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Biomedical subjects

J Petres

Publications and source records attributed to J Petres.

At least 19 recordsLinked to original sources
PubMed2000

Long-term results of wide surgical excision in 106 patients with hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa (acne inversa) is a chronic recurrent disorder characterized by abscessing inflammation, fistulating sinus tracts, and scarring. Predilection sites are the intertriginal regions. The severe course of the disease demands an early and curative treatment. OBJECTIVE: The aim of this study was to review the effect of radical surgical excision concerning cure rate and potential complications within a large group of patients. METHODS: We analyzed data for 106 patients suffering from hidradenitis suppurativa treated during the period 1980-1998. The mean duration of the disease was 7 years. In about 90% of the cases, two or more sites were affected. Inguinal (70.8%) and axillary regions (61.3%) were most commonly involved. All patients were treated by radical wide excision using intraoperative marking of sinus tracts with methylviolet solution. The method of reconstruction depended on the size and location of the defect. Median postoperative follow-up time was 36 months. RESULTS: The overall complication rate was 17.8%. Most of these were minor complications such as suture dehiscence, postoperative bleeding, and hematoma. Wound infection occurred in only 3.7% of patients. The rate of recurrence within the operated fields was 2.5%. There was no relation between the surgical method of reconstruction and the rate of recurrence. Recurrence was related to the severity of the disorder. CONCLUSION: Our results confirm early radical excision as the treatment of choice for hidradenitis suppurativa. Using intraoperative color-marking of sinus tracts, the recurrence rate is minimal. The method of reconstruction has no influence on recurrence and should be chosen with respect to the size and location of the excised area.

Adult↗
PubMed1999

[Congenital melanocytic nevi].

Congenital melanocytic nevi are benign skin tumours with a population-based prevalence of 1-6%. They run an increased life-time risk of transformation into malignant melanoma. Additionally, they can be associated with an involvement of the leptomeninges (neurocutaneous melanosis), and may cause considerable cosmetic and psychic problems. In contrast to the past, the risk of congenital melanocytic nevi developing into melanoma is now regarded as well-established. Thus, excision is recommended whenever possible. Large lesions which do not allow complete excision should be treated by dermabrasion within the first weeks of life.

Adolescent↗
PubMed1997

Dermabrasion of congenital nevocellular nevi: experience in 215 patients.

BACKGROUND: The indication for surgical treatment of congenital nevocellular nevi results from aesthetic-cosmetic consideration as well as from the increased risk of melanomatous transformation. OBJECTIVE: We evaluated the outcome after dermabrasion of congenital nevi of different sizes and treated at different ages. METHODS: 215 patients treated by dermabrasion during the years 1979-1995 were examined at a median interval of 24 months postoperatively. RESULTS: No postoperative development of malignant melanoma arising from the congenital nevus was seen in any of the patients during the time of follow-up. No serious long-term complications were seen. Hypertrophic scars were seen within parts of the operation field in 14.6%, but in those the cosmetic result was still satisfactory. Permanent reduction of pigmentation to 0-20% as compared with the preoperative status was achieved if treatment was performed within the newborn period. In case of large and giant nevi, permanent removal of pigmentation was better than in small or medium-sized nevi. CONCLUSION: Dermabrasion proved to be an adequate modality for removal of pigmentation in the therapy of large and giant congenital nevocellular nevi when assessed within 2 years following the procedure. Early treatment is crucial for permanent removal of pigmentation. Long-term effects remain to be adequately monitored.

Age Factors↗
PubMed1996

[Elective lymph node dissection in primary malignant melanoma].

The role of elective lymph node dissection (ELND) in primary malignant melanoma is controversial. Our purpose was to evaluate the benefit of ELND regarding survival and disease-free survival in malignant melanoma of the trunk and extremities. By matched-pair analysis, 375 patients treated by wide local excision (WLE) plus ELND were compared to 375 patients treated by WLE only. There was no difference in survival between the two treatment groups; however, the disease-free interval was significantly higher in the collective treated by WLE plus ELND (P < 0.05). Increased survival rates were noted for intermediate tumor thickness of 1.51-4.0 mm for the WLE+ELND group although the difference was not significant (P = 0.14), and disease-free survival was significantly improved in this group (P < 0.001). ELND elicited a higher benefit in male patients with intermediate thickness melanoma. Our results confirm the findings of several studies that ELND improves the outcome after primary treatment of malignant melanoma of intermediate tumor thickness.

Adult↗
PubMed1995

Human leukocyte antigens and multiple basal cell carcinomas.

This study presents data on human leukocyte antigen (HLA) phenotypes of 49 unrelated patients with multiple basal cell carcinomas (five or more BCC). Previous investigators noted an association with HLA-DR1 and a negative association with HLA-DR4. However, the previously found association was weak. HLA typing for class I (HLA-A, -B, -C) and class II antigens (HLA-DR, -DQ) was done from acid citrate dextrose (ACD)-stabilized peripheral blood using the modified lymphocytotoxicity test after T/B cell separation by immunobeads. Antigen frequencies of the patient group were compared to those of healthy individuals of a local German population (n = 716). Chi-square test and Fisher's exact test were used for statistical evaluation. While a significant association with HLA-DR1 was not observed in our study, we were able to confirm a significant decrease of HLA-DR4 in the patient group (12.2% versus 25.1%; p < 0.05; relative risk, RR, 0.48). In addition, HLA-Cw7 was significantly increased in the patient group (61.2% versus 40.8%; p < 0.01; RR, 2.29). In a subgroup of patients with multiple BCC located on the trunk (n = 25), the negative association with HLA-DR4 was even stronger (4% versus 25.1%; p < 0.02; RR, 0.12), whereas HLA-Cw7 was not significant (60.0% versus 40.8%; p = 0.06). Our results showed decreased frequencies of HLA-DR4 and increased frequencies of HLA-Cw7 in cases of multiple BCC, although statistical evaluation revealed only a weak association. This might be due to possible heterogeneity in this disease, e.g., BCC of the trunk versus BCC of the face, or any other cofactors.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗
PubMed1995

Role of elective lymph node dissection in stage I malignant melanoma: evaluation by matched pair analysis.

The role of elective lymph node dissection (ELND) in clinical stage I malignant melanoma continues to be controversial. We present a matched pair analysis of 375 patients treated in the Department of Dermatology in Kassel between 1979 and 1991 by wide local excision (WLE) plus ELND. Multivariate analysis revealed tumor thickness, level of invasion, age, sex, and localization as independent prognostic factors, and 375 patients treated by WLE alone were matched as controls to the patients treated by ELND and WLE. There was no significant benefit from WLE plus ELND compared to WLE alone in the total group as shown by the 5-year survival rates (87.3% versus 86.4%) and 10-year survival rates (80.1% versus 77.82%). Increased survival rates were noted for tumor thicknesses 1.51-4.0 mm for the WLE plus ELND group, as shown by the 10-year survival rates of 73.1% versus 60.3%. However, these data were not significant (p = 0.14). Disease-free survival rates were significantly higher in the group treated by additional ELND for all tumor thicknesses (p < 0.05) and even more in intermediate tumor thicknesses of 1.51-4.0 mm (p < 0.001). A significant benefit of elective lymph node dissection was detected for malignant melanoma of the trunk (all tumor thicknesses), as shown by the 5-year survival rates of 92.0% versus 79.7% and 10-year survival rates of 80.4% versus 45.16% (p < 0.05). Malignant melanoma of the extremities revealed no significant differences in survival rates. We conclude that there is a certain benefit from ELND in clinical stage I malignant melanoma for tumor thicknesses of 1.51-4.00 mm. Especially in malignant melanoma of the trunk, WLE plus ELND was more beneficious than WLE alone.

Actuarial Analysis↗
PubMed1995

Elective lymph node dissection in primary malignant melanoma: a matched-pair analysis.

The role of elective lymph node dissection (ELND) in primary malignant melanoma is still controversial. Our purpose in this study was to evaluate the benefit from ELND on survival and disease-free survival in malignant melanoma of the trunk and extremities. We performed a matched-pair analysis on 750 patients. There was no significant benefit from wide local excision (WLE) plus ELND compared with WLE in the total group. Increased survival rates were noted for tumour thicknesses of 1.51-4.0 mm for the WLE+ELND group, as shown by 10-year survival rates of 73.1% vs 60.3% (p = 0.14). A significant benefit of ELND was detected for malignant melanoma of the trunk (p < 0.05). Disease-free survival rates were significantly higher in the collective treated by additional ELND for all tumour thicknesses (p < 0.05) and even more in intermediate tumour thicknesses of 1.51-4.0 mm (p < 0.001). Our data give further support that ELND may be valuable in improving the prognosis in case of malignant melanoma of intermediate Breslow thickness.

Adult↗
PubMed1994

[Status of surgical dermatology in the hospital and general practice].

Dermatosurgery has been gaining in importance in recent years. In departments of dermatology German-speaking countries the total number of operations increased by 58% from 1984 to 1991. The increase in the number of operations of moderate and extreme severity was especially marked. Out-patient dermatosurgery was also performed mainly by dermatologists as opposed to other specialties. From 1988 to 1992 dermatologists in private practice recorded an increase of 40.6% in the number of operative procedures they performed. The importance of dermatosurgery in hospital and private practice can be expected to continue increasing in the future; dermatologists must therefore prepare themselves for the present and future challenges inherent in surgery of the skin.

Ambulatory Surgical Procedures↗
PubMed1994

HLA phenotypes and multiple basal cell carcinomas.

BACKGROUND: Previous investigators noted an association of multiple basal cell carcinomas (BCC) with certain HLA antigens; however, these findings were contradictory, and the associations were only weak. OBJECTIVE: The aim of the study was to objectify the previously found associations. METHODS: Serologic HLA typing for class I and class II antigens was performed in 49 unrelated patients with 5 or more BCCs. RESULTS: HLA-DR4 showed decreased frequencies in the patient group as compared with healthy controls (n = 716). Cw7 was found to be increased in the total group of patients as well as in a subgroup with multiple BCCs of the face (n = 24), while a subgroup with BCCs mainly on the trunk (n = 25) revealed increased frequencies of HLA-A11, -B17, -B22 and -Cw3. However, none of these deviations appeared significant after correction of p values. CONCLUSION: We conclude that, if at all, the HLA system plays only a minor role in the development of multiple BCCs.

Adult↗
PubMed1993

[Variations of the ultrasound image in malignant melanoma].

High-resolution ultrasound plays an important role in the preoperative assessment of malignant melanoma. The typical ultrasonographic image showing few internal echoes and sharp delineation allows statements on the benign or malignant nature and on tumour thickness. Diagnostic pitfalls are encountered if deviations from the typical structure are present, as they are caused by underlying dermal naevi, lymphocytic infiltration, or hair follicles. We describe variations in the ultrasonic imaging of malignant melanoma with reference to three cases.

Adult↗
PubMed1993

[Cerebriform intradermal nevus].

A case is reported of an extended cerebriform intradermal naevus of the scalp. Additional skin findings were generalized small intradermal and compound-type naevi. There were no neurological or other internal anomalies.

Adult↗
PubMed1991

[Treatment of recurrent herpes labialis using a herpes simplex Type-I subunit vaccine. A prospective randomized double-blind multicenter study].

A herpes simplex type I subunit vaccine developed by Behring-Werke (Marburg/Lahn, FRG) was compared with placebo for therapeutic effectiveness in the treatment of recurrent orolabial herpes simplex in a multicentre study involving the major hospitals in Frankfurt/Main (n = 34), Hamburg (n = 18), Giessen (n = 17) und Kassel (n = 14). The effectiveness of the vaccine was judged on the reduction in the frequency of recurrences. Within the period of the 8-month study there was no statistically significant difference in the frequency of recurrences with vaccine or placebo. Both placebo and verum led to a significant decrease in the number of recurrences of orolabial herpes simplex, but the effect of placebo was slightly more pronounced.

Adult↗
PubMed1990

[Erythema migrans arciforme et palpabile (T-cell pseudolymphoma)].

A 65-year-old man with recurrent erythema migrans arciforme et palpabile (EMAP) is reported. EMAP is characterized as a T-cell pseudolymphoma, the cell populations of which are composed of T-helper- and T-suppressor cells in a ratio of 2:1. EMAP can therefore not be differentiated immunohistologically from the lymphocytic infiltration of Jessner-Kanof.

Aged↗
PubMed1990

[Pruritic urticarial papules and plaques in pregnancy].

PUPP is a specific eruptive dermatosis in pregnancy, clinically characterized by erythematous papules and plaques with intense itching in periumbilical localization. This disease typically tends to spread to the extremities without involving the head and neck regions. The differential diagnosis of PUPP can be established by immunological and microscopical investigations. Since PUPP is a benign disease with a good prognosis and spontaneous clearing, we recommend only mild symptomatic treatment.

Adult↗
PubMed1990

[Clinical experiences of interval treatment with dermatologic agents containing urea].

Topical vehicles containing urea are increasingly used in dermatology because of their favorable pharmacological properties, which are due to the following capacities of urea: (1) its beneficial influence on the structure and physiology of the skin, and (2) its therapeutic effect in combination with other topically active agents in various skin diseases, such as psoriasis, ichthyosis, and chronic eczema. Our own experiences presented here are in accordance with these statements.

Dermatologic Agents↗
PubMed1990

[Surgical interventions of the nail organ].

The nails are the largest appendage of the skin. They provide protection of the tactile regions of the fingers; moreover, well cared-for nails are an attribute of beauty. Operations of the nails should, therefore, regard both functional and cosmetic aspects. Surgical procedures are indicated in the case of nail deformities, bacterial or mycotic infections, as well as pigmentation of the nail wall or plate, and periungual or subungual tumors, which are always suspicious of malignant melanoma. All operations of the nail region can be performed in Oberst's anesthesia. We recommend the preoperative application of a tourniquet to stop the blood flow.

Humans↗
PubMed1988

[Pedicle flap-plasties].

Pedicle flaps are performed within the operative dermatology basically to close larger operation defects following surgical excision of malignant skin tumors. It is a fact, that more than 3/4 of these skin tumors are located on the head and the cervical region. Especially in this area local and regional flaps guarantee a functionally an aesthetically satisfying reconstruction of the excised structures. As a matter of fact the basic methods of pedicle flaps as the transposition and the advancement-flaps are known for more than a hundred years. In the meantime the techniques were merely refined and modified, so that even extended skin and soft-tissue defects can be closed without compromising on radicality. Based on broad own experience the indication and the application of these techniques are described. Possible risks are demonstrated which can arise by disregarding anatomical and morphological conditions.

Facial Neoplasms↗