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Biomedical subjects

B Eberlein-König

Publications and source records attributed to B Eberlein-König.

At least 19 recordsLinked to original sources

The course of eczema in children aged 5-7 years and its relation to atopy: differences between boys and girls.

BACKGROUND: The role of atopy in the pathophysiology of eczema is still under debate. The concept and analyses of the nonatopic and atopic subtypes of eczema have gained increasing interest in recent studies. The course of these subtypes and differences between boys and girls have not been investigated so far. OBJECTIVES: To examine the course of nonatopic and atopic eczema in preschool children from Germany with regard to sex. METHODS: Repeated cross-sectional studies were performed in 5-7-year-old preschool children from Germany between 1994 and 2000. Individuals with eczema were identified by a dermatological examination. In addition to a questionnaire, skin prick tests and analyses of serum IgE antibodies against seven and five environmental allergens, respectively, were performed. Atopy was defined by sensitization to at least one of five common aeroallergens (birch, grass and mugwort pollen, house dust mites, cat dander). In part of the study population investigations of spare time behaviour and skin function were carried out (including stratum corneum hydration and skin surface pH). RESULTS: A total of 2693 girls and 2783 boys underwent a full dermatological examination of the skin and determination of sensitization. Among the girls, 8.7% demonstrated eczema clinically at the day of investigation in contrast to 6.1% of the boys. In girls, early onset eczema (< 2 years of age) was strongly related to atopy at age 5-7 years [odds ratio (OR) 3.7; 95% confidence interval (CI) 2.7-5.1], whereas late-onset eczema (> or = 2 years of age) was not (OR 1.0; 95% CI 0.7-1.5). Boys were more often atopic at the age of 5-7 years than girls (28.3% vs. 20.6%), and early and late-onset eczema were related to atopy without such a difference (OR 2.8, 95% CI 2.0-4.0; OR 1.9, 95% CI 1.3-2.8, respectively). The excess of current eczema in 5-7-year-old girls compared with boys was related to the nonatopic type. The higher susceptibility of girls in that age group to develop eczema was reflected by the skin physiological examination: even girls without eczema had significantly higher skin surface pH and lower stratum corneum hydration than boys. Additionally, questionnaire data revealed that girls more often than boys predominantly played indoors, which was associated with more eczema. CONCLUSIONS: Atopy and eczema develop differently in boys and girls. Boys are more often atopic, whereas girls suffer significantly more often from eczema without relation to atopy. The nonatopic type of eczema in preschool girls is noticed predominantly after their second birthday. Genetic and lifestyle factors may contribute to this difference.

Age of Onset↗

Influence of short-term exposure to airborne Der p 1 and volatile organic compounds on skin barrier function and dermal blood flow in patients with atopic eczema and healthy individuals.

BACKGROUND: Epidemiological studies indicate environmental pollutants to be involved in the increase in the prevalence of allergic diseases. In human exposure studies, volatile organic compounds (VOCs) have been shown to cause exacerbations of allergic asthma whereas, no data concerning atopic eczema (AE) are available. OBJECTIVE: We investigated the effect of airborne VOCs on the skin of patients with AE and controls in the presence or absence of house dust mite allergen, Der p 1. METHODS: In a double-blind crossover study, 12 adults with AE and 12 matched healthy volunteers were exposed on their forearms to Der p 1 and subsequently to a mixture of 22 VOCs (M22, 5 mg/m(3)) in a total body exposure chamber for 4 h. Transepidermal water loss (TEWL) and skin blood flow were measured in all subjects before, during and after exposure. Additionally, an atopy patch test (APT) with Der p 1 was applied to the skin after exposure. RESULTS: A significant increase in transepidermal water loss was observed 48 h after exposure to VOCs as compared with exposure with filtered air in all individuals (mean difference: +34%; 95% Confidence Interval: 7-69%). Prior Der p 1 exposure resulted in a significant rise of dermal blood flow after 48 h in patients with AE but not in controls. Six out of seven patients showed enhanced atopy patch test (APT) reactions to HDM allergen after previous exposure to VOCs. CONCLUSION: Our results show that exposure to VOCs - at concentrations commonly found in indoor environments - can damage the epidermal barrier and enhance the adverse effect of Der p 1 on sensitized subjects with AE. These findings may contribute to a better understanding of the mechanisms underlying the increase in prevalence and exacerbation of AE.

Adult↗

Comparison of basophil activation tests using CD63 or CD203c expression in patients with insect venom allergy.

BACKGROUND: Flow cytometric basophil activation tests have been developed as cellular tests for in vitro diagnosis of IgE-mediated reactions. Different activation markers (CD63 or CD203c) with distinct ways of regulation have been used after stimulation with various allergens. OBJECTIVE: It was the aim of the present study to compare basophil activation tests by measuring both CD63 and CD203c upregulation in patients with insect venom allergy. MATERIALS AND METHODS: 43 patients with a history of insect venom anaphylaxis were examined. A careful allergy history was taken, and skin tests and determination of specific IgE-antibodies were performed. Basophil activation tests (BAT) using CD63 or CD203c expression were done after stimulation with different concentrations of bee and wasp venom extracts. 25 healthy subjects with negative history of insect venom allergy were studied as controls. RESULTS: The CD203c protocol showed a slightly higher sensitivity than the CD63 protocol (97% vs. 89%) with regard to patients' history. The magnitude of basophil response was higher with CD203c in comparison to CD63 for both insect venoms. Specificity was 100% for the CD63 protocol and 89% for the CD203c protocol with regard to controls with negative history and negative RAST. CONCLUSION: These results support the reliability of basophil activation tests using either CD63 or CD203c as cellular tests in the in vitro diagnosis of patients with bee or wasp venom allergy with a slightly higher sensitivity for the CD203c protocol.

Allergens↗

In vitro basophil activation using CD63 expression in patients with bee and wasp venom allergy.

The diagnosis of insect venom allergy and the indication for specific immunotherapy is based on history, skin tests and demonstration of hymenoptera venom-specific IgE-antibodies. Cellular tests can add useful information but the role of basophil activation tests for the different venoms has to be elucidated further. We evaluated positive reactions in a basophil activation test using CD63 expression as marker independently for bee or wasp venom in patients with hymenoptera allergy. Fifty-seven patients with a history of insect venom anaphylaxis were examined (12 x bee venom, 39 x wasp venom, 6 x bee plus wasp venom). Skin tests and determination of specific IgE-antibodies were performed. Basophil activation test (BAT) using CD63 expression was performed after stimulation with different concentrations of bee and wasp venom. The BAT is based on double staining with anti-IgE antibodies and anti-CD63 and subsequent determination of the percentage of activated basophils by flow cytometry. In patients with bee venom allergy, BAT was positive in 100% to bee venom and 75% to wasp venom. In patients with bee and wasp venom allergy, positive reactions for both venoms were found in 100%. In patients with wasp venom allergy, 97% reacted positive to wasp venom and only 56% to bee venom. These results show the reliability of the basophil activation test as a cellular test in the in vitro diagnosis in patients with bee and wasp venom allergy. They also show that positive reactions in the basophil activation test reflect both sensitization status and cross-reactivity between venom species.

Adolescent↗

Successful UVA1 phototherapy in a patient with scleredema adultorum.

Scleredema adultorum is a rare connective tissue disorder of unknown cause. Both bath-PUVA and cream-PUVA therapy were reported to be effective. We describe a patient with scleredema adultorum who showed a striking clinical improvement with a medium-dose UVA1 phototherapy (single dose, 50 J/cm(2); 35 treatments).

Humans↗

Relevance of vitamins C and E in cutaneous photoprotection.

Ultraviolet (UV) radiation-induced oxidative stress may result in acute and chronic photodamage. Based on the endogenous antioxidant system, the administration of antioxidants for scavenging reactive oxygen species might be a promising strategy in the prevention of UV-induced skin reactions. The relevance of the most common antioxidants, vitamins E and C, is reviewed focusing on topical and systemic photoprotective effects in animals and humans. Topically applied vitamin C induced significant photoprotective effects at concentrations of at least 10% in animals and humans, whereas a photoprotective effect has not been demonstrated by oral administration even at high doses in humans. Topical vitamin E reduced erythema, sunburn cells, chronic UV-B-induced skin damage, and photocarcinogenesis in the majority of the published studies, whereas only high doses of oral vitamin E may affect the response to UV-B in humans. Combination of vitamins C and E, partly with other photoprotective compounds, did increase the photoprotective effects dramatically compared to monotherapies. This synergistic interplay of several antioxidants should be taken into consideration in future research on cutaneous photoprotection.

Journal Article↗

Disseminated granuloma annulare--treatment with fumaric acid esters.

BACKGROUND: The therapy of disseminated granuloma annulare has often limited success. Treatment of granuloma annulare with fumaric acid esters (FAE) has recently been reported to be effective in 2 patients. OBJECTIVES: To assess the efficacy of a systemic therapy with FAE in consecutive patients with disseminated granuloma annulare. METHODS: Eight patients with disseminated granuloma annulare were treated with FAE in tablet form according to the standard therapy regimen used in psoriasis. The colour and the elevation of the skin lesions were assessed by a visual analogue scale before and after therapy. RESULTS: Systemic therapy with FAE induced a significant clinical improvement in elevation and colour of skin lesions, with remission in 3 and partial remission in 4 patients. One patient remained unchanged. Side-effects associated with the therapy were seen in 6 patients. CONCLUSIONS: Systemic therapy with FAE can be effective in patients suffering from disseminated forms of granuloma annulare, but side-effects of FAE have to be taken into consideration.

Administration, Oral↗

Use of CD63 expression as marker of in vitro basophil activation in identifying the culprit in insect venom allergy.

BACKGROUND: The diagnosis of insect venom allergy and the indication for specific immunotherapy is based on history, skin tests and demonstration of hymenoptera venom specific IgE-antibodies. In cases with contradictory test results additional cellular tests are recommended. OBJECTIVE: We evaluated the usefulness of a newly introduced test based on basophil CD63 expression as marker of activation in comparison with the basophil histamine release test (BHR) and the cellular antigen stimulation test (CAST) measuring leukotriene release. METHODS: In 14 patients (10 males, 4 females; age; 12 to 67 years, mean: 42.5 +/- 15.1 years) with systemic reactions to hymenoptera stings in their history skin tests and determination of specific IgE-antibodies (CAP-RAST-FEIA) had shown inconsistent results: No demonstration of specific IgE-antibodies (n = 4), one sting by an unknown insect together with positive skin test and/or positive RAST to both bee and wasp venom (n = 4), several stings of partly unknown insects with positive skin test and/or demonstrable specific IgE-antibodies to more than one insect venom (n = 4), uncertain history and divergent results in skin test and/or RAST (n = 2). BHR, CAST and basophil activation test (BAT) were done according to the manufacturers with negative and positive controls and different concentrations of bee and wasp venom. The BAT is based on double staining with anti-IgE antibodies and anti-CD63 and subsequent determination of the percentage of activated basophils by flow cytometry. RESULTS: BAT and skin test were concordant in 42.9%, BAT and RAST in 57.1%. Concordance of all three cellular tests was seen in 57.1%, of BAT and BHR in 69.1%, of BAT and CAST in 78.6% and of BHR and CAST in 64.3%. In 6 cases where the three cellular tests (BHR, CAST, BAT) were not in accordance the addition of BAT led to a more reliable diagnostic result concerning the relevant insect in 3 cases and added no further information in 3 cases. BAT in controls always was negative. Correlation between CAST and BAT was higher than between CAST and BHR. CONCLUSIONS: In difficult cases of hymenoptera allergy, where history, skin tests and determination of specific antibodies do not allow a clear decision regarding the relevant insect species for immunotherapy, the additional performance of cellular tests (CAST and BAT) may be helpful.

Adolescent↗

[Scrotal leiomyoma].

Genital leiomyomas of the scrotal skin are extremely rare benign tumors, originating from the tunica dartos of the scrotum. We describe a 55-year-old caucasian male with a 3-year history of a slowly growing asymptomatic scrotal knot which was first clinically regarded as a cyst and finally diagnosed histopathologically as leiomyoma. This typical case demonstrates that leiomyomas should be considered in the differential diagnosis of scrotal tumors.

Diagnosis, Differential↗

[Skin allergies].

Explore the source record for details and available documents.

Dermatitis, Allergic Contact↗

[Allergy and the environment].

The prevalence of allergic diseases has increased in modern Western countries during the last decades. Among the hypotheses for the reasons the idea that environmental pollutants may play a role is intensively discussed. In order to characterise the influence of these pollutants on the development, elicitation and chronification of allergic reactions (allergotoxicology) epidemiological, clinical and experimental data have to be considered. These investigations showed that among the pollutants with an enhancing effect on allergic diseases pollution types with nitrogen oxides (NOx), ozone (O3), tobacco smoke, particulate matter and diesel exhaust particles are of special interest.

Air Pollutants↗

Internet advice in dermatology and allergy: 1 year analysis of telerequests and answers.

The purpose of this study was to analyze the content and objectives of questions asked by internet users who accessed the homepage of the Department of Dermatology and Allergy Biederstein at the Technical University of Munich. Users were offered the opportunity to ask free questions on the Web site. The results of lay and medical individuals seeking advice were collected over a 12 month period and the answers given were reviewed. We received inquiries from 279 laypersons and 31 physicians. The majority of questions (53.8%) asked by non-medical users dealt with dermatology-related problems. Inquiries related to hair (13.3%) and acne or rosacea (11.3%) were most common. 46.2% of e-mail requests were allergy-related. Most of the interest focused on food allergy and adverse food reactions (22.5%) or hay fever and perennial rhinoconjunctivitis (19.4%). Previous consultation of a physician was reported in 40.9%. 13.6% had consulted an allergist or dermatologist. The majority of questions asked by physicians concerned allergy-related topics (64.6%). Most questions were answered by a short letter giving advice and encouraging the non-medical user to visit a dermatologist and/or allergist (72.4%). In 27.6% we felt that the inquiries were answered completely.

Adult↗

Systemic vitamin C and vitamin E do not prevent photoprovocation test reactions in polymorphous light eruption.

The possible influence of oxidative stress is discussed in the pathogenesis of polymorphous light eruption (PLE). A double-blind, placebo-controlled study of prophylactic treatment with systemic administration of vitamin C (3 g/d) and E (1500 IU/d) for 8 days was undertaken in 9 patients with PLE (verum, n=4; placebo, n=5). Evaluation of the maximal effects after photoprovocation before and after intake of the antioxidants revealed a reduction of most skin reactions (overall skin reaction, papules/vesicles) in both groups with marked differences in the placebo group. The antioxidants in the doses given and over the time period used did not influence the development of PLE, but might interfere with immunosuppressive effects of repeated photoprovocation tests.

Administration, Oral↗