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Biomedical subjects

M Landthaler

Publications and source records attributed to M Landthaler.

At least 199 records · Page 11Linked to original sources
PubMed1995

Laser therapy of childhood haemangiomas.

A total of 37 haemangiomas were treated in 28 patients by means of the flashlamp-pumped pulsed dye laser (FPDL). Twenty-nine haemangiomas were classified as superficial, and eight as mixed type. With FPDL treatment, excellent or good results were obtained in nearly 60% of superficial haemangiomas and 40% of mixed haemangiomas. In three of four patients with mixed type haemangiomas good results were obtained by means of Nd: YAG laser irradiation. In two patients, small superficial haemangiomas were removed by argon laser coagulation or CO2 laser vaporization, respectively. These results indicate that many children benefit from laser therapy of haemangiomas. Side-effects were rare. The FPDL is the treatment modality of choice for superficial haemangiomas, and the Nd: YAG laser for thicker lesions. Based on our results and the results reported in the literature, early laser therapy of childhood haemangiomas can be recommended.

Female↗
PubMed1995

Treatment of severe localized scleroderma by plasmapheresis--report of three cases.

We report three patients with severe, localized scleroderma, and with elevated titres of antinuclear antibodies, who were treated by plasmapheresis in combination with systemic steroid therapy. The therapeutic effectiveness of plasmapheresis was assessed on the basis of improvement in cutaneous and joint lesions. In all cases, significant improvement occurred after 2 months of therapy. Thus, in addition to treating systemic sclerosis, plasmapheresis can also be recommended for treatment of severe cases of localized scleroderma with elevated titres of antinuclear antibodies and antibodies to ss-DNA.

Adult↗
PubMed1995

Recurrent inflammation in incontinentia pigmenti of a seven-year-old child.

A young girl has undergone the typical skin manifestations of incontinentia pigmenti, leaving now only discrete hyperpigmentation on the flexor sides of the lower extremities. Each time when she has a feverish infection, a recurrence of inflammation can be seen within the hyperpigmented areas. At the same time when the fever subsides, the acute skin manifestations disappear as well. The combination of recurrent inflammatory skin manifestations within the hyperpigmented skin areas of incontinentia pigmenti and fever is unique. The reasons for this phenomenon and for its strict limitation to the areas of incontinentia pigmenti remain unclear.

Child↗
PubMed1995

Unilateral localized basaliomatosis: treatment with topical photodynamic therapy after application of 5-aminolevulinic acid.

A 74-year-old woman presenting with multiple unilateral localized basal cell carcinomas present for 30 years on the left side of her body is reported. There was no history of arsenic ingestion or X-ray exposure. Typical signs of nevoid basal-cell carcinoma syndrome (Gorlin's syndrome) like jaw keratocysts, skeletal malformations, and small palmoplantar pits were missing. Although treatment with many therapeutic regimens was tried, there were still tumor recurrences. Photodynamic therapy was performed after topical application of 5-aminolevulinic acid. This treatment resulted in good tumor control with an optimal cosmetic result.

Administration, Cutaneous↗
PubMed1995

Late irradiation damage to the skin caused by soft X-ray radiation therapy of cutaneous tumors.

BACKGROUND: Although radiotherapy of skin tumors has lost its former preeminence, there is still need for this modality. The aim of this study was, therefore, to determine the frequency of radiogenic ulcers and tumors following soft x-ray therapy of skin lesions. STUDY DESIGN: A total of 612 radiation sites in 522 patients were retrospectively analyzed by means of medical records. All patients received at least a total dose of more than 12 Gy and had a minimum follow-up time of 10 years. The average radiation dose was about 80 Gy, ranging from 56 to 184 Gy. Determined was occurrence of radiogenic tumors after more than 10 years and of ulcers during the entire follow-up period. The frequency of radiogenic tumors and ulcers was related to the total dose applied and the patient's age at the time of irradiation. RESULTS: In the 612 radiation fields used, 58 ulcers (9.4%), 12 basal cell carcinomas (2%), and nine squamous cell carcinomas (1.5%) were observed. There was no relationship between the total dose of radiation and the frequency of tumors; in contrast, radiogenic ulcers increased with a higher total dose. Radiogenic ulcers occurred more often in patients who were of a younger age at the time of irradiation. CONCLUSIONS: The risk of developing radiogenic ulcers and tumors after soft x-ray therapy is not very high. Since most of the ulcers can be prevented by modern dose recommendation (time dose fractionation factor), soft x-ray therapy can be considered as a safe and effective means of therapy, especially in older patients.

Aged↗
PubMed1994

[The interdisciplinary aspects of notalgia paraesthetica].

For 3 years a 75-year-old man with type II diabetes had been suffering from paroxysmal pruritus in a circumscribed area of brown discoloration of the skin over the left should blade. This condition, also known as notalgia paraesthetica, is a rare, but perhaps underdiagnosed, neurocutaneous entity, a largely sensory neuropathy due to a muscular compression phenomenon. In this case histological examination of a biopsy specimen showed focal acanthosis, obvious basal hyperpigmentation and discrete perivascular lymphocytic infiltration with numerous melanophages. At first, glucocorticoids were administered unsuccessfully against the distressing pruritus. Purely symptomatic local capsaicin treatment decreased the pruritus temporarily. Endocrinological diagnosis failed to demonstrate multiple endocrine neoplasia (MEN) syndrome 2A, which has been frequently described in association with notalgia paraesthetica.

Aged↗
PubMed1994

[Adenoid cystic sweat gland carcinoma. A clinicopathologic and immunohistochemical study].

Adenoid cystic carcinoma of the skin is one of the rarest sweat gland tumours. We have studied two cases of adenoid cystic sweat gland carcinoma clinically, histologically and immunohistochemically. One tumour was located on the occiput of an 18-year-old male patient, while the other developed on the back of a 49-year-old woman. Histologically, both carcinomas were characterized by basaloid tumour cells showing the typical adenoid-cystic growth pattern. The cells were arranged in solid, cribriform, tubular and cystic aggregates, which were surrounded by mucoid, Alcian blue material. Immunohistochemically, the tumour cells showed coexpression of cytokeratins typical of stratified epithelia (CK1/5/10/14) and cytokeratins of the simple epithelial type, namely CK7, CK8, CK18, and CK19. Coexpression of these cytokeratins is usually observed in normal fetal sweat glands, but not in adult sweat glands.

Adolescent↗
PubMed1994

The ABCD rule of dermatoscopy. High prospective value in the diagnosis of doubtful melanocytic skin lesions.

BACKGROUND: The difficulties in accurately assessing pigmented skin lesions are ever present in practice. The recently described ABCD rule of dermatoscopy (skin surface microscopy at x10 magnification), based on the criteria asymmetry (A), border (B), color (C), and differential structure (D), improved diagnostic accuracy when applied retrospectively to clinical slides. OBJECTIVE: A study was designed to evaluate the prospective value of the ABCD rule of dermatoscopy in melanocytic lesions. METHODS: In 172 melanocytic pigmented skin lesions, the criteria of the ABCD rule of dermatoscopy were analyzed with a semiquantitative scoring system before excision. RESULTS: According to the retrospectively determined threshold, tumors with a score higher than 5.45 (64/69 melanomas [92.8%]) were classified as malignant, whereas lesions with a lower score were considered as benign (93/103 melanocytic nevi [90.3%]). Negative predictive value for melanoma (True-Negative divided by [True-Negative+False-Negative]) was 95.8%, whereas positive predictive value (True-Positive divided by [True-Positive+False-Positive]) was 85.3%. Diagnostic accuracy for melanoma (True-Positive divided by [True-Positive+False-Positive+False-Negative]) was 80.0%, compared with 64.4% by the naked eye. Melanoma showed a mean final dermatoscopy score of 6.79 (SD, +/- 0.92), significantly differing from melanocytic nevi (mean score, 4.27 +/- 0.99; p < 0.01, U test). CONCLUSION: The ABCD rule can be easily learned and rapidly calculated, and has proven to be reliable. It should be routinely applied to all equivocal pigmented skin lesions to reach a more objective and reproducible diagnosis and to obtain this assessment preoperatively.

Dermatology↗
PubMed1994

Immunohistochemical demonstration of myoepithelial cells in sweat gland carcinomas.

Although myoepithelial cells are detectable in many benign sweat gland tumours, little is known about their role in sweat gland carcinomas. To specifically demonstrate myoepithelial cells, paraffin sections from 46 sweat gland carcinomas were stained, using a standard avidin-biotin-peroxidase complex method, with the monoclonal alpha-smooth muscle actin antibody 1A4. Myoepithelial cells were not found in adenoid cystic eccrine carcinoma (n = 2), malignant nodular hidradenoma (n = 2), porocarcinoma (n = 4), extramammary Paget's disease (n = 12), sclerosing sweat duct carcinoma (n = 4) or in adenosquamous-mucoepidermoid carcinoma (n = 1). In contrast, myoepithelial cells were demonstrated in two of eight apocrine adenocarcinomas, one of six mucinous eccrine carcinomas and two of seven eccrine adenocarcinomas. In all these tumours myoepithelial differentiation was found in peripheral cells of solid tumour islands, or in basal cells of tubular structures. However, in most areas of the tumours, myoepithelial layers were discontinuous. Cells in the centre of solid tumour nodules, and luminal cells of tubular structures, were negative for alpha-smooth muscle actin. In analogy to breast tumours, in which malignancy and invasiveness correlate with scattered or absent myoepithelial cells, we suggest that disrupted myoepithelial layers in sweat gland carcinomas may be interpreted as a loss of the invasion barrier.

Actins↗
PubMed1994

Successful treatment of hydroxyethyl starch-induced pruritus with topical capsaicin.

We report a case of recalcitrant pruritus after infusion therapy with hydroxyethyl starch (HES) for sudden deafness. The diagnosis was confirmed by detection of typical HES storage vacuoles within dermal macrophages and perineural cells. Treatment with antihistamines and antipruritic agents, UVB irradiation, and neuroleptic drugs, was ineffective. Topical capsaicin (0.05%) twice daily produced excellent symptomatic relief, without side-effects.

Administration, Topical↗
PubMed1994

Differentiation between malignant melanomas and benign melanocytic nevi by computerized DNA cytometry of imprint specimens.

Recently image analysis (IA) and DNA-cytophotometry (CP) have proved to be useful for the differentiation between benign and malignant melanocytic lesions on paraffin sections. Since, on sections, these procedures are very time-consuming, we tested in the present study whether IA of imprint specimens, which can be evaluated in less than 30 minutes, might also be sufficient. In 39 malignant melanomas (MM), 18 melanocytic nevi (MN), and 6 dysplastic nevi (DN), 12 different morphometric and DNA cytometric features were determined in 100 randomly selected nuclei. In univariate analysis, 5 features were found to be significantly different between the benign and malignant groups (p < 0.0001): mean value (MAREA) and standard deviation (SAREA) of nuclear area and the 80th, 90th, and 95th percentiles of DNA distribution. Using SAREA, the best univariate feature, 82.5% of the cases could be correctly separated. In multivariate analysis with a combination of three features--standard deviation of nuclear area (SAREA), mean DNA value (MDNA), and 95th percentile of DNA distribution (PERC95)--a correct diagnosis was achieved in 89.5% of the cases. Results obtained in the cases of DN indicated an increased proliferation, but did not allow the separation of DN from MM and MN. Since our technique allows a rapid analysis without loss of tissue, which might be important for histological analysis, and the classification rates are equal or still higher than reported in studies on sections, imprints of melanocytic lesions seem to be most appropriate for the calculation of DNA cytometric features as helpful diagnostic criteria in equivocal melanocytic lesions.

Adult↗
PubMed1994

Penetration potency of topical applied delta-aminolevulinic acid for photodynamic therapy of basal cell carcinoma.

Penetration potency of delta-aminolevulinic acid (ALA) was studied by examining fluorescence of endogenous protoporphyrin IX in different histological types of basal cell carcinoma. Ten basal cell carcinomas were coated with an ointment containing 10% ALA prior to excision; five served as controls. Tumors were excised either 4 h or 12 h after application of ALA using a modified Mohs' micrographic surgical technique. Horizontal sections were cut from deep dermis to tumor surface and examined under a fluorescence microscope. After 4 h of application, only skin appendages demonstrated fluorescence typical of protoporphyrin IX. After 12 h, fluorescence was detectable in tumor cells in deep dermis. The five controls revealed no fluorescence at any site. These results may confirm the high penetration potential of topically applied ALA and its usefulness in photodynamic therapy. For tumors penetrating to deep dermis, an application time of more than 4 h seems necessary, at least when hydrophilic solvents for ALA are used.

Administration, Topical↗
PubMed1994

Granuloma pyogenicum as a complication of flashlamp-pumped pulsed dye laser.

The flashlamp-pumped pulsed dye laser (FPDL) is a dye laser with 585-nm wavelength and 300- to 450-microseconds pulse width and has been demonstrated to effectively and safely treat port-wine stains, telangiectases and superficial hemangiomas. We report 2 cases of pyogenic granuloma following the treatment with FPDL.

Adult↗
PubMed1994

A possible new incoherent lamp for photodynamic treatment of superficial skin lesions.

Since coherence of laser light is not necessary for photodynamic therapy of skin lesions, attempts have been made to construct incoherent lamps. A recent development is the PDT 1200 (Waldmann Medizintechnik/Germany), a light source consisting of a 1200 watt metal halogen lamp. Emission of 600 to 800 nm radiation is achieved by using cut-off filters. Power density can be varied from 30 mW/cm2 to 200 mW/cm2 in an area from 100 to 300 cm2. Biological effectiveness was proved by comparison with the radiation of an argon-pumped dye laser (Kiton red) emitting light at 630 nm. Three human cell lines were incubated with photofrin at different concentrations. After irradiation, cell viability was tested (MTT assay). Results proved biological effectiveness of the light source PDT 1200. No significant difference in cell viability was detected using either concentration of sensitizer. Therefore, we believe that PDT 1200 is a promising new light source for photodynamic therapy of skin lesions.

Cell Survival↗