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Biomedical subjects

G Plewig

Publications and source records attributed to G Plewig.

At least 253 records · Page 14Linked to original sources

[Isotretinoin in local treatment of acne and rosacea and animal experiment studies on isotretinoin and arotinoid].

Fifteen patients with acne and 4 with rosacea were treated topically with 0.2% isotretinoin cream twice a day for 16 weeks. Inflammatory lesions responded better (30 +/- 22 versus 15 +/- 12) than non-inflammatory lesions (23 +/- 44 versus 17 +/- 24). Neither the "causal level" (123 +/- 85 versus 130 +/- 66 micrograms/cm2 nor the "replacement sum" (70 +/- 29 versus 77 +/- 30 micrograms/cm2) were changed (lipometer assay). In 150 adult male Syrian hamsters 1-2 drops of isotretinoin in concentrations varying from 0.3% to 0.001% and arotinoid ranging in concentration from 0.3% to 0.00001% in acetone were applied to the left ventral ear or the left flank organ twice a day (5/7 days) for 21 days. In higher concentrations there was a significant reduction in sebaceous gland size. Arotinoid, however, is extremely toxic. Even in concentrations as low as 0.00001% the animals showed severe side-effects within the 1st week.

Acne Vulgaris↗

[Retinoids and lipid metabolism].

Since systemic administration of synthetic retinoids was introduced into dermatology and oncology, side-effects of synthetic vitamin-A derivatives on lipid and lipoprotein metabolism have become apparent. Retinoids of the first and second generation, 13-cis-retinoic acid and etretinate, are capable of inducing secondary hyperlipoproteinemias. For further evaluation of the atherogenic risk of retinoid-induced hyperlipoproteinemias, the most relevant effects of natural and synthetic retinoids on lipid metabolism as well as the interactions between lipid and retinoid metabolism are considered in this review.

Arteriosclerosis↗

[Light-induced postherpetic erythema exsudativum multiforme].

A 37-year-old man had erythema multiforme over a period of 20 years following recurrent herpes simplex infections. On the basis of the results of provocative UV-A tests as well as histological findings a diagnosis of photosensitive erythema multiforme was made. The erythema multiforme exsudativum like variant of polymorphous light eruption is discussed in the differential diagnosis.

Adult↗

The effect of aromatic retinoid Ro 10-9359 (etretinate) on fingernail growth.

Fingernail growth was studied in 28 patients who were receiving systemic treatment with the aromatic retinoid, Ro 10-9359 known as Tigason (etretinate; AR). A group of 15 patients with psoriasis was compared with a group of 13 patients with other dermatoses which are known to have a good response to AR therapy. In the second group, oral therapy with AR appeared to have no effect on the daily growth rate of fingernails (99 +/- 4 microns). With AR treatment, the nail-plate growth rate in the psoriatics increased to 132 +/- 5 microns.

Adolescent↗

[Porokeratosis plantaris, palmaris et disseminata].

A 24-year-old female patient was treated for many years for "verrucae vulgares". Signs of porokeratosis were found by microscopy. Her medical history, the distribution of the hyperkeratotic-verruciform lesions and the characteristic histology features permitted the diagnosis to be made of porokeratosis plantaris, palmaris et disseminata.

Adult↗

[UV-ray sensitivity of patients with malignant melanoma].

In 77 patients with malignant melanoma and 74 control subjects without skin tumors caused by sunlight, the minimal erythema dosage (MED) in the UV-C and UV-B areas, immediate pigment darkening (IPD), and minimal tanning dose (MTD) were determined according to skin type. Direct (MED-UV-B, MED-UV-C) and inverse (IPD, MTD) correlations were established according to skin type. These parameters showed no differences between patients with malignant melanoma and the control group.

Adult↗

[Oral treatment of acne conglobata using 13-cis-retinoic acid. Results of the German multicentric study following 24 weeks of treatment].

Results of the isotretinoin (13-cis-retinoic acid, Ro 4-3780) German Cooperative Study Group, with 198 acne conglobata patients being treated in 19 departments are reported. For the first 12 weeks (phase I) there was an open assignment to 0.2, 0.5 or 1.0 mg/kilogram bodyweight (kg bw). This was followed by further 12 weeks (phase II). If there was at least a two-third improvement of lesions, the 0.2 mg/kg bw was continued, and the 0.5 mg/kg bw dose lowered to 0.2 mg/kg bw. If there was no such improvement, the dose was elevated to 0.5 and 1.0 mg/kg bw respectively. The initial high dose group of 1.0 mg/kg bw was divided after twelve weeks into 0.2 mg/kg bw maintenance therapy, or no therapy at all. Non-inflammatory and inflammatory acne lesions from the entire body were counted. Seborrhea was graded on a four scale (0 to 3+). Subjective side effects were registered. Laboratory data included hematological profile with differential counts, creatinin, SGOT, SGPT, alkaline phosphatase, total bilirubin, serum cholesterol and serum triglycerides, and urine analysis. For statistical analysis 171 patients were available, 27 dropped out of the study, mostly for reasons unrelated to the drug. At least 75 per cent improvement was seen, in the 0.2 mg/kg bw group in 73.7 and 59.5 per cent respectively; in the 0.5 mg/kg bw group in 72.5 and 61.2 per cent respectively; and in the 1.0 mg/kg bw group in 85.4 and 92 per cent respectively (phase I t12 and phase II t24 values, respectively). Sebum suppression was dose-related. Subjective side effects were fairly well dose-related, particularly those of skin and mucous membranes. Myalgia was rare. There was a dose-related elevation of triglycerides and cholesterol, but not significant for the means of each group. Single patients did show significant elevation of blood lipids. All other laboratory parameters did not change significantly. Isotretinoin is presently the most effective drug to control severe forms of acne, leading to long lasting remissions.

Acne Vulgaris↗

[Toxic shock syndrome].

The toxic-shock syndrome (TSS) is a recently recognized syndrome characterized by sudden onset of high fever, vomiting, and diarrhea with rapid progression to hypotension and shock. It is caused by one or more not yet clearly defined exotoxins from staphylococcus aureus. The disease primarily affects young women using tampons during their menstrual periods, although it occurs also in non-menstruating women and in men. In these cases extragenital staphylococcus aureus infections are found. Since 1981 the toxic-shock syndrome associated with menstruation has occurred less frequently, whereas the non-menses-related toxic-shock syndrome appears with similar frequency. The syndrome resembles Kawasaki disease (mucocutaneous lymph node syndrome) in several aspects, namely fever, rash with subsequent desquamation, and cardiovascular involvement. However, shock, which is prominent in toxic-shock syndrome, is not usually seen in Kawasaki disease.

Adolescent↗

[Giant pore and hair-shaft acanthoma. Clinical and histologic diagnosis].

This report presents clinical and histological data of dilated pores of 54 biopsies from 45 patients from Munich and 39 biopsies from 36 patients from Detroit. The dilated pore of Winer is a relatively common benign adnexal tumor originating from the outer hair root sheath. Three-dimensional reconstructions of the tumor show that four different types of dilated pores can be considered. The dilated pore is a tumor sui generis and not a trichoepithelioma. A second benign adnexal tumor, the pilar sheath acanthoma of Mehregan and Brownstein, is presented in 11 biopsies from 11 patients from Munich and in nine biopsies from nine patients from Detroit. Clinical and histological features and differential diagnosis are shown.

Adult↗

Steatocystoma multiplex: anatomic reevaluation, electron microscopy, and autoradiography.

Histologic and electron-microscopic features of steatocystoma multiplex were investigated. Specimens from 25 patients (8 females, 17 males) were serially cut and three-dimensional drawings constructed. Steatocystoma multiplex is a nevoid sebaceous duct and sebaceous gland tumor, originating from sebaceous follicles, but is not a dermoid tumor. One pilary unit continuously produces vellus hairs, which are trapped in the cystic cavity or in the pilary canal (trichostasis). Steatocystoma multiplex is connected to the epidermis by a straight or meandering epithelial cord, the remnant of the follicular infundibulum. This infundibulum is a more or less solid strand, often containing sebocytes or sebaceous lobulelike structures. A lumen, partly present in a few areas of the cord, is filled with cellular debris of keratinocytes, corneocytes, sebocytes, or trapped hairs. Steatocystoma multiplex has electron-microscopical features similar to the sebaceous duct and sebaceous glands of sebaceous follicles. The 3H-thymidine labeling index of the cyst wall with or without sebaceous acini is lower than in sebaceous follicles. Steatocystoma multiplex suppurativum, characterized by spontaneous rupture of the cyst, inflammation and scarring, mimics acne conglobata with hidradenitis-suppurativa-like lesions as seen in the acne triade or tetrade.

Adolescent↗

Action of isotretinoin in acne rosacea and gram-negative folliculitis.

Good to excellent clinical results have been obtained in the treatment of severe inflammatory acne (acne conglobata, acne fulminans, and acne conglobata with hidradenitis and dissecting cellulitis of the scalp) with orally administered isotretinoin (13-cis-retinoic acid). Similar promising results have been obtained in patients with severe rosacea and gram-negative folliculitis. Isotretinoin probably has multiple modes of action, including (1) inhibition of sebaceous gland activity, (2) inhibition of the growth of Propionibacterium acnes within the follicle, although the retinoid is not antibacterial, (3) inhibition of inflammation, and (4) alteration of the pattern of keratinization within the follicle, as demonstrated by light and ultrastructural studies.

Acne Vulgaris↗

Polymorphous light eruption. Experimental reproduction of skin lesions.

The clinical features of polymorphous light eruption (PLE) are reviewed from the literature with special emphasis on the experimental reproduction of skin lesions. Our clinical experience with 180 patients is reported. In forty-three patients a newly developed UVA provocation test was performed. UVA, free of sunburn radiation (50-100 J/cm2), was administered, sometimes repeatedly up to four times, to large sites of previously involved skin. With this technic the reproduction of PLE lesions under laboratory conditions was possible in 90% of this group of forty-three patients. The diagnosis was substantiated by microscopic examination of genuine and experimentally induced lesions. Characteristic histologic features of PLE are described. Phototesting with large doses of UVA aids in confirming the diagnosis of PLE. Hitherto, this diagnosis depended often on exclusion of other dermatoses. Eusolex 8021, a UVA-effective sunscreen, blocked eruptions of PLE lesions under laboratory conditions. An effective means of treatment is offered by PUVA therapy.

Adolescent↗