[Dermatologic rehabilitation--chances in crisis]

The political activities concerning the health care system in recent months have made the chronic crisis involving dermatological rehabilitation clinics in Germany more apparent. While dermatology has continual to evolve in acute care clinical facilities, no critical analysis of dermatological rehabilitation clinics has occurred. A commonly accepted, standardized document defining precisely the goals of dermatological rehabilitation as well as the appropriate ways to measure the quality of the treatment and its results is not available. An expert panel appointed by the responsible working group of the Bavarian public health care system succeeded in defining mandatory structural requirements which will soon be obligatory for all Bavarian dermatological rehabilitation clinics. In the future, a general concept for the medical care of patients with chronic dermatological diseases on the appropriate level--ambulatory or hospital--has to be established. A close cooperation between clinicians working in acute care facilities and dermatologists in ambulatory practices could, at least in the long run, result in establishing local and national centers of competence for diagnosis, therapy, prevention, and rehabilitation of chronic dermatological diseases.