Monkeypox (mpox), a former rare viral zoonosis, has increasingly made it into the public eye since the major outbreak that started in May 2022. Mpox presents with skin lesions that change over time and go through different stages (macular, papular, pustular, and early and late ulceration). In this study, we evaluated skin biopsies of all stages. Therefore, five biopsies from four patients were analyzed histologically, immunohistochemically with anti-Vaccinia virus antibodies, and electron-microscopically. Notably, the early macular stage only showed subtle viropathic changes; it did not express of Orthopoxvirus proteins in immunohistochemistry and therefore can easily be missed histologically. In later stages, immunohistochemistry with anti-Vaccinia virus antibodies might be useful to distinguish mpox from differential diagnoses such as herpes virus infections. In the ulcerative stages, the identified occlusive vasculopathic changes could be an explanation for the severe pain of the lesions reported by some patients. Despite the small number of samples examined, our analysis suggests that the histological findings of mpox are highly dependent on the stage of the biopsied lesion. Therefore, knowledge of all different stages of histology is necessary to reliably diagnose mpox histologically, especially when molecular testing is not available.

Background: Technological advances in the field of virtual reality (VR) offer new opportunities in many areas of life, including medical education. The University of Münster has been using VR scenarios in the education of medical students for several years, especially for situations that are difficult to reproduce in reality (e.g., brain death). Due to the consistently positive feedback from students, a dermatological VR scenario for skin cancer screening was developed.Objectives: Presentation and first evaluation of the skin cancer screening VR scenario to determine to what extent the technical implementation of the scenario was evaluated overall by the students and how their subjective competence to perform a skin cancer screening changed over the course of the teaching unit (theory seminar, VR scenario, theoretical debriefing).Methods: Students (n = 140) participating in the curricular pilot project during the 2023 summer term were surveyed throughout the teaching unit using several established questionnaires (System Usability Scale, Simulation Task‐Load‐Index, Realism and Presence Questionnaire) as well as additional questions on cybersickness and subjective learning.Results: (i) The use of VR is technically feasible, (ii) students evaluate the VR scenario as a useful curricular supplement, and (iii) from the students' subjective perspective, a good learning outcome is achieved. Although preparation and follow‐up appear to be important for overall learning, the greatest increase in subjective competence to perform a skin cancer screening is achieved by the VR scenario.Conclusions: Technically feasible and positively evaluated by students, VR can already be a useful addition to dermatology education, although costs are still high. As a visual discipline, dermatology offers special opportunities to create VR scenarios that are not always available or comfortable for patients in reality. Additionally, VR scenarios guarantee the same conditions for all students, which is essential for a high‐quality education.

This study investigates the impact of hand representation in virtual reality based medical education on user behaviour, with a particular focus on medical teaching objectives and navigation within the scenario. In VR it is common to adapt established concepts from other disciplines. One way of representing the hands in VR is to follow common design concepts and stay within a colour scheme that includes all interaction elements. In a medical context, this can lead to the hands not being perceived as “naked” and raises the question of whether important hygienic routines for protecting oneself and others are not being performed. A randomised, double-centre trial was conducted with medical students from the University of Münster and the University of Saarland. Participants were assigned to one of two virtual hand representations - realistic or artificial (green). The study assessed students’ performance in a VR-based skin cancer screening simulation, focusing on their adherence to hygiene protocols and subjective experiences of presence and embodiment. No significant differences were found in perceived embodiment between the two hand variants. While realistic hands significantly improved the frequency of glove use, artificial hands had a small positive effect on initial navigation. No significant differences were found in door closing and hand disinfection behaviours. Participants subjectively preferred the realistic hands for future VR-based scenarios. The use of realistic hand representation seems to have an advantage for training hand-related routines in medicine, while the use of interaction-friendly design facilitates navigation for learners. Depending on the use case of new applications and intended learning outcomes, these findings should be taken into account when developing new applications. Close interdisciplinary collaboration in development is highly relevant in order to identify and address such distinctive requirements.

SUMMARY: Digital transformation is fundamentally reshaping dermatology, creating new opportunities in diagnostics, therapy, and healthcare organization. Large datasets combined with Artificial Intelligence (AI) enable more precise classification and prognosis, particularly through the analysis of clinical and dermoscopic imaging. Increasingly, synthetically generated data is used to train new algorithms, though its clinical validity remains under evaluation. Teledermatology has established itself as an integral part of care. Video consultations and asynchronous image transfers enhance accessibility to dermatological expertise and can bridge care gaps, especially in structurally weak regions. Furthermore, mobile applications and digital platforms promote adherence, self‐monitoring, and active patient engagement. Despite these opportunities, challenges regarding data protection, interoperability, and regulatory frameworks must be addressed to ensure sustainable implementation. Interdisciplinary collaboration between medicine, technology, and health economics is crucial. Physicians play a central role as subject matter experts in assessing data quality and providing clinical interpretation of digital systems. Continuous training of medical staff remains essential. Overall, digitalization offers significant potential to improve dermatological care, provided there are structured processes, quality assurance, and consistent patient involvement.