Difficult differential diagnosis of lichenoid reactions on mucosal skin.
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Child↗
Biomedical subjects
H Gollnick
Publications and source records attributed to H Gollnick.
The antipsoriatic dimethyl-fumarate suppresses interferon-gamma -induced ICAM-1 and HLA-DR expression on hyperproliferative keratinocytes. Quantification by a culture plate-directed APAAP-ELISA technique.
The derivatives of fumaric acid show antipsoriatic effects but details of the mechanism of action are largely unknown. The study focused on the effect of fumaric acid, dimethyl-fumarate, Zn-, Ca- and Mg-monoethyl-fumarate on the interferon-gamma (IFN-gamma)-induced expression of ICAM-1 and HLA-DR molecules on keratinocytes. Human hyperproliferative keratinocytes of the HaCaT cell line were exposed to IFN-gamma (10 U/ml) alone or in combination with fumaric acid and its derivatives for 48 hrs. The effect of fumarates was investigated semiquantitatively using the alkaline phosphatase-anti-alkaline phosphatase (APAAP) method. Subsequently, the effect of dimethyl-fumarate, the main component of "fumaric acid therapy", was evaluated quantitatively by means of an APAAP-ELISA technique. The semiquantitative evaluation revealed that in the micromolar dose range investigated only dimethyl-fumarate demonstrated substantial growth inhibition and down-regulation of the cell surface markers. In the quantitative evaluation, dimethyl-fumarate significantly (p</=0.05) suppressed the expression of ICAM-1 (84%) and HLA-DR (67%) on HaCaT keratinocytes at a subtoxic concentration of 4.0 microM as compared to untreated controls (100%). In contrast, concentrations of 4.0, 12 and 35 microM dimethyl-fumarate had no influence on the ICAM-1 and HLA-DR expression on IFN-gamma-exposed normal human epidermal keratinocytes in primary cultures. Thus, there is experimental evidence that dimethyl-fumarate may exert its antipsoriatic effect not only as an antiproliferative agent but also by down-regulation of ICAM-1 and HLA-DR molecules on hyperproliferative keratinocytes.
Cell Division↗
Successful treatment of disseminated facial verrucae with contact immunotherapy.
Disseminated flat warts are a common therapeutic problem in immunocompromised patients. However, disseminated infection on the face is, even in the immunocompetent host, a challenge. We report on a 14-year-old girl who had suffered from increasing eruptions of multiple disseminated verrucae planae et filiformes of the face for 18 months. As an alternative to silk-touch CO2-laser, contact cryotherapy or systemic immune enhancer we administered topical immunotherapy with diphenylcyclopropenone (DCP). The initial challenge with DCP 2% was performed on the forehead and the challenge was repeated weekly with DCP 0.01%. After four applications, the girl reported peeling of single warts on the forehead but more importantly at distant sites which had not received DCP. After eight weeks the patient's face was free of lesions. So far, the patient has remained free from relapse. This is the first case report of successful topical immunotherapy with DCP in disseminated facial verrucae planae and should be regarded as an effective therapeutic tool in this indication, emphasizing the great advantage of prevention of scarring of the skin induced by other therapeutic modalities.
Administration, Topical↗