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Biomedical subjects

M Landthaler

Publications and source records attributed to M Landthaler.

At least 217 records · Page 12Linked to original sources
PubMed1994

Nd:YAG laser hyperthermia in the treatment of recalcitrant verrucae vulgares (Regensburg's technique).

Heat therapy of cutaneous diseases has been used for decades. During the last years several kinds of energy sources, including electromagnetic energy from radiofrequency, microwaves and sonic energy from ultrasound, have been used to produce local hyperthermia. The general principle of this treatment is based on the fact that disease tissue which is being treated is more sensitive to the effects of elevated temperature than normal tissue and thus less able to recover after heat exposure. We report the case of a 54-year-old female patient with recalcitrant verrucae vulgares on the little finger of her right hand and on her left sole, who was treated with Nd:YAG laser hyperthermia. Laser energy was applied twice with an interval of 6 weeks. Laser output power was 10 W, spot size 8 mm and irradiation time up to 20 s. By this technique it was possible to receive a surface temperature of about 40 degrees C for 30 s. After hyperthermia no skin changes like whitish discoloration, blistering or crusting were observed. After the patient had completed the second course a total remission took place. No recurrence was seen in a follow-up period of 3 months. This method could be used in the treatment of recalcitrant warts on the fingers and hands, periungual and other parts of the body including plantar surfaces.

Female↗
PubMed1994

UV-A-provoked localized bullous pemphigoid.

A 71-year-old woman had noticed the development of blisters on her forehead 4 months before she was referred to our department. Treatment with oral corticosteroids resulted in complete healing, but new blisters subsequently developed on the face, neck and backs of the hands. After the possibility of phototoxic and photoallergic reactions, as well as an abnormal porphyrin profile, had been excluded, the diagnosis of bullous pemphigoid was made by histological and direct immunofluorescent examination. UV-A provocation on the upper arm produced lesions histologically and immunohistochemically typical of bullous pemphigoid. Of particular importance was the fact that the blisters were limited strictly to light-exposed skin areas.

Aged↗
PubMed1994

[Classification, diagnosis and differential diagnosis of malignant melanoma].

Due to the recent increase of incidence of malignant melanoma and due to the significance of early detection for a definite cure from the disease, diagnosis and differential diagnosis of malignant melanoma are very important. At first glance the malignant potential of a pigmented mole can be evaluated by the macroscopical ABCD rule (Asymmetry, irregular Border, different Colors, and Diameter larger than 6 mm). In addition, also the history of the patient might be helpful. Thus a malignant melanoma should be considered when a patient reports a new rapidly growing pigmented lesion or a change in an existing mole in color, size, shape, and surface. Itching or burning should also arouse the suspicion of malignant change. Risk factors for the development of a malignant melanmoma are a high number of benign melanocytic nevi, large congenital melanocytic nevi, fair skin types with a tendency to sunburns and a malignant melanoma in the family of the patient. With dermatoscopy, which is skin surface microscopy at 10x magnification, the difficult macroscopical differential diagnosis is facilitated, because this technique opens a new dimension between macroscopy and microscopy.

Adolescent↗
PubMed1994

Dose comparison of tropisetron (Navoban) 5 mg and 10 mg orally in the prophylaxis of dacarbazine-induced nausea and emesis.

In this double-blind, randomized trial performed at five study centers, the prophylactic, antiemetic effect of two different dosages of tropisetron (Navoban; Sandoz Pharma Ltd, Basel, Switzerland) was investigated in dacarbazine-treated patients with melanoma. Patients received tropisetron 5 mg or 10 mg orally (as one capsule) once daily (minimum 3 days) on each day of chemotherapy. No significant differences were found in the effects of tropisetron 5 mg and 10 mg. During the first 24 hours, total control of vomiting was seen in 93% and 98% of patients receiving tropisetron 5 mg and 10 mg, respectively. Total control of nausea was achieved in 84% and 80% of patients receiving tropisetron at these dosages. Over days 2 to 7 of chemotherapy, total control of vomiting and nausea remained high. Patients reported that quality of life remained good throughout chemotherapy, as did mood; only a small decrease in food intake occurred. Tropisetron was well tolerated. Constipation was the most common adverse event, occurring in 13% of patients. Headache (4%), diarrhea (4%), and anorexia (2%) also were observed.

Administration, Oral↗
PubMed1993

Relapsing polychondritis presenting as cutaneous polyarteritis nodosa.

Relapsing polychondritis is an infrequently diagnosed, though not necessarily uncommon, systemic disorder characterized by recurrent and potentially destructive inflammation of cartilaginous structures, the eye, and the audiovestibular and cardiovascular systems. Although dermal involvement occurs in approximately 25% of patients with relapsing polychondritis, in only few cases has a skin biopsy been obtained revealing lesions such as leukocytoclastic vasculitis, livedo reticularis, erythema nodosum or keratodermia blenorrhagicum. We describe a patient with relapsing polychondritis in whom a cutaneous polyarteritis nodosa preceded cartilage inflammation by 6 months. Cutaneous polyarteritis nodosa is a rare form of vasculitis that appears to be limited primarily to the skin, muscles, and joints. In contrast to the systemic form of the disease it is characterized by the absence of visceral lesions and a relapsing but benign course. The present case and the fact that vasculitis is a concomitant feature in approximately 30% of patients with relapsing polychondritis [21] demonstrates that this condition may not represent a distinct clinical entity.

Aged↗
PubMed1993

Deposits of paraprotein in small vessels as a cause of skin ulcers in Waldenström's macroglobulinemia.

A 71-year-old man presented with epistaxis and large ulcers on arms and legs. A monoclonal IgM-kappa gammopathy and high levels of cryoglobulins were found. Histology of the affected skin showed deposits of paraprotein in the small vessels, causing luminal obstruction. This in turn caused ischemic skin lesions, which were successfully treated with cortisone (fluocortolone 100 mg/day every second day) and cyclophosphamide (100 mg/day).

Aged↗
PubMed1993

Laser therapy of verrucous epidermal naevi.

Forty-three patients with verrucous epidermal naevi were treated either with argon-laser coagulation or with carbon-dioxide laser vaporization. With the argon laser, very good to acceptable results could be achieved in 85% of patients with 'soft', papillomatous lesions. In 'hard', keratotic naevi the argon laser proved ineffective. In some of these cases CO2-laser treatment was effective, whereas generally there was a tendency to hypertrophic scar formation with this laser. As other therapeutic modalities for epidermal naevi are either insufficient or not applicable in widespread lesions, we feel that laser treatment is a valuable therapeutic alternative.

Adolescent↗
PubMed1993

[Interferon-gamma. Therapy of recurrent furunculosis in HIV infections].

Four HIV-antibody-positive patients in stages CDC II to CDC IV C2 with furuncles that had so far proved refractory to treatment were successfully treated with systemic application of recombined gamma-interferon, 50 micrograms s.c. on days 1, 2 and 3 of the first week with a new cycle after 3 weeks. A significant clinical improvement was seen in all patients after three to five cycles. Side-effects of therapy with gamma-interferon were similar to the symptoms of influenza and improved during therapy. No changes in immunological parameters and white blood cells counts were observed. The general condition of the patients improved or remained unchanged. A few weeks after discontinuation of therapy two patients relapsed, but they were again successfully treated with gamma-interferon.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Photodynamic therapy of skin tumors].

Photodynamic therapy (PDT) is still an experimental modality using red light in conjunction with a systemic or topical photosensitizer. The photosensitizers have a longer retention time in malignant tumors compared with the normal surrounding tissue. Irradiation with a red light at wavelength of 630 nm results in photochemical generation of cytotoxic singulet oxygen. The systemic sensitizer mostly used is hematoporphyrin derivative (HPD) and the light sources are argon-pumped dye lasers, gold vapour lasers and even more simple light sources based on conventional lamps. The most important side effect of systemic application of HPD is light hypersensitivity in the UVA range, which lasts up to several weeks. Multiple studies in recent years have proved that superficial basal cell carcinomas, squamous cell carcinomas, Bowen's disease and epidemic Kaposi's sarcoma respond to systemic PDT. Up to now, however studies with greater numbers of patients and a sufficient follow-up have been lacking. Topical application of sensitizers like amino-levulinic acid (ALA) and tetraphenylporphine sulfonate (TPPS) have been used for the treatment of superficial basal cell carcinomas and squamous cell carcinomas. Possible future applications of PDT are virus papillomas and psoriasis. Even if PDT is an experimental therapeutical modality at present, it may become more clinical relevant in the future.

Basal Cell Carcinoma↗
PubMed1992

Metastatic signet-ring cell melanoma in a patient with an unknown primary tumor. Histologic, immunohistochemical, and ultrastructural findings.

Signet-ring cell melanoma is a rare morphologic variant of malignant melanoma. We describe a 27-year-old man with widespread cutaneous and internal metastases of an unknown primary tumor. One skin biopsy specimen and a fine-needle aspirate showed polygonal tumor cells consistent with the diagnosis of metastatic melanoma, but a second skin biopsy specimen revealed neoplastic cells with a signet-ring cell appearance. Both specimens, however, yielded identical immunohistochemical findings. Tumor cells were positive for vimentin and S-100 protein and reacted with the melanoma markers HMB-45 and NKI-C3. Ultrastructural studies revealed abundant intermediate filaments in the cytoplasm of the signet-ring cells. Based on these findings, a diagnosis of metastatic melanoma was made. In this report we describe the fourth case of metastatic signet-ring cell melanoma, and discuss how malignant melanoma may lead to metastases that have divergent morphologic appearances in the same patient.

Adult↗
PubMed1992

Acute mercury intoxication with lichenoid drug eruption followed by mercury contact allergy and development of antinuclear antibodies.

A 31-year-old black man was examined for evaluation of a suspected occupational disease. Three years earlier he had been suffering from acute mercury intoxication during work in a mercury recycling factory. Skin symptoms then had been a lichenoid drug eruption, patchy alopecia and stomatitis, which had all disappeared rapidly after systemic glucocorticosteroid treatment. The examination revealed positive patch test reactions to metallic mercury and inorganic mercury compounds, an elevated titre of serum antinuclear antibodies and normal IgE levels. The induction of antinuclear antibodies by mercury has been shown in animal experiments. It can be hypothesized that this patient, who may have had an increased individual susceptibility, became allergic to mercury by the mercury intoxication.

Acute Disease↗