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  • 1
    Electronic Resource
    Electronic Resource
    Copenhagen : Munksgaard International Publishers
    Contact dermatitis 44 (2001), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Data on the incidence and prevalence of occupational contact dermatitis (OCD) are scarce, and most of our knowledge about OCD is derived from clinical case reports or clinical studies of in- and out-patients. Therefore, we investigated in the epidemiological, prospective Audi cohort study (PACO study) the incidences of work-related hand eczema in different apprenticeships of Audi AG. In total, 2078 apprentices were investigated at the start of their apprenticeship and systematically followed up over a 3-year period. At the end of the study, information on 2042 (98.2% follow-up) apprentices was available. The 1-year cumulative incidences of hand eczema were 9.2% (95%-confidence interval 7.8–10.7) in metalworkers, 8.8% (95%-CI 7.0–10.7) in other blue-collar workers, and 4.6% (95%-CI 2.3–8.1) in white-collar apprentices. The 3-year cumulative incidences of hand eczema were 15.3% (95%-CI 13.6–17.2) in metalworkers, 14.1% (95%-CI 11.8–16.5) in other blue-collar workers, and 6.9% (95%-CI 4.0–10.9) in white-collar apprentices. In females, the cumulative incidence of hand eczema was higher compared to men (1-year incidence 10.1%, 95%-CI 7.7–13.0, versus 8.3%, 95%-CI 7.1–9.5; 3-year incidence 16.1%, 95%-CI 13.1–19.5 versus 13.6%, 95%-CI 12.2–15.2). In some occupations, like cooks, tool mechanics, milling cutters and varnishers, the incidence of hand eczema was significantly increased. In those occupations, however, no job change was necessary, and no notifiable occupational contact dermatitis occurred. The incidence was not uniformly distributed over the 3-year period. Within the first 6 months, a particularly high rate of hand eczema occurred, which then declined and remained steady at a lower rate over the 2nd and the 3rd years. The results of our study give important suggestions for preventive measures at the workplace and effective occupational pre-employment advices.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Experimental dermatology 14 (2005), S. 0 
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  Percutaneous absorption of lipophilic substances has major implications for therapeutical use or toxicological effects. We, therefore, using dermal microdialysis, measured local toluene concentrations and assessed the effects of duration of exposure, skin barrier disruption and the use of skin-care products.Three microdialysis membranes (3000 kDa) were inserted intradermally at a length of 2 cm in the abdominal skin of 82 anaesthetized male Wistar rats. They were perfused with albumin solution (5%) at 10 µl/min. A skin area of 1.5 × 0.6 cm above the membranes was exposed to toluene (100%, 200 µl) for 15 or 240 min. Dialysate was sampled at 20-min intervals. Using GC-FPD (gas charomotography flame photometric detector), it was analysed for toluene. In addition, the effects of tape stripping and pretreatment with topical products were assessed. In each of the 12 permutations of exposure time, pretreatments and tape stripping, five to eight animals were investigated.Maximum toluene concentrations were reached at 60 min after exposure (3.07 ± 0.40 µg/ml, 15 min; 5.38 ± 0.92 µg/ml, 240 min). In 15-min exposure experiments, dermal toluene concentrations decreased slowly to reach baseline values after 240 min. After 240-min exposure, a plateau of approximately 6 µg/ml was reached after 60 min. Neither tape stripping nor the pretreatment with barrier cream induced a significant change on dermal toluene concentrations.The slow kinetics of toluene penetration results in a steep concentration gradient in the skin with very-high local toluene concentrations and a delayed wash out, which might be relevant not only toxicologically, but also therapeutically.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 23 (1990), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 23 (1990), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1173
    Keywords: Schlüsselwörter:█ ; Key words: Langerhans cell histiocytoses – Non-Langerhans cell histiocytoses – Paraffin-embedded tissue – Immunohistology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. To date, the rare primary histiocytoses of the skin are diagnosed definitively on the basis of the clinical symptoms, H&E-stained sections, and demonstration of CD1 positivity in frozen sections and of Birbeck granules on electron microscopy. The improvement and analysis of antibodies with the ability to react in paraffin tissue allow retrospective evaluation and classification of these disorders. The antibodies for S-100-protein, peanut agglutinin (PNA) and PCNA (proliferating cell nuclear antigen) have been advocated for differentiation of the specific cells of Langerhans cell histiocytosis (LCH) from other histiocytic cell systems. To date the non-Langerhans cell histiocytoses (non-LCH) have no common ultrastructural and immunohistochemical characteristics. The infiltrate is made up of multiple cell populations, which are of significance for the cellular pathobiology (subtypes of monocytes/macrophages and dendritic cells). The number and distribution of the different monocyte/macrophages and dendritic cells and their ability to react with immunohistochemical markers in paraffin tissue can be completely different in different clinical entities. The antibodies against factor XIIIa (shown on xanthoma disseminatum) and the monoclonal antibody Ki-M1P (shown on juvenile xanthogranuloma) seem to be valuable in discrimination between LCH and non-LCH. Both markers show a positive staining pattern with the characteristic large macrophages. In juvenile xanthogranuloma, the foam cells and giant cells express Ki-M1P, KP1 and anti-cathepsin B. Other monocyte/macrophage markers with the ability to react in paraffin tissue, such as Mac387, lysozyme, α1-antitrypsin and Leu-M1 (Anti-CD 15), in contrast, did not show a typical staining pattern with the characteristic large macrophages dominating the histological picture.
    Notes: Zusammenfassung. Bisher beruhte die exakte Diagnostik der sehr seltenen primären Histiozytosen der Haut neben der Klinik und der Histologie am H&E-Schnitt auf der Elektronenmikroskopie (Birbeck-Granula) und der Immunhistologie am Gefrierschnitt (CD1a). Fortschritte in der Entwicklung und Analyse paraffingängiger Marker ermöglichen jetzt auch an formalinfixiertem Material eine (auch retrospektive) Aufarbeitung und genaue Einteilung dieser Erkrankungen. Mit Antikörpern gegen S-100-Protein und mittels des Lektins peanut agglutinin (PNA) und PCNA (proliferating cell nuclear antigen) können die klassischen Zellen der Langerhanszell-Histiozytosen (LZH) von anderen histiozytären Zellsystemen abgegrenzt werden. Bei den sog. non-Langerhanszell-Histiozytosen (non-LZH) gab es bis dato keine einheitlichen elektronenoptischen und immunhistologischen Charakteristika. Die Infiltrate bestehen aus mehreren Zellpopulationen, die für die zelluläre Pathobiologie von großer Bedeutung sind (Subtypen von Monozyten/Makrophagen und dendritischen Zellen). Häufigkeiten und Verteilungen der unterschiedlichen Monozyten/Makrophagen und der dendritischen Zellen und deren Reaktionen mit den entsprechenden paraffingängigen immunhistologischen Markern können innerhalb der verschiedenen klinischen Entitäten sehr unterschiedlich sein. Diagnostische Aussagekraft hinsichtlich der Abgrenzung von den Langerhanszell-Histiozytosen scheinen Antikörper gegen Faktor XIIIa (gezeigt am Beispiel des Xanthoma disseminatum) und der monoklonale Antikörper Ki-M1P (gezeigt am juvenilen Xanthogranulom) zu haben. Beide Marker zeigen mit den für das Krankheitsgeschehen typischen epitheloiden Zellen ein positives Reaktionsmuster. Beim juvenilen Xanthogranulom (JXG) exprimie█.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Neurodermitis ; Coping-Therapie ; Keywords Atopic eczema ; Coping therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract With the help of the German Ministry of Health and the health insurance companies a national interdisciplinary project for children and adolescents with atopic eczema will be developed. The aim of the project is to generate standardized teaching concepts for parents and children covering medical, psychological and social aspect of the disease. 800 children and adolescents of different age groups will be enrolled in this poject. Furthermore, during the three years of the study the efficacy of the teaching concept will be evaluated.
    Notes: Zusammenfassung Im Rahmen eines nationalen interdisziplinären Modellprojekts werden mit Unterstützung des Bundesministeriums für Gesundheit und der Krankenkassen Schulungsmaßnahmen für Kinder und Jugendliche mit Neurodermitis erarbeitet. Ziel dieses Projektes ist es, standardisierte Schulungsinhalte zu generieren, die medizinische, psychologische und soziale Aspekte der Erkrankung abdecken. In die Untersuchung werden 800 Kinder und Jugendliche der unterschiedlichsten Altersgruppen aufgenommen. Die Effektivität der Schulungsmaßnahmen wird über die Dauer von 3 Jahren evaluiert.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-1173
    Keywords: Schlüsselwörter: Anticardiolipin-Antikörper – Großflächige Hautnekrosen – Erfolgreiche Therapie ; Key words: Anticardiolipin antibodies – Widespread cutaneous necrosis – Successful therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. In anticardiolin syndrome (ACS) a typical antibody constellation is associated with thrombotic and hematologic disorders. Furthermore, recurrent abortion, cerebral ischemia and different skin disorders occur. We report the case of a 29-year-old female suffering for the first time from painful, necrotic deep ulcers on the upper and lower legs and livedo racemosa on the arms as a rare example of a merely cutaneous manifestation of ACS with no demonstrable underlying disease. After systemic treatment with high-dose methylprednisolone, azathioprin and hydrocolloid dressings, healing of the scar tissue occurred. Simultaneously, a maintenance dose of acetylsalicylic acid (100 mg/day) was administered. So far, neither cutaneous relapse nor other signs of ACS have occurred.
    Notes: Zusammenfassung. Beim sog. Anticardiolipin-Syndrom (ACS) sind neben den typischen Antikörperbefunden sowie thrombotischen und hämatologischen Störungen, rezidivierenden Spontanaborten und zerebralen Ischämien auch verschiedene, diagnostisch richtungsweisende schwere Hautveränderungen bekannt. Wir berichten über eine 29jährige, Anticardiolipin-Antikörper-positive, adipöse Patientin mit erstmals aufgetretenen schmerzhaften, tief ulzerösen Nekrosen an beiden Beinen und Gesäß sowie Livedo racemosa an den Oberarmen als seltenes Beispiel einer dermalen Manifestation eines ACS ohne Hinweise auf eine gleichzeitig bestehende Begleiterkrankung. Nach hochdosierter Behandlung mit Methylprednisolon und Azathioprin, adäquater Lokaltherapie mit hydrophilen Gelverbänden und unter Erhaltungstherapie mit Acetylsalicylsäure (100 mg/d) konnte narbige Abheilung der großflächigen Hautdefekte und bisher (1 Jahr) Rezidivfreiheit erzielt werden.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Berufsdermatosen ; Begutachtung ; Psychotherapeutische Medizin ; Rechtliche Grundlagen ; Multiple chemical sensitivity ; Key words Occupational dermatoses ; Expertise ; Psychotherapeutic medicine ; Legal grounds ; Multiple chemical sensitivity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Skin diseases, the psyche and psychological changes are often intertwined, especially in patients presenting for expert dermatologic opinion. In many cases an additional evaluation provided by psychotherapeutic medicine may be necessary. This resource may help with the diagnosis, explanation of the problem and estimation of the degree of disability. The different legal guidelines of the various evaluation boards must be considered. The role of psychotherapeutic evaluation is demonstrated through case examples. The evaluation of new possibly occupationally-related disorders such as multiple chemical sensitivity and mobbing is considered.
    Notes: Zusammenfassung Zwischen Haut und Psyche sowie psychischer Alteration bestehen bei vielen Dermatosen wechselseitige Zusammenhänge, die auch in Begutachtungssituationen zutagetreten können. In bestimmten Fällen kann daher eine Zusatzbegutachtung durch die psychotherapeutische Medizin erforderlich werden, insbesondere wenn daraus neue Erkenntnisse zur Aufklärung, Diagnosesicherung oder Einschätzung der Minderung der Erwerbsfähigkeit (MdE) resultieren. Die unterschiedlichen rechtlichen Grundlagen der verschiedenen Rehabilitationsträger sind dabei zu berücksichtigen. Die unterschiedlichen Indikationen zur Zusatzbegutachtung durch die psychotherapeutische Medizin werden anhand von konkreten Gutachtensbeispielen dargestellt. Die Wertung neuer möglicherweise berufsassoziierter Erkrankungen wie z.B. „multiple chemical sensitivity” und Mobbing wird diskutiert.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Methotrexat ; Ulzerierende Stomatitis ; Überdosierung ; Nebenwirkungen ; Key words Methotrexate ; Ulcerative stomatitis ; Overdose ; Side effects
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Gastrointestinal side effects and the developpement of toxic liver fibrosis are well-known side effects of low dose methotrexate therapy. A female patient receiving a long term low dose methotrexate therapy for a seronegative chronic polyarthritis developed an ulcerative somatitis, as clinical clue to an inadvertently given methotrexate overdose. A summary of other side effects of methotrexate and of oral side effects of other cytostatic agents and immonosuppressive drugs is given.
    Notes: Zusammenfassung Als Nebenwirkung einer niedrigdosierten Langzeittherapie mit Methotrexat (MTX) sind gastrointestinale Beschwerden und eine toxische Leberfibrose bekannt. Wir stellen eine Patientin vor, die unter einer niedrigdosierten Langzeittherapie einer seronegativen chronischen Polyarthritis aufgrund eines Verordnungsfehlers eine ulzerierende Stomatitis als Zeichen einer akuten MTX-Überdosierung entwickelte. Eine Übersicht weiterer Nebenwirkungen von MTX und oraler Nebenwirkungen von Zytostatika und Immunsuppressiva wird gegeben.
    Type of Medium: Electronic Resource
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  • 10
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Digitale Ischämie ; Fingerkuppengangrän ; Paraneoplastisches Syndrom ; Serös-papilläres Adenokarzinom des Endometrium uteri ; Kryoglobulin ; Key words Digital ischemia ; Gangrene of fingertips ; Paraneoplastic syndrome ; Serous-papillary adenocarcinoma of the endometrium uteri ; Cryoglobulins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Digital ischmia with gangrene of one or several fingertips has been described as a paraneoplastic syndrome associated with various malignant tumors, especially adenocarcinomas. Most often this paraneoplastic syndrome represents the first symptom of an occult neoplasia in an advanced stage. We present the case of an 83 year-old patient with digital ischemia and gangrenous fingertips in association with a latent adenocarcinoma of the uterus and metastatic involvement of the paraaortal lymph nodes. Acute occurrence of digital ischemia and gangrene without pathological laboratory findings and negative past medical history concerning cardiovascular-induced emboli, arteriosclerotic occlusion, or rheumatologic and autoimmune diseases should suggest this paraneoplastic syndrome and lead to thorough search for an underlying tumor.
    Notes: Zusammenfassung Eine digitale Ischämie mit Gangrän einzelner oder mehrerer Fingerkuppen wurde als seltene Paraneoplasie bei verschiedenen Tumoren, insbesondere metastasierenden Adenokarzinomen unterschiedlicher Organsysteme, beschrieben. Sie kann das erste Symptom einer bis dahin latenten malignen Neoplasie in fortgeschrittenem Tumorstadium sein. Die Befunde dieses paraneoplastischen Syndroms werden anhand der Kasuistik einer 83jährigen Patientin mit einem paraaortal lymphogen metastasierenden latenten Adenokarzinom des Endometrium uteri vorgestellt. Das akute Auftreten einer digitalen Ischämie mit Gangrän bei fehlenden pathologischen Laborbefunden und negativer Anamnese für rheumatologische, autoimmunologische und kardiovaskuläre Grunderkrankungen (i.e. Emboliequelle oder arteriosklerotisch bedingte Verschlüsse) ist charakteristisch für dieses seltene paraneoplastische Syndrom und muß zu umfassender Tumorsuche Anlaß geben.
    Type of Medium: Electronic Resource
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