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Biomedical subjects

Gregor B E Jemec

Publications and source records attributed to Gregor B E Jemec.

At least 19 recordsLinked to original sources
PubMed2006

Instrumental assessment of atopic eczema: validation of transepidermal water loss, stratum corneum hydration, erythema, scaling, and edema.

BACKGROUND: Quantification of skin diseases can be carried out in many ways. Clinical scores are widely used in atopic eczema (AE), and noninvasive instruments are a relevant supplement. OBJECTIVE: Our purpose was to validate 5 noninvasive instruments in quantification of AE severity. METHODS: In all, 101 patients with AE and 30 control subjects were assessed twice in a clinical cross-sectional examination. Assessment of transepidermal water loss, stratum corneum hydration, erythema, scaling, and subepidermal edema was assessed on 3 predetermined skin sites. RESULTS: The methods discriminated among various severity degrees and correlated significantly with objective assessment of disease severity. High correlations were found among instruments assessing acute symptoms of AE. Threshold values for transepidermal water loss and capacitance were found. LIMITATIONS: No gold standard exists for severity assessment of atopic eczema. Therefore, the methods used cannot be validated in relation to such a standard. Furthermore, atopic eczema is a generalized disease and the methods used assess target lesions. By assessing target lesions, information about the disease is reduced. CONCLUSION: Noninvasive instruments are valuable in quantification of disease severity in a mixed group of patients with active AE. Assessment with ultrasound has contributed new information about the pathophysiology in AE.

Adolescent↗
PubMed2006

Ultrasound imaging of nails.

The nail apparatus contains tissues of various echogenicities and is thus well suited for ultrasound examination. Furthermore, ultrasonography is widely available and non-invasive and may therefore be used for longitudinal studies of tissues and diseases. Characteristic ultrasound pictures can be seen in psoriasis, cysts, vascular abnormalities,and other nail diseases. Ultrasound examination can visualize and quantify morphologic and functional aspects of nail biology.

Humans↗
PubMed2006

The bacterial flora of the skin surface following routine MAL-PDT.

Photodynamic therapy using methylated 5-aminolevulate (MAL-PDT) appears to have an effect on non-neoplastic skin diseases, for example acne vulgaris and rosacea, for which antibiotics are sometimes used, and a possible antibiotic effect of PDT has previously been suggested. It does, however, also cause local immunosuppression and post-treatment barrier defects, which may promote infection. At the same time, PDT-induced therapeutic skin damage is sometimes confused with secondary bacterial infection by non-dermatologists. The possible changes in bacterial flora associated with MAL-PDT were therefore studied in 47 patients undergoing treatment. Skin swabs were taken immediately before applying the MAL and instantly after light irradiation. Bacterial growth was identified in 18 cases. No statistically significant changes were seen, either in the specific species found or the estimated bacterial density on the skin surface. The observations do not support the notion that routine MAL-PDT affects the bacterial flora of the skin in a clinically significant manner. Therefore, the possible antibacterial effect of routine MAL-PDT is probably not the main explanation of its apparent effect on non-neoplastic skin disease.

Adult↗
PubMed2006

A bibliometric study of dermatology in central Europe 1991-2002.

BACKGROUND: Bibliometric studies have gained interest in recent years, although most analyses are limited to simple use of average citations rates for journals, also known as the "impact factor". Central Europe has a long tradition of dermatological research which has been negatively impacted by general political developments for a long period. This study was undertaken in order to describe the progress made in recent years. METHODS: The study was conducted in two parts: First the annual national output for the period 1991-2002 was identified for each country by MEDLINE searches. In the second part of the study a sample was drawn from the papers identified in the first part and the number of citations for each paper noted. RESULTS: The annual national output showed great variation between countries and from year to year. The mean citation rates were found to vary between 0-5 citations/year, and some underlying publications were 10 years old. Countries with national indexed journals appear to hold a bibliometric advantage over countries without indexed journals. CONCLUSIONS: Throughout the last decade of the 20th century the number of publications has grown with an average of 21.7% per year, and publication rates have only suffered in countries directly involved in war or similar disturbances. The mean citation rates were low, with a varying age of the underlying publications. Some cited publications were however old suggesting a persistent relevance. A national or regional indexed journal appears to confer a bibliometric advantage.

Bibliometrics↗
PubMed2006

Mechanical properties and barrier function of healthy human skin.

The aim of this study was to investigate the relationship between the mechanical properties and the epidermal barrier function of the skin in vivo. A suction cup device commonly used for measurement of skin mechanics was used to provide a defined stress to the skin using the ventral forearm in 16 healthy volunteers. The integrity of the barrier function was assessed by trans-epidermal water loss and skin capacitance. In the first part of the study, changes in barrier function were measured following the application of standardized strain to the skin barrier. In the second part of the study changes in skin mechanics were assessed following standardized barrier removal. The Wilcoxon signed rank test and Spearman's rank correlation were used for statistical analysis. Significant increases were established in trans-epidermal water loss (p < 0.01) with concomitant significant decreases in capacitance (p < 0.05) following 400 mbar and 600 mbar of suction, suggesting that the mechanical integrity of the skin barrier was disrupted. A significant increase in distensibility (p < 0.05) and hysteresis (p < 0.01) was found following stripping, relating the role of the skin barrier to the overall mechanical properties of the skin. This study showed that the water permeability of the epidermis was significantly affected by the application of mechanical stress to the skin and vice versa, the mechanical properties of the skin were altered when the barrier was compromised. These observations suggest that the mechanical strength of the skin barrier may play a role in the development of, for example, friction dermatitis and other skin diseases affected by mechanical stress.

Adult↗
PubMed2006

Time spent on treatment (TSOT). An independent assessment of disease severity in atopic dermatitis.

INTRODUCTION: Time spent on treatment (TSOT) appears to reflect disease severity in pediatric patients with atopic dermatitis (AD). Our purpose was to examine the relationship between time spent on treatment and parental psychological parameters such as anxiety and depression. METHODS: TSOT was studied in a group of parents of patients with AD participating in an eczema school. TSOT included all types of topical treatment. In addition, dermatological life quality (the IDLQI questionnaire), depression (the MDI questionnaire), and anxiety (the STAI questionnaire) were assessed as well as the self-reported (by parent) disease severity, treatment effect, and confidence in treatment (VAS scales) using descriptive statistics, multiple linear regression, and rank correlations (Kendall's tau). RESULTS: TSOT was found to be significantly associated with parental age (older parents report lower TSOT) and IDLQI (low quality of life with high TSOT), whereas all the other parameters appeared redundant. Sex of the parent showed no effect on TSOT. CONCLUSION: Our data suggest that TSOT is not correlated with anxiety or depression. A positive independent correlation was found with general quality of life, offering mutual validation of the measures. The observations suggest that further investigation of TSOT as a surrogate measure of morbidity in AD may be of practical interest in order to develop an internationally comparable morbidity measure in AD.

Adolescent↗
PubMed2005

[Screening for skin cancer in organ transplant recipients in Denmark].

INTRODUCTION: Non-melanoma skin cancer (NMSC) is a serious cause of morbidity and mortality in organ transplant recipients. The necessary immunosuppressive therapy is linked to an increased number of biologically more aggressive acting skin tumours. Preventing disease and providing early diagnosis and treatment is thus essential. This is done through repetitive patient education and regular examination of the skin performed by a trained specialist, i.e., a dermatologist. We investigated the routine level of monitoring for NMSC in organ transplant recipients in Denmark. MATERIALS AND METHODS: A questionnaire survey was conducted on how hospital departments educate patients in NMSC prevention, the frequency of full-body skin examination and where patients are treated when a tumour is found. The questionnaire was sent to 28 medical departments in Denmark that follow up organ transplant recipients. Twenty-five departments returned the questionnaire. RESULTS: A full-body skin examination was routinely done in six (24%) of the departments. Fifteen (60%) of the departments informed patients about the risk factors for developing skin cancer, but only five (20%) provided written information. DISCUSSION: There appears to be considerable scope for improvement in the follow-up of organ transplant recipients. Providing thorough and repeated information to organ transplant patients, in addition to early diagnosis and treatment carried out by trained specialists according to standard guidelines, can minimize the morbidity and mortality caused by non-melanoma skin cancer in these patients. We suggest that written guidelines be provided in order to improve these patients" treatment and prognosis. A corresponding survey done in the United Kingdom produced almost the same conclusions.

Follow-Up Studies↗
PubMed2005

Photodynamic therapy in the treatment of rosacea.

BACKGROUND: Rosacea is a common disease, with an estimated prevalence of 5-10%. Established systemic and topical treatment is often effective but requires continuous medication. AIM: We report the outcome of photodynamic therapy (PDT) in 4 patients with rosacea. METHODS: Prior treatment consisted of standard treatment with tetracycline and metronidazole. The treatment was however either ineffective or the patients were dissatisfied with the need for continuous treatment. The patients all received standard treatment with PDT. RESULTS: The treated skin cleared in 3 of the 4 patients. Treatment with light alone did not appear to have any effect. In one of the patients there has been no relapse during a 9-month follow-up. In 2 patients, remissions lasted 3 months, during which time no additional or supplementary treatment was used. CONCLUSION: Our observation suggests that PDT may play a role in the future treatment of selected cases of rosacea.

Adult↗
PubMed2005

Patient education and morbidity in atopic eczema.

Effective treatment of atopic eczema is dependent upon good management by the patients and parents. It is possible to encourage patients and improve their compliance through nurse consultation and Web-based information.

Child, Preschool↗
PubMed2004

Does visible atopic dermatitis affect quality of life more in women than in men?

BACKGROUND: Studies have suggested that women overreport symptoms in nondermatologic disease. Gender-dependent differences in patients' perception of dermatologic disease are poorly described. The description of possible gender differences in morbidity in a skin disease with comparable prevalence in men and women may therefore provide relevant data. OBJECTIVE: The goal of this study was to examine gender-dependent differences in the self-reported morbidity of patients with atopic dermatitis (AD). METHODS: Questionnaires from members of the Atopisk Eksem Forening (Danish Association of Atopic Eczema) aged > or = 15 years were analyzed. Data were gathered regarding age, sex, disease duration and severity, and localization of AD, including the results of the Dermatology Life Quality Index (DLQI), a quality-of-life questionnaire designed for use in adults (ie, patients aged > or = 15 years). RESULTS: Questionnaires from 112 patients were analyzed. The final study population comprised 88 females and 24 males; mean age was 35.3 years (range, 15-77 years). For women, a significant positive correlation was found between DLQI score and disease severity (P < 0.001) and also between DLQI score and visible regions affected by disease (P = 0.001); these correlations were not observed in men. For the total number of body regions affected, a significant correlation with severity was found for women (P = 0.001) but not for men. No significant differences between men and women were noted for age, disease duration, overall disease severity, or quality of life as assessed using the DLQI. CONCLUSION: Self-reported morbidity is highly consistent among women with AD, but not so among men. Normally visible areas of AD appear to affect women significantly more than men.

Adolescent↗
PubMed2004

Lipid raft-enriched stem cell-like keratinocytes in the epidermis, hair follicles and sinus tracts in hidradenitis suppurativa.

Hidradenitis suppurativa (HS) is a disease, that causes considerable morbidity in patients. A histological hallmark of the disorder is the formation of sinus tracts in the dermis and the subcutis. Biologically, they represent a poorly understood phenomenon involving the infiltrative growth of proliferating non-malignant keratinocytes. Lipid domains in plasma membranes (lipid rafts) play a role in the function of growth factors and are suspected of having a pathogenic role in cell migration and invasive growth. Using HS as a model, the presence of lipid rafts was studied using cholera toxin conjugated with FITC (CTx-FITC) and antibeta1 integrin (CD29)-CyChrome conjugate fluorescence staining of unfixed and acetone-fixed cryostat sections of lesional and paralesional skin samples. The double-labeled skin samples were observed in the confocal laser-scanning fluorescence microscope. Samples were obtained from five patients with HS. The lesional epidermis of HS contained three populations of keratinocytes: CD29(bright)CTx(dim), CD29(dim)CTx(bright) and a third hitherto unseen population containing double-positive CD29(bright)CTx(bright) cells. The CD29(bright)CTx(dim) population resembles the earlier described epidermal stem-like cells, while the CD29(dim)CTx(bright) basal keratinocytes overlap with the transit-amplifying cell pool. The new population of double-positive CD29(bright)CTx(bright) cells was localized on the slopes of the papillas, focally in the suprabasal epidermal layers, in some hair follicles and in the majority of sinus tracts. Such double-positive cells have not previously been encountered by us in normal epidermis and hair follicles. Using HS as a model, it is suggested that the keratinocytes involved in sinus tract formation are CD29(bright)CTx(bright) cells. Owing to the physical proximity of the cells, it is hypothesised that the described CD29(bright)CTx(bright) cells result from an increased expression of CD29 on the CTx(bright) cells. It is likely that the double-positive CD29(bright)CTx(bright) cells emerge due to the influence of local inflammatory cytokines. Sinus tract formation may represent an aberrant epidermal repair response executed by the activated CD29(bright)CTx(bright) keratinocytes capable of non-malignant infiltrative growth in the dermis and subcutis.

Adolescent↗