Biomedical subjects
Publications and source records attributed to H Mensing.
Leukocytoclastic vasculitis is one of the more frequent syndromes of the spectrum of vasculitis. It represents a heterogeneous group of diseases, characterized by the cutaneous phenomenons of palpable purpura and persistent urtica, and the histologic patterns of vessel wall necrosis, leukocytoclasia, and hemorrhage. Pathogenetic and clinical aspects, just as therapeutic approaches are discussed in this report.
Based on the results of a capillary microscope study on 43 patients with connective tissue disorders, the characteristic morphological abnormalities observed in the capillaries of the nail fold are presented. A high correlation was found between the pattern of changes in the capillaries and the individual connective tissue diseases. The diagnostic and prognostic usefulness of this easily performed in vivo technique is discussed in particular with regard to patients with Raynaud's phenomenon.
A 19-year-old patient suffering from Jadassohn's anetoderma with progressive dermatrophia showed positive reaction to treatment with chloroquin diphosphate.
Papular acrodermatitis (Gianotti-Crosti syndrome) was seen in a six-year-old girl. The disease was marked by the characteristic triad of a papular-vesicular rash, lymphadenopathy and liver damage. Serological findings suggest an infection with Epstein-Barr virus as the causative factor. In such cases hepatitis-B induced papular eruptive acrodermatitis should be considered in differential diagnosis.
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Epstein-Barr virus was demonstrated electronmicroscopically in a leucoplakic area of the tongue of a man infected with HTLV-III/LAV. Oral "hairy" leucoplakia, diagnosed from the clinical findings, histology and by electronmicroscopy, in this patients is to be interpreted as the initial sign of an HTLV-III/LAV infection.
During in vitro chemotaxis, human embryonic fibroblasts migrate toward the leukotriene B4 (LTB4) contained in ionophore-induced human mononuclear-cell supernatants, but they do not migrate toward the LTB4 contained in ionophore-induced neutrophil supernatants. We further analyzed and characterized this inhibitory effect. The inhibitor was found to be present in stimulated, but not in unstimulated, neutrophil supernatants. The inhibitor was also shown to be heat labile, to interfere with the chemotaxis of the tumor cell lines HT 1080 and L 929, and to be effective during chemotaxis stimulated by LTB4, conditioned medium, or fibronectin. At Sephadex-G-200 chromatography, the inhibitor eluted in a region corresponding to a molecular mass of 16,000 daltons. Preincubation experiments showed that its mechanism of action is not cell directed, and it had no effect on random migration, cell spreading, and cell attachment. Furthermore, the inhibitor does not interact with the binding of fibronectin to its specific antibody; thus, an interaction of the inhibitor with nonspecific sites which are common to several chemotactic factors must be postulated instead. The biological role of the inhibitor may be related to the regulation of cell migration during wound repair.
In a microbiologically controlled, open study the 4-quinolone derivative enoxacin was tested in 51 patients suffering from infectious dermatoses. Clinical cure or improvement was observed in 91% of the patients, microbiological cure occurred in 65%. According to the results of our trial enoxacin is recommended as a therapeutic alternative, especially for the treatment of dermatitis caused by gram-negative bacilli.
Sera from 101 patients with progressive systemic scleroderma were analyzed for circulating aminopropeptides of type III collagen using a radioimmunoassay which measures the intact and degraded forms (Fab assay). About 41% of the patients were found to have values above the normal range. A good correlation was observed between elevated levels of aminopropeptides and the degree of involvement of the skin and internal organs in the patients. Most patients (89%) with an active progression of the disease but not those in a stationary phase showed increased serum levels of aminopropeptides. Treatment with corticosteroids apparently normalized the levels of aminopropeptides. Only minor changes were observed with an antibody-based radioimmunoassay which measures primarily the intact form of the aminopropeptide.
In a patient suffering from benign lesions of epidermodysplasia verruciformis due to human papillomavirus type 5 little clinical improvement could be observed after 6 months of oral etretinate. The drug was given 75 mg/day for 1 month before dosage was reduced to 50 mg/day. Control biopsy after 3 months of treatment still revealed large quantities of virions and typical cytopathic effects in light and electron microscopic examination.
Patients from five German Departments of Dermatology (Düsseldorf, Erlangen, Frankfurt am Main, Hamburg and Munich) affected with progressive systemic scleroderma (PSS) were classified and examined. The results of the clinical investigations are presented. In order to guarantee a uniform classification of all patients, the patients were divided into three groups according to the distribution of the affected skin: type I consisted of those with acrosclerosis distal to the wrist, type II had scleroderma extending along the wrist in a proximal direction, and type III had diffuse scleroderma beginning on the trunk. Altogether, 194 patients with PSS were investigated, and the following distribution was found: type I, 32%; type II, 60%; type III, 7%; 1% of the patients could not be classified. The distribution according to the patients' sex and age was in good agreement with published reference data. The incidence, significance, and localization of the major symptoms were investigated. The Raynaud symptom could be identified as being the main clinical symptom in 90% of the patients. Joint involvements (10%-73% depending in the applied parameters), dysphagia (51%), and rest dyspnea (30%) contributed to the main internal symptoms. The extensive clinical, chemical, and immunological results are summarized. In 80% of the cases, high ANA titers could be detected, but these were not correlated to the type of disease.
A report is given on the combination of local 5-fluorouracil and systemic etretinate to treat a patient suffering from intra-anal Bowen's disease.
A new born girl perinatally suffered from a generalized blistering disease of the skin. By means of histological, in particular ultrastructural methods the diagnosis of Epidermolysis bullosa herpetiformis Dowling Meara could be confirmed in the first weeks of life. The Dowling Meara type is one of the epidermal variants of this group of inherited blistering diseases with a relative benign course. The early diagnosis is helpful in the prognostic assessment of the disease and in the medical and genetic advice for the parents.
For several years cyclosporin A has been used as an immunosuppressive agent in transplantation medicine and to avoid graft-versus-host disease. Some case reports concerning beneficial effects on different dermatoses have aroused speculation about the application of this drug in dermatology. The mode of action, a summary of the dermatologic case reports, and a discussion of the side effects of cyclosporin A are presented in this article.
Using the electron microscopic technique of negative staining, viruses of the herpes group were detected in leukoplakic lesions on the tongue of a bisexual, HTLV-III-/LAV-infected male. Oral "hairy" leukoplakia was diagnosed, which was the first clinical symptom of on HTLV-III/LAV infection in this patient.
Ecthyma contagiosum is caused by a member of the parapoxvirus group, the so-called orf virus. The typical feature of the disease is described, and some of its peculiarities are illustrated by means of a case report.
Fibroblast are responsible for the synthesis of the structural proteins of the connective tissue. A further property of these cells, their migratory ability, could be analyzed in the last years. A special form of migration is chemotaxis, which can be quantitatively measured in a modified Boyden chamber in-vitro. Using this method chemoattractive substances could be characterized, which are able to stimulate fibroblasts and tumorcells to chemotactic migration. Furthermore it could be proved, that benign and transformed cell lines react in a different manner towards these chemoattractive substances. The in-vitro results allow some hypotheses about both fibroblast migration in wound healing or chronic inflammation, and the mechanisms of tumor cell evasion in the tumor surrounding tissue or the metastasizing process in other organs.
Using human umbilical cord endothelial cell cultures and a modified 3HTdR uptake technique, endothelial cell cytotoxic activity (ECA) has been demonstrated in sera of 95/130 patients with progressive systemic sclerosis (PSS), 14/20 patients with Raynaud syndrome (RS), 52/153 rheumatoid arthritis (RA), and 47/113 systemic lupus erythematosus (SLE) sera. ECA could be enriched by gel filtration from PSS sera in a molecular weight range of 5 k daltons. ECA was partially associated with serum proteins, mainly in the albumin containing fraction, albeit at a lower level of activity. In PSS, no relationship of ECA to the type of skin involvement was observed. ECA appears to be a low molecular weight mediator of, as yet, unknown origin.