, find further details on our website: www.wundordination.at
Since my residency I dealt with patients having complex diseasses, being undiagnosed for a long time, often years. I edged this interest in 2012 by embarging on a fellowship within the "Undiagnosed Diseases Program" at the National Institutes of Health, Bethesda/Washington, Maryland, USA. This is a clinical research program dedicated to patients form the US and other parts of the world suffering from undiagnosed diseases seeking to solve such constellations.
This group fo diseases is very rare. However, their initial symptoms are common: fever, joint pain, skin rashes. In most cases, the reason for these diseases are mutations in the so called inflammasome; this is a functional unit of the inborn immune system which is responsible for recognizing and defeating of e.g. bacteria. During my fellowship at the National Institutes of Health, Bethesda, Maryland/USA, I dealt with this SPECTRUM of diseases. They comprise e.g. the familial mediterranean fever, the CAPS, Still`s disease and the Schintzler syndrome.
A work-up demands a lot of detail work, precise investigations of long lasting medical histories as well as an interdisciplinary cooperation with dedicated physicians of other disciplines.