Micrographic surgical treatment of melanoma in Municipal Hospital Karlsruhe

About the department

The Department of Dermatology, Allergology and Phlebology at the Municipal Hospital Karlsruhe provides modern diagnostics and effective treatment of various skin diseases, including allergic reactions, and medical care for patients with venous diseases. The priority areas of the department's clinical practice include the treatment of benign and malignant skin tumors, psoriasis, atopic dermatitis, bullous dermatoses, infectious skin lesions, and various allergic diseases, including food, drug, and insect venom allergies. The doctors of the medical facility have a vast arsenal of conservative and surgical treatment methods that allow them to achieve excellent therapeutic results. The department is headed by Prof. Dr. med. Claus-Detlev Klemke.

With an annual number of more than 4,000 surgical interventions of varying complexity, the department's specialists have exceptional qualifications for effective surgical treatment, while a satisfactory aesthetic outcome also plays an important role. The department annually admits more than 1,800 inpatients and about 11,500 outpatients. The department has 33 beds for the hospitalization of its patients.

The department offers the services of an advanced Skin Cancer Center, which provides diagnostics and treatment for patients with skin tumors. The essential area of ​​work is skin cancer treatment – the center has been certified following the standards of the German Cancer Society. The center's doctors have long experience in the diagnostics, treatment and follow-up monitoring of patients with skin tumors: melanomas, basal cell carcinomas, spinaliomas, and rare skin cancers, including angiosarcomas, atypical fibroxanthomas, dermatofibrosarcoma protuberans, skin sarcomas and Merkel cell carcinomas. Doctors perform an interventional procedure to take biological material for a histological examination to determine a specific type of tumor. Advanced tumors may require imaging tests (in the Department of Interventional Radiology and the Department of Nuclear Medicine). As for the therapy, the first-line treatment is usually surgical removal of the neoplasm, followed by plastic reconstruction surgery, if required. The operation can be supplemented with cryotherapy, immunotherapy, laser therapy, photodynamic therapy, radiation therapy, chemotherapy, targeted therapy, etc. A particular complex of therapeutic measures is prescribed by the patient's attending physician, based on his diagnostics and clinical data.

The department's team of dermatologists also provides conservative treatment of benign skin pathologies: psoriasis, atopic dermatitis and various types of eczema, bullous dermatoses, erysipelas, herpes zoster, acne, leg ulcers and other diseases. These diseases can be treated with drugs, photodynamic therapy, phototherapy, laser procedures and other methods.

Allergology is especially focused on treating food, drug, and insect venom allergies. The diagnostic stage includes provocation tests, prick tests, epicutaneous and intracutaneous skin tests, etc. Allergic manifestations on the skin can be eliminated with medications (ointments, gels and creams for topical application, pills, etc.), and allergen-specific immunotherapy (hyposensitization).

The department's doctors also admit patients with venous diseases. Particular attention is paid to the treatment of varicose veins and deep vein thrombosis. A diagnosis is usually made with Doppler sonography and color duplex sonography. Varicose veins can be eliminated with methods such as stripping, laser treatment, sclerotherapy, phlebectomy, and compression therapy. The treatment regimen for deep vein thrombosis usually includes anticoagulant drugs and compression therapy.

The department's range of medical services includes:

• Dermatology
  • Diagnostics and treatment of malignant skin diseases
    • Diagnostics
      • Dermatoscopy
      • Dermatohistological and immunohistological tests
      • Molecular diagnostics (BRAF, NRAS and c-Kit mutations, etc.)
      • Skin and lymph node ultrasound scanning
      • Sentinel lymph node biopsy
      • Tumor marker monitoring
      • Imaging tests (ultrasound, X-ray, PET-CT, MRI, CT, and scintigraphy)
    • Treatment
      • Surgical treatment: tumor resection, plastic reconstructive surgery, and intraoperative diagnostics after an express biopsy
      • Local therapy: cryotherapy and immunotherapy
      • Non-surgical treatment: photodynamic therapy, laser therapy, extracorporeal photopheresis, and radiation therapy
      • Drug therapy: Immunotherapy/antibody therapy (for example, interferon alfa, PD-1 inhibitors and CTLA4-AK inhibitors), targeted therapy (for example, BRAF inhibitors and MEK inhibitors), and chemotherapy
  • Diagnostics and treatment of benign skin diseases
    • Conservative treatment methods
      • Drug therapy: topical therapy with ointments, gels and creams, as well as the intake of pills
      • Photodynamic therapy
      • Laser therapy
• Allergology
  • Diagnostics and treatment of food, drug and insect venom allergies
    • Diagnostics
      • Provocation tests
      • Prick tests
      • Epicutaneous and intracutaneous skin tests
    • Treatment
      • Medicines (ointments, gels and creams for topical application, pills)
      • Allergen-specific immunotherapy (hyposensitization)
• Phlebology
  • Diagnostics
    • Dopplerography
    • Color duplex sonography
  • Treatment
    • Anticoagulant therapy
    • Stripping
    • Laser treatment
    • Sclerotherapy
    • Phlebectomy
    • Compression therapy
• Other medical services