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H A Neumann

Publications and source records attributed to H A Neumann.

At least 19 recordsLinked to original sources
PubMed2001

[Rosacea in the year 2001].

Rosacea is a chronic skin disorder of the face. Initially erythema and telangiectasia develop, followed at a later stage by papules and papulopustules. Females between 30 and 50 years of age are most affected. Pathogenesis is not clearly understood. Finally rhinophyma and persistent lymphoedema can develop. It can be difficult to distinguish acne vulgaris, seborrheic eczema, perioral dermatitis and lupus erythematosus from rosacea. Treatment of first choice consists of topically or systemically applied antibiotics. More severe cases can be treated with isotretinoin. Erythema and telangiectasia respond well to treatment with vascular lasers.

Adult↗
PubMed2001

In vivo pharmacokinetics of protoporphyrin IX accumulation following intracutaneous injection of 5-aminolevulinic acid.

Photodynamic therapy with 5-aminolevulinic acid (ALA) derived protoporphyrin IX (PpIX) as photosensitizer is a promising treatment for basal cell carcinomas. Until now ALA has been administered topically as an oil-in-water cream in most investigations. The disadvantage of this administration route is insufficiënt penetration in deeper, nodular tumours. Therefore we investigated intracutaneous injection of ALA as an alternative administration route. ALA was administered in 6-fold in the normal skin of three 6-week-old female Dutch pigs by intracutaneous injection of an aqueous solution of ALA (pH 5.0) in volumes of 0.1-0.5 ml and concentrations of 0.5-2% and by topical administration of a 20% ALA cream. During 8 h fluorescence of ALA derived PpIX was measured under 405 nm excitation. For the injection the measured fluorescence was shown to be dose dependent. All injected doses of 3 mg ALA or more lead to a faster initial increase rate of PpIX synthesis and significantly greater fluorescence than that measured after topical administration of ALA. Irradiation (60 Jcm(-2) for 10 min) of the spots was performed at 3.5 h after ALA administration. After 48 and 96 h visual damage scores were evaluated and biopsies were taken for histopathological examination. After injection of 2 mg ALA or more the PDT damage after illumination was shown to be significantly greater than after topical application of 20% ALA. An injected dose of 10 mg ALA (0.5 ml of a 2% solution) resulted in significantly more tissue damage after illumination than all other injected doses.

Administration, Cutaneous↗
PubMed2000

[Diagnostic image (16). Sweet's syndrome].

In a 68-year-old man suffering from painful erythematous infiltrated nodules and plaques on the face, the neck and the hands Sweet's syndrome was diagnosed. Histopathological examination showed the typical massive dermal infiltration by neutrophylic granulocytes, without vasculitis. He was successfully treated with oral corticosteroids.

Aged↗
PubMed2000

[Diagnostic image (13). Erythropoietic protoporphyria].

In a five-year-old girl with photosensitivity (burning skin sensation after a sun bath) and purpura on the nose and the sides of the fingers erythropoietic protoporphyria was diagnosed, an autosomal dominant disease.

Child, Preschool↗
PubMed2000

[Sexually transmitted diseases in Limburg in 1997; prevalence according to a survey of family practitioners and specialists and according to reports from microbiological laboratories].

OBJECTIVE: To determine the incidence of sexually transmitted diseases (STDs) and to compare data reported by general practitioners (GPs) and specialists with those reported by microbiological laboratories. DESIGN: Retrospective. METHOD: All 593 GPs and gynaecologists, dermatologists and urologists in Limburg, the Netherlands, in 1998 were asked to fill in a questionnaire about the number of cases of Chlamydia trachomatis, condylomata acuminata, genital herpes and gonorrhoea in 1997, by sex, age and diagnostic test. Data were compared with information gathered from the six laboratories of medical microbiology. For gonorrhoea the results were compared with those from a study in 1985. RESULTS: The response to the enquiry amounted to 75%. A total of 2730 cases were reported (32 per 10,000 of the population. Infection with C. trachomatis was the most frequent sexually transmitted disease (46%), followed by condylomata acuminata (28%), genital herpes (17%) and gonorrhoea (8%). Of the diseases 84% occurred in persons younger than 35 years of age and 66% in women. The GPs saw 79% of the STDs, they diagnosed 'gonorrhoea' in 25% of the cases merely on the basis of the clinical picture. Compared to 1985 the number of gonorrhoea cases was decimated in Limburg in 1997. Of those who answered the questions about warning the partner (approximately 50% of those concerned), 87% reported that they had let the partner know. It appears from the data of the six laboratories that the incidence of C. trachomatis infection was 3.2 and that of gonorrhoea 0.6 per 10,000 of the population. For the diagnosis of infection with C. trachomatis the GPs and specialists use a culture in 50% of the cases, as against 2% of the laboratories, for the ligase chain reaction and polymerase chain reaction tests these proportions were 20 and 78%.

Adult↗
PubMed2000

[A new option for skin rejuvenation: CO2-laser resurfacing].

Resurfacing denotes mechanical, chemical or physical removal of the superficial layers of aging skin, after which collagenesis is reactivated with improved epidermal architecture as a result. CO2 laser resurfacing is a modern technique for the treatment of skin aging. With CO2 laser resurfacing it is possible to perform accurate ablation of layers of the skin. Besides the cosmetic indications, this technique is a good treatment modality for a broad spectrum of dermatological diseases.

Carbon Dioxide↗
PubMed2000

Photodynamic therapy with delta-aminolaevulinic acid for nodular basal cell carcinomas using a prior debulking technique.

The incidence of basal cell carcinomas (BCCs) is still increasing, and there is a demand for an easy, effective and selective non-invasive treatment such as topical photodynamic therapy (PDT). Twenty-three patients with 24 nodular BCCs were treated once with delta-aminolaevulinic acid (delta-ALA) PDT (100 mW cm(-2), 120 J/cm2) 3 weeks after prior debulking of the BCCs. Three months after PDT, all lesions were surgically excised and histopathologically evaluated for residual tumour. Twenty-two (92%) of the 24 nodular BCCs showed a complete response on clinical and histopathological examination. PDT for superficially abraded nodular BCCs with topically applied delta-ALA and the VersaLight as light source is an easy, effective and safe therapy, with excellent cosmetic results and no serious side-effects, in cases where non-surgical treatment of BCCs is indicated.

Basal Cell Carcinoma↗
PubMed2000

An impressive therapeutic result of class III compression stockings in a patient with longstanding, extensive, combined leg ulcers.

BACKGROUND: Only a few publications are available in the literature concerning the treatment of venous leg ulcers by means of medical compression stockings. SUBJECT: A 59-year-old female patient with longstanding, extensive bilateral leg ulcers due to venous insufficiency, arteriolosclerosis and secondary lymphoedema, was treated successfully by flat-knitted medical compression stockings of compression-class III. CONCLUSION: The great advantage of this treatment is the fact that it is comfortable and easy to carry out at home. Furthermore, the costs of compression therapy with medical compression stockings are only a fraction of those of conventional therapy by means of compressive non-elastic bandages. Once or twice weekly visits of the patient to the hospital are not necessary and less specialized dermatological nurses are needed.

Bandages↗
PubMed2000

The effect of medical elastic compression stockings with different slope values on edema. Measurements underneath three different types of stockings.

BACKGROUND: Medical elastic compression stockings are widely used in venous diseases. Their effects on the venous system have been shown in the past. Up to now, little is known about the slope or stiffness factor of stockings. OBJECTIVE: To evaluate the effect of different slope and stiffness factors of medical elastic compression stockings on the venous system. METHODS: Examinations were carried out in 29 legs of 25 different patients (12 men, 13 women) with a mean age of 66.0 years. All patients were known with chronic venous insufficiency. On all these patients three different elastic medical compression stockings were tested; one with a low slope, one with a high slope, and one with a low slope but a higher pressure at the ankle. The tests were carried out by determining capillary filtration rate (CFR) with air-plethysmography (APG) while wearing the stockings. RESULTS: The mean value of the CFR without wearing a stocking was 4.65 ml/min (SD = 1.68), with Compriform (low slope, 30 mmHg) the mean CFR was 3.54 ml/min (SD = 1.22), with Bellavar (high slope, 30 mmHg) a mean CFR of 3.15 ml/min (SD = 1.17) was found, and the mean CFR related to Fast-fit (low slope, 34.5 mmHg) was 3.02 ml/min (SD = 1.12). There is a highly statistically significant difference in CFR between no stockings and wearing a stocking (paired Student's t-test; P < 0.01). Regarding the individual stocking, there is a highly statistically significant difference in CFR between the Compriform and the other two stockings (paired Student's t-test; P < 0.01). Between Bellavar and the Fast-fit the difference was not statistically significant. CONCLUSIONS: There is a statistically significant difference in CFR, and consequently in the development of edema, between not wearing an elastic compression stocking and wearing an elastic compression stocking. There is also a statistically significant difference in CFR between elastic compression stockings with the same compression, but a low slope profile and a high slope profile. Stockings with a low slope, but a higher compression may perform as well as stockings with a higher slope but a lower compression in reducing the CFR. In patients with a strong tendency to develop edema it may be advisable to prescribe stockings with a high slope profile.

Adult↗
PubMed2000

Cosmetic results of cryosurgery versus surgical excision for primary uncomplicated basal cell carcinomas of the head and neck.

BACKGROUND: The incidence of multiple facial basal cell carcinomas (BCCs) is increasing. OBJECTIVE: Comparison of cosmetic results after cryosurgery and excision for primary BCCs. METHODS: Cosmetic results after cryosurgery and excision (prospective randomized study) of primary BCCs in the head/neck area were assessed by five independent professional observers and by the patients. RESULTS: Ninety-six BCCs were treated either with surgical excision (n = 48) or cryosurgery (n = 48). Clinical professionals evaluated the cosmetic results after surgery as significantly better. The beautician had no preference for either therapy. The patient had a significant preference for excision. Localization and size of the tumor did not modify this general preference for excision. The male dermatologist, however, had a tendency to evaluate results in the cheek, periauricular, and neck area as inferior to those in the rest of the face, regardless of which therapy was given. CONCLUSION: In general, cosmetic results after excision are better than after cryosurgery.

Adolescent↗
PubMed1999

The prevalence of factor V Leiden mutation in patients with leg ulcers and venous insufficiency.

OBJECTIVES: To study the prevalence of factor V Leiden mutation in patients with chronic venous insufficiency and venous leg ulcers, compared with a control group, and to find out whether factor V Leiden mutation is more frequent in patients with chronic venous insufficiency and a history of deep venous thrombosis. DESIGN: A case control study. SETTING: Three outpatient dermatological clinics. PATIENTS: Ninety-two patients (37 men, 55 women) with venous leg ulcers and 53 control patients (23 men, 30 women). MAIN OUTCOME MEASURE: Factor V Leiden mutation. RESULTS: Factor V Leiden mutation was significantly more frequent in patients with chronic venous insufficiency and venous leg ulcers than in the control group (23% vs 7.5%; P=.03), and the patients with factor V Leiden mutation were more likely to have a history of venous thromboembolism (91% vs 48%, P=.002). Also, recurrent deep venous thrombosis (38% vs 14%) and recurrent leg ulcerations (9 episodes or more) occurred more frequently in the patients with factor V Leiden mutation (43% vs 19%, P=.01). No difference was observed in venous refill time or in the presence of dermatoliposclerosis and atrophie blanche. CONCLUSIONS: Factor V Leiden mutation is more frequent in patients with venous leg ulceration than in the control group and the general population. Patients with factor V Leiden mutation have an increased risk of developing deep venous thrombosis and recurrent leg ulceration.

Adult↗
PubMed1999

Familial dyskeratotic comedones.

We report a 49-year-old white woman having asymptomatic hyperkeratotic comedone-like lesions on her legs, arms and trunk. Her sister is similarly affected, but less severely. The clinical and histopathological features indicated a diagnosis of familial dyskeratotic comedones, a rare autosomal dominant condition.

Arm↗
PubMed1999

Long cotton wool rolls as compression enhancers in macrosclerotherapy for varicose veins.

BACKGROUND: Macrosclerotherapy in combination with compression has proven to be safe and effective in the treatment of varicose veins. Local compression is increased by pads, according to Laplace law. Firm rolls of cotton wool are fixed over the course of the entire vein to increase local compression and to reduce complications. Additional compression is given by a combination of a class I (daytime and nighttime) and class II (daytime only) medical compression hosiery. PURPOSE: To evaluate the effectiveness and side effects of sclerocompression therapy with cotton wool rolls in combination with medical compression hosiery. METHOD: Prospective study with 100 patients (120 legs) with primary varicose veins, which are treated with polidocanol as sclerosant with the empty vein technique. Immediately after the injection, a long cotton wool roll is placed over the entire vein and fixed. Additional compression is obtained with class I and class II medical compression hosiery. The interface pressure on the skin, just under the cotton wool roll, is measured on 12 legs with the aid of an interface pressure measuring instrument (Oxford Pressure Monitor). RESULTS: Good sclerosing results are obtained in all patients. Side effects are classified as early and late. In 16 patients, minor side effects which needed no treatment are observed. In only 3 cases (2.5%), intravascular blood clots (2) and phlebitis (1) needed incision and expression. The mean interface pressure of all measuring sensors under the cotton wool roll is 84 mm/Hg (68 to 122 mm/Hg). CONCLUSION: This study proves the high effectiveness of a cotton wool roll compression right at the place of treatment. By using these long cotton wool compression rolls, the compression part of sclerocompression therapy becomes more effective and much easier to perform.

Animals↗
PubMed1999

Plethysmography.

Explore the source record for details and available documents.

Humans↗
PubMed1999

Bockenheimer's syndrome.

A case of a very extensive form of the rare Bockenheimer's syndrome (genuine diffuse phlebectasia) in a 45-year-old female patient is presented. The subject presented phlebectasias of the upper right leg, the vulva and the right side of the abdomen. The diagnostic and therapeutic possibilities for cases of patients with Bockenheimer's syndrome are described.

Abdominal Muscles↗