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H F Merk

Publications and source records attributed to H F Merk.

At least 19 recordsLinked to original sources
PubMed2006

[Laboratory tests and therapeutic strategies for the porphyrias].

The porphyrias are a heterogeneous group of predominantly hereditary metabolic diseases resulting from a dysfunction of heme biosynthesis. Most of the porphyrias can manifest with a broad range of cutaneous symptoms on the sun-exposed areas of the body, whereas other variants reveal life-threatening acute neurological attacks. Further, mixed types of porphyrias exist. Besides the skin, other organs can be affected, such as the liver and the central nervous system. Therefore, interdisciplinary supervision of these patients is mandatory. In this review we will first present the clinical picture and diagnosis of the porphyrias, including the specific biochemical laboratory tests and a diagnostic algorithm. Thereafter, the current therapeutic concepts will be briefly addressed. Finally, we introduce the European Porphyria Initiative (EPI), an association of various European porphyria centers that is aiming at gathering the broad experience of internationally renowned porphyria experts for the development of European consensus guidelines for diagnosis and treatment of these metabolic disorders.

Algorithms↗
PubMed2006

[In vitro allergy testing].

Along with the history, skin tests and provocation tests, in vitro test procedures are essential for the adequate care for patients with allergies. While serological investigations of immediate-type allergic reactions primarily detect allergen-specific IgE antibodies, basophil activation tests with different read-out parameters are available for cellular diagnosis of immediate-type reaction patterns. If clinically necessary, further immunological methods (i. e. immunoblots, lymphocyte transformation tests) can be employed. New options are provided by allergen microarray technology, which makes it possible to determine not only the specific antigenic protein but also to analyze different epitopes.

Allergens↗
PubMed2006

[Photodermatoses].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2006

Xenobiotics in vitro: the influence of L-cystine, pantothenat, and miliacin on metabolic and proliferative capacity of keratinocytes.

To investigate the effect of cell growth-stimulating agents on human epidermal keratinocytes, we exposed monolayers of normal human keratinocytes derived from foreskin to different concentrations of the amino acid L-cystine, the member of the vitamin B family D-pantothenat, the phytosterol miliacin, and a combination thereof in keratinocyte growth medium. As a test system for the metabolic capacity, we used the activity of mitochondrial deyhdrogenases as measured by XTT, and for the cell proliferation, we determined the BrdU-uptake. The additives, active ingredients of the hair growth drug PRIORIN, were added in the presence of fully supplemented keratinocyte growth medium or a deficient medium without L-cystine, L-methionine, L-histidin, D-pantothenat, epidermal growth factor, and bovine pituary gland extract. Deficient medium itself reduced the metabolic capacity of keratinocytes to 35% compared with keratinocytes in fully supplemented growth medium. In deficient medium cell, proliferation was not measurable. Increasing doses of L-cystine restored the reduced metabolic capacity from 46% (0.009 mg/L) to 54% (0.09 mg/L) and 92% (0.45 mg/L) in deficient medium. Addition of D-pantothenat (0.43 mg/L) enhanced the metabolic capacity to 150% only in fully supplemented growth medium, compared with untreated controls with growth medium. Miliacin (6 mg/mL) increased not only the metabolic capacity (162%) but also stimulated cell proliferation (215%) as measured by BrdU-uptake in growth medium. The combination of all three additives increased the metabolic capacity (245%) synergistically in growth medium. We were able to show effects of D-panthenol, L-lysine, and miliacin on proliferation and metabolic capacity of keratinocyte monocell culture, which was further increased by combination of the three substances. These basic results suggest a beneficial effect on keratinocyte growth and stimulation by products combining these substances (e.g., Priorin). Furthermore, this work emphasizes the suitability of keratinocyte monolayers for pharmacological testings.

Bromodeoxyuridine↗
PubMed2006

EAACI/GA2LEN/EDF guideline: management of urticaria.

This guideline is the result of a consensus reached during a panel discussion at the second International Consensus Meeting on Urticara, Urticaria 2004, a joint initiative of the EAACI Dermatology Section and GA2LEN. Urticaria has a profound impact on the quality of life, and effective treatment is therefore required. The recommended first line treatment are nonsedating H1 antihistamines. They have proven to be effective in double-blind controlled studies, but dosages increased up to fourfold over the recommended doses may be necessary. However, for different urticaria subtypes and in view of individual variation in the course of the disease and response to treatment, additional or alternative therapies may be required. Immunosuppressive drugs like cyclosporin A and corticosteroids are not recommended for long-term treatment due to unavoidable severe adverse effects. This guideline was, in addition, accepted by the European Dermatology Forum (EDF) and formally approved by the European Union of Medical Specialists (UEMS).

Anti-Allergic Agents↗
PubMed2006

EAACI/GA2LEN/EDF guideline: definition, classification and diagnosis of urticaria.

This guideline is the result of a consensus reached during a panel discussion at the 2nd International Consensus Meeting on Urticaria, Urticaria 2004, a joint initiative of the European Academy of Allergology and Clinical Immunology Dermatology Section and the European Union (EU)-funded network of excellence, GA2LEN. It covers the definition and classification of urticaria, taking into account the recent progress in identifying causes, eliciting factors and pathomechanisms of this disease. We have outlined useful diagnostic approaches for different subtypes of urticaria. This guideline was, in addition, accepted by the European Dermatology Forum (EDF) and was formally approved by the European Union of Medical Specialists (UEMS).

Allergens↗
PubMed2006

Barber's hair sinus in a female hairdresser: uncommon manifestation of an occupational dermatosis.

Hairdressers are prone to developing occupational skin diseases, particularly hand eczema of different origins. Rather uncommon, however, is the so-called barber's hair sinus that is caused by hair fragments penetrating the skin preferably in the interdigital spaces of their hands. Whereas, to date, the disease has almost exclusively been reported to occur on the hands of male hairdressers, we herein present the first case of a female hairdresser who developed a barber's hair sinus on one of her feet.

Barbering↗
PubMed2005

In vitro analysis of birch-pollen-associated food allergy by use of recombinant allergens in the basophil activation test.

BACKGROUND: Basophil activation is associated with the expression of CD63. In birch-pollen-associated food allergy to celery, carrot and apple, Bet v 1, Api g 1, Dau c 1 and Mal d 1 are major allergens. Recombinant allergens have not yet been used in the CD63-based basophil activation test (BAT). OBJECTIVE: To evaluate the feasibility of using recombinant allergens in the BAT in the diagnosis of allergy to apple, carrot and celery and to compare results with routine tests, i.e. skin prick tests (SPTs) and specific IgE. METHODS: Thirty-two patients with an oral allergy syndrome induced by apple, carrot or celery and 22 controls were studied. SPTs were performed with native foods. Specific IgE was determined by the CAP method and basophil activation by flowcytometry upon double staining with anti-IgE/anti-CD63 monoclonal antibodies after incubating with purified recombinant Bet v 1, Bet v 2, Api g 1, Dau c 1 and Mal d 1. RESULTS: By the combined use of the BAT and the CAP method, sensitization to Bet v 1 and Bet v 2 was detected in 100 and 25% of all subjects, respectively. Sensitivity of specific IgE for apple, carrot and celery was 60, 70 and 75% with corresponding specificities of 64, 86 and 82%. Sensitivity of the BAT for Mal d 1, Dau c 1 and Api g 1 was 75, 65 and 75% with corresponding specificities of 68, 100 and 77%. CONCLUSIONS: The BAT using recombinant allergens provides a valuable new in vitro method for the detection of sensitization to foods. Although double-blind placebo-controlled food challenges remain the gold standard to confirm food allergy, the CD63-based BAT with recombinant allergens may supplement routine tests for allergy diagnosis.

Allergens↗
PubMed2005

[Basophil activation tests in the diagnosis of drug reactions].

Over the past 10 years a number of studies on basophil activation tests (BAT) have been published which focus on their use as diagnostic methods in clarifying IgE-mediated hypersensitivity reactions to various allergens including drugs. These BAT are based on flow cytometric quantification of allergen- induced CD63 or CD203 expression or measurement of sulfo leukotriene release by ELISA. In the diagnosis of penicillin allergy, the combined use of the CD63-BAT and specific IgE increases sensitivity. The role of BAT in the diagnosis of non-IgE-mediated reactions to non-steroidal anti- inflammatory drugs remains to be clarified. This article focuses on (1) the principles of BAT, (2) technical aspects, (3) clinical applications and (4) recommendations for further development.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2005

[Pharmacogenetics: Important aspects for dermatology].

Pharmacogenetics, pharmacogenomics or metabonomics are terms reflecting a new trend in pharmacology taking into consideration individual factors which influence the effects of drugs. Examples in dermatology include glucose-6-phosphate dehydrogenase-polymorphism (DADPS), dihydropyrimidine dehydrogenase-deficiency (5-Fluoruracil), thiopurine-S-methyltransferase-deficiency (azathioprine), cytochrome P450 isoenzymes and transferases (drug allergy and allergic contact dermatitis), and intolerant reactions to NSAIDs.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2005

[Drug allergies. Clinical aspects, pathophysiology and treatment of cutaneous manifestations].

Cutaneous adverse drug reactions (ADR) are common and encompass a broad clinical spectrum. Since the skin acts as a signaling organ for ADR, the dermatologist plays a key role in their diagnosis. Only a minor part of cutaneous ADR are due to underlying allergic mechanisms. Among these, delayed-type reactions such as maculopapular exanthems and immediate-type reactions such as urticaria and angioedema predominate. Risk factors for the development of cutaneous allergic ADR may be related to the patient (e.g. certain HLA-types), the drug (e.g. its reactivity), and underlying conditions (e.g. viral infections). Antibiotics, non-steroidal anti-inflammatory agents and anticonvulsive medications are most often reported to be causally related.

Drug Eruptions↗
PubMed2005

[Contact allergens in the standard patch test series from 1980-2004 at the University Clinic Aachen].

Allergic contact dermatitis is a common disease whose specific therapy is avoidance of allergens. It is critical to identify frequency of occurrence of allergic reactions to initiate preventive measures (e.g. elimination of substances with an especially high allergic potential). This study analyzes results of patch testing performed between 1980 and 1993 at the University Clinic of the RWTH Aachen. Additionally, age and sex-related distribution was evaluated. The data is compared to published patch test results covering the years 1995-2001 and patch test results from 2004 in the University Clinic Aachen.

Adolescent↗
PubMed2004

[Allergic occupational dermatoses. Role of in vitro studies in diagnosis and prevention].

Recently published guidelines only recommended in vitro assays for atopy screening by the determination of specific IgE antibodies in occupational cutaneous allergic diseases. However further indications include latex allergy, occupational drug allergy and wasp/ bee venom allergy. The lymphocyte transformation test may be an alternative to the patch test, in order to differentiate allergy from irritancy, or it may be an alternative to the patch test if hazardous compounds such as carcinogens are the possible antigens.

Dermatitis, Atopic↗
PubMed2004

[Type I sensitization to seminal fluid. Urticaria and angioedema].

Allergy to human seminal fluid is a rare but potentially life-threatening disorder. Acute symptoms range from local reactions to generalized symptoms. A 30-year-old woman experienced vulvovaginal itching, erythema and swelling as well as generalized urticaria and angioedema of the neck and face after unprotected sexual intercourse. A scratch test with undiluted seminal fluid and the detection of specific IgE antibodies revealed a type I allergy to seminal fluid. Risk factors and therapeutic options are discussed.

Adult↗