Keloids are benign fibrous growths with characteristic clinical features, whose underlying pathogenic mechanisms are not fully understood. While numerous treatment approaches are available, there is little evidence for efficacy based on controlled clinical studies. Therapeutic results are often not satisfactory. The best approach employs multiple modalities appropriate for the stage of the lesion. Combining invasive methods such as cryotherapy, surgery, intralesional steroid injections, laser or radiotherapy with external or physical approaches has helped to optimize treatment efficacy. Newer clinical studies with intralesional substances such as interferons which may directly influence collagen metabolism show promising results; these substances may be valuable therapeutic additions.

the follow-up is still insufficient to determine long-term risk both in children and in adults. 5 Nevertheless, etanercept is well tolerated by both adult and paediatric patient populations, and data available on its use have demonstrated a good safety profile. To the best of our knowledge, this is the first experience in children with psoriasis. Although more studies are needed, our observations suggest that etanercept may be an efficacious and welltolerated drug for the treatment of severe forms of childhood psoriasis.

Leg ulcer is a polyaetiologic condition the successful treatment of which is decisively influenced by correct diagnosis of the underlying cause. About 76% of leg ulcer cases are due to chronic venous insufficiency. Nonhealing venous leg ulcers are the domain of local surgical therapy with a variety of symptomatic and causal surgical methods. Shave therapy is the treatment of choice, with relatively low invasiveness and good long-term results. Today subfascial endoscopic perforator vein surgery and the surgical treatment of fascia cruris (fasciotomy, fasciectomy) are used rarely but increasingly indicated. Long-lasting healing is decisively influenced by thorough follow-up treatment with complex physical compression treatment and exercises following the surgical treatment of nonhealing venous leg ulcers.

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