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Biomedical subjects

M Hundeiker

Publications and source records attributed to M Hundeiker.

At least 19 recordsLinked to original sources
PubMed1995

[Rare keratoacanthoma variants].

Keratoacanthomas are made up of the same spinocellular differentiated cell material as squamous cell carcinomas, but they differ from the latter in origin and growth properties. The majority--in our series 98% of 741 examined cases--are of the "crateriform" type, which after rapid growth during the initial stage give way to spontaneous regression, mostly with complete restoration of the cutaneous structure. Less than 2% belong to the rare destructive variants with disturbed or absent regression and persistent invasive growth. Keratoacanthoma marginatum centrifugum, mutilating keratoacanthomas and aggregated keratoacanthomas can lead to extremely severe defects. None of the "conservative" treatment methods recommended in the literature up to now has proved effective, with the exception of surgery and radiotherapy with tumour ratio doses. Many publications are obviously based on uncritically interpreted individual observations.

Aged↗
PubMed1995

[Results of cryosurgery in 394 patients with hypertrophic scars and keloids].

Cryosurgery with liquid nitrogen led to total or partial success in 64% of 336 patients with keloids and in 82% of 58 persons with hypertrophic scars. In 11% and 3% of the patients, respectively, the results were disappointing. In 19% and 12%, patients broke off the painful and long-term therapy. Nonetheless, in view of the results of other therapeutic methods, we prefer cryosurgery (either as monotherapy or combined with corticoids or conventional surgery) for keloids. For hypertrophic scars, however, the therapy is restricted to exceptional cases since nearly all lesions regress spontaneously within a few years.

Adolescent↗
PubMed1991

[Not diagnosable malignant melanomas].

Of the 3574 malignant melanomas treated in Hornheide between December 1981 and August 1990 (not including preinvasive cases) 97 were not immediately recognized. These tumours did not look like melanomas. In 72% they were smaller than 10 mm in diameter, and in 20%, smaller than 5 mm. Clark's so often quoted "pencil rule" should no longer be used as an aid to exclusion of invasive melanoma. Localization of the unrecognized melanomas was on the head and neck in 22% of cases. In 37%, the patients were under the age of 40 years. No less than 25% of the patients had multiple melanomas. Many of these melanomas. Many of these melanomas were thin tumours (less than 0.75 mm in 55% and less than 1.5 mm in 77%). This explains why more than 50% of the lesions are described as "macules". The most common incorrect diagnoses were dysplastic naevi (44%) and common (23%) naevi. The most important anamnestic criteria are the patients' own statements about changes in size, colour and shape. These "dynamic" elements must be more carefully observed and documented during process of the clinical diagnosis.

Adult↗
PubMed1990

[Cryosurgical treatment of precancerous cheilitis abrasiva].

Between 1984 and 1988, 44 patients suffering from cheilitis abrasiva praecancerosa were treated with cryosurgery using a nitrous oxide cryoprobe. A single treatment proved sufficient in 35 patients (80%). 9 patients (20%) developed a recurrent lesion 4 to 28 months after cryosurgery. All recurrences appeared within the first year. On account of the recidivity of the disease, we recommend a careful follow-up of the patients. On the other hand, cryosurgery has the advantage that it can be applied in elderly persons as well as in patients with concomitant internal diseases. In pracancerous lesions, the common drawbacks of a surgical therapy such as diminution of the lower lip and impairment of the superficial sensitivity can be avoided with the help of this technique. Invasive carcinomas of the lower lip, however, should not be treated with cryosurgery.

Aged↗
PubMed1990

[Problems in surgery of the sole of the foot].

The structure of the weight-bearing plantar skin and the subcutaneous cushion is adapted to mechanical loads of 3-10 kp/cm2 under walking conditions. Such loads, however, are only tolerated when compensated by constant alternation of loaded points. If the surgical therapy with free skin grafts or pedicled flaps does not take into account the vascular and neural architecture of the plantar skin, healing without problems may result--but only for a short time. As a rule, such grafting is later followed by painful keratotic lesions or non-healing "trophic" ulcers, which are caused by loss of sensitive innervation, changing of loaded points as well as the specific subcutaneous architecture. Therefore, reconstructive surgery of loaded plantar skin often requires innervated musculo-cutaneous flaps. Plantar warts or other benign lesions with possible regression are not indications for grafting at all.

Adult↗
PubMed1990

[Satellite recurrence of eruptive angioma. A clinical, histologic and immunocytochemical study].

Some weeks after operative removal of an eruptive angioma, satellite angiomas may develop within and around the scar. During the further course they remit spontaneously. So far these recurrences have been observed almost exclusively on the trunk in children and young adults, especially in male patients. Four new cases are reported. The course is consistent with earlier observations. Histologically, the cell proliferations follow the ramifications of afferent arteries. In older satellites, there are focal changes of intravascular papillary endothelial hyperplasia. These are interpreted as regression phenomena. Immunocytochemically, desmin-negative cells positive for muscle-actin are found in addition to endothelial cells. They are considered to be pericytes and myofibroblasts. Because of the close relationship with the afferent arterioles, disturbances in the vascular system are thought to be responsible for the development of angioma. If such underlying vascular disorders are not corrected by primary excision, satellite recurrences may occur. Because of their tendency to spontaneous remission, active therapeutic measures are not recommended.

Actins↗
PubMed1989

[Vascular tumors in the aged].

In elderly people, we find other vascular malformations and neoplasms to be frequent and important than during the first decades of life. The features of malformations change in the course of the years due to degenerative processes (e.g., venous lakes in solar degeneration, Pasini's ectasias of the lower lip). True angiomas are relatively rare in old people (except "senile" or tardive angiomas). Most of the malignant vascular tumors do not develop until very late in life (e.g., the sporadic type of Kaposi's sarcoma, Stewart-Treves syndrome, multicentric angiosarcoma of the scalp). Except for these malignancies, there is a greater range of therapeutic means in the elderly, since aged skin is more extensible and late sequelae of X-ray therapy are of minor importance.

Aged↗
PubMed1988

Diagnostic excision of the Rosenmüller's node. Screening for occult metastases before elective regional lymph node dissection in patients with lower limb melanoma?

Elective radical groin dissection was performed on 297 consecutive patients with high-risk melanoma of the leg, Anderson Stages I, IIA, IIIA. By separate histologic examination of the so-called "Rosenmüller's node," the other inguinal, and the external iliac lymph nodes, the diagnostic excision of the Rosenmüller's node was tested as a suitable mode of screening for metastases before a planned elective regional lymph node dissection. Eighty patients (27%) presented with what was histologically determined to be occult groin metastases. Rosenmüller's node was involved in 30 of these cases; in the remaining 50, however, it was not affected; that is, 63% of the cases were false-negative. Thus, the involvement of Rosenmüller's node is not representative of metastases in the other ilioinguinal lymph nodes, but is rather a matter of chance. In women with superficial spreading melanoma the rate of occult lymph node metastases was significantly lower than that in men with melanomas of the other type. Iliac lymph node involvement was observed in 18 patients (22%) depending on clinical stage and depth of invasion of the primary tumor.

Female↗
PubMed1988

Architectural features in melanocytic lesions with cellular atypia.

According to the quantity of single atypical melanocytes at the dermoepidermal junction 334 nevi were assigned to 3 groups: (1) with pronounced nuclear and cellular atypia (n = 73); (2) with moderate atypia (n = 127), and (3) without atypical melanocytes (n = 134). Three architectural features were almost exclusively observed in groups 1 and 2 with cellular and nuclear atypia: atypical localization of melanocytes in the epidermis, irregular distribution of melanocytes in the junctional zone and atypical nests of melanocytes. A combination of 2 or 3 of these features was seen in 76% of the nevi with pronounced cellular and nuclear atypia, in 28% of those with moderate atypia and in none of those without atypical melanocytes. Regarding 4 other criteria only minor but still statistically significant differences were found between the 3 groups of nevi. We conclude that these 4 other criteria, i.e. inflammatory infiltrate, lamellar and/or concentric fibroplasia, persisting lentiginous hyperplasia and dust-like pigment in melanocytes and nevus cells are not helpful for the diagnosis of a dysplastic nevus because of their low specificity. Minimal requirements for the diagnosis of a dysplastic nevus are suggested.

Adolescent↗
PubMed1988

[Suture materials in dermatology].

In a short review, we describe the chemical, physical, and mechanical properties of some skin suture materials. More attention must be paid to the elasticity of most modern synthetic materials as a cause for ingrowing loops in sutures with too much tension. In addition, we deal with the various dissolution times of absorbable materials.

Biomechanical Phenomena↗
PubMed1987

[Squamous keratoacanthoma].

On the previously unaffected skin of the nose of a 48-year-old patient a very rapidly growing tumour had been unsuccessfully excised twice. The second recurrence had been misinterpreted as erysipelas because of its rapid spread, inflammatory reddening at the margin and sensitivity to pressure. Increasing hardness and yellow discolouration eventually led to the diagnosis "plate-shaped keratoacanthoma". Spontaneous regression of the tumour resulted in complete cure within six months.

Biopsy↗
PubMed1987

[Prurigo diseases].

The term "prurigo" is universally used in dermatology. But, up to now, no definition of this term has been generally accepted. The "classic" description of the "urticarial papules" as the primary skin eruptions of prurigo is not correct, for these papules do not show any momentary edema but a persistent cellular infiltration. In the past, some authors already pointed out that the histologic structure of such papules looks very much like that of the characteristic papulovesicles in eczema--especially those in atopic dermatitis. The various forms of the prurigo nodes secondarily develop in case of the coincidence of three main factors: (1) the particular cutaneous response to repeated irritation (especially in autosomally dominant ichthyosis simplex), (2) reduced threshold for or constitutional disposition to pruritus (especially in atopy), and (3) internal (e.g. intestinal disorders) or external (e.g. insect bites) triggers. Probably none of the prurigo diseases represents a nosologic entity.

Dermatitis, Atopic↗