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  • 1
    Electronic Resource
    Electronic Resource
    Papillomatosis confluens et reticularis Erfolgreiche Therapie mit Minocyclin* (1996)
    Springer
    Der Hautarzt 47 (1996), S. 209-213 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Papillomatosis confluens et reticularis ; Minocyclin ; Tetracycline ; Elektronenmikroskopie ; Key words Confluent and reticulated papillomatosis ; Minocycline ; Tetracycline ; Electron microscopy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Confluent and reticulated papillomatosis (CRP) is a rare dermatosis of unknown aetiology. Recent electron microscopic studies suggest that CRP is a disorder of keratinisation. In our case we could not confirm the previously reported ultrastructural findings. CRP is generally resistant to therapy. We treated a 19-year-old patient with typical CRP with oral minocycline. Within a few weeks the eruption resolved completely. A mild relapse 7 months later responded promptly to a repeated course of minocycline. Twelve months after discontinuatin of therapy there is no evidence of recurrence. In CRP minocycline should be preferred to systemic retinoid therapy because of its minor side effects.
    Notes: Zusammenfassung Die Papillomatosis confluens et reticularis (PCR) ist eine seltene Erkrankung unklarer Ätiopathogenese. Neuere elektronenmikroskopische Untersuchungen stützen die Vermutung, daß eine Keratinisierungsstörung vorliegt. Anhand unseres Falles konnten wir diese Befunde allerdings nicht bestätigen. Die PCR ist ausgesprochen therapieresistent. Wir behandelten einen 19jährigen Patienten mit klinisch und histologisch typischer PCR systemisch mit Minocyclin. Innerhalb weniger Wochen heilten die Effloreszenzen vollständig ab. Ein 7 Monate später auftretendes leichtes Rezidiv konnte durch einen zweiten Behandlungszyklus schnell und erfolgreich behandelt werden. Der Patient ist jetzt bereits 12 Monate nach Absetzen der Therapie erscheinungsfrei. Zur Behandlung der PCR sollte Minocyclin wegen seiner geringeren Nebenwirkungen systemischen Retinoiden vorgezogen werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050405
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  • 2
    Electronic Resource
    Electronic Resource
    Molluscum contagiosum-ähnliche Papeln im Rahmen einer disseminierten Infektion mit Mycobacterium avium complex bei einem AIDS-Patienten (1996)
    Springer
    Der Hautarzt 47 (1996), S. 634-637 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Mycobacterium avium complex-AIDS-Molluscum contagiosum ; Key wordsMycobacterium avium complex-AIDS-Molluscum contagiosum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 38-year-old HIV-positive man had several attacks of high fever associated with extensive perspiration over a 10-week period. Simultaneously, he developed molluscum contagiosum-like papules and an erythematous plaque on the face, ulcerated papules on both shoulders and buttocks and subcutaneous nodules on the arms. Histological examination of biopsy specimens revealed a diffuse, histiocytic infiltrate with abundant rod-shaped bacteria. Mycobacterium avium complex was cultured from the tissue and Mycobacterium avium complex DNA was detected by the polymerase chain reaction. The diagnosis of disseminated disease was additionally confirmed by culturing Mycobacterium avium complex from blood, sputum and stool. The skin lesions healed completely within 10 weeks by a multiagent as the patient was treated with a drug therapy. We describe the differential diagnosis, diagnostic procedures and therapy of disseminated infection with Mycobacterium avium complex.
    Notes: Zusammenfassung Bei einem 38jährigen HIV-infizierten Patienten traten seit ca. 10 Wochen rezidivierende Schweißausbrüche und Fieberschübe mit septischen Temperaturen auf. Zeitgleich entwickelten sich Molluscum-contagiosum-ähnliche Papeln und ein infiltrierter, erythematöser Plaque im Gesicht, ulzerierte Papeln an den Schultern und am Gesäß sowie subkutane Knoten an den Armen. In den Histologien der Hautbiopsien zeigte sich ein diffuses, histiozytäres Infiltrat mit massenhaft stäbchenförmigen Bakterien. Aus dem Gewebe wurden Mycobacterium avium complex kultiviert und Mycobacterium-avium-complex-DNA nachgewiesen. Die Diagnose einer disseminierten Infektion konnte durch den kulturellen Nachweis von Mycobacterium avium complex im Blut, Sputum und Stuhl gesichert werden. Unter einer antibiotischen Kombinationstherapie heilten die Hautveränderungen innerhalb von 10 Wochen vollständig ab. Anhand des Falles werden die klinische Differentialdiagnostik, die notwendigen diagnostischen Maßnahmen und die Therapie der disseminierten Infektion mit Mycobacterium avium complex dargestellt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050481
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  • 3
    Electronic Resource
    Electronic Resource
    Umschriebene retikuläre Hyperpigmentierungen – ein weites klinisches Spektrum (1999)
    Springer
    Der Hautarzt 50 (1999), S. 580-585 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Retikuläre Hyperpigmentierung ; Morbus Dowling-Degos ; Morbus Kitamura ; Haber-Syndrom ; Genitale Hyperpigmentierung ; Key words Reticulate hyperpigmentation ; Dowling-Degos disease ; Reticulate acropigmentation of Kitamura ; Haber’s syndrome ; Genital hyperpigmentation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 34 year-old pregnant woman presented with reticulate pigmentation of the flexures, the dorsum of the hands and the genitoperianal region. She was in good health and her family history was unremarkable. Histologic examination of the hyperpigmented patches revealed pigmented filiform downgrowths of the interfollicular epidermis and follicular infundibula, as well as small epithelial cysts. Upon immunohistochemical and ultrastructural studies, the number of melanocytes appeared normal. The elongated dendritic processes of the melanocytes contained many mature melanosomes. In the adjacent keratinocytes large melanosomes did not aggregate into complexes. The diagnosis of localized reticulate pigmentary disorder was established. The knowledge of the broad clinical spectrum of localized reticulate hyperpigmentations with its favorable prognosis is of practical importance. Genital or flexural pigmented lesions have to be differentiated from melanosis of the vulva or acanthosis nigricans. The presented case gives further evidence that many of the proposed entities characterized clinically by reticulate pigmented macules and hyperkeratotic follicular lesions are different phenotypic expressions of the same autosomal dominant genodermatosis.
    Notes: Zusammenfassung Wir berichten über eine 34jährige gravide Patientin, bei der sich seit der Pubertät in den großen Beugen, an den Handrücken und genitoperianal dunkelbraune retikuläre Hyperpigmentierungen entwickeln. Histologisch finden sich umschrieben adenoide hyperpigmentierte Proliferationen der Epidermis und der Follikelinfundibula, vereinzelt imponieren kleine Epidermalzysten. Immunhistochemisch und elektronenmikroskopisch zeigt sich eine normale Anzahl von Melanozyten, ihre verlängerten Dendriten weisen gehäuft ausgereifte Melanosomen auf. In den umliegenden Keratinozyten sind die Melanosomen vergrößert und liegen überwiegend dispers verteilt vor, die Zahl der Melanosomenkomplexe ist reduziert. Aufgrund dieser Befunde konnte die Diagnose umschriebene retikuläre Hyperpigmentierung gestellt werden. Anhand des vorgestellten Falles werden das klinische Bild, die Ätiologie und die Behandlungsmöglichkeiten dieser komplexen Genodermatose diskutiert, deren mannigfaltige Erscheinungsformen lange Zeit als eigene Entitäten geführt wurden. Die Kenntnis des klinischen Spektrums der umschriebenen retikulären Hyperpigmentierungen ist insbesondere aufgrund der Differentialdiagnose zur Acanthosis nigricans und Melanosis der Vulva von praktischer Bedeutung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050962
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  • 4
    Electronic Resource
    Electronic Resource
    Grüne Haare durch häufiges Poolbaden (1997)
    Springer
    Der Hautarzt 48 (1997), S. 568-571 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Grüne Haare ; Exogene Haarverfärbung ; Kupfer ; Swimmingpool ; Key words Green hair ; Exogen hair discoloration ; Copper ; Swimmingpool
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Three patients presented with an acquired green discoloration of their scalp hair. History revealed that all of them swam regularly in private swimming pools. Examination of the hair by atomic emission spectroscopy showed that the green discoloration was caused by an excessively high copper content of the hair. This exogeneous discoloration is characteristically related to the uptake of copper from private swimming pools.
    Notes: Zusammenfassung Wir berichten über 3 Patienten mit einer erworbenen Grünverfärbung der Kopfbehaarung. Die Anamnese ergab, daß alle 3 Patienten regelmäßig im privaten Swimmingpool badeten. Die Untersuchung der Haare mittels Atomemissionsspektroskopie wies einen exzessiv hohen Kupfergehalt als Ursache der Grünverfärbung nach. An Hand unserer Beobachtungen möchten wir auf die charakteristische Verknüpfung dieser exogenen Haarverfärbung mit der Aufnahme von Kupfer durch Schwimmwasser hauseigener Schwimmbecken hinweisen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050628
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  • 5
    Electronic Resource
    Electronic Resource
    Hyperkeratosis lenticularis perstans (M. Flegel) (2000)
    Springer
    Der Hautarzt 51 (2000), S. 31-35 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter ; Hyperkeratosis lenticularis perstans ; Morbus Flegel ; Calcipotriol ; Vitamin D ; Key words ; Hyperkeratosis lenticularis perstans ; Flegel’s disease ; Calcipotriol ; Vitamin D
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Hyperkeratosis lenticularis perstans (Flegel’s disease) is a rare but clinically and histologically highly characteristic genodermatosis. We report on new immunohistochemical and ultrastructural findings suggesting a complex disorder of epidermal differentiation. In this context, a good response to calcipotriol, a synthetic vitamin D3 derivative is of particular interest.
    Notes: Zusammenfassung Die Hyperkeratosis lenticularis perstans (M. Flegel) ist eine autosomal-dominant vererbbare Genodermatose, bei der sich in der 2. Lebenshälfte bevorzugt an den unteren Extremitäten multiple, persistierende, hyperkeratotische Papeln entwickeln. In dem vorgestellten Fall eines 72jährigen Patienten zeigten unsere ultrastrukturellen und immunhistochemischen Untersuchungen eine stark verminderte Ausbildung regelrechter Keratohyalingranula sowie fehlende Expression von Filaggrin, Loricrin und Keratinen höheren Molekulargewichtes. Die Unterentwicklung der Odland Körperchen und die durch das Fehlen von Loricrin erklärbare mangelhafte Strukturierung des ”cornified envelopes” scheinen für die starke Retentionshyperkeratose verantwortlich zu sein. Die Therapie des M. Flegel ist schwierig. Vielversprechend erwies sich ein Therapieversuch mit einem synthetischen Vitamin-D3-Derivat (Calcipotriol), das erfolgreich in die komplexe Differenzierungsstörung dieser Genodermatose einzugreifen scheint.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050007
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  • 6
    Electronic Resource
    Electronic Resource
    Kongenitale Poikilodermie mit verruziformen Hyperkeratosen (Typ Dowling) (1998)
    Springer
    Der Hautarzt 49 (1998), S. 586-590 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Kongenitale Poikilodermie Typ Dowling ; Verruziforme Hyperkeratosen ; M. Bowen ; Spinaliom ; Dermabrasio ; Key words Congenital poikiloderma (type Dowling) ; Warty hyperkeratoses ; Bowen’s disease ; Squamous cell carcinoma ; Dermabrasion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A male patient with congenital poikiloderma (type Dowling) developed Bowen’s disease and initial squamous cell carcinoma. As the patient suffered from hypertriglyceridaemia (Frederickson type IV) and a long term tumor prophylaxis with retinoids was not appropriate, we attempted to treat the hyperkeratotic plaques with dermabrasion. After a period of six month we found complete healing of several plaques and only slight keratoses left in a few others. Long term follow up results are not yet available. Through this case report, the heterogenous clinical picture of congenital poikiloderma with warty hyperkeratoses and its high risk of malignancies is discussed.
    Notes: Zusammenfassung Wir berichten über einen Patienten mit kongenitaler Poikilodermie Typ Dowling, bei dem seit dem 52. Lebensjahr wiederholt M. Bowen und initiale Spinaliome in den Arealen der verruziformen Hyperkeratosen aufgetreten und exzidiert worden sind. Da eine längerfristige Tumorprophylaxe mit Retinoiden wegen einer Hypertriglyzeridämie Typ IV (nach Frederickson) nicht durchführbar war, entschlossen wir uns zu einem Behandlungsversuch mittels Dermabrasio. In einem Nachbeobachtungszeitraum von 12 Monaten zeigten sich mehrere komplett abgeheilte Hautveränderungen, daneben in einigen Arealen noch kleinere verbliebene Restkeratosen. Langzeitergebnisse stehen noch aus. Anhand des vorgestellten Falles wird das heterogene Krankheitsbild der kongenitalen Poikilodermie Typ Dowling diskutiert und auf das hohe Entartungsrisiko hingewiesen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050794
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  • 7
    Electronic Resource
    Electronic Resource
    Topische Anwendung von Capsaicin in der Dermatologie zur Therapie von Juckreiz und Schmerz (2000)
    Springer
    Der Hautarzt 51 (2000), S. 164-172 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Capsaicin ; Juckreiz ; Schmerz ; Polymodale Nervenfasern ; Neuropeptide ; Substanz P ; Key words Capsaicin ; Itch ; Pain ; Polymodal nerve fibres ; Neuropeptides ; Substance P
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background and Objectives. Treatment of pruritus as observed in many dermatological and internal diseases may be very often disappointing. There are many reports describing the topical use of capsaicin, the pungent agent in red pepper. Long term administration of capsaicin depletes neuropeptides in unmyelinated, polymodal C-type and small myelinated Aδ-type cutaneous nerves that conduct pruritus and pain. Patients/Methods. The aim of this study was to evaluate the efficacy, safety and practicability of capsaicin in the treatment of pruritus and pain of different origin in a total of 40 patients. Results. Capsaicin suppressed completely itch in all patients. Conclusions. In addition to its excellent antipruritic and analgetic effect, capsaicin significantly contributed to healing of some dermatoses, such as prurigo nodularis and psoriasis.
    Notes: Zusammenfassung Hintergrund und Fragestellung. Juckreiz ist eine schwer therapierbare Begleiterscheinung zahlreicher Dermatosen und innerer Erkrankungen. In den letzten Jahren wurde Capsaicin, ein Alkaloid aus der Paprikapflanze, als alternative Behandlungsmöglichkeit empfohlen. Capsaicin blockiert bei topischer Applikation nach einer initialen Phase der neurogenen Entzündung unmyelinisierte, polymodale C- und Aδ-Nervenfasern und unterdrückt dadurch selektiv Juckreiz und Schmerz. Patienten/Methodik. Es wurden 40 Patienten mit verschiedenen juckenden und schmerzhaften Erkrankungen mit Capsaicin behandelt. Im Folgenden wird über Möglichkeiten, Nebenwirkungen und Grenzen der Capsaicintherapie berichtet. Ergebnisse. Die topische Capsaicintherapie führte in sämtlichen Fällen zum vollständigen Sistieren des Juckreizes. Schlussfolgerungen. Neben seiner ausgezeichneten symptomatischen antipruritischen und analgetischen Wirkung greift Capsaicin in pathophysiologische Mechanismen bestimmter Dermatosen, v.a. der Prurigo nodularis und Psoriasis ein und unterstützt ihre Abheilung.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050051014
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  • 8
    Electronic Resource
    Electronic Resource
    Stimulation of keratinocyte differentiation – a new role for the vanilloid receptor subtype 1 (VR1/TRPV1)? (2005)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Experimental dermatology 14 (2005), S. 0 
    Details
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Vanilloids and endogenous cannabinoids mediate their actions via the vanilloid receptor subtype 1 (VR1/TRPV1), a non-selective cation channel, which is widely distributed in the central and peripheral nervous system. Only recently, VR1 has been shown to be expressed in keratinocytes in vitro and in vivo. However, a precise description of VR1 localization in epithelial cells was missing. To determine this, we investigated VR1-immunoreactivity as well as mRNA and protein expression in a series of biopsies from normal, diseased, and capsaicin-treated human skin. VR1 was found in epidermal keratinocytes, the inner root sheet and the infundibulum of hair follicles, differentiated sebocytes, sweat gland ducts, and the secretory portion of eccrine sweat glands upon immunohistochemistry, RT-PCR and Western blot analysis. Interestingly, in diseased skin such as prurigo nodularis, psoriasis vulgaris, and atopic dermatitis, VR1 expression in keratinocytes correlated with the degree of epidermal differentiation. Enhanced VR1 immunoreactivity and protein content was found in prurigo nodularis in which epidermal keratinocytes are highly differentiated. Under effective capsaicin therapy of prurigo nodularis, the epidermis thinned and the distribution pattern of VR1 on epidermal keratinocytes normalized. In psoriasis vulgaris, a disease with disturbed epidermal differentiation, less intense immunostaining for VR1 was observed. This could be confirmed by western blot analysis showing less VR1 protein amount in comparison to prurigo nodularis although histologically both showed a thickened epidermis. In atopic dermatitis, which is characterized by a moderate epidermal hyperplasia only and regular differentiated keratinocytes, VR1 immunoreactivity was unchanged in comparison to normal skin. These findings suggest that VR1 may contribute to regular differentiation of keratinocytes. VR1 activation opens non-selective cation channels with high permeability to calcium, a ion that is crucially important for the synthesis of cornification proteins such as involucrin, fillagrin and loricrin. The role of VR1 in other epithelial cells of appendage structures remains to be determined. In summary, VR1 is widely distributed in the skin suggesting a central role for this receptor not only in nociception but also maturation and function of epithelial cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0906-6705.2005.0266h.x
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  • 9
    Electronic Resource
    Electronic Resource
    Indeterminate cell histiocytosis: fact or fiction? (2005)
    Oxford, UK; Malden, USA : Munksgaard International Publishers
    Journal of cutaneous pathology 32 (2005), S. 0 
    Details
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  Indeterminate cell histiocytosis is a rare disorder, in which the predominant cells have the characteristics of both Langerhans cells and macrophages. We, in this study, describe 18 patients and compare them with those previously published. Most patients were adults with either solitary or multiple red-brown papules or nodules. While most lesions were confined to the skin, both conjunctival and bony involvement was seen. Histologically, the lesions showed patterns resembling those described for xanthogranulomas, with predominantly oncocytic (nine patients), spindled (five patients), scalloped (two patients) or vacuolated (two patients) macrophages. The accompanying infiltrate was mainly lymphocytic, although eosinophils and occasionally plasma cells were seen. All lesions were positive for macrophage markers, such as KP1 (CD68) and Ki-M1p, as well as for S-100 protein and showed variable reactivity for CD1a. No Birbeck granules were seen ultrastructurally in one patient. Some patients shared features with sinus histiocytosis with massive lymphadenopathy. It is unclear whether this disorder is a separate entity or represents various macrophage disorders identified at various time points in the inflammatory response.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0303-6987.2005.00382.x
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  • 10
    Electronic Resource
    Electronic Resource
    Fibroblastic/myofibroblastic sarcoma of the skin: a report of five cases (2003)
    Oxford, UK : Munksgaard International Publishers
    Journal of cutaneous pathology 30 (2003), S. 0 
    Details
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: A number of malignant soft tissue tumors, particularly those of fibroblastic and fibrohistiocytic derivation, have been found to display myofibroblastic differentiation focally. The term myofibroblastic sarcoma, a controversial presumably distinctive entity, defines a malignant soft tissue tumor in which myofibroblasts are quantitatively the predominant cell type.Methods: Five cases of cutaneous spindle-cell sarcomas showing fibroblastic-myofibroblastic differentiation with predominance of fibroblasts were retrieved from the files of three large centers of dermatopathology. Tumors were analyzed histopathologically, immunophenotypically, and, in two cases, ultrastructurally. Results were compared with those previously reported in fibrosarcoma, malignant fibrous histiocytoma, and myofibroblastic sarcoma.Results: Immunophenotypic and ultrastructural profiles of the cases analyzed in this series were closer to fibrosarcoma and to malignant fibrous histiocytoma than to myofibroblastic sarcoma by virtue of quantitative predominance of fibroblasts over myofibroblasts. On the other hand, histopathologic findings were in keeping with those reported in myofibroblastic sarcoma.Conclusions: Our series highlights the intrinsic problems in attaching certain cutaneous sarcomas with fibroblastic-myofibroblastic differentiation to one of the recognized entities and gives support to the hypothesis that fibrosarcoma, malignant fibrous histiocytoma, and myofibroblastic sarcoma are related histogenetically.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1034/j.1600-0560.2003.00014.x
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