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Biomedical subjects

C Luderschmidt

Publications and source records attributed to C Luderschmidt.

At least 37 records · Page 2Linked to original sources
PubMed1985

Drug-induced toxic epidermal necrolysis (Lyell's syndrome) in a 4-year-old girl.

Toxic epidermal necrolysis (Lyell's syndrome) with erythematous skin lesions and bulla formation developed in a 4-year-old girl. An accurate diagnosis using the cryostat technique on the top of a bulla was available within 1 h of hospital admission. The course was unusually mild, probably because of early treatment with corticosteroids. Skin prick tests revealed salicylamide as the agent responsible for inducing the disease. The patient was advised to avoid this substance for the rest of her life.

Child, Preschool↗
PubMed1985

Gonoblennorrhoea adultorum (gonococcal conjunctivitis)--a "disappearing disease" which does not disappear.

Gonoblennorrhoea adultorum (GA) still occurs in spite of contrary statements. During the last 10 years, 4 cases were seen in the Munich Clinic of Dermatology (constituting 0.19% of all patients with gonorrhoea). While the conjunctivae alone were involved in 3 of them, in 1 the cornea showed alterations as well. Thus, the disease has not lost its potential danger. Yet the newer cephalosporins seem to cure GA rapidly, even if given in a single dose (together with local treatment).

Adult↗
PubMed1985

[Circumscribed scleroderma: internal manifestations and significant correlation to HLA-DR1 and DR5].

In 44 patients with morphea the incidence of internal organ involvement was studied. For the clinical study, only patients with disseminated (22 patients), linear (20 patients), and generalized morphea (2 patients) were considered. Systemic parameters were determined for inflammation and the function of the esophagus, lung, heart and kidneys. In 22 patients, mostly with the linear form of morphea, the muscles were studied by electromyography. In 23 patients the HLA-A, HLA-B, HLA-C and HLA-DR patterns were determined; 27% of the patients showed systemic organ manifestations. Esophagus function was impaired in 10 and lung function in 6 cases; 15 patients showed myositis. The degree of systemic involvement was correlated with the type of morphea and the grade of systemic inflammation. Generalized morphea showed a high rate of organ involvement (2 of 2); in linear morphea organ involvement was reduced to 34% and in the disseminated form, to 14%. There was a significant association of HLA-DR1 and -DR5 with the different types of morphea.

Adult↗
PubMed1985

Preputial abscesses caused by beta-lactamase-producing gonococci.

Preputial abscesses occurred in three men who had had sexual intercourse with prostitutes in Thailand. Neisseria gonorrhoeae could be grown from the lesions. Two of the strains were tested for beta-lactamase production and proved positive. While all three patients showed no clinical signs of urethritis, urethral swabs were positive for gonococci in two.

Abscess↗
PubMed1985

[Steroid receptors in malignant melanomas].

Epidemiological and experimental investigations have led to the hypothesis that the growth of malignant melanoma is induced by hormones. The demonstration of free-hormone binding sites in melanoma tissue may help to determine the validity of this hypothesis, as receptors are necessary for the transformation of hormonal action. The DCC assay with subsequent saturation analysis was used for the demonstration of specific cytoplasmatic binding sites of steroid hormones. The presence of free-cytosolic estrogen-, progesterone- and glucocorticosteroid receptors was investigated in 50 melanoma samples from 46 patients. In 20 of the 50 specimens, free estrogen and progesterone receptors were found. Free-glucocorticosteroid receptors we found in 10 cases. The use of four fold-labeled estradiol (2,4,6,7-[3]-17 beta-estradiol) in the DCC assay produced a false-positive demonstration of free-estrogen receptors. Tyrosinase hydroxylates estradiol at the C2 level of the steroid. Using fourfold labeled estradiol, tritium is separated at the C2 position, thus forming radioactive water in the cytosol which mimics high, free-estrogen binding sites. The use of twofold-labeled estradiol or L-dopa in the experiments with fourfold labeled estradiol produced no false-positive determinations of estrogen receptors. The demonstration of receptors in malignant melanomas was unaffected by the sex of the patient. Also, the type of malignant melanoma, the invasion level, and the prognostic index did not show a correlation with the presence of the various hormone receptors. In metastases, free steroid hormone receptors were detected less often than in the primary tumor.

Breast Neoplasms↗
PubMed1984

[Progressive systemic scleroderma. Clinical spectrum and prognostic parameters in 131 patients].

The course of progressive systemic scleroderma was analysed from data collected on 131 patients. Classification was according to the extent of cutaneous involvement, type I (28%): sclerosis as far as the wrist-joint; type II (65%): sclerosis beyond the wrist-joint; type III (7%): sclerosis beginning to affect the trunk. In addition, they were subdivided into those with or without signs of systemic inflammation. The sex ratio was 3.5 females to 1 male. In half of the patients the disease manifested itself between the age of 30 and 50 years, with a clear peak about the 40th year. Serological evidence of inflammatory and immunological phenomena was present in nearly 50%, predominantly in those with type II or III. Oesophageal involvement was present in 84%, of the lung in 56% of all patients. ECG and echocardiographic changes were demonstrated in 34% of patients, while liver, intestines and kidneys were only rarely affected. The degree of organ involvement increased from type I to type III. Signs of systemic inflammation were predominantly associated with a clinically severe course.

Adult↗
PubMed1984

[Cutaneous nodular Kaposi sarcoma following kidney transplantation and immunosuppression].

Five months after renal transplantation and an immunosuppressive trial with azathioprine and methylprednisolone, a black African female developed a cutaneo-nodular Kaposi's sarcoma that occurred symmetrically on the lower legs, thighs and forearms. Intensive search for visceral involvement was negative. Histologically, the nodes consisted of spindle cells; there were many new vessel formations with proliferation of atypical endothelial cells. After therapy with cytostatica and x-rays there was a time-limited disappearance of the Kaposi's sarcoma; 1 year later a relapse developed on the left lower leg. Field radiotherapy with accelerated electrons in a single dose of 8 Gy was successful. There is a greater incidence, in the literature, of Kaposi's sarcoma in immunosuppressed patients with organ transplants. Treatment with immunosuppressive substances is probably significant in the development of the Kaposi's sarcoma in those patients.

Adult↗
PubMed1984

Relapsing acute febrile neutrophilic dermatosis and essential thrombocythemia.

Relapsing acute febrile neutrophilic dermatosis ( AFND ) is reported in a patient with essential thrombocythemia representing the first case of this kind described in the literature. The patient presented with fever, malaise, neutrophilic leukocytosis, dysproteinemia, and coalescing bluish-red painful plaques and papules at palms, forehead, lid, forearm, and thigh. There was a dramatic response to steroids, or indomethacin, with no scarring. AFND was preceded by sore throat and an upper respiratory infection and was accompanied by conjunctivitis and arthritis of knees and ankle-joint. The association of AFND with essential thrombocythemia and with other neoplastic disorders is discussed.

Dermatitis↗
PubMed1984

17 alpha-Propylmesterolone (SH 434): an antiandrogenic sebosuppressive substance not influencing circulating testosterone concentrations. Experimental studies in Syrian hamsters.

17 alpha-Propylmesterolone is a new synthetic 5 alpha-reduced steroid with a propyl group in C-17 position and a methyl group in the A ring. The antiandrogenic action of 17 alpha-propylmesterolone on the sebaceous glands, testes weights and plasma testosterone concentrations were examined in the animal model of the Syrian hamster. The substance was given systemically (3, 5 or 10 mg/kg) and topically (3 or 5 mg/kg). 17 alpha-propylmesterolone reduced both sebaceous gland size and sebogenesis significantly in a dose-dependent manner. The topical administration was more effective than the systemic treatment. There was no influence of 17 alpha-propylmesterolone on testosterone concentration in plasma or testes weights although a diminished capacity or absence of free cytoplasmatic androgen receptor sites was detected in the sebaceous glands of the systematically or topically treated Syrian hamster. 17 alpha-Propylmesterolone exerts a potent topical sebosuppressive effect in the animal model. These findings should give rise to human studies and clinical trials.

Androgen Antagonists↗
PubMed1984

Influence of photoperiodism on testicular function and sebaceous glands in Syrian hamster.

The photoperiod (i.e., the daylight fraction of the 24-h day and its seasonal changes) influences the annual cycle of many mammalian species. Especially the Syrian hamster (Mesocricetus auratus), which is an appropriate animal model to investigate the sebaceous gland activity, shows a strong photoperiodism controlling the sexual development as well as the function of androgen-controlled organs such as sebaceous glands. Short photoperiods with accompanying long dark periods lead to a sexual regression while long photoperiods stimulate the recrudescence. In light-physiologic studies Syrian hamsters were exposed to different light schedules. The daily light exposure was increased from 8 to 12, 13, 14, and 16 h. Sebaceous gland areas, weight of testes and accessory glands, tubular areas, and plasma levels of testosterone were determined. Syrian hamsters are sexually stimulated at a daily light exposure of 14 h. Below this light threshold the sexual regression begins. At a light schedule of 8 h the testes shrink, plasma testosterone levels and sebaceous gland areas show a significant reduction ("photoperiodic castration"). Therefore, in experiments of androgen-controlled organs of the Syrian hamster a minimum daily light period of 14 or 16 h is necessary for a sufficient testicular function and therefore for an effective stimulation of the sebaceous gland activity. Control animals of the same age and the same light schedule should be required to avoid pitfalls of photoperiodic effects.

Animals↗
PubMed1984

Lung involvement in scleroderma.

Lung involvement (LI) was studied by lung function (LF) in 101 scleroderma patients (circumscribed scleroderma, n = 17; progressive systemic scleroderma [PSS], n = 84; with the subtypes I, acroscleroderma [n = 19]; 2, proximal ascending scleroderma [n = 61]; 3, trunk scleroderma [n = 4]). Eighteen percent of morphea, 32 percent of type 1, 56 percent of type 2, and 75 percent of type 3 patients had impaired LF. The LI was more frequent (57 percent vs 45 percent) and more severe (20 percent vs 3 percent) in PSS with systemic inflammation (form A) compared to those without (form B). Elevated lymphocytes/neutrophils in bronchoalveolar lavage (BAL) were found associated with form A and severe LI. The LF of patients showing an inflammatory cell pattern in initial BAL (n = 3) worsened, whereas those with normal BAL findings (n = 4) did not. Collagenase activity in BAL was significantly elevated in those with elevated lymphocytes/neutrophils in lavage. Patients with type 2 or 3 of PSS, especially form A, carry a higher risk of developing severe LI than circumscribed scleroderma, type 1, or form B patients. Differential cell count and collagenase activity in BAL is correlated with active disease and provides prognostic information.

Adolescent↗
PubMed1983

[Pigmented exanthema after spironolactone allergy in progressive systemic scleroderma].

A 37-year-old man developed generalized medium-brown hyperpigmentation in the course of progressive systemic scleroderma. Histologically there were numerous Melanin granules in the basal epidermis, but also in the upper Malpighian layer and in corneocytes. An allergic rash developed on administration of spironolactone given for the scleroderma. After healing there remained slate-grey spots. As a consequence of the drug rash the already present hyperpigmentation was aggravated by marked pigment deposition in the upper corium. At the same time there were numerous melanophages as sign of an absorptive removal of the melanin granules. The drug allergy was thus the occasion for the persisting pigment deposition with circumscribed spotty pigmentation of the skin.

Adult↗
PubMed1983

[Cutaneous coumarin necrosis of the breast].

In a 62-year-old female patient petechial haemorrhages of the right breast were observed after the 4th day of treatment with phenprocoumon. Within a few hours large cutaneous necroses developed. Histology showed lymphocytic vasculitis with vessel wall destruction and erythrocytic extravasates as well as necrobiotic changes of the middle and lower corium. High-dosage treatment with prednisolone was started after withdrawal of phenprocoumon. Progression of the necrosis to the left breast could be prevented. However, necrosis of the haemorrhagic area of the right breast could not be arrested. Aetiology and pathomechanisms of coumarin-induced necrosis have to date not been ascertained. Allergic precipitating mechanisms probably were of no importance in our patient.

4-Hydroxycoumarins↗
PubMed1983

[The sterile Behçet pustule: a typical skin manifestation of the Behçet syndrome].

Solitary pustules were excised from five patients with Behçet's syndrome and examined histologically, immunohistologically, and--in one case--by immunoelectron microscopy. Histologically the changes were largely confined to the venules of the middle and lower corium. The endothelium was swollen, in part the vascular walls were destroyed. In the perivascular spaces there was round-cell infiltration, mixed with numerous neutrophilic granulocytes, some of them disintegrated. Immunofluorescence-microscopy revealed perivascular deposition of complement C3 and C1q. In fresh lesions there were also IgG or IgM precipitates. Immuno-electron microscopy also demonstrated complement C3 subendothelially. Fibrin deposition and disintegrating neutrophilic granulocytes marked the leukocytoclastic vasculitis. Taken together the findings indicate that an immune-complex vasculitis takes part in the pathogenic mechanism of pustule formation in Behcet's syndrome.

Behcet Syndrome↗