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Biomedical subjects

H H Roenigk

Publications and source records attributed to H H Roenigk.

At least 19 recordsLinked to original sources
PubMed1992

Autoerythrocyte sensitization syndrome (psychogenic purpura).

A case of autoerythrocyte sensitization syndrome is reported. This syndrome most often appears in young women who have an underlying emotional disorder; features include bizarre, tender ecchymotic lesions, which are most commonly located on the arms and legs. Systemic symptoms often accompany the onset of these lesions. A diagnosis of autoerythrocyte sensitization syndrome may be made in a patient who has the typical history and clinical picture of the syndrome and in whom a skin test with use of the patient's blood reveals a positive reaction.

Acute Disease↗
PubMed1992

Autologous fat transplantation. Long-term follow-up.

We present a clinical long-term follow-up of our autologous fat transplantation patients. Our study group consists of 43 patients followed over 3-48 months (mean 26 months). Cosmetic defects treated include linear morphea, expression lines, acne scars, discoid lupus erythematosus scars, and post-traumatic scarring. Postoperative complications were rare and short term. We conclude that autologous fat transplantation is a safe and effective procedure. Fat graft longevity is examined in relation to the cosmetic defect treated, the recipient site, and the donor site.

Acne Vulgaris↗
PubMed1992

Trichloroacetic acid peel of molluscum contagiosum in immunocompromised patients.

Seven human immunodeficiency virus-(HIV) positive patients with biopsy proved extensive facial molluscum contagiosum were treated with trichloroacetic acid peels. Peels were performed with 25 to 50% trichloroacetic acid (average 35%) and were repeated every 2 weeks as needed. A total of 15 peels were performed with an average reduction in lesion counts of 40.5% (range 0 to 90%). No spread of molluscum lesions, scarring, or secondary infection developed at 2 months' follow-up. Trichloroacetic acid peeling in concentrations of 35% or less appears to be a safe, effective, adjuvant therapy in the treatment of extensive molluscum contagiosum in immunocompromised patients.

Chemexfoliation↗
PubMed1991

Mycosis fungoides and the Sézary syndrome: a review of pathogenesis, diagnosis, and therapy.

Mycosis fungoides (MF) and the Sézary syndrome (SS) are non-Hodgkin's lymphomas with a T-cell phenotype, which have cutaneous involvement as their predominant feature. These disorders are becoming more common, and the patients are frequently being referred to medical oncologists for assistance in management. The development of advanced laboratory techniques, such as molecular genetics and cell-surface phenotyping, has greatly enhanced our understanding of their pathogenesis and may lead to identification of responsible etiologic factors. A myriad of treatment options have been investigated including topical approaches, systemic chemotherapy, and external radiation. Currently, extensive trials are underway examining the potential benefits of agents such as the interferons, interleukin-2, monoclonal antibodies, the retinoids, 2-chlorodeoxyadenosine, and other novel biologic response modifiers or chemotherapeutics. Although all these therapies have benefit in phase II trials, few randomized comparative trials have been performed to identify optimal therapies. Performance of such trials should now become a priority.

Combined Modality Therapy↗
PubMed1991

AIDS and infection control in dermatologic surgery.

In summary, the AIDS epidemic has created many new questions for the dermatologist, with no clear answers. As dermatologic surgery is increasing in most dermatology practices, the dermatologic surgeon must take a careful look at his office techniques and educate his personnel on the proper handling of blood and body fluids. The medical and ethical issues raised by the AIDS epidemic are complex, with new issues being raised as more is learned about the disease. The adage "do no harm" should be kept in mind in the counseling, diagnosis, and treatment of HIV-infected individuals.

AIDS Serodiagnosis↗
PubMed1991

Cutaneous T-cell lymphoma in patients with human immunodeficiency virus infection.

The development of cutaneous T-cell lymphoma is unusual in individuals with human immunodeficiency virus type 1 infection. We present four patients with cutaneous T-cell lymphoma and human immunodeficiency virus type 1 infection. Immunophenotyping of lymph node tissue in three of these patients revealed a predominance of T-suppressor cells. Possible causes for the development of cutaneous T-cell lymphoma in the presence of human immunodeficiency virus type 1 infection are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Interferon alfa-2a combined with phototherapy in the treatment of cutaneous T-cell lymphoma.

Escalating doses of recombinant interferon alfa-2a (Roferon-A), administered intramuscularly three times weekly, combined with psoralen plus ultraviolet light irradiation (PUVA), were tested in a phase I trial for the therapy of patients with cutaneous T-cell lymphomas (CTCL). Interferon doses were escalated in groups of three patients from 6 million to 30 million IUs three times weekly. Disease stages ranged from IB to IVB. Eighty percent of the patients entered in this trial had failed at least one prior therapy. Complete remissions were obtained in 12 of 15 patients, and partial responses were seen in two of 15 patients, for an overall response rate of 93%. The median duration of response exceeded 13 months (range, 3-15+). All patients who responded have been maintained on therapy. The dose-limiting toxic effects were constitutional symptoms such as fevers and malaise (93.3%), leukopenias (40.0%), mental status changes consisting of depression and confusion (33.3%), and photosensitivity (26.6%). These side effects were reversible with a decrement in dose or discontinuation of the interferon. No patient tolerated 30 million IU of the interferon for extended periods; the maximally tolerated dose was 18 million IU. Interferon plus PUVA appears to be a highly effective regimen for the treatment of patients with CTCL. Phase II studies investigating this combination, using 18 million IU of interferon alfa-2a three times weekly, should be undertaken to expand these findings, and to attempt to reduce the toxic effects associated with this therapy.

Combined Modality Therapy↗
PubMed1990

Phase II study of recombinant human interferon gamma for treatment of cutaneous T-cell lymphoma.

Recombinant human interferon gamma (rIFN-gamma) was used for the treatment of 16 patients with various stages of cutaneous T-cell lymphoma (CTCL). All patients had been previously treated with standard topical and/or systemic therapies, and some had received experimental treatment with retinoids, recombinant human interferon alfa-2a (rIFN-alpha 2a), or radiolabeled monoclonal antibodies; most patients had an advanced stage of disease. Objective partial responses (PRs) were noted in five patients (31%) and lasted 3 months to greater than 32 months (median, 10 mo). One of these five patients had previously had disease progression after an initial PR with rIFN-alpha 2a. Six other patients (38%) showed minor or mixed responses. The most common side effects of rIFN-gamma included fever, weight loss, mild neutropenia, elevated lactate dehydrogenase, and elevated hepatic transaminases. Additionally, one episode of nephrotic syndrome and one cutaneous allergic reaction were noted. None of the toxic effects were life threatening, and all were reversible. These results suggest that rIFN-gamma has efficacy in the treatment of CTCL refractory to rIFN-alpha 2a.

Antibodies↗
PubMed1990

Photochemotherapy alone or combined with interferon alpha-2a in the treatment of cutaneous T-cell lymphoma.

Eighty-two patients with either mycosis fungoides (MF) or parapsoriasis en plaques were treated with psoralens ultraviolet A light (PUVA). Clinical and histologic parameters were followed for a period from 6 months to 10 years. Complete clinical clearing of lesions was observed in 51 patients (62%) and most of them were in limited-plaque MF group or parapsoriasis en plaque. The mean total dose of PUVA for complete clearing was less for early MF. Thirty-one patients (38%) relapsed and responded to additional PUVA. Patients in early stages of the disease remained clear for up to 68 months after the first course of PUVA. Post-treatment skin biopsies with early MF showed histologic clearing. A new combination therapy for MF is presented in 15 patients. Recombinant interferon alpha-2a (Roferon-A), administered intramuscularly combined with PUVA were tested in a phase I trial. Interferon doses were from 6-30 million units three times weekly. Disease stages ranged from I-B to IV-B. Complete responses were obtained in 12 of 15 patients, and partial responses seen in 2 of 15 patients, for an overall response rate of 93%. The median duration of response exceeded 23 months (range, 3 to 25 months). All responding patients have been maintained on therapy. The dose-limiting toxicities were constitutional symptoms such as fevers and malaise (93.3%), leukopenias (40.0%), mental status changes consisting of depression and confusion (33.3%), and photosensitivity (26.6%). Interferon plus PUVA appear to be highly effective regimens for the treatment of patients with cutaneous T-cell lymphomas.

Adult↗
PubMed1990

Current surgical management of skin cancer in dermatology.

Skin cancer has become a major public health problem in the United States and worldwide. Epidemiologic studies confirm a continued increase in the number of basal cell carcinomas, squamous cell carcinomas, and malignant melanomas. Dermatologists, the primary caretakers of the skin, manage skin cancer with various modalities that have been time tested and found reliable, including excision, electrosurgery, cryosurgery, and Mohs micrographic surgery. Extirpative procedures for basal cell carcinoma and squamous cell carcinoma are considered with attention to cure, restoration of function, and cosmesis--in that order. The dermatologic management of melanoma is critical because early diagnosis and treatment of thin lesions has been the only effective improvement in melanoma management in the last several decades. Wide excision, with a 1-3-cm margin, of thin stage I melanoma has moved surgical management from the operating room to the outpatient surgical setting. Management of these increasingly common problems, as reviewed here, is principally responsible for the growth of surgical practice as a subspecialty of dermatology.

Carcinoma↗
PubMed1990

Liposuction of lipomas.

When lipomas reach 4 cm or more in size or are multiple, liposuction becomes an excellent alternative to excisional surgery. The basic concept is that fat lobules are bluntly broken down or curetted by a cannula and then removed through the cannula's aperture by a vacuum force generated from a suction machine. There are few minor sequelae, and these are rarely of a prolonged nature. The benefits of liposuction are decreased surgical time, a shorter scar, a better final contour, and the ability to remove several lipomas through one opening. In addition, liposuction surgery is a useful modality for the removal of lipomas because of the low recurrence rate and minimal malignant potential of these tumors.

Female↗