Background: Several cases of lichen planus (LP) associated with hepatitis C virus (HCV) infection have been described. The reported prevalence rates of anti-HCV in patients with LP show wide geographical variations. An association of HCV-associated disorders with certain HCV geno/subtypes has not been investigated so far. Objective: The aim of the present study was to define the prevalence rate of anti-HCV in German patients with LP and to determine the distribution of HCV geno/subtypes. Methods: All patients with LP of the present study (n = 84) were tested for anti-HCV antibodies by an enzyme-immunoassay (second generation). HCV RNA was detected by reverse-transcription polymerase chain reaction (RT-PCR) and HCV geno/subtyping was performed by the reverse hybridization assay. Serum samples of 87 patients with various cutaneous diseases excluding LP served as control group. Results: Anti-HCV antibodies were detected in 13/84 patients with LP (16%), and 12/13 anti-HCV-positive patients were viraemic as assessed by the presence of HCV RNA. Most patients were infected with subtype HCV-1b (10/12 patients), while the 2 remaining patients were infected with HCV-2b and HCV-3a, respectively. In the control group, anti-HCV antibodies were only observed in 1/87 patients (1.1%), infected with subtype HCV-1b. Conclusion: The statistically significant (p < 0.002) high prevalence of HCV RNA in patients with LP is suggestive of an aetiological role of HCV in the pathogenesis of LP. Compared to the geno/subtype distribution of patients with chronic hepatitis C without LP of the same geographical area, no convincing correlation between geno/subtype and the presence of LP was obtained.

In recent years, numerous computer assisted learning (CAL) programmes based on new teaching methods, as for example the principles of cognitive apprenticeship and problem based learning, have euphorically been developed for various medical fields. However, many of these programmes failed due to either low acceptance, economic inefficiency, or, most seriously, problems with the implementation and evaluation in medical curricula. In 1999, the practical training course 'Dermatology 2000', an interactive multimedia programme for dermatological education, was developed and completely integrated into the regular dermatological curriculum of five German medical schools. The formative evaluation of an implemented relational database revealed contemporary information about the programme's quantity of use. So far, 3050 students have participated in 6557 lessons. The evaluation of two online questionnaires showed a high learner acceptance regarding the programme's instructional design, ergonomics, and didactical presentation and, after completion of Dermatology 2000, an increased interest in medical education software. A comparison of the objective learning outcome illustrated that Dermatology 2000 students (n = 31) not only outperformed non-participants (n = 7) but also showed a (10%) lower rate of errors in a conventional knowledge test. Additionally, single-case studies demonstrated the increased ability of participating students to apply the acquired knowledge to diagnostic problems. We conclude that the implementation of CAL in present medical curricula can contribute to reformations of medical education. The instructional design of Dermatology 2000 is well accepted and suitable to provide both theoretic biomedical knowledge and clinical skills.

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