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J Brasch

Publications and source records attributed to J Brasch.

At least 19 recordsLinked to original sources
PubMed2006

[Calcinosis cutis in Albright hereditary osteodystrophy: pseudohypoparathyroidism type Ia].

Albright hereditary osteodystrophy (AHO) is characterized by a symptom complex including short stature, brachymetacarpia, obesity, round facies, cutaneous osteomas, and mental retardation. AHO is caused by mutations in the GNAS-gene localized on chromosome 20 encoding for Gsalpha protein, a signal transducer of endocrine pathways. Therefore, AHO is often associated with endocrinopathy such as pseudohypoparathyroidism or hypothyroidism. A nine-month-old boy presented with typical features of this syndrome. The diagnosis was confirmed by biochemical and molecular analyses. An unusual feature was calcinosis cutis at such an early age, which led to extensive differential diagnostic procedures.

Calcinosis↗
PubMed2006

Late reactions to the patch-test preparations para-phenylenediamine and epoxy resin: a prospective multicentre investigation of the German Contact Dermatitis Research Group.

BACKGROUND: Late patch-test reactions, developing at day (D) 7 or later have been described for several allergens. Late reactions may reflect patch-test sensitization. Para-phenylenediamine (PPD) and epoxy resins (ER) are potent allergens and therefore may potentially induce patch-test sensitization. Up to now, there has been no prospective study on the frequency of late reactions in routine patch testing with these allergens. OBJECTIVES: To assess the frequency of late reactions to PPD and ER. PATIENTS/METHODS: In 1748 patients PPD (PPD-base, 1% pet.) and ER [based on diglycidylether of bisphenol A (DGEBA, 1% pet.)], and in 812 patients, nickel sulphate (5% pet.) were removed from the test panel of the standard series and applied on the medial side of the upper arm. Patch-test occlusion time was 24 h in 588 (PPD and ER) and 241 patients (nickel sulphate), respectively, and 48 h in 1160 (PPD and ER) and 571 (nickel sulphate) patients, respectively. Patch tests were read on D1-3 and D2-3, respectively; additional late readings were performed on D7, D14 and D21 after patch-test application. Patients who were not able to return for all scheduled late readings were telephoned on D7, D14 or D21, and questioned about a reaction at the test sites. Patients were instructed to perform daily self-examination from D4 onwards and to return immediately to the clinic if a reaction at the upper arm became visible. RESULTS: Data of 1428 patients (ER and PPD) and 638 patients (nickel) were evaluable. In 25 patients (1.8%), patch tests became positive not before D7, among them 21 reactions to PPD (1.5%) and four reactions to ER (0.3%). In five of seven patients, repeated patch tests with PPD disclosed patch-test sensitization as the cause of the late reaction. All late reactions, except for one, occurred in patients in whom patch tests were applied for 48 h. No late reactions were seen with nickel sulphate. CONCLUSIONS: PPD (1% pet.) elicited late reactions in 1.5% of routine patch tests, the majority of them probably being caused by patch-test sensitization. Therefore, the German Contact Dermatitis Research Group decided to remove PPD 1% pet. from the German standard series and to take efforts to optimize the patch-test conditions of PPD. One way to optimize PPD testing could be to reduce the exposure of PPD 1% to 24 h. Alternatively the patch-test concentration of PPD might be reduced.

Adolescent↗
PubMed2006

Strong allergic patch test reactions may indicate a general disposition for contact allergy.

BACKGROUND: Patch test patients have two or more positive reactions to unrelated allergens more often than to be expected by chance. This study evaluates synchronous patch test reactions to test the hypothesis that in such cases an allergen-independent disposition for contact sensitization may be involved. METHODS: Data of 87 834 patients tested with a standard patch test series in 42 centers of a Central European Network were retrospectively evaluated. Analyses were done for synchronous positive reactions of graded strength to nickel sulfate, fragrance mix, and to those five allergens that followed in frequency of positive results. All seven allergens selected were not related by chemical structure or exposure. Descriptive univariate and bivariate analyses as well as a polytomous logistic regression analysis were performed. Odds ratios with 95% confidence intervals were calculated. RESULTS: With an increasing strength of a positive reaction to nickel or to fragrance mix the likelihood of further positive reactions to unrelated contact allergens increased significantly, and the mean strength of such additional reactions raised steadily with an increasing strength of a nickel or fragrance reaction. CONCLUSIONS: Our findings support the idea that patients who respond with a strong patch test reaction may have a particular general disposition to acquire contact sensitivity to additional unrelated allergens. They should therefore not only be advised to avoid their known allergen but in addition to minimize exposure other contact allergens.

Adolescent↗
PubMed2006

A high-positive patch test load correlates with further positive patch test reactions irrespective of their location.

BACKGROUND: Patch testing is the standard clinical procedure to prove contact sensitization. It is a common practice to attach multiple patch tests at the same time. However, synchronous reactions to unrelated allergens may not be completely unassociated. If so, the reaction in a given test field might be influenced by other positive test reactions in a distance-related degree. This article analyses whether there is a distance-related effect of synchronous positive patch test reactions on the outcome of a target patch test. METHODS: Data collected from patients patch tested for diagnostic purposes with 15 standard allergens attached in a specific pattern between 1992 and 2004 in 20 centres in a Central European network were retrospectively evaluated. The association between the target patch test result (allergic vs negative reaction to the thiuram mix) and the number and cumulated strength of synchronous positive reactions (positive patch test load) to allergens placed in nearby or distant positions to the target patch was analysed by using logistic regression analysis. RESULTS: The likelihood of a positive reaction to thiuram mix significantly increased with an increasing synchronous positive patch test load generated by positive reactions to allergens unrelated to thiuram mix. The effect of allergens neighbouring the target allergen was not significantly stronger than that of allergens placed in distant positions. CONCLUSION: For the interpretation of patch test results, the potentially enhancing effects of a synchronous positive patch test load should be considered. The local distribution of the patches on the back is, however, not critical.

Dermatitis, Contact↗
PubMed2006

Effects of repeated low-dose UVB irradiation on the hyphal growth of Candida albicans.

Ultraviolet B light (UVB) can have negative phototropic effects on fungi. Candida albicans is often found on human skin exposed to UVB. Therefore, it is of medical interest to know whether a negative phototropic response to UVB irradiation can support an invasive growth of this potentially dangerous agent. In our study we investigated how repeated irradiation with low doses of UVB can influence the hyphal growth of C. albicans. Six randomly chosen strains of C. albicans were tested. Formation of hyphae was induced and maintained within transparent agar plates. The fungi were exposed to UVB three times daily for 7 days from either the observe or the reverse side during incubation. The wavelength spectrum was in the range of 310-315 nm, single doses were between 0.0018 and 0.432 J cm(-2). After 7 days the morphology and growth direction of C. albicans cells were determined microscopically. All six strains showed a common and dose-dependent response to UVB irradiation: the progression of hyphal growth was inhibited, no phototropic effects were seen and as a new finding an increased formation of blastospores was observed. We conclude that an irradiation of human skin colonized by C. albicans with doses of UVB that can occur under natural or artificial conditions is unlikely to trigger skin invasion by C. albicans.

Candida albicans↗
PubMed2005

[The raubitschekii variant of Trichophyton rubrum has reached Germany].

This is the second report on an isolation of the variety raubitschekii of Trichophyton (T.) rubrum in Germany. The patient was a young man born in Cameroon who presented with an extensive tinea corporis et manuum. The variety raubitschekii can be distinguished from similar looking dermatophytes by its brownish color, by the formation of abundant T. rubrum-like macroconidia, by the production of urease, by a negative hair perforation test, and by DNA analysis. In addition, further characteristics of this variety were determined. So far, the variety raubitschekii has been primarily found as a cause of tinea corporis in patients from Asia or Africa. In the future, it should be considered as a potential pathogen in Germany as well.

Adult↗
PubMed2005

[Patch testing with the DKG standard series 2001-2004. Results from the IVDK].

Patch testing is the standard procedure to detect contact sensitivity. The most frequent contact allergens are included in the standard series. We report on current trends regarding results obtained with the standard series from 2001-2004 in Germany, Austria (Graz, Vienna) and Switzerland (Basel). This analysis includes the frequency of the most common contact allergens and other aspects such as age and gender distribution and parameters of diagnostic quality such as reaction index and positivity ratio. Information on the most common contact allergens is updated.

Adult↗
PubMed2005

The European standard series in 9 European countries, 2002/2003 -- first results of the European Surveillance System on Contact Allergies.

Since January 2001, the European Surveillance System on Contact Allergies (ESSCA), supported by European Union funding (contract QLK4-CT-2001-00343), has started to collect patch-test data. This comprises a standardized clinical history and the patch-test results using the European standard series, from 17 centres in 9 European countries listed above. In 2002 and 2003, 10 511 patients' test results have been pooled and analysed. The anamnestic data partly reflect the subspecialties of some centres. The most common allergen was nickel sulfate (17.3%); however, large international variations were observed. The prevalence of contact allergy to Myroxylon pereirae resin (balsam of Peru) (5.8%) is coming close to the frequency found with the fragrance mix (6.4%). Regarding contact allergy to chromium compounds, different frequencies were noted in the 2 centres focused on occupational dermatitis (2.3% in the FIOH versus 7.4% in the Nofer Institute). These most likely reflect the beneficial effect of addition of ferrous sulfate in one, but not the other country. As differences may partly be due to different patch-test reading, standardization may need to be refined further. By providing post-marketing surveillance in the field of contact allergy, ESSCA will meet its objective of increased consumer safety across Europe.

Adult↗
PubMed2005

Simultaneous sodium lauryl sulphate testing improves the diagnostic validity of allergic patch tests. Results from a prospective multicentre study of the German Contact Dermatitis Research Group (Deutsche Kontaktallergie-Gruppe, DKG).

BACKGROUND: There is evidence that a higher skin susceptibility may induce nonspecific erythematous or weak positive reactions to contact allergens in patch testing. OBJECTIVES: To evaluate whether simultaneous application of sodium lauryl sulphate (SLS) along with diagnostic patch tests with contact allergens can provide information regarding skin irritability which may help to discriminate allergic from nonspecific irritant reactions to contact allergens. METHODS: Between July 2001 and June 2003, this prospective study collected patch test data of 5971 patients from 19 centres in Germany and Austria in the Information Network of Departments of Dermatology (IVDK). In addition to contact allergens (standard series and eight known 'problematic' allergens with a low reaction index and a high positivity ratio: 1,3-diphenylguanidine, amerchol L-101, benzalkonium chloride, benzoyl peroxide, cocamidopropyl betaine, octyl gallate, phenyl mercuric acetate and propylene glycol), patches with SLS 0.5% and 0.25% aq. were applied. Reactions to the allergens and to SLS were analysed at the IVDK data centre. The association between an erythematous or positive reaction to a certain allergen and an irritant reaction to SLS was assessed with logistic regression analysis, at the same time controlling for the influence of age and sex. RESULTS: Of the 29 allergens of the standard series, 23 and 21 gave a higher percentage of nonspecific erythematous reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, in comparison with SLS-negative patients. All eight 'problematic' allergens gave an increased percentage of nonspecific erythematous reactions. Similarly, 22 and 21 allergens of the standard series gave a higher percentage of positive allergic reactions in patients with an irritant reaction to 0.25% and 0.5% SLS, respectively, and seven of the eight 'problematic' allergens gave a higher percentage of positive allergic reactions (exception: octyl gallate). For most allergens, the markers of skin reaction (reaction index and positivity ratio) were worse in SLS-positive patients. Differences were more pronounced when testing with SLS 0.25% than with SLS 0.5%. CONCLUSIONS: Because there is a convincing association between skin irritability (evaluated by SLS test) and the degree of skin reaction to contact allergens, the SLS test may help in deciding whether a doubtful erythematous or weakly 'positive' skin reaction should be interpreted as allergic or irritant.

Adult↗
PubMed2005

Dermatophytes can trigger cooperative (CAMP-like) haemolytic reactions.

BACKGROUND: Dermatophytes usually grow on skin that is also colonized by bacteria. Therefore, a possible interaction between dermatophytes and bacteria is of potential relevance for the pathogenesis of skin infections. Cell membranes contribute substantially to epidermal barrier function. Erythrocyte haemolysis is a model commonly used to study membrane-damaging effects of microbial factors. Cooperative (CAMP-like) haemolytic reactions are known from distinct bacteria, but not from dermatophytes and bacteria. OBJECTIVES: To investigate CAMP-like reactions of dermatophytes. METHODS: Species of dermatophytes representing the genera Microsporum, Trichophyton and Epidermophyton, erythrocytes from sheep, horse and cattle, cultures of Staphylococcus aureus, S. intermedius, Listeria ivanovii, S. hyicus and S. epidermidis, and cell-free supernatants of bacterial cultures were used to search for cooperative haemolytic effects in in vitro agar diffusion assays. RESULTS: A cooperative (CAMP-like) haemolytic reaction was identified for all dermatophytes tested. Using erythrocytes from sheep and cattle, pretreated with a sphingomyelinase from S. aureus, S. intermedius or L. ivanovii, the fungi induced a distinct zone of complete haemolysis on solid media and in a diffusion test. No CAMP reaction could be detected using S. hyicus or S. epidermidis as a first-step agent or with equine erythrocytes. The lytic reaction of the CAMP-cohaemolysin derived from dermatophytes was always separate from the zone of complete haemolysis, indicating two different cytolytic factors. CONCLUSIONS: Our results show, for the first time, that in principle a CAMP-like effect can occur with dermatophtyes. This is a new observation of potential relevance for the pathogenesis of skin infections. The membrane-damaging factors released by dermatophytes should be further analysed.

Animals↗
PubMed2004

[Standard and recently developed methods for the differentiation of dermatophytes].

Although dermatophytoses can often be diagnosed clinically, the identification of the dermatophyte species causing the disease gives additional relevant information. Species identification is necessary to survey the current epidemiologic situation, and it is also needed in each individual case to trace back the path of infection, thereby to avoid reinfection, and to optimize the therapy. Classical methods to differentiate dermatophytes are based on the assessment of their macroscopic and microscopic morphology and on the observation of physiologic properties. For scientific taxonomic purposes mating experiments are indispensable. In recent years, DNA analysis has been refined to make a genetic-based differentiation of dermatophyte species possible, although such methods are not available for routine practice. No elaborate technical equipment is needed to differentiate dermatophytes in the office. The investigator's mycological expertise, however, is of crucial importance. Mycological courses and dermato-mycological quality control are appropriate means to ensure that dermatologists retain their competence in treating patients with dermatophytoses.

Adult↗
PubMed2004

Iodopropynylbutyl carbamate 0.2% is suggested for patch testing of patients with eczema possibly related to preservatives.

BACKGROUND: Iodopropynyl butylcarbamate (IPBC) is a new preservative in medical and cosmetic leave-on products. Although cases of allergic contact dermatitis to IPBC have been reported, it is not known whether the usual test concentration of 0.1% is appropriate for screening tests with IPBC. OBJECTIVES: To determine the concentration of IPBC that should be used in screening patch tests. METHODS: An analysis was made of data filed by 26 centres of dermatology on patch tests performed with one or two concentrations of IPBC (0.1%, 0.2%, 0.3% or 0.5%) in 8106 unselected patients. Criteria used to determine the best test concentration of IPBC were the reaction index, the positivity ratio, the rate of crescendo reactions, and the relations between IPBC reactions and the MOAHLFA index irritant reactions to sodium lauryl sulphate (SLS), and allergic reactions to other contact allergens including preservatives. RESULTS: IPBC 0.1%, 0.2%, 0.3% and 0.5% yielded 0.5%, 0.8%, 1.3% and 1.7% positive reactions, but this increase was accompanied by an even greater increase in doubtful and irritant reactions. These figures and the other criteria examined suggested the range of suitable test concentrations of IPBC to lie between 0.2% and 0.3%. A detailed analysis of MOAHLFA indices and of associations between reactions to IPBC and reactions to other allergens and to SLS showed that most of the positive reactions to IPBC 0.2% can be assumed to be allergic ones and that with IPBC 0.2% fewer false-positive reactions can be expected than with IPBC 0.3%. CONCLUSIONS: Patch testing with IPBC 0.2% is suggested for patients with eczema possibly related to preservatives.

Adult↗
PubMed2003

Oral lichenoid reactions associated with amalgam: improvement after amalgam removal.

BACKGROUND: The pathogenetic relationship between oral lichenoid reactions (OLR) and dental amalgam fillings is still a matter of controversy. OBJECTIVES: To determine the diagnostic value of patch tests with amalgam and inorganic mercury (INM) and the effect of amalgam removal in OLR associated with amalgam fillings. METHODS: In 134 consecutive patients 467 OLR were classified according to clinical criteria. One hundred and fifty-nine biopsies from OLR lesions were histologically diagnosed according to the World Health Organization criteria for oral lichen planus (OLP) and compared with 47 OLP lesions from edentulous patients without amalgam exposure. One hundred and nineteen patients were patch tested with an amalgam series. In 105 patients (357 of 467 lesions) the amalgam fillings were removed regardless of the patch test results and OLR were re-examined within a follow-up period of about 3 years. Twenty-nine patients refused amalgam removal and were taken as a control group. RESULTS: Eleven patients with OLR (8.2%) had skin lesions of lichen planus (LP). Histologically, the lesions in the OLR group could not be distinguished from those seen in the OLP group. Thirty-three patients (27.7%) showed a positive patch test to INM or amalgam. Amalgam removal led to benefit in 102 of 105 patients (97.1%), of whom 31 (29.5%) were cured completely. Of 357 lesions, 213 (59.7%) cleared after removal of amalgam, whereas 65 (18.2%) did not improve. In the control group without amalgam removal (n = 29) only two patients (6.9%) showed an improvement (P < 0.05). Amalgam removal had the strongest impact on lesions of the tongue compared with lesions at other sites (P < 0.05), but had very little impact on intraoral lesions in patients with cutaneous LP compared with patients without cutaneous lesions (P < 0.05). Patients with a positive patch test reaction to amalgam showed complete healing more frequently than the amalgam-negative group (P < 0.05). After an initial cure following amalgam removal, 13 lesions (3.6%) in eight patients (7.6%) recurred after a mean of 14.6 months. CONCLUSIONS: Of all patients with OLR associated with dental amalgam fillings, 97.1% benefited from amalgam removal regardless of patch test results with amalgam or INM. We suggest that the removal of amalgam fillings can be recommended in all patients with symptomatic OLR associated with amalgam fillings if no cutaneous LP is present.

Adult↗
PubMed2003

Lichenoid reactions of murine mucosa associated with amalgam.

BACKGROUND: In 97% of all patients with oral lichenoid reactions (OLR) associated with dental amalgam a removal of the fillings leads to a decline of the lesions, as a minimum. OBJECTIVES: The aim of this study was to determine if contact allergic or local toxic effects or both may contribute to OLR using an animal model with mercury-sensitive and non-sensitive rats. METHODS: Twenty Brown Norway rats, which have a genetic predisposition for an autoimmune syndrome after exposure to mercury and 20 Lewis rats, not mercury sensitive, were treated as follows: 10 animals of each group were sensitized with a low dose of mercuric chloride. Half of all animals received local exposure of the right buccal mucosa to amalgam (left: control), the others to amalgam alloy free of mercury. All rats were patch tested with an amalgam series. RESULTS: After 20 days of exposure 96% of all animals showed white mucosal lesions restricted to the contact zone of the alloy on the treated side, but only up to 25% had a positive patch test reaction to amalgam or inorganic mercury (INM). The lesions showed no relation to species, alloy, sensitization or patch test reaction. CONCLUSIONS: While allergic mechanisms may contribute to mucosal contact lesions in Brown Norway rats, this is less probable in Lewis rats. Mercury in general appears to be irrelevant in the development of ORL in this study. If this holds true for humans as well, patch testing with an amalgam series may be helpful in a minor fraction of all patients with OLR.

Animals↗
PubMed2003

Inhibition of dermatophytes by optical brighteners.

The aim of this study was to investigate a possible effect of optical brighteners on the growth of dermatophytes. Typical strains of Trichophyton rubrum, T. mentagrophytes, Microsporum canis and Epidermophyton floccosum were grown on agar plates containing two different brighteners of stilbenedisulfonic acid type in concentrations between 5 x 10(-5) and 1 x 10(-2) mol l-1 and their thallus diameters were compared with controls. In addition, hyphae grown with brighteners were compared with controls by fluorescence microscopy and by transmission electron microscopy. Both brighteners had a significant dose-dependent growth-suppressive effect on all dermatophytes tested, that was complete at a concentration of 10(-2) and 10(-3) mol l-1, respectively. Fluorescence microscopy of hyphae showed a pronounced fluorescence of the septal areas and a less-intense staining of the outer cell walls. Electron microscopy revealed a marked thickening and blurred contours of the cell walls grown with brighteners. These new observations relate very well to an interference of optical brighteners with the formation of normal chitin fibrils as described previously. Optical brighteners of stilbenedisulfonic acid type may be rewarding objects for the development of new antifungal agents.

Antifungal Agents↗
PubMed2003

[Sensitization to tea tree oil in Germany and Austria. A multicenter study of the German Contact Dermatitis Group].

BACKGROUND AND AIM: Tea tree oil, a distillation product of the Australian tea tree (Melalence alternitolia) is increasingly used as an alternative remedy for various dermatological diseases. Tea tree oil contains several allergenic monoterpenes and sesquiterpenes. In this multicenter study it was evaluated, whether the increasing use of tea tree oil has lead to an increased frequency of sensitization in Germany and Austria which would justify its inclusion into the standard series. PATIENTS AND METHOD: For patch testing a standardized tea tree oil was used, dissolved 5% in diethylphtalate (DEP). Consecutive patients of 11 dermatological departments in Germany and Austria were tested. Readings were taken on day 2 and 3 according to the guidelines of the German Contact Dermatitis Research Group (DKG). RESULTS: 5% tea tree oil was positive in 36/3375 patients (1.1%). Sensitization frequencies showed great regional variations and ranged from 2.3% (Dortmund), 1.7% (Buxtehude), 1.1% (Essen), 0.7% (Graz), to 0% (Berlin, Vienna). 14/36 patients (38.9%) also showed a positive patch test reaction to oil of turpentine. CONCLUSION: Our results show that tea tree oil is an important contact allergen for some centers. It should be tested, if medical history suggests its previous use. Considering the great regional differences in frequencies of sensitization its inclusion into the standard series is not recommended yet.

Adult↗