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Biomedical subjects

P Altmeyer

Publications and source records attributed to P Altmeyer.

At least 199 records · Page 11Linked to original sources
PubMed1997

[Analysis of compound prescriptions by practicing dermatologists. A study of 72,615 prescriptions for patients insured by the North Rhine-Westphalia BKK].

Over 72,000 prescriptions from practicing dermatologists were reviewed to obtain an overview of current prescribing trends including both medical and economic aspects. One main point of concern was the quality of compounded prescriptions, which play an important role in dermatology, comprising 39.5% of the total and 47.8% of the topical prescriptions. Mixtures containing corticosteroids play a central role, being present in 45.2% of topical preparations, and comprising 35.9% of the standard preparations. While most mixtures were totally acceptable, some seemed questionable, either because of the number of active ingredients (as many as 7), the combinations (corticosteroid, antibiotics and antifungals) or the selected concentrations. The increased number of prescriptions and the use of compounding both appear fertile areas for cost-control measures.

Cost-Benefit Analysis↗
PubMed1997

[Health consciousness and risk behavior of prostitutes].

Regular examinations of prostitutes may reduce the incidence of sexually transmitted diseases in this high risk group. Therefore since April 1988 regular mandatory examinations have been offered by the regional health office in cooperation with the Department of Dermatology of the Ruhr-University of Bochum. The aim of this study was to evaluate the acceptance and efficiency of such an examination. The study was based on anonymous questionnaires. Mean age of the 80 prostitutes was 31.4; 67 of then were born in Germany. 78 of the women always used condoms, while 71 thought that condoms prevent STDs. Three women suffered from a STD in the last 12 months. The majority the women (75 from this 80 prostitutes) did not perceive the examination as discrimination, while 71 felt the examinations were of high quality. These results indicate that regular mandatory examinations should be part of health prevention care of prostitutes and that they are well accepted and tolerated by these women.

Adult↗
PubMed1997

[Balneophotochemotherapy of lichen ruber. Personal results and comparison with photochemotherapy modalities employed up to now].

Twelve patients with extensive lichen planus, resistant to different regimes of prior external and internal therapy, were treated with PUVA-bath photochemotherapy (psoralen bath followed by UVA irradiation) using bath water containing 0.5 mg/L of 8-methoxypsoralen (8-MOP). In 11 of the 12 patients, the skin lesions showed a significant improvement or even complete remission within six weeks of treatment. In one patient, only limited clinical improvement could be achieved. A mean of 19.1 (SD +/- 3.6) PUVA-bath treatments were carried out. The mean cumulative UVA-dose given until clearance of the lichen planus was 16.7 (SD +/- 4.8) J/cm2. No side effects were seen except an increased phototoxic reaction in two patients manifested as slight erythema. The results of this trial show, that PUVA-bath photochemotherapy with 8-MOP is an effective therapeutic alternative to all other known therapies in the treatment of extensive, exanthematic and also hypertrophic-hyperkeratotic lichen planus. In comparison to oral PUVA therapy and PUVA-bath therapy using 4,s',8-trimethoxypsoralen, balneophotochemotherapy with 8-MOP shows an excellent efficiency-side effect correlation. The clearance of the refractive skin lesions by balneophotochemotherapy with 8-MOP demonstrates the superiority of this therapy over all other common therapeutic modalities used for lichen planus.

Adult↗
PubMed1997

[Balneophotochemotherapy with 8-methoxypsoralen in lichen sclerosis et atrophicus].

A 66-year-old woman with longstanding lichen sclerosus et atrophicus improved strikingly with PUVA bath photochemotherapy over a period of 6 weeks. The cumulative UVA dose was 31.7 J/cm2; the single UVA dose ranged from 0.3 to 2.3 J/cm2. After 16 treatment sessions, the sclerotic lesions had softened greatly, while after 24 treatments, the skin lesions were almost completely cleared and pruritus was diminished. Histopathological analysis of biopsy specimens from previously affected sites as well as 20 MHz ultrasound examinations showed almost no residual sclerosis. Although long-term results are not yet available, PUVA bath photochemotherapy seems to be a promising and effective new treatment modality without systemic side effects for patients with disseminated lichen sclerosus et atrophicus.

Aged↗
PubMed1997

[Keratosis palmoplantaris maculosa seu papulosa (Davies-Colley) simulating multiple cornua cutanea].

Patient with extensive keratosis palmoplantaris maculosa seu papulosa (Davies-Colley) presented with multiple cutaneous horns. The clinical picture, the histology, the electro microscopic examination, the negative tumor screening and the viral classification in the tissue allowed the differentiation from other palmoplantar keratoses. The patient was treated successfully using a combination of acitretin with physical and chemical measures.

Callosities↗
PubMed1997

[The successful monotherapy of hypereosinophilic dermatitis with PUVA-bath photochemotherapy].

A 70-year-old woman with long-standing hypereosinophilic dermatitis improved strikingly with PUVA-bath photochemotherapy. The single UVA doses ranged from 0.3 to 3.3 J/cm2. After 19 treatment sessions pruritus disappeared, and after 32 treatments the erythematous maculae completely cleared. Under continuous treatment three times a week, no relapse has occurred to date. PUVA-bath photochemotherapy seems to be a promising new treatment modality without systemic side effects for patients with hypereosinophilic dermatitis.

Aged↗
PubMed1997

[PUVA-bath photochemotherapy in Hallopeau's acrodermatitis continua suppurativa].

A 73-year-old man presented with severe, relapsing acrodermatitis continua of Hallopeau, which had been resistant to prior local and systemic therapy for eight years. The patient was treated with selective hand PUVA-bath photochemotherapy. The cumulative dose of UVA used over 10 weeks of treatment was 54.6 J/cm2 on the palms and 26.8 J/cm2 on the dorsum of the hands. The single UVA doses ranged from 0.5 to 2.5 J/cm2 on the palms and 0.2 to 1.4 J/cm2 on the dorsum of the hands. After 16 treatment sessions, the acrodermatitis continua started to improve, and after 24 treatments, had cleared completely. In the four months following the PUVA therapy, there was no relapse. PUVA-bath photochemotherapy is an efficient therapeutic alternative in the treatment of acrodermatitis continua due to its clinical effectiveness and lack of any systemic side effects. It also possesses the advantage of allowing selective photosensitization of certain areas of the skin such as the hands.

Acrodermatitis↗
PubMed1997

Intracutaneous histamine injection can detect damage of cutaneous afferent fibres in postherpetic neuralgia.

BACKGROUND: The axon reflex response in diseased skin of patients with postherpetic neuralgia may be significantly impaired. OBJECTIVE: In the present study we introduced a simple test for quantifying the decreased axon reflex flare response in the clinical routine. METHODS: Histamine was intradermally applied to the diseased dermatome as well as to the corresponding dermatome of the contralateral side of the body. Ten minutes after application, skin blood flow and the extension of the hyperaemic response were assessed by means of laser Doppler scanning. RESULTS: In the skin region affected by the postherpetic neuralgia, the hyperaemic area was significantly smaller than in the healthy skin. The mean flux values did not differ significantly between the two sites. There was no correlation between the hyperaemic response and the intensity of pain sensation assessed by a clinical visual analogue score. CONCLUSION: The smaller hyperaemic area in the dermatome with postherpetic neuralgia strongly indicates a C fibre or C nociceptor damage. We consider histamine injections as a useful tool in the differential diagnosis of postherpetic neuralgia.

Aged↗
PubMed1997

In psoriasis the epidermis, including the subepidermal vascular plexus, grows downwards into the dermis.

In psoriatic lesions, capillaries in the papillary bodies seem elongated and increased in number. Most researchers postulate that there is angiogenesis of intrapapillary capillaries in psoriatic plaques. In this study we will show, by means of computer-aided three-dimensional reconstructions in four patients suffering from chronic plaque-type psoriasis, and in a healthy volunteer, that the elongation and increase of intrapapillary capillaries are not the result of angiogenesis. Our three-dimensional reconstructions show that the papillary body of psoriasis contains lymph capillaries besides the blood capillaries. Additionally, an inclusion of two tips of papillary bodies into one papilla at the base of the rete ridges becomes obvious. The vessels of the two tips are connected by a horizontal vessel. At the level of the horizontal connecting vessel there is the blind beginning of a lymphatic vessel. The connecting blood vessel, as well as the lymph capillary, belong to the horizontal subpapillary venous plexus but lie within the papillary body. The three-dimensional reconstructions show that by growing towards the dermis, the rete ridges include the vessels of the horizontal plexus. Surrounded by rete ridges, these vessels appear as intrapapillary capillaries.

Aged↗
PubMed1997

[High resolution 20 MHz ultrasound diagnosis in dermatology for noninvasive imaging of malignant melanomas].

For years, high-resolution b-scan ultrasound is a well established technique in dermatology regarding the preoperative determination of thickness of skin tumors like malignant melanoma or basal cell carcinoma. Most tumors appear as echopoor areas in high-frequency sonography. Until today, a differentiation between skin tumors by means of high-frequency ultrasound is not possible. This is also true concerning the differentiation between the tumor tissue itself and its subtumoral inflammatory infiltration. Therefore, this lack of differentiation leads to the fact that sonometric thicknesses of tumors often exceed the originally measured tumor thickness in histology. By means of three-dimensional reconstruction of serial b-scan images, it is possible to determine each tumor's volume and surface as well as the topographical arrangement of echopoor areas and sonographical structures. Besides high-frequency ultrasound, additional non-invasive techniques like MRI, ultrasound- or laser-doppler, computer-aided image analysis and epiluminescence microscopy are also available for diagnosing malignant melanoma. Epiluminescence microscopy is used today as a standard technique in the diagnosis of malignant melanoma due to the possibility of differential diagnosis. Latest techniques like OCT (optical coherence tomography) are not ready yet to be applied regularly in diagnosis of tumors in the field of dermatology.

Diagnosis, Differential↗