Treatment with azelaic acid 20 % cream significantly improves acne severity and disease-related QoL in adult women.

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A 67-year-old male patient noticed a foreign body sensation following a trivial trauma to the sole of the left foot approximately 4 months before presentation. The existing skin alteration had been self-treated with pumice stone and an unidentifiable wart tincture. The examination revealed an approximately 2 cm in diameter macula on the left heel with a zonal construction. The periphery was formed by a polycyclic dark brown ring which enclosed a reddish skin colored macula with several minute erosions. Dermatoscopy revealed an unspecific pattern with polymorphic vessels in the center. The peripheral ring showed radially running streaks as well as a parallel track-like pattern in one region. Histology revealed this to be an acral melanoma. A melanoma should always be included in the differential diagnostic considerations of atypical acral lesions. A biopsy should always be carried by unclear clinical and light microscopical findings out to enable a final diagnosis.

Die Anwendung von 20%iger Azelainsäure-Creme führt bei erwachsenen Frauen zu einer signifikanten Besserung der Acne vulgaris und der krankheitsbedingten Lebensqualität.