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Biomedical subjects

G Plewig

Publications and source records attributed to G Plewig.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Bath-PUVA therapy of granuloma annulare].

Sixteen patients with generalized granuloma anulare and two patients with localized granuloma anulare received bath-PUVA therapy. Their lesions previously had not responded to conventional therapy. After an average of 55 (11 to 61) treatments and a mean cumulative dose of 69.5 (7.1 to 261.5) J/cm2, complete remission was observed in 5 patients and a clear improvement in 10 patients. Three patients stopped therapy after few treatments. Recurrent lesions appeared in 4 patients; in three of them reinitiation of the bath-PUVA-therapy again led to complete remission. Maintenance therapy for several months may be useful for patients suffering from relapsing granuloma anulare. Potential risks of long-lasting bath-PUVA therapy should be taken into consideration.

Baths↗
PubMed1999

Side-controlled intradermal injection of botulinum toxin A in recalcitrant axillary hyperhidrosis.

BACKGROUND: Although topical application of aluminium chloride is the most common measure against axillary sweating, severely affected patients often undergo surgical procedures that are expensive and may have considerable side effects. Recently botulinum toxin A (BT-A) has been reported as a potentially effective antihyperhidrotic agent. OBJECTIVE: Our purpose was to determine the therapeutic strength, safety, and mode of application of BT-A in severe axillary hyperhidrosis. METHODS: Intradermal injection of BT-A (Dysport) was given in an open left-versus-right side trial with each patient being his own control for initial efficacy, followed by treatment of the contralateral side. RESULTS: Seven days after initial treatment sweat production fell to below 10% of the untreated contralateral axilla as determined by gravimetry. Satisfaction was rated unanimously as "very good," the highest of 5 rankings. No side effects such as skin irritation or muscle weakness were noted in any patient. CONCLUSION: Intradermal injection of BT-A is a potent and well-accepted therapeutic option in patients with recalcitrant axillary hyperhidrosis.

Adult↗
PubMed1999

Long-term application of extracorporeal photochemotherapy in severe atopic dermatitis.

BACKGROUND: Extracorporeal photochemotherapy (ECP) using UVA irradiation of enriched leukocytes in the presence of methoxsalen as a photoactivatable substrate has been employed for the treatment of several immunologically mediated disorders. OBJECTIVE: Our purpose was to determine the efficacy and safety of long-term ECP in the treatment of severe atopic dermatitis. METHODS: Fourteen patients with severe recalcitrant atopic dermatitis were treated with ECP in an open clinical trial at 2-week intervals. Disease activity was scored before each ECP cycle by means of a standardized protocol. RESULTS: A complete clinical remission was achieved in 4 patients (29%). Five patients (36%) experienced a substantial response with reduction of skin inflammation by at least 75%, whereas in one patient (7%) disease activity was reduced by more than 50%. Four patients were withdrawn from the study for unresponsiveness. No clinical signs of immunosuppression or other severe adverse events became evident. CONCLUSION: Long-term ECP may have significant beneficial effects on the course of atopic dermatitis and should therefore be considered as a treatment modality for patients suffering from severe and otherwise refractory atopic skin disease.

Adult↗
PubMed1999

Paraneoplastic pemphigus with fatal pulmonary involvement in a woman with a mesenteric Castleman tumour.

A 42-year-old woman presented with oral and labial erosions, conjunctivitis, facial rash and lichenoid erythematous papules on the trunk. Paraneoplastic pemphigus (PNP) was suspected, and a search for a neoplasm revealed an intra-abdominal Castleman tumour sized 7 x 5 x 6 cm. After removal of the Castleman tumour, the skin and mucosal inflammation gradually subsided over the next 12 months. However, due to irreversible pulmonary involvement the patient died of intractable respiratory distress 2 years after the onset of the disease. Systemic corticosteroids, azathioprine, cyclophosphamide, high-dose intravenous immunoglobulins and thalidomide were ineffective. The diagnosis of PNP was confirmed by keratinocyte antigen immunoprecipitation with the patient's serum.

Adult↗
PubMed1999

Bacteriologic and immunologic aspects of gram-negative folliculitis: a study of 46 patients.

BACKGROUND: Gram-negative folliculitis is an infection with gram-negative rods that most often occurs as a complication of prolonged broad-spectrum antibiotic therapy in patients suffering from acne and rosacea. METHODS: The bacteriologic and immunologic findings are reported in 46 patients, 39 men and 7 women, aged 16-79 (median, 28) years, with gram-negative folliculitis. Hypersensitivity reactions to various microbial recall antigens as well as granulocyte functions were evaluated. Quantitative measurements of serum levels of immunoglobulin M, G, A, and E, total complement activity, complement factors C3 and C4, and alpha-1-antitrypsin were performed. RESULTS: The gram-negative organisms most frequently cultivated from nares, facial skin, and pustules were Klebsiella spp., Escherichia coli, Enterobacter spp., and Proteus spp. In all patients, deviations of one or more immune parameters were detected, including lowered serum concentrations of immunoglobulin M and alpha-1-antitrypsin, and elevated levels of immunoglobulin E. The humoral and cellular parameters were not influenced by isotretinoin therapy of gram-negative folliculitis. CONCLUSIONS: These findings suggest that gram-negative folliculitis is not only a complication of long-lasting antibiotic treatment of acne and rosacea, but might be an entity of its own. Immunologic factors may play a critical role in the pathogenesis of gram-negative folliculitis.

Adolescent↗
PubMed1999

[Clinical and epidemiological data of patients with malignant melanoma from the Munich Tumor Center 1977-1997].

Since 1997, data of patients with malignant melanomas have been systematically documented in the tumor registry of the Tumor Center Munich. Analysis of data of 8071 patients revealed that tumor thickness has steadily declined over the years. While in 1977 the median tumor thickness was 1.45 mm, it is now 0.75 mm. This has been followed by a significant improvement in overall survival. Males and older patients tend to have thicker melanomas than females and younger patients. There has been a relative increase of melanomas of the trunk. At diagnosis, 95% of patients had local disease. Of these patients, 18.3% developed metastastes. At least two-thirds of these patients had progression at the primary tumor site or the regional lymph nodes, both of which can be assessed by clinical or ultrasound examinations. Overall survival of patients with thin melanomas is excellent and does not differ substantially from the overall survival of the general population comparable in sex and age.

Adult↗
PubMed1998

[Basalioma].

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Basal Cell Carcinoma↗
PubMed1998

[Actinic keratoses].

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Cell Transformation, Neoplastic↗
PubMed1998

[Acne inversa].

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Acne Vulgaris↗
PubMed1998

[Botulinum toxin A in dermatology].

Based on its unique botulinum toxin is referred to as the most poisonous poison. Its specific inhibition of the acetyl-cholin-dependent neuromuscular transmission is used by ophthalmologists and neurologists for the relaxation of spastic or dystonic muscles, preferably in muscle groups in the head and neck area. Analogously, it is being used by dermatologists to remove facial wrinkles by paralyzing mimic muscles which account for mechanically induced wrinkling. Apart from this purely cosmetic use, botulinum toxin has gained recent attention in dermatology as a potent treatment modality for circumscribed hyperhidrosis.

Botulinum Toxins, Type A↗
PubMed1998

[Axillary hyperhidrosis: successful treatment with botulinum toxin A].

Severe hyperhidrosis may present as a vexing condition for the patient and a therapeutic challenge for the physician. As botulinum toxin-A (BT-A) can potently block cholinergic sympathic innervation of sweat glands it was used in an open trial for controlling severe axillary hyperhidrosis. After visualization of hyperhidrosis using the iodine-starch-test BT-A (Dysport, 400 Units) was injected intradermally in one axilla. One week later gravimetric quantification of sweat secretion revealed a reduction of sweating to 4-9% of initial values. In order to rule out daily variations as well as other factors interfering with sweat production BT-A treatment was restricted to only one axilla in each individual clearly demonstrating extensive anhidrotic efficacy on the treated side only. The treatment was well tolerated without side-effects and was assessed as 'completely satisfying' by all patients. BT-A may offer a fast, safe and highly effective therapeutic option for severe hyperhidrosis.

Adolescent↗