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Biomedical subjects

M Winzer

Publications and source records attributed to M Winzer.

18 recordsLinked to original sources
PubMed2005

[Calciphylaxis in terminal renal failure as a rare manifestation of leg ulcers].

Calciphylaxis is a potentially life-threatening disease that occurs up to 4% of patients with chronic terminal renal failure and secondary hyperparathyroidism. Clinical symptoms are painful skin erythema and ischemic necrosis as a result of calcification of the small and medium-sized arteries of the subcutaneous tissues. The mortality of the disease is as high as 87% mainly due to sepsis from superinfection. We report on a 59-year-old patient with chronic renal failure and normal calcium-phosphate-product with leg ulcers as a rare manifestation of a calciphylaxis. In spite of an early parathyroidectomy and a temporary complete wound-healing the death because of calciphylaxis could not be prevented.

Calciphylaxis↗
PubMed2003

[Mycosis fungoides in childhood and adolescence with clonal T-cell receptor gamma gene rearrangement. Two cases].

Mycosis fungoides (MF) is a cutaneous T-cell lymphoma (CTCL) characterized by its typical progress in three stages: the patch-, the plaque- and the tumour-stage. The incidence of mycosis fungoides rises with age and the average age at presentation is about 50. Children and adolescents are rarely affected and there are only few reports in the literature. We report a 12- and a 15-year-old boy showing refractory skin lesions not typical for mycosis fungoides. The histo- and immunohistological investigations and the detection of clonal T-cell receptor gamma gene rearrangements confirmed the diagnosis of early onset mycosis fungoides in both cases.

Adolescent↗
PubMed2000

[Symplastic hemangioma].

BACKGROUND AND OBJECTIVE: Endothelial nuclear atypia is the hallmark of malignant vascular tumors. Pleomorphic nuclei of the muscular vessel wall and the adventitia are manifestations of degenerative phenomena and should not be misinterpreted as signs of malignancy. PATIENTS/METHODS: Three long-standing solitary superficial vascular tumors (61-year-old woman, 48- and 63-year-old men) were removed by primary excision. Sections were stained according to standard histologic and immunohistologic protocols. RESULTS: Symplastic hemangiomas show the silhouette of a small superficial angioleiomyoma or capillary hemangioma. Characteristic features are multinucleate cells of the muscular vessel wall and the adventitia with pleomorphic nuclei, broad hyalinized vessel walls, and the distinctive lack of endothelial nuclear atypia. Recurrences or metastases were not reported (follow-up of 9, 45 and 90 months). CONCLUSIONS: Symplastic hemangioma is a benign superficial hemangioma with histological features of a pseudomalignancy. The distinctive lack of endothelial nuclear atypia allows distinction from malignant vascular tumors.

Angiomyoma↗
PubMed1999

Architectural organization of filiform papillae in normal and black hairy tongue epithelium: dissection of differentiation pathways in a complex human epithelium according to their patterns of keratin expression.

BACKGROUND: An inadequate understanding of the complex morphologic characteristics of human filiform papillae has hampered the histopathological characterization of disorders affecting tongue keratinization. To better define the 3-dimensional cytoarchitecture of tongue epithelium, we performed detailed immunohistochemical analyses of normal and black hairy tongue tissues using a panel of antikeratin antibodies. OBSERVATIONS: The dome-shaped base of the human filiform papilla (primary papilla) is surmounted by 3 to 8 elongated structures (secondary papillae). These secondary papillae are composed of a central column of epithelial cells expressing hair-type keratins and an outer rim of cells expressing skin-type keratins. The epithelium overlying the primary papillae and between the individual primary papillae express esophageal-type keratins. In black hairy tongue disease, there is a marked retention of secondary papillary cells expressing hair-type keratins. CONCLUSIONS: Using a panel of antikeratin probes, we define the precise topographical localization of cell populations undergoing 3 distinct differentiation programs in dorsal tongue epithelium. Comparative analyses of black hairy tongue specimens indicate that defective desquamation of the cells in the central column of filiform papillae results in the formation of highly elongated, cornified spines or, "hairs"--the hallmark of this disease.

Antibodies↗
PubMed1992

[Bullous poikilodermatitic amyloidosis of the skin with junctional bulla development in IgG light chain plasmacytoma of the lambda type. Histology, immunohistology and electron microscopy].

A 75-year-old patient presented with bullae, poilokilodermatic skin and nail dystrophy as signs of systemic amyloidosis 1 year before an IgG myeloma of the lambda type was diagnosed. The skin lesions appeared at mechanically irritated locations on the trunk and at the tensor sites of the extremities. Histology showed a subepidermal blister and necrotic keratinocytes in the epidermis. There were amyloid deposits in the papillary dermis perivascular, and in the deep dermis around eccrine glands and in arrectores pilorum muscles. Polyclonal antibodies allowed classification of the deposits as amyloid composed of lambda light-chain immunoglobulins. Electron microscopy revealed globoid deposits of non-branching filaments typical of amyloid. The blister was formed at the level of the lamina lucida, with the lamina densa at the base of the bottom of the bulla. So far, junctional blister formation in bullous amyloidosis of the skin has been described only once. Our case is the second report of this blister type, and to our knowledge the first published report of a junctional blister in myeloma-associated systemic amyloidosis.

Actin Cytoskeleton↗
PubMed1991

Cutaneous metastases from follicular thyroid carcinoma: histology, immunohistology, and electron microscopy. A report of two cases.

Cutaneous metastases from thyroid carcinoma are extremely rare. We report 2 cases of skin metastases from a follicular thyroid carcinoma. A 53-year-old female patient underwent subtotal thyroidectomy because of the clinical suspicion of malignancy. Histological examination of the resected tissue did not clearly prove malignant features. Eight years later a cutaneous metastasis erupted next to the operation site at the neck. A 66-year-old female patient noticed a growing solitary skin nodule in the occipitoparietal region of her scalp 2 years before a follicular thyroid carcinoma was detected.

Adenocarcinoma↗
PubMed1991

[Specific skin infiltration in Hodgkin's disease].

A 60 year old man consults the dermatologist because of a bean sized centrally ulcerated painless tumor in the skin of his left axilla. The axillary lymph nodes proximal to the skin tumor are firm and enlarged. The skin biopsy reveals a dense mixed infiltrate composed of lymphocytes, histiocytes, plasma cells and granulocytes and there are multiple neoplastic mononuclear and some multinuclear giant cells, resembling Hodgkin- and Reed-Sternberg-cells. Thus the diagnosis of Hodgkin's disease was considered on the grounds of the skin biopsy. Immunohistologically the atypical giant cells express the CD-30 (Ki-1)-antigen. Histology of the subsequently excised lymph nodes resembled the changes in the skin and showed classical Hodgkin's disease of mixed cellularity.

Antigens, CD↗
PubMed1991

[Acute disseminated histiocytosis X (Langerhans cell histiocytosis) with fatal course in an adult].

Histiocytosis X is very rare in late adulthood, usually taking a benign course with a good prognosis. A 56-year-old patient developed acute disseminated histiocytosis X with multiorgan involvement. Despite extensive diagnostic work-up the diagnosis could only be established on the grounds of a skin biopsy. Histiocytosis X cells are S 100 protein-positive and express the membrane antigens CD 1, CD 4 and HLA-DR. Electron microscopy reveals Birbeck granules. On static cytophotometry, histiocytosis X cells exhibited normal DNS content without aneuploidy. One year after the onset of disease the patient's condition deteriorated rapidly despite aggressive polychemotherapy (CHOP), and he died of multiorgan failure due to histiocytosis X.

Acute Disease↗
PubMed1989

[Siliconoma].

We report on a 73-year-old woman who, 12 years after liquid silicone injection for cosmetic purposes, developed siliconoma of her forehead within 9 months. We discuss the clinical and histopathological aspects of this foreign body granuloma.

Aged↗
PubMed1989

[Desmoplastic trichoepithelioma with nevus cell nevi].

Among a total of 270,000 skin biopsies, 87 desmoplastic trichoepitheliomas were identified, 11 (12.6%) of which were associated with nevocytic nevi. Histopathologically we found nevocytes next to horn cysts and thin strands of monomorphous basaloid neoplastic cells in a dense desmoplastic stroma. The frequency of this association suggests that it may be a combined malformation rather than a chance occurrence. On clinical examination most cases had been misdiagnosed as basal cell carcinomas. Most biopsies were taken from the faces of fairly young women.

Adolescent↗
PubMed1989

Localized and disseminated pagetoid reticulosis. Diagnostic immunophenotypical findings.

Pagetoid reticulosis (PaRet) is a rare skin disease with an intraepidermal infiltrate of atypical lymphocytes. We performed phenotypic studies on two patients with classic localized PaRet (Woringer-Kolopp disease) and one patient with the disseminated type (Ketron-Goodman disease) and compared these with all published reports of cases; both variants show intraepidermal, highly activated, proliferating T cells with variable loss of pan-T-cell antigens, contrasting with nonactivated dermal reactive T cells. This pattern is unique among cutaneous lymphomas and can be used for diagnosis. Despite the fact that localized PaRet does not show a malignant course, recent genotypic analysis of one patient showed monoclonality. Comparable constellations are found in other diseases like lymphomatoid papulosis, which also represent monoclonal disorders of activated T cells with a benign course. To unify these seeming discrepancies, we introduce the concept of "benign cutaneous lymphomas."

Adult↗
PubMed1988

[Hairy tongue and hairy oral leukoplakia--a differential histopathologic diagnosis].

10 specimens taken from oral hairy leukoplakia were compared to 8 histological preparations from hairy tongue. We found 9 criteria helpful concerning the histopathologic differential diagnosis of these entities. Oral hairy leukoplakia shows a gently papillated surface, a prominent horny layer with confluent bacterial overgrowth, and ballooned epithelial cells with a distinct perinuclear halo in a bandlike arrangement. Hairy tongue, in contrast, grows exophytically with a digitiform surface, the horny layer is rather thin, and the microorganisms are confined to the ends of the digitations; the ballooned epithelial cells show pale cytoplasm. Considering the growing incidents of HIV infection, the dermatologist should be familiar with the characteristics of oral hairy leukoplakia and its histopathological differential diagnosis.

Biopsy↗
PubMed1988

[Impetigo herpetiformis].

We report the case of a 30-year-old patient who had impetigo herpetiformis during hormonal contraception and during two successive pregnancies. The diagnostic features of impetigo herpetiformis are reviewed. An association with HLA-Cw 6 is recognized. A large post-traumatic spleen cyst probably influenced the course of the disease. Postpartum therapy with oral glucocorticosteroids and etretinate was successful.

Adult↗
PubMed1988

[Histopathology of oral "hairy" leukoplakia].

We studied biopsy specimens from ten male Caucasian patients with oral "hairy" leukoplakia. All patients either had the acquired immunodeficiency syndrome (AIDS) or showed symptoms of the AIDS related complex (ARC). On the basis of the specimens studied, we describe the histopathological features of this new entity and discuss the already established criteria. Histopathologically, "oral hairy leukoplakia" is characterized by a prominent confluent parakeratotic cornified layer, a subcorneal horizontal bandlike array of large ballooned epithelial cells with pale eosinophilic cytoplasm and a clear perunuclear halo. PAS staining revealed hyphae in two of the ten biopsies. The histopathological changes seen in oral "hairy" leukoplakia are characteristic, but not specific. Thus they must be differentiated from a variety of histologically similar looking dermatoses of the oral cavity.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Benign familial chronic pemphigus and pityriasis rosea. Clinical aspects and histology of the coexistence of both dermatoses].

We report the course of benign familial pemphigus (Hailey-Hailey disease) in a 45-year-old woman. While this condition was in remission the patient started to suffer from pityriasis rosea. A biopsy of this coexisting dermatosis revealed the typical features of Hailey-Hailey disease (suprabasal acantholysis) and of pityriasis rosea within the same lesion.

Axilla↗
PubMed1987

Cutaneous pseudolymphoma at the site of prior herpes zoster eruption.

A 55-year old woman with a history of herpes zoster in the dermatome supplied by the mandibular branch of the trigeminal nerve developed cutaneous red papules and umbilicated nodules within the same segment. The clinical and histological diagnosis was pseudolymphoma. The lesions showed a polymorphous infiltrate without germinal center formation. Immunologic phenotyping with monoclonal antibodies revealed the predominance of helper T cells and distinct compartmentalization of B and T cells. The lesions healed up within 7 weeks. The development of pseudolymphomas at the site of previous herpes zoster eruptions seems to be extremely rare.

Adult↗
PubMed1985

[Budd-Chiari syndrome following dacarbazine therapy of malignant melanoma--an avoidable complication?].

A 51-year-old female patient died of Budd-Chiari syndrome during treatment with adjuvant DTIC mono-chemotherapy for malignant melanoma. We report on clinical course and laboratory findings in detail. Differentiating BCS from VOD, we describe the liver damages referring to the latest findings about the effect of DTIC in fibrinolysis. In order to prevent further lethal complications, we suggest to regard pre-existing liver damage as a contra-indication for DTIC therapy; to prefer intraspinal anesthesia for malignant melanoma of the lower extremities; to avoid hepatotoxic drugs and alcohol during chemotherapy; to protect DTIC from light; to extend the interval between first and second cycle. Laboratory data, the "finger-prints" of DTIC, are unreliable. Great attention should be paid to clinical findings which may justify immediate and high dose corticosteroid therapy as well as intensive care monitoring.

Budd-Chiari Syndrome↗