Biomedical subjects
Publications and source records attributed to P Altmeyer.
Partial unilateral lentiginosis is a rare pigmentary disorder characterized by multiple lentigines on otherwise normal skin affecting one side of the body. The histology is that of a lentigo. We report two young men with an extensive form of partial unilateral lentiginosis affecting the skin. No systemic abnormalities could be identified.
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BACKGROUND: There are already many effective topical therapies available for use in the treatment of chronic plaque psoriasis. Unfortunately, these treatments are often associated with a rather significant risk of undesirable effects. OBJECTIVE AND METHODS: In this randomized, prospective clinical trial, the effects of the vitamin D(3) analog calcipotriol were evaluated against those of a recently developed vitamin B(12) cream containing avocado oil in an intraindividual right/left-side comparison. The trial population consisted of 13 patients, 10 men and 3 women, with chronic plaque psoriasis. The observation period was 12 weeks; the effects of therapy were assessed on the basis of a PASI score adapted to the right/left-side comparison technique, the subjective evaluations of the investigator and patients and the results of 20-MHz sonography. RESULTS: There was a more rapid development of beneficial effects with the use of calcipotriol in the initial 8 weeks, although differences in effects were significant only at the time point of therapy week 8 (p < 0.05). After 12 weeks, neither the PASI score nor 20-MHz sonography showed significant differences between the two treatments. While the efficacy of the calcipotriol preparation reached a maximum in the first 4 weeks and then began to subside, the effects of the vitamin B(12) cream containing avocado oil remained at a constant level over the whole observation period. This would indicate that the vitamin B(12) preparation containing avocado oil may be suitable for use in long-term therapy, a hypothesis further supported by the fact that the investigator and the patients assessed the tolerability of the vitamin B(12) cream containing avocado oil as significantly better in comparison with that of calcipotriol. CONCLUSION: The results of this clinical trial provide evidence that the recently developed vitamin B(12) cream containing avocado oil has considerable potential as a well-tolerated, long-term topical therapy of psoriasis.
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The dermatoglyphic pattern of human palms and soles is individually unique and unchanging. Their prints show the course of the papillary ridges as papillary lines. Case reports and a few older studies of repeatedly taken fingerprints could, however, show that so-called interpapillary lines can develop between the papillary lines. The questions of this study were: How often do interpapillary lines occur? Can the differences between papillary and interpapillary ridges be quantified? Five-hundred and two ink prints of the palms and fingers from the archive of the Bochum Police Department were examined retrospectively. In 121 volunteers, the appearance of interpapillary lines was examined prospectively. From the later collective, the fingerprints of 13 people with interpapillary lines and nine people without were examined further by taking two silicon prints and measuring them with laser profilometry In 215 of the 502 ink prints (42.8%) interpapillary lines could be demonstrated. In those subjects younger than 20 years they were less frequently observed (34.1%) than in those above the age of 20 (51.8%). In all cases using laser profilometry the interpapillary lines could be related to a corresponding interpapillary ridge. The interpapillary ridge heights were 24.9 +/- 10.0 microm, significantly lower than the papillary ridges, which measured 59.0 +/- 19.2 microm. Interpapillary ridge widths were with 194.8 +/- 65.1 microm significantly narrower as compared to 435.5 +/- 57.4 microm in the papillary ridge. Those papillary ridges, between which interpapillary ridges were found, were significantly further apart from each other (610.5 +/- 78.9 microm) than those without interpapillary ridges (484.9 +/- 70.6 microm). During the course of a lifetime new ridges between the regular papillary ridges can develop or manifest. The fact that interpapillary lines are more frequently found on the right hands in men and those with increasing age is consistent with the theory that they correspond to degenerative changes and with sensitivity of touch.
This article was written to update information on test methods and standards for determining the UV protection of apparel textiles and on factors affecting UV protective properties of fabrics, from dermatological and textile technological viewpoints. Articles from dermatological and textile technological journals published from 1990 to 2001 were identified from MEDLINE, Excerpta Medica/EMBASE, World Textiles, and Textile Technology Digest. Peer-reviewed dermatological articles, textile technological research articles, and normative publications were selected. Independent data extraction was performed by several observers. Spectrophotometry is the preferred method for determining UV protection factor of textile materials. Various textile qualities affect the UV protection factor of a finished garment; important elements are the fabric porosity, type, color, weight, and thickness. The application of UV absorbers in the yarns significantly improves the UV protection factor of a garment. With wear and use, several factors can alter the UV protective properties of a textile, including stretch, wetness, and degradation due to laundering. Standards in the field exist in Australia and Great Britain, and organizations such as the European Standardization Commission in Europe and the American Association of Textile Chemists and Colorists and the American Society for Testing and Materials in the United States are also establishing standards for the determination and labeling of sun protective clothing. Various textile qualities and conditions of wear and use affect UV protective properties of apparel textiles. The use of UV blocking fabrics can provide excellent protection against the hazards of sunlight; this is especially true for garments manufactured as UV protective clothing.
In patients with normal immunity, cat scratch disease typically develop a papule at the portal of entry and no other cutaneous features. A 73 year old male patient with a myelodysplastic syndrome developed generalized petechial, papular and, vasculitic skin lesions in association with cat scratch disease. After the diagnosis was established by identifying the causative organism in a lymph node biopsy, the patient was treated with erythromycin for three weeks resulting in progressive clearance of the skin lesions. Apart from the soluble IL-2 receptor, no other serologic inflammatory parameters were elevated. IgG antibodies against Bartonella henselae and Bartonella quintana increased only slightly during acute exacerbation of the disease, but significantly increased some months later. The diagnosis was established by the positive staining of the lymph node biopsy using the Warthin-Starry stain.
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BACKGROUND: Raynaud's phenomenon is a hallmark of progressive systemic sclerosis (SSc). While nailfold capillary changes are well known, morphological changes in larger arteries have less been focused on. OBJECTIVE AND METHODS: In the study presented we examined how often in digital subtraction angiography organic changes of the arteries of the fingers, hands and forearms were observed, whether they showed a typical picture like the changes in nailfold capillaries and whether they correlated with cutaneous sclerosis, Raynaud's phenomenon and serological findings. 29 patients were examined, 14 with acroscleroderma and 15 with proximal ascending sclerosis. RESULTS: In 27 of those 29 patients a stenosis of the arteries of the upper extremity was found. The frequency of arterial occlusions decreased from the fingers (26 patients) to the forearms (9 patients with occlusion of the ulnar artery, none with occlusion of the radial artery). The arteries of 47% of patients with proximal ascending sclerosis showed no reactivity towards the alpha-sympatholyticum tolazoline hydrochloride due to severe organic changes while in patients with acroscleroderma only 14% of patients did not respond to tolazoline hydrochloride. The severity of Raynaud's phenomenon did not correlate with the severity of the angiographic findings. In patients with stenoses refractory to tolazoline hydrochloride and in those with occlusions Scl-70 autoantibodies were more frequently positive than in other patients with SSc (44% compared to 23%). CONCLUSION: As in SSc the severity of the organic arterial changes is in close correlation with the extent of the cutaneous sclerosis and with the serological findings the arterial system should gain much more importance in the diagnosis and therapy of SSc.
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We examined leukocyte counts and ex vivo cytokine response of whole blood to lipopolysaccharide (LPS) or lipoteichoic acid (LTA) in patients under low-dose molgramostim therapy. Patients were injected subcutaneously daily for ten days with 1 microg/kg (n=9) or 2 microg/kg (n=14) molgramostim. Leukocytosis was observed in all patients, but only the eosinophil fraction was significantly increased in relation to other leukocyte populations. Ex vivo IFN-gamma release was decreased and IL-10 and IL-1ra secretion were increased in response to LPS or LTA. Thus, in non-neutropenic patients, leukocytosis can already be initiated by low doses of molgramostim. The ex vivo cytokine data suggest that these doses prime blood towards a systemic anti-inflammatory response.
In skin lesions of chronic venous incompetence (CVI) transcutaneous oxygen pressure (tcpO(2)) at the ankle is often reduced. However, in some CVI patients the tcpO(2) during suprasystolic occlusion remains significantly higher than in healthy subjects. The aim of the present study was to investigate which kind of CVI patients develop this phenomenon and whether the higher tcpO(2) during occlusion is caused by a smaller oxygen consumption of the skin or by an increased local oxygen content. The oxygen consumption of the skin was measured by the pO(2) decrease (DeltatcpO(2)/Deltat) after stopping the arterial oxygen supply when the hemoglobin was saturated by oxygen inhalation, i.e., at tcpO(2) values above 120-130 mmHg. By multiplying the tcpO(2) with the mean oxygen solubility coefficient of the skin the content of physically dissolved oxygen is obtained. The decrease of tcpO(2) in the 55- to 45-mmHg range indicates the consumption of oxygen physically dissolved and chemically bound to hemoglobin. It gave a parameter for estimating the local hemoglobin content of the skin. These values and the minimal tcpO(2) after a 5-min arterial occlusion were measured in 14 healthy subjects, in 13 patients with varicose veins, but no skin lesions, in 10 patients with CVI lesions like white atrophy and lipodermatosclerosis and in 16 CVI patients with open venous ulcers. During suprasystolic occlusion tcpO(2) at the ankle remained significantly higher in CVI patients with skin lesions than in the healthy control subjects (25.6 +/- 18.9 versus 8.0 +/- 7.0 mmHg). The steepness of the tcpO(2) decrease caused by cutaneous oxygen consumption in healthy subjects was not significantly different from the CVI patients. In contrast, the decrease of tcpO(2) at the ankle between 55 and 45 mmHg was 1.9 +/- 2.0 mmHg/s in the control group and 0.7 +/- 0.5 mmHg/s in the group with open venous ulcers. These results indicate a higher hemoglobin content in the skin of the CVI patients than in healthy subjects. Obviously, the hemoglobin bound oxygen content in the skin of CVI patients is increased. Thus, a lack of oxygen is unlikely to be the primary reason for the development of skin lesions in CVI.
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BACKGROUND AND OBJECTIVE: Studies about the personality of dermatological patients are numerous. The results are inconsistent and peculiarities of the personality are rarely confirmed. Contrary to the usual procedure, this study asks for the impressions physicians have about their patients. PATIENTS/METHODS: To elicit associations dependent on a dermatological diagnosis, 27 physicians filled in a three-dimensional differential asking for their impressions about patients with atopic dermatitis, leg ulcer, malignant melanoma, or psoriasis vulgaris in order to quantify these impressions. RESULTS: The dimension valence (good-bad) did not differ between the groups. The dimensions of excitation (active-passive) and potency (strong-weak) showed the biggest differences between patients with atopic dermatitis and ulcus cruris. The latter get significantly lower values on both dimensions. The correlations between the impression and the duration of employment in dermatology were low. CONCLUSIONS: In our opinion it is necessary to raise the impression of medical personal about their patients because these impressions affect the interaction of the personal with the patient.
Therapy of Darier disease is rarely satisfactory. Oral retinoids can improve the skin lesions. Because of previous positive results with topical retinoids, which were often not practical because of marked skin irritation, two patients were treated with the new, topical acetylene-retinoid tazarotene in a 0.01% gel preparation. In both patients skin cleared within 2 to 4 weeks. After stopping the medication patients did not develop any new skin lesions for 12 months. In a third patient, healing with tazarotene gel 0.025% was faster than with a topical preparation containing 10% urea. Tazarotene is an important addition to the therapeutic possibilities in Darier disease.