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Biomedical subjects

H Hönigsmann

Publications and source records attributed to H Hönigsmann.

At least 145 records · Page 8Linked to original sources

[Photochemotherapy of psoriasis: increasing its effectiveness with an oral aromatic retinoid (clinical results in 134 patients) (author's transl)].

The effectiveness of photochemotherapy can be substantially increased by the concomitant administration of an oral aromatic retinoid. 134 patients with severe plaque-type or palmoplantar psoriasis were given various combined treatment schedules. In the initial (clearing) phase a significant synergistic effect was achieved if retinoid administration was started before photochemotherapy, and if the dose was 1.0 mg/kg body-weight. This shortened by half the time required in a control group given photochemotherapy alone (7.7 +/- 4.5 irradiation sessions within 14.1 +/- 8.6 days), and reduction of the total UVA energy necessary for complete clearing to one third (32.4 +/- 40.0 J/cm2). After clearing the patients received standard photochemotherapy maintanance treatment. The incidence of relapses observed during a 10-month follow-up was the same as that in patients cleared and maintained with photochemotherapy alone. Short courses of retinoid treatment in addition to photochemotherapy were highly effective in clearing patients who had failed to do so or had not been maintained in a cleared state on standard photochemotherapy.

Administration, Oral↗

Epidermolytic hereditary palmoplantar keratoderma. Report of a family and treatment with an oral aromatic retinoid.

This study describes a family of 30 people in which 14 members have hereditary epidermolytic palmoplantar keratoderma. Four patients were treated with an oral aromatic retinoid for up to 5 months. They responded in a uniform and dramatic way: 10-14 days after the onset of therapy, the hyperkeratotic horny layer was sequestered in large sheets resulting in normal appearing skin and restoration of normal surface sensitivity. Biopsies revealed that the underlying disorder of keratinization had remained unchanged. Treatment with the retinoid had to be discontinued as the sensitivity and vulnerability restricted normal function of hands and feet.

Adult↗

[Photochemotherapy in mycosis fungoides].

Nineteen patients with mycosis fungoides (m.f.), without involvement of lymph nodes and/or internal organs, were treated with oral photochemotherapy (PUVA). After four to five weeks of PUVA therapy (four irradiations/week) complete remission of erythematous and infiltrative plaques occurred; tumorous m.f. lesions also responded to treatment but required longer treatment times. After complete resolution of m.f. lesions the patients were controlled regularly, the observation periods ranging from 6 to 27 months. When recurrences occurred the initial treatment schedule was resumed. Recurrences, more often seen in the tumorous m.f. stage, responded to PUVA equally well as the initial lesions. PUVA therapy of m.f. is thus more effective than conventional UVB-irradiation and less problematic than treatment with cytotoxic agents or ionizing radiation. Present experience indicates that PUVA represents the treatment of choice in early stage m.f.

Adult↗

[The testing of photochemotherapy in various dermatoses].

Experimental PUVA therapy in five different skin diseases showed excellent results in lichen planus and pityriasis lichenoides et varioliformis. Present experience indicates a favourable influence of PUVA also in pityriasis rubra pilaris and in lymphomatoid papulosis. In Darier's disease PUVA leads to acute exacerbation.

Adult↗

[Spectinomycin (Trobicin) in Male Gonorrhoea (author's transl)].

28 male patient with uncomplicated acute gonorrhoea were treated with a single intramuscular injection of 2.0 g spectinomycin. All of them were cured. The suitable alternative to penicillin in the treatment of uncomplicated gonorrhoea, but it will not cure simultaneously-acquired syphilis. Its use should, therefore, be restricted to specific indications.

Adolescent↗

Photochemotherapy for pustular psoriasis (von Zumbusch).

Photochemotherapy (PUVA) with oral methoxsalen and UV-A was instituted in 8 patients with generalized pustular psoriasis (von Zumbusch). Complete clearing of skin lesions and of systemic symptoms was achieved in all patients. Patients who had been on systemic treatment prior to PUVA had to be treated with considerably more UV-A energy than patients who had received topical therapy alone. Seven patients were kept in complete remission by maintenance therapy for an observation period of up to 1 1/2 years. Side effects of systemic pre-PUVA treatment resolved during several months of maintenance therapy.

Adolescent↗

[Photochemotherapy for psoriatic patients treated with corticosteroids and methotrexate].

The effect of photochemotherapy with oral administration of 8-methoxypsoralen followed by irradiation with UVA (PUVA) was investigated in 34 cases of severe, generalized psoriasis which could be controlled only by systemic administration of corticosteroids and cytotoxic agents. In each case clearing of psoriatic lesions was achieved under PUVA treatment. As expected, the average duration of the initial PUVA treatment period was longer when compared to patient groups not pretreated with corticosteroids and cytotoxic agents. In order to avoid relapses, maintenance treatment was installed after complete healing of psoriatic lesions comprising an average of one PUVA exposures per week. Eighty percent of such treated patients are continuously completely clear; the remaining patient group is 70--90% improved. The side effects, elicited by the previous administration of corticosteroids and/or cytotoxic agents are improved or have resolved under PUVA therapy. The present study indicates, that PUVA treatment of psoriasis is not only an alternative to the use of systemic corticosteroids and cytotoxic agents but is superior to these treatment modalities due to its lack of side effects and its higher effectiveness.

Adrenal Cortex Hormones↗

Mouse model for protoporphyria. III. Experimental production of chronic erythropoietic protoporphyria-like skin lesions.

Albino mice were made protoporphyric with griseofulvin according to an established procedure. Photosensitivity flares were elicited once a week throughout a 10-month period, using black light as a source for 410 nm radiation and the flares were monitored by the intravenous injection of vascular tracers and by light and electron microscopy. Each irradiation led to a selective destruction of the endothelial cells of superficial capillaries which was followed by massive vascular leakage. The basal lamina remained largely intact, providing the scaffold for regenerating endothelial cells which deposited new basal lamina material at their periphery. Subsequent exposures to 410 nm radiation reproduced the endothelial damage and subsequent basal lamina formation; multiple irradiations thus resulted in excessive, concentric, tubelike basal lamina deposits around dermal vessels which light microscopically appeared as PAS-positive hyaline material and clinically gave the skin a thickened, waxy appearance. This model thus reproduced the skin of erythropoietic protoporphyria clinically, microscopically, and at the ultrastructural level.

Animals↗