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Biomedical subjects

P Altmeyer

Publications and source records attributed to P Altmeyer.

At least 271 records · Page 15Linked to original sources
PubMed1989

[Pagetoid reticulosis of the Ketron-Goodman type].

The case of a 79-year-old woman with widespread pagetoid reticulosis (Ketron-Goodman type) is presented. The nature of the epidermal cellular infiltrate in pagetoid reticulosis of the Ketron-Goodman type was examined by immunohistochemical methods and by electron microscopy. On ultrastructural examination the infiltrating cells proved to be medium-sized and large Sézary-type and blastoid cells. Immunohistochemically, the epidermal infiltrate was composed of approximately 80% immature T cells (OKT 16) and 30% proliferating cells (Ki 67). Mature T cells (CD 5) were found to account for only 15-30% of all cells in the infiltrate. These results suggest that pagetoid reticulosis (Ketron-Goodman type) is a malignant T-cell lymphoma, which is characterized, in addition to the epidermotropic behavior common to all T-cell lymphomas, by innidiation and in-situ spread within the epidermis.

Aged↗
PubMed1989

The three-dimensional histological architecture of pustulosis palmo-plantaris.

Using computer reconstruction techniques, it is possible to study and understand the three-dimensional architecture of the histo-pathological changes in pustulosis palmo-plantaris (PPP). In PPP vesicles and pustules develop. As the vesicles move upwards, they may gain contact with a granulocytic lake above them. Through the roof of the vesicle, granulocytes then break into the vesicle thereby changing it into a pustule. The blood vessels in PPP exhibit a bulbous vascular network at the epidermal end of the dermal papillae. At lower levels, the capillaries may form loops and arches. It is suggested that this special architecture of the vascular system produces a marked retardation of the blood flow in the tips of the dermal papillae, allowing a longer contact of the blood with the capillary wall. The granulocytes can therefore easily immigrate.

Algorithms↗
PubMed1989

Pustulosis palmoplantaris. How initial ultrastructural alterations change into vesicles and pustules.

The diagnosis pustulosis palmoplantaris describes a clinical aspect. Apart from the pustules, a different number of dyshidrotic vesicles characterize the clinical morphology. This study was carried out to elucidate a facultative relationship between vesicles and pustules. The first ultrastructural changes are small intercellular gaps in the basal layers of the epidermis containing one Langerhans' cell. Larger intraepidermal vesicles are filled with stimulated lymphocytes and interdigitating Langerhans' cells. Below the vesicle a dense infiltrate consisting predominantly of CD 8-positive cells was observed. Mature pustules are situated just beneath the stratum corneum and filled with a lot of granulocytes and only few lymphocytes. The subepidermal infiltrate is almost missing. Between vesicles and neighbouring pustules we could prove a direct connection below the stratum corneum, a direct subcorneal granulocyte pathway. The result is a vesicle with lymphocytes at the bottom and granulocytes at the top of its cavity--a transformed vesicle. The described intercellular cavities are considered as common evolutionary stages in the development of pustules and vesicles.

Adult↗
PubMed1988

[Ultrasound microscopy of skin sections].

In vivo ultrasound examination has been introduced into dermatology as a non-invasive diagnostic technique. The resolution capacity, however, has been limited so far, and the in vivo ultrasonic features have not been fully understood. Using high frequencies (GHz range) in acoustic microscopy, we have been able to achieve a resolution comparable to that in light microscopy. In a first step, we examined normal human skin sections and compared them to histological specimens. The following study on melanocytic nevi, malignant melanoma, and metastases of melanoma showed that their acoustic images were more pronounced than those of the surrounding tissue. The echo intensity of solid basal cell carcinoma and squamous cell carcinoma resembled that of the epithelium. The structures found in acoustic microscopy can be correlated to those seen in light microscopy.

Biopsy↗
PubMed1988

Eccrine sweat gland reaction. A histological and immunocytochemical study.

Secondary alteration of eccrine sweat glands is frequent in neoplastic and inflammatory skin diseases. The histological changes are characterized by a remarkable variability. However, a systematic classification of these reactions does not exist. We examined routine histological sections of biopsy specimens and found morphological alterations of eccrine sweat gland in the secretory coil, the duct, and the surrounding connective tissue. Dilation with or without retention was the most common histological variation seen in the secretory segments and the ducts. In association with dilation, flattening of the secretory and ductal cells occurs. Other cell changes were hydropic alteration and vacuolization of the secretory cells; seldom was a thickening of the cuticle observed. A striking phenomenon was the proliferation of ductal epithelium in different skin tumors. We found histological changes of the surrounding connective tissue less frequently: marked periglandular fibrosis and mucinous degeneration occurred.

Biopsy↗
PubMed1988

[Plaque-formed cutaneous mucinosis with telangiectasis].

We report the case of a 71-year-old man with a combination of circumscribed euthyroid myxodermia and clinically visible telangiectasias. We excluded the possibility of a sympathetic lesion being the cause of the telangiectasias by using a new method, transcutaneous PO2 measurement. Different possible reasons for the simultaneous occurrence of mucinosis and telangiectasias are discussed.

Aged↗
PubMed1988

[Vulvovaginitis circinata in Reiter's disease].

A case of Reiter's disease with circinate vulvovaginitis is presented. As a clinical analogue to circinate balanitis, it should have the same diagnostic value. A combined treatment of prednisone and aromatic retinoid proved to be effective.

Adult↗
PubMed1987

[UV light sensitivity of the skin--possibilities and limits of clinical diagnosis].

Our study on 58 test persons showed that the sensitivity of human skin to UV light is independent of the color of skin, hair, eyes or the pigmentation of the mamillae. Therefore, the sensitivity to UV light must be ascertained by subtle phototesting. By means of the new UV phototesting set SBA-LT-400, Saalmann Co., 4900 Herford/West Germany, we determined the minimal erythema doses (MED) of UV-B and UV-A as basic, reproducible parameters regarding Central European people. 7 and 24 hours after radiation, MED showed mean values of 0.032 and 0.037 Joule/cm2, resp., for UV-B, whereas 24.1 and 25.6 Joule/cm2 were measured for UV-A. The pigmentation responses to UV radiation of human skin described in the literature can be reproduced in Mediterranean skin types only.

Adolescent↗
PubMed1987

[Disorders of steroid metabolism in inflammatory skin diseases].

The corticosteroid and androgen metabolites in the urine of 37 test subjects (11 healthy volunteers, 16 patients with eczema, and 10 patients with psoriasis) were investigated by means of gas chromatography and mass spectrometry. In addition, we studied the cortisol and testosterone levels in the plasma by radioimmunoassay. Those patients who had been treated with corticosteroids during the last two weeks were excluded. Our findings revealed that the excretion rate of steroid metabolites was significantly reduced in dermatological patients. The excretion rate of corticosteroids in urine was decreased an average of 25% (eczema) and 29% (psoriasis). The reduction of the androgen metabolites amounted to 26% and 31%. Cortisol and testosterone levels in the plasma were normal in all the cases.

Adrenal Cortex Hormones↗
PubMed1987

Diagnostic assessment of diabetic microangiopathy by tcPO2 stimulation tests.

Transcutaneous PO2 measurements at 37 degrees C can recognize and quantify diabetic microangiopathy if suitable stimulation tests are used. The following parameters are of practical importance: resting PO2, postocclusive PO2, rubefacient-induced PO2 and 45 degrees C heating PO2. Patients with diabetic microangiopathy show diminished PO2 values in rubefacient-induced PO2 and 45 degrees C heating PO2. The former ist probably related to endothelial-cell function disturbances and the letter to organic vessel wall changes. Thus, a quantitative and differentiated picture of microangiopathy can be obtained in each individual patient.

Adult↗
PubMed1987

Metabolism of [14C]arachidonic acid by polymorphonuclear leukocytes in patients with psoriasis.

The formation of LTB4 and its omega-oxidation products 20-hydroxy- and 20-carboxy-LTB4 from exogenous [14C]arachidonic acid (AA) by neutrophils from 12 psoriatic patients and 10 healthy controls was investigated. Only a slight difference was detected in the mean amount of [14C]LTB4 produced. In contrast, the amounts of [14C]omega-oxidation products obtained from psoriatic PMN were 2.4-fold higher than the amounts from PMN of healthy controls. We conclude that in vitro, psoriatic PMN synthesize more LTB4 from exogenous AA than do PMN of healthy individuals and due to an efficient omega-oxidation system, the net release of LTB4 in both groups appears to be similar.

Adult↗
PubMed1987

[Skeletal scintigraphy in diseases of the psoriasiform group. A study in 182 patients].

Bone scintigraphy using 99mTc-EHDP was carried out in 147 psoriatics of both sexes and in 35 nonpsoriatic patients. The psoriatics were subdivided into four groups according to clinical aspects: psoriasis vulgaris (Pv, n = 55), psoriasis inversa (Pinv, n = 32), psoriasis pustulosa of the Königsbeck-Barber type (PpK-B, n = 28), and pustulosis palmaris et plantaris (Ppp, n = 32). The following frequencies of joint involvement were found in the different groups: Pv = 18.3%; Pinv = 22.6%, PpK-B = 11.1%; Ppp = 12.5%; control group 2.3%. In patients suffering from psoriasis vulgaris and psoriasis inversa a pathologic preferential radionuclide uptake was demonstrated in the small peripheral joints of the hands and fingers. The characteristic psoriatic pattern with axial and transverse joint involvement was found in all groups of psoriatic patients. No correlation could be proved between age and pathologic accumulation of the radionuclide or between duration of psoriasis and joint involvement. The so-called anterior chest wall syndrome was found in all patients, but predominantly in those with psoriasis palmaris et plantaris. Finally the indications for bone scintigraphy are discussed.

Arthritis↗
PubMed1987

[Classification of progressive systemic scleroderma].

A new classification of forms of progressive systemic scleroderma (PSS) is presented. Compared with previous classifications, it includes not only frequent, typical forms of PSS, but also rarer manifestations. For the first time, it considers pathogenetic factors, such as the phenomena which have become known concerning the immunological system, and distinguishes between noninflammatory and inflammatory subtypes. Etiological (in this case, immunogenetic) criteria are also considered. This classification is open to further differentiation and development.

Antibodies, Antinuclear↗
PubMed1987

[Recurrent angioedema with eosinophilic dermatitis--minus variants of the hypereosinophilic syndrome].

Recurrent angio-oedema with eosinophilic dermatitis is characterized by the following symptoms: persistent hypereosinophilic, episodes of angio-oedema, urticarial papular and papulo-pustular exanthema, episodes of fever, as well as increased IgE and IgM levels. Eosinophilic dermatitis with subcorneal pustulation can be seen on histological examination. This disease should be distinguished from the classical hypereosinophilic syndrome because of the absence of internal symptoms and because the prognosis is apparently favourable. Internal corticosteroids are the therapy of choice.

Adolescent↗
PubMed1987

[Urticaria pigmentosa--an obligate systemic disease? Results of nuclear medicine studies and etiopathogenetic significance].

The objective of the present investigation was to establish the frequency of systemic spreading of urticaria pigmentosa by means of bone and bone marrow scintigraphy as a noninvasive imaging technique with a low radiation exposure. Bone scintigraphy: Seven of nine patients investigated showed diffuse and focal nuclide accumulation. After exclusion of other causes by reference to the case history and the clinical and chemical laboratory findings, these nuclide accumulations were regarded as mastocytosis-specific in accordance with the atypical localization. Bone-marrow scintigraphy: All the patient investigated showed a peripheral expansion of the bone marrow. This must be interpreted as an expansion of the macrophages of the bone marrow on the basis of the method used. Since the mast cell is regarded as a more highly differentiated form of the same cell-type as macrophages/monocytes, on the basis of the scintigraphic results presented, urticaria pigmentosa can be regarded pathogenetically as a hyperplasia of the macrophages of the bone marrow organ, with increased differentiation in mast cells. The extent of this differentiation and its pathological quality then determine the clinical signs and symptoms (cutaneous, systemic, or malignant mastocytosis). Urticaria pigmentosa thus has the character of a systemic disease.

Adult↗
PubMed1986

[Kyrle's disease in diabetes mellitus and chronic terminal kidney failure].

The diagnosis of Kyrle's disease is based on both clinical and histological findings. The penetration of the keratin plug into the dermis is no pathognomonic feature but the result of pathologic events. Kyrle's disease may be caused and promoted by association with other diseases going along with hyperkeratosis and causing damage to tissue proteins by non-enzymatic glycosylation (e. g., diabetes mellitus and renal failure).

Adult↗
PubMed1986

[Alpha interferon in the therapy of cutaneous T cell lymphomas].

5 patients suffering from T-cell lymphomas at different stages were treated with human alpha-interferone. One of the patients showed mild partial remission, two patients had but a poor and short-lasting improvement of their condition, in one case there was no change at all, and in another case, worsening of the clinical picture was observed. Controls of the relevant laboratory parameters (including NK-cells, T-cell subpopulations, antibodies and complement, oligo-(A)-synthetase, and interferone serum levels) did not always reveal the changes that had been expected to be induced by the therapy.

Combined Modality Therapy↗