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  • 1
    Electronic Resource
    Electronic Resource
    Novel pharmacological approaches in the treatment of psoriasis (2005)
    Oxford, UK : Blackwell Science Ltd
    Journal of the European Academy of Dermatology and Venereology 19 (2005), S. 0 
    Details
    ISSN: 1468-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Progress in the understanding of psoriasis as a T-cell mediated inflammatory disease has led to the development of new immunomodulatory therapies. Currently the main focus is on the so-called biologics (or biological agents), including fusion proteins, monoclonal antibodies, cytokines and selective receptors. They mainly target single steps in the complex cascade of humoral and cellular inflammatory immunomechanisms that finally lead to the accelerated growth of epidermal and vascular cells in the psoriatic lesions. The most promising and advanced biological agents are discussed along with their influence on the critical pathophysiological steps in psoriasis, including depletion of T cells, blockade of initial T-cell activation and T-cell receptor (TCR) stimulation, blockade of costimulatory signals and T-cell proliferative signals as well as restoration of the T helper type 1 (Th1)/Th2 balance by diminishing type 1 cytokines and administration of type 2 cytokines. In addition to the biological agents, further development of ‘classical’ dermatological therapies, such as retinoids, or the discovery of new indications for non-dermatological agents contribute to the novel pharmacological approaches in the treatment of psoriasis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1468-3083.2004.01070.x
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  • 2
    Electronic Resource
    Electronic Resource
    Cyclophosphamide–dexamethasone pulsed therapy for treatment of recalcitrant necrobiotic xanthogranuloma with paraproteinemia and ocular involvement (2005)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 153 (2005), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.2005.06737.x
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  • 3
    Electronic Resource
    Electronic Resource
    Keratinocyte-derived cytokines after photodynamic therapy and their paracrine induction of matrix metalloproteinases in fibroblasts (2004)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 151 (2004), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Recent studies have shown that collagen-degrading matrix metalloproteinase (MMP)-1 and MMP-3 are produced by fibroblasts in response to photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) and are considered to be involved in the antisclerotic effects of ALA-PDT observed in the treatment of localized scleroderma.Objectives  As the primary target of topical PDT is epidermal keratinocytes, we studied the indirect participation of keratinocytes in the production of MMPs and collagen by dermal fibroblasts.Methods  Keratinocytes were treated with sublethal doses of ALA (100 µmol L−1) and red light. The conditioned media were collected 24 h after PDT and primary human fibroblasts were exposed to these media for 6–48 h. Further, a coculture model, keratinocytes seeded on to collagen type IV-coated transwells in the upper chamber and fibroblasts in the lower chamber, was used to study paracrine effects of keratinocytes after PDT.Results  Keratinocyte supernatants after PDT showed a significant, up to 10-fold increase of interleukin (IL)-1α and a 2·5-fold increase of tumour necrosis factor-α as determined by enzyme-linked immunosorbent assay, while IL-6, MMP-1 and MMP-3 were not altered significantly. Fibroblasts treated with keratinocyte-conditioned media after PDT showed an induction of MMP-1 and MMP-3 protein levels up to threefold in both models used, suggesting that ALA-PDT modulates MMP-1 and MMP-3 production via indirect mechanisms. Collagen type I mRNA expression by fibroblasts was not altered significantly in either model. The addition of an IL-1 receptor antagonist to the keratinocyte-conditioned media completely inhibited the induction of MMP-1 and MMP-3 in stimulated fibroblasts, suggesting that IL-1 is mainly responsible for the observed paracrine effects.Conclusions  We present evidence that PDT can trigger MMP production in dermal fibroblasts not only directly as has been already shown, but also by an indirect paracrine loop mediated by soluble factors released by epidermal keratinocytes.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.2004.06209.x
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  • 4
    Electronic Resource
    Electronic Resource
    Histopathological diagnosis of onychomycosis by periodic acid–Schiff-stained nail clippings (2003)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 148 (2003), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary Background The current laboratory methods for diagnosing fungal infections of the nails are the potassium hydroxide (KOH) scraping technique and fungal culture. However, due to the long incubation period required for fungal culture and the reported rate of approximately 30% false negative results observed when using these methods, a quick and highly specific screening test for diagnosing onychomycosis is urgently needed. Objectives In a prospective study, to compare the traditional mycological diagnostics using culture medium and KOH preparation with the histopathological diagnosis of onychomycosis by periodic acid–Schiff (PAS)-stained nail clippings. Methods Material from 387 nails of 350 patients suspected of having onychomycosis was obtained and a KOH stain as well as two fungal cultures (Kimmig agar with and without cycloheximide) were prepared. In addition, the same specimen was histopathologically examined (PAS stain). Results Culture medium and KOH preparation respectively revealed 100 and 156 cases of onychomycosis, as compared with 182 cases by histological examination. Histological examination gave a significantly higher rate of positive results (P 〈 0·05). Considering the total number of positive results given by at least one of the three methods (total = 438), histological evaluation was found to give the highest rate of successful recognition of mycotic infection (41·6%). Conclusions The histopathological evaluation of PAS-stained nail clippings is very quick and easy to perform, and will increase the frequency of diagnosing onychomycotic disease above that achieved by culture and KOH preparation alone. However, because information concerning the vitality of the fungi and accurate identification of the specific pathogen is not available through this investigation alone, mycological culture continues to remain the indisputable ‘gold standard’ of mycological diagnostics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2003.05029.x
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  • 5
    Electronic Resource
    Electronic Resource
    Simultaneous occurrence of folliculitis decalvans capillitii in identical twins (2000)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 143 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Folliculitis decalvans is a chronic purulent folliculitis resulting in permanent hair loss and follicular atrophy. We report 32-year-old identical female twins presenting with relapsing pruritic outbreaks on the scalp resulting in areas of permanent baldness. Staphylococcus aureus was detected in the lesions of both women. Histopathology confirmed the diagnosis of folliculitis decalvans. Immunological testing showed no alteration of the immune system. To our knowledge, this is the first report on folliculitis decalvans occurring in identical twins, suggesting a possible genetic component in this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2000.03616.x
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  • 6
    Electronic Resource
    Electronic Resource
    Epidermodysplasia verruciformis treated using topical 5-aminolaevulinic acid photodynamic therapy (1999)
    Oxford BSL : Blackwell Science Ltd
    British journal of dermatology 140 (1999), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We describe a 65-year-old woman who had had wart-like lesions on the hands, lower arms and forehead for about 45 years. She had already had several basal cell carcinomas excised. Histological study, electron microscopy and in situ hybridization [human papilloma virus (HPV)-types 5/8/12/14/19–23/25/36] of skin biopsies confirmed a diagnosis of epidermodysplasia verruciformis (EV). Photodynamic therapy (PDT) was performed using a 20% 5-aminolaevulinic acid ointment applied for 6 h to the lesions and irradiating using an incoherent light source (λ = 580–740 nm, 160 mW/cm2, 160 J/cm2). Following PDT, blistering and crusting of the lesions occurred, but these healed completely within 2–3 weeks without scarring, and the cosmetic result was excellent. Six months after PDT a skin biopsy was taken. In situ hybridization was positive for HPV type 8 in skin which was clinically and histologically normal. Twelve months after PDT a few lesions had recurred on the hands. Although permanent cure of EV cannot be achieved by any therapy at present and single lesions continue to appear in this patient, topical PDT might result in better control of HPV-induced lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.1999.02830.x
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  • 7
    Electronic Resource
    Electronic Resource
    Successful treatment of hydroxyethyl starch-induced pruritus with topical capsaicin (1994)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 131 (1994), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report a case of recalcitrant pruritus after infusion therapy with hydroxyethyl starch (HES) for sudden deafness. The diagnosis was confirmed by detection of typical HES storage vacuoles within dermal macrophages and perineural cells. Treatment with antihistamines and antipruritic agents, UVB irradiation, and neuroleptic drugs, was ineffective. Topical capsaicin (0.05%) twice daily produced excellent symptomatic relief, without side-effects.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2133.1994.tb08529.x
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  • 8
    Electronic Resource
    Electronic Resource
    Topische photodynamische Therapie in der Behandlung oberflächlicher Hauttumoren (1995)
    Springer
    Der Hautarzt 46 (1995), S. 315-318 
    Details
    ISSN: 1432-1173
    Keywords: Key words Photodynamic therapy — 5-aminolevulinic acid — Basal cell carcinoma — Bowen's disease ; Schlüsselwörter Photodynamische Therapie — 5-Aminolävulinsäure — Basaliom — Morbus Bowen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Photodynamic therapy (PDT) is an experimental treatment modality which is based on photochemical destruction of tumour tissue by means of different sensitizers and irradiation with red light. The greatest disadvantage of systemic administration of photosensitizers (mostly porphyrins) is cutaneous photosensitization of the patient, which lasts for some months. An alternative therapeutic technique for superficial skin tumours is the topical application of sensitizers, especially 5-aminolevulinic acid (ALA). Therapeutic selectivity derives from enhanced ALA penetration across abnormal parakeratotic stratum corneum and from preferential accumulation of bioconverted protoporphyrin IX, which serves as photosensitizer in cells of epithelial origin. Two patients suffering from different epithelial tumours (superficial basal cell carcinoma, Bowen's disease) and treated with topical PDT after ALA application are reported. Both tumours showed complete remission, and up to 12 months after treatment there were no clinical or histological signs of tumour recurrence. Cosmetic results were good.
    Notes: Zusammenfassung Die photodynamische Therapie (PDT) ist ein experimentelles Therapieverfahren, welches auf einer Photodestruktion von Tumorzellen nach Sensibilisierung und nachfolgender Bestrahlung mit kohärentem oder inkohärentem Licht (λ = 630 nm) beruht. Wesentlicher Nachteil der systemischen Gabe von Photosensibilisatoren (in der Regel Porphyrin-Derivate) ist die über Monate anhaltende Lichtempfindlichkeit der Patienten. Bei kleineren oberflächlichen Tumoren der Haut stellt die topische Gabe von Sensitizern (insbesonder 5-Aminolävulinsäre, ALA) eine wirkungsvolle Alternative mit hoher therapeutischer Selektivität dar. ALA penetriert dabei bevorzugt durch parakeratotische Hornschichten und wird vornehmlich in Zellen epithelialen Ursprungs zu dem potenten Photosensibilisator Protoporphyrin IX umgesetzt. Anhand 2er Patienten mit epithelialen Tumoren (oberflächliches Basaliom, M. Bowen) wird die Behandlung mittels PDT nach topikaler ALA-Gabe demonstriert. In der Nachbeobachtung (bis 12 Monate) zeigte sich in beiden Fällen eine klinisch und histologisch vollständige Tumorrückbildung ohne Anhalt für ein Rezidiv bei gutem kosmetischen Ergebnis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050258
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  • 9
    Electronic Resource
    Electronic Resource
    Ektopes Parotisgewebe – Eine ungewöhnliche Differentialdiagnose zervikaler zystischer Tumoren (2000)
    Springer
    Der Hautarzt 51 (2000), S. 865-868 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Ektopes Speicheldrüsengewebe ; Zervikale Tumoren ; Parotistumoren ; Keywords Ectopic salivary gland tissue ; Cervical tumors ; Parotid gland tumors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Cystic tumors of the neck are usually cysts, inflamatory masses, lymph nodes, benign and malignant tumors or metastases. Malformations are less common. Ectopic salivary tissue is a rather rare but clinically important malformation. Accessory and aberrant tissue can be identified histologically. There may be an association with lymphatic tissue. Possible complications include inflammation as well as the development of benign and in rare cases malignant salivary gland tumors. We report on two patients who underwent surgical treatment under the tentative diagnosis of epidermal cysts which histologically turned out to be ectopic parotid tissue.
    Notes: Zusammenfassung Die Differentialdiagnose zervikaler zystischer Tumoren ist vielfältig. Zu denken ist zunächst an Zysten, entzündliche Tumoren und Lymphknoten, benigne und maligne Tumoren bzw. Metastasen. Erst an zweiter Stelle stehen Fehlbildungen. Ektopes Speicheldrüsengewebe ist eine relativ seltene, aber auf Grund seiner Komplikationen wichtige Fehlbildung. Entscheidend ist zum einen die Unterscheidung zwischen akzessorischem oder aberrierendem Gewebe, zum anderen die Klärung der Frage, ob eine Assoziation zu lymphatischem Gewebe besteht. In ektopem Speicheldrüsengewebe können sich neben Entzündungen vor allem gutartige, in sehr seltenen Fällen auch bösartige Tumoren entwickeln. Wir berichten über zwei Patienten, denen unter der Verdachtsdiagnose von epidermalen Zysten ektopes Parotisgewebe entfernt wurde.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050051232
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  • 10
    Electronic Resource
    Electronic Resource
    Fluoreszenzgestützte Biopsie von Basalzellkarzinomen (2000)
    Springer
    Der Hautarzt 51 (2000), S. 920-924 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Basalzellkarzinom ; Fluoreszenz ; Biopsie ; 5-Aminolävolinsäure ; Digitale Bilderarbeitung ; Keywords Basal cell carcinoma ; Fluorescence ; Biopsy ; 5-Aminolaevulinic acid ; Digital Imaging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Background and Objective. The diagnosis of precancerous and cancerous skin leasons in pretreated or scarred skin can be difficult. The determination of the right biopsy site in a suspected area depends largely on the physician's experience. Patients/Methods. The possibility of using a CCD-camera system and measuring tumor fluorescence following topical application of 5-aminolevulinic acid was employed in a single case to facilitate accurate choice of biopsy site. Results. An user-independent evaluation of the induced fluorescence intensity was achieved by means of the described optical system and digital imaging. The contrast of the acquired fluorescence images can be significantly enhanced and allows the determination of a threshold. As result an initial, clinically not visible basal cell carcinoma was detected and excised by a punch biopsy in toto. Conclusions. Using the described optical system the early recognition of a superficial basal cell carcinoma and the determination of the exact biopsy site was achieved in pretreated skin. The routine employment of the system will be assessed in a prospective study.
    Notes: Zusammenfassung Hintergrund und Fragestellung. Die Diagnose von präkanzerösen oder kanzerösen Hautveränderungen in vorbehandelten oder vernarbten Arealen kann oft sehr schwierig sein. Insbesondere hängt die richtige Wahl der Entnahmestelle von Gewebeproben zum Malignitätsausschluss von der Erfahrung des behandelnden Arztes ab. Patienten/Methodik. In dieser Arbeit soll anhand eines Fallberichtes dargestellt werden, wie durch die Verwendung eines CCD-Kamera-Systems und der Fluoreszenzdiagnostik nach topischer Applikation von 5-Aminolävulinsäure eine gezielte Entnahme von Gewebeproben stattfinden kann. Ergebnisse. Mithilfe des verwendeten optischen Systems und digitaler Bildverarbeitung wurde eine benutzerunabhängige Bewertung der gemessenen Fluoreszenzintensitäten möglich. Zudem konnte der Kontrast in den Fluoreszenzbildern entscheidend verstärkt und ein Schwellwert für einen Malignitätsverdacht festgelegt werden. Im vorliegenden Fall konnte so ein initiales, subklinisches Basalzellkarzinom detektiert werden, das bei der anschließenden Biopsie in toto exzidiert wurde. Schlussfolgerungen. Durch das vorgestellte System sind eine frühzeitige Erkennung von oberflächlichen Basalzellkarzinomen und eine gezielte Gewebeentnahme möglich. Die routinemäßige Einsetzbarkeit des Systems wird in einer größer angelegten Studie überprüft werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050051240
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