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Biomedical subjects

D Abeck

Publications and source records attributed to D Abeck.

At least 91 records · Page 5Linked to original sources
PubMed1998

Current antimicrobial susceptibility of cutaneous bacteria to first line antibiotics.

Antimicrobial susceptibility of common bacterial species occurring on human skin appears to be falling. Data for the antimicrobial susceptibility of major groups of bacteria isolated from human skin during routine cultures were complied and analysed over a period of 9 months. Routine diagnostics of specimens from skin lesions and normal human skin were analysed for the presence of specified groups of bacteria. The species were identified using standard methods. Anti-microbial susceptibility was determined using a broth microdilution system giving breakpoints, the Sensititre system. Of the 333 Staphylococcus aureus, 129 Streptococcaceae, 180 Enterobacteriaceae and 120 Pseudomonadaceae strains investigated more than 5% of Staphylococcus aureus strains were resistant to flucloxacillin and thus methicillin (MRSA). More than 25% of Staphylococcus aureus strains were resistant to tetracycline and erythromycin. Many MRSA strains were found multi-resistant. Gentamicin was active against a large majority of Enterobacteriaceae strains but many Pseudomonadaceae strains were resistant. Compared with previous corresponding surveys methicillin-resistant Staphylococcus aureus strains are clearly on the increase. To prevent a further increase of resistant strains a defined strategy for antibiotic use is needed in dermatology.

Anti-Bacterial Agents↗
PubMed1998

Proteus syndrome with widespread portwine stain naevus.

Proteus syndrome is a rare condition comprising asymmetrical overgrowth of different parts of the body in association with various cutaneous abnormalities. We describe a 3-year-old boy with Proteus syndrome, who presented with hemihypertrophy of the right leg, asymmetric macrodactyly, subcutaneous masses and a widespread portwine stain interspersed with angiokeratomas on the right leg, scrotum and on the middle and left side of the back. Doppler ultrasound of the right leg did not show hypercirculation, but did reveal the absence of the right superficial femoral vein.

Child, Preschool↗
PubMed1998

Staphylococcus aureus colonization in atopic dermatitis and its therapeutic implications.

Skin colonization with Staphylococcus aureus is a characteristic feature of atopic dermatitis with more than 90% of patients being colonized. Extracellular matrix proteins are important for the adherence of S. aureus to human keratinocytes. The bacterium interferes in the inflammatory process of atopic dermatitis in various ways, among which the ability to release superantigens in a high percentage of clinical isolates is of great importance. As the colonization correlates significantly with the severity of eczema, anti-staphylococcal treatment measurements are widely used. In cases of atopic dermatitis exacerbation with wide-spread weeping lesions, a systemic antibiotic treatment is warranted, with erythromycin no longer being recommended due to an increased resistance rate. In localized superinfected lesions the topical application of an antibiotic-glucocorticoid preparation may offer advantages to the mere steroid application. Based on efficacy and resistance data, fusidic acid is the antibiotic of choice. There is evidence that phototherapy in atopic dermatitis may be even more effective when combined with anti-staphylococcal measurements. In the future new therapeutical options may be available.

Anti-Bacterial Agents↗
PubMed1998

Role of Staphylococcus aureus surface-associated proteins in the attachment to cultured HaCaT keratinocytes in a new adhesion assay.

Colonization of human skin with Staphylococcus aureus is a common feature in a variety of dermatologic diseases. In order to reproducibly investigate the adherence of Staphylococcus aureus to human epidermal cells, an in vitro assay was established using the biotin/streptavidine labeling system and the HaCaT cell line. This assay was used to define the role of several Staphylococcus aureus surface proteins with regard to their function in the staphylococcal adhesion process. Our studies included the standard laboratory strain Newman as well as its genetically constructed mutants DU5873, DU5852, DU5854, and DU5886 generated by allele replacement or transposon mutagenesis, which are deficient in the elaboration of staphylococcal protein A (spa), clumping factor (clfA), coagulase (coa), and the fibronectin-binding proteins A and B (fnbA/B), respectively. In comparison with strain Newman all mutants showed remarkably reduced adherence to the HaCaT keratinocyte cell line in our assay, yielding only between 43% and 60% of the adherence capacity of strain Newman after 60 min. Bacterial adherence could be re-established by introducing the cloned wild-type genes for the surface proteins on shuttle plasmids into the chromosomally defective mutants, thus suggesting a pathogenetic role of these proteins in the attachment of Staphylococcus aureus to human keratinocytes. Bacterial adherence was additionally enhanced by alkaline pH-values that are characteristic for skin conditions with epidermal barrier dysfunction. The use of Staphylococcus aureus mutant strains, deficient in the elaboration of defined proteins, allows specific investigation of colonization and virulence factors of this dermatologic relevant microorganism.

Bacterial Adhesion↗
PubMed1998

Isolation of cDNA clones coding for IgE autoantigens with serum IgE from atopic dermatitis patients.

Recently we demonstrated that a high percentage of atopic dermatitis (AD) patients displayed specific immunoglobulin E reactivity to human proteins. Here we show that IgE autoreactivity is found predominantly in AD patients with severe skin manifestations and reveal the molecular nature of four IgE autoantigens. An expression cDNA library constructed from a human epithelial cell line (A 431) was screened with serum IgE from two AD patients. DNA sequence analysis of three IgE-reactive clones identified the alpha-chain of the nascent polypeptide-associated complex, cytokeratin type II, and the BCL7B oncogen as atopy-related IgE autoantigens (ara). The fourth cDNA coded for an IgE autoantigen containing a typical calcium binding motif that occurred in histogenetically different cells and tissues (keratinocytes, muscle, brain). Recombinant Escherichia coli-expressed IgE autoantigens bound IgE from AD but not from patients with other immunologically mediated disorders (graft vs. host disease, systemic lupus erythematosus) and elicited immediate type skin reactions in AD patients. In serum samples collected from an AD patient over a period of 5 years, IgE anti-ara NAC antibody levels peaked during disease exacerbation. Our finding that ara BCL7B was detected in serum bound to IgE antibodies suggests that intracellular IgE autoantigens can become released after tissue damage and may occur as IgE immune complexes. Via binding to antigen presenting cells as well as to effector cells, IgE autoantigen immune complexes may contribute to exacerbation and/or perpetuation of severe atopic diseases even in the absence of exogenous allergens.

Amino Acid Sequence↗
PubMed1998

Safety and efficacy of intermittent therapy with itraconazole in finger- and toenail onychomycosis: a multicentre trial.

The efficacy and safety of intermittent itraconazole therapy were investigated in patients with onychomycosis. Patients were divided into two groups according to site and extent of infection. Group A comprised 635 patients with toenail onychomycosis (at least one nail with > or = 20% involvement; n = 560) or fingernail onychomycosis (at least one nail with > 75% involvement; n = 63) or both (n = 12). These patients received itraconazole 400 mg day-1 for 1 week per month for 3 months. Group B comprised 48 patients with fingernail onychomycosis (at least one nail with > or = 20% involvement but no nail with > 75% involvement) who received itraconazole 400 mg day-1 for 1 week per month for 2 months. Patients were followed for a further 18 weeks without treatment, and received another treatment cycle if not cured or markedly improved 6 weeks after the end of the last cycle. An additional cycle was administered to 76 patients with fingernail onychomycosis (group A, n = 43; group B, n = 28) and to 316 patients with toenail onychomycosis. Clinical response rates and mycological cure rates at study end point were 89.0% and 68.4% respectively for toenails, 91.4% and 85.3% respectively for group A fingernails and 84.4% and 77.1% respectively for group B fingernails. Most adverse events occurred infrequently; major changes in liver function tests were not noted. In conclusion, intermittent itraconazole therapy is highly effective and safe in patients with onychomycosis.

Adult↗
PubMed1998

Photoallergic contact dermatitis due to combined UVB (4-methylbenzylidene camphor/octyl methoxycinnamate) and UVA (benzophenone-3/butyl methoxydibenzoylmethane) absorber sensitization.

In a 71-year-old male Caucasian patient with persistent eczema on light-exposed skin, photocontact allergy was demonstrated to the UV filter substances 4-methylbenzylidene camphor (UVB), octyl methoxycinnamate (UVB), benzophenone-3 (UVA) and butyl methoxydibenzoylmethane (UVA) present in sunscreen products used by the patient over several years. A significantly reduced UVB sensitivity of 25 mJ/cm2 in this patient (normal minimal erythema dose in our laboratory = 70-130 mJ/cm2) was considered an early indication of a persistent light reaction. Topical anti-inflammatory treatment over 2 weeks together with consequent application of a sunscreen containing Mexoryl SX/titanium dioxide led to complete remission. Taking into account the widespread use of the above UV filter substances not only in sun protection products, but also in cosmetics such as antiaging lotions and day care products, the possible risk of allergy to these chemicals has to be taken seriously. The substitution of known photocontact sensitizers in UV filters by photostable compounds and detailed product information are the basis of preventive strategies.

Aged↗
PubMed1998

Gianotti-Crosti syndrome: clinical, serologic, and therapeutic data from nine children.

Gianotti-Crosti syndrome (GCS), a self-limiting papulovesicular acrodermatitis often associated with underlying viral infection, is mainly described in children. Nine children with GCS were evaluated with dermatologic examination and serologic tests for viral infections. Therapy was modified according to the subjective symptoms of patients, which included characteristic acrolocated papulovesicles, generalized skin eruption, and mild to severe pruritus. Results of serologic investigations revealed Epstein-Barr virus, Coxsackie A virus, parvovirus B19, and parainfluenza virus 1/2. In three children no underlying viral infection was found. Therapeutic interventions included topical clioquinol lotion 1 percent, topical application of corticosteroids, systemic antihistaminic therapy, and systemic methylprednisolone. Skin lesions resolved after 2 to 4 weeks in treated as well as in nontreated children. Although GCS in children often lacks close association with a causative viral infection, such severe infections as hepatitis B and human immunodeficiency virus must be considered. Whole-body involvement seems to correlate with severe pruritus and additional general symptoms requiring more intensive therapy.

Acrodermatitis↗
PubMed1997

Palpable migratory arciform erythema. Clinical morphology, histopathology, immunohistochemistry, and response to treatment.

BACKGROUND: Palpable migratory arciform erythema is clinically characterized by sharply circumscribed, infiltrated erythematous patches that tend to spread irregularly, resulting in arciform morphologic features. The histopathologic features are characterized by a patchy inflammatory perivascular and periadnexal T-lymphocytic infiltrate throughout the dermis. The disease runs a chronic course and is rarely described in the literature. OBSERVATION: Three middle-aged patients of both sexes had palpable migratory arciform erythema with 1, several, or multiple lesions on the trunk. There was a dense perivascular and periadnexal, predominantly lymphocytic infiltrate of the reticular dermis without any interstitial distribution of inflammatory cells. Absence of mucin deposits and plasma cells was a striking feature. The immunohistochemical profile showed an infiltrate dominated by T cells of polyclonal origin. In addition, polyclonal B cells and histiocytes were present in small numbers. In all 3 cases, oral antibacterial treatment resulted in a complete (2 patients) or temporary (1 patient) resolution of skin lesions. CONCLUSIONS: Palpable migratory arciform erythema shows distinctive differences in clinical and pathological features and treatment in contrast to other diseases with cutaneous lymphocytic infiltrates, including lymphocytic infiltration of Jessner and Kanof. Therefore, it is likely a distinct disease entity.

Adult↗
PubMed1997

[Perianal ergotismus gangraenosus].

Ergotamine-containing drugs are widely used in the treatment of acute migraine attacks. Among others, spastic vasoconstrictions are one of the possible side effects usually affecting the lower extremities and sometimes leading to gangrene. The case of a 75 year old woman is presented who was suffering from migraine-attacks since adolescence. Due to longterm use of ergotamine containing suppositories she developed perianal ulcers. After withdrawal of the drug the ulcers healed up entirely. The spectrum of ergotamine-induced side-effects and possible intervention strategies are discussed.

Aged↗
PubMed1997

[Treatment of atopic eczema in childhood].

Adjuvant basic therapy plays a central role in the therapeutic approach to atopic eczema in childhood. It involves the regular use of emollients and oil baths according to the clinical picture. Emollients containing urea may cause problems when used in younger children due to their stinging effect. Glucocorticosteroids still form the mainstay of anti-inflammatory therapy and are superior to other topical drugs with anti-inflammatory effects. Antihistamines preferably of the sedative type can be used successfully during periods of exacerbation. Systemic use of antibiotics is essential in cases of impetiginized atopic eczema. In cases of bacterial-triggered eczema, the topical use of antibiotics in cases of limited or antiseptics in generalized disease may be helpful.

Administration, Topical↗