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Biomedical subjects

P Altmeyer

Publications and source records attributed to P Altmeyer.

At least 145 records · Page 8Linked to original sources
PubMed2000

Superior vena cava syndrome presenting as persistent erythematous oedema of the face.

The superior vena cava syndrome occurs when extrinsic compression or intraluminal occlusion impedes blood flow through this vessel. Detecting the characteristic cutaneous features can lead to an early diagnosis of this condition. We report a 73-year-old patient with a 4-year-history of erythematous oedema of the face. The underlying cause was a large retrosternal goitre obstructing the superior vena cava. Subtotal thyroidectomy led to dramatic improvement of all dermatologic symptoms.

Aged↗
PubMed2000

Clearance of ichthyosis linearis circumflexa with balneophototherapy.

We report a 13-year-old boy suffering from severe ichthyosis linearis circumflexa. Evidence of hair shaft abnormalities and impaired immunity could not be found. The patient was treated with salt water baths and artificial UVB radiation (balneophototherapy) 3-5 times weekly. After 40 treatments with balneophototherapy the skin lesions were almost completely cleared and maintenance UVB monotherapy was performed twice weekly for 2 months. After 4 months, however, the disease relapsed. Balneophototherapy presents a potentially effective and well tolerated phototherapeutic option for ichthyosis linearis circumflexa. As only short periods of remission may be expected, intermittent balneophototherapy would be probably necessary to control the disease.

Adolescent↗
PubMed2000

Deep shave excision of macular melanocytic nevi with the razor blade biopsy technique.

BACKGROUND: Shave excision is an established surgical method for removing benign skin lesions for cosmetic and functional reasons. Usually superficial shave excision is performed with a common scalpel blade for the removal of papular nevi. However, there is little known about deep shave excision of macular melanocytic nevi with the razor blade technique. OBJECTIVE: The present study was undertaken to evaluate the cosmetic outcome of deep shave excision of macular melanocytic nevi with the razor blade technique. Moreover, its potency for sufficient removal of these lesions was investigated. METHODS: Within routine skin cancer screening 45 outpatients with a total of 77 macular melanocytic nevi were prospectively recruited. Deep shave excisions of these lesions were performed with a double-edged razor blade followed by chemical hemostasis. Histologically all specimens were processed and evaluated in a routine manner. After 6 months the physician and patients evaluated the shave sites for cosmetic outcome with a score graded from 1 to 4 (1 = excellent; 2 = good; 3 = moderate; 4 = poor). RESULTS: Histologically 88% (68 of 77) of the melanocytic lesions were described as completely excised and 60% (46 of 77) were diagnosed as atypical melanocytic nevi; 12% (9 of 77) of the nevi were incompletely excised on the depth. On average, the deep margin of the specimens (n = 77) was 0.5 mm (range 0-1.8 mm) and the lateral margin was 2 mm (range 0.3-8.2 mm). After 6 months 56 shave sites could be reassessed. We observed mild hypopigmentation in 52% (29 of 56), hyperpigmentation in 32% (18 of 56), and erythema in 23% (13 of 56). Recurrent nevi occurred in 13% (7 of 56). The evaluation of the cosmetic outcome by the patients (mean score 1.7) achieved better results than the evaluation by the physician (mean score 2.5). The cosmetic results showed no significant (P >.05) differences in various anatomic sites. CONCLUSION: Our data confirm that deep razor blade excision presents a highly useful and inexpensive method for the removal of macular melanocytic nevi that yields adequate specimens for pathologic interpretation. We consider that shave excision with the razor blade technique is potentially much less scarring than full-thickness scalpel excisions of nevi. In particular, this is of great significance for patients with multiple nevi, such as dysplastic nevi syndrome.

Adolescent↗
PubMed2000

In vitro and in vivo determination of the UV protection factor for lightweight cotton and viscose summer fabrics: a preliminary study.

BACKGROUND: One of the most important elements in the prevention of skin cancer is the use of comfortable UV-protective clothing. Owing to their low weight, cotton fabrics, and especially viscose fabrics made from filament yarns, are ideal for summer clothing and in fact enjoy a high degree of acceptance among consumers. Two methods are available for determining the UV protection factor (UPF) of textiles: the in vitro method is based on the spectrophotometric determination of the transmission of UV radiation through these fabrics; the in vivo method is based on the determination of the minimal erythema dose for a test subject with and without textiles. OBJECTIVE: This study was performed to assess the UPF of lightweight cotton and viscose fabrics and whether the use of these two methods to determine the UPF of viscose fabrics and cotton fabrics produces congruent results. METHODS: We tested 7 different viscose fabrics and 7 different cotton fabrics. Three of the viscose fabrics (ENKA SUN) had been specially treated, by depositing pigments in the fibers, to confer UV-protective properties. The determination of the in vitro and in vivo UPF was performed with a spectrophotometer and sun simulator, respectively. RESULTS: The in vivo measurements on the untreated viscose fabrics produced UPF values lower than those obtained from the in vitro measurements. For one of these untreated viscose fabrics, the difference between the in vivo UPF and the in vitro UPF was statistically significant (P <.05). In contrast, the in vivo measurements on the specially treated viscose textiles and on the cotton fabrics resulted in UPF values higher than the in vitro UPF values. For one specially treated viscose fabric and 4 cotton fabrics, this difference was statistically significant (P < .05). CONCLUSION: Our results suggest, however, that-depending on the type of fabric-determination of the UPF by the in vitro method is not in agreement with the in vivo method. In vivo measurements made with lightweight specially treated UV-protective clothing showed in contrast to the untreated viscose fabrics that these garments offer very good protection against UV radiation. These results underscore the importance of developing and refining such UV-protective materials.

Adult↗
PubMed2000

Treatment of Birt-Hogg-Dubé syndrome with erbium:YAG laser.

We describe a female patient with Birt-Hogg-Dubé syndrome presenting with multiple, disfiguring papules on the cheeks, nose, and ears. In addition, there was evidence of photoaggravation and inflammatory processes in this case. The patient was treated with an erbium:YAG laser. Although the lesions could be successfully ablated up to the papillary dermis without scar formation, a relapse was observed after 6 months. Thus deeper laser ablations may possibly prevent relapses from dermal residual lesions.

Erbium↗
PubMed2000

Change in ultraviolet (UV) transmission following the application of vaseline to non-irradiated and UVB-exposed split skin.

BACKGROUND: Topical preparations such as emollients used in combination with phototherapy can interfere with such treatment. OBJECTIVES: This study was performed to investigate the impact of vaseline on the ultraviolet (UV) transmission of non-irradiated split skin and on split skin previously exposed to UVB radiation. METHODS: Split-skin specimens were obtained from 20 patients. In each case, one sample was taken from an area of non-irradiated skin, while the second was taken from an area that had been previously exposed to UVB. The transmission was spectrophotometrically measured with split skin placed in specially designed quartz glass cuvettes before and after the application of two different amounts of vaseline (2.5 and 17.5 mg cm-2). RESULTS: Application of vaseline to skin previously exposed to UVB caused significant (P < 0.0001) changes in UV transmission in certain wavelength ranges. In the UVA range, a greater increase in transmission was achieved with 2.5 mg cm-2 vaseline, whereas in the UVB range, a greater increase was achieved with 17.5 mg cm-2 vaseline. The thicker the layer of vaseline applied, the lower was the difference in transmission between non-irradiated split skin and UVB-exposed split skin. CONCLUSIONS: Application of the correct amount of vaseline can enhance transmission in either the UVA or UVB range, and would enable dose reduction during a course of phototherapy.

Adult↗
PubMed2000

UV transmission measurements of small skin specimens with special quartz cuvettes.

BACKGROUND: The penetration of different wavelengths of UV radiation through human skin is of major importance, especially for the determination of photoprotective properties of sunscreens and UV-protective clothes. OBJECTIVE: In this study we present a new method for the measurement of UV transmission through small skin specimens. METHODS: The transmission measurements were performed by using a UV spectrophotometer with an integrating sphere operating in the wavelength range of 280-390 nm. For the skin samples, special quartz glass cuvettes were developed which allowed measurements for very thin and small skin specimens. Furthermore, the cuvettes prevented dehydration of the specimens and guaranteed, by using an additional diaphragm, that the transmission data were derived solely from the small skin specimen examined. Specimens measuring 8 x 3 mm(2) with a thickness of 0.3 mm (histometric and sonographic control) were taken from the thighs of 10 subjects via shave biopsy. RESULTS: In the UVA range (315-390 nm) we obtained a mean transmission of 4.6% and for the UVB range (280-315 nm) of 0.9%. No significant (p >0.14) difference of UV transmission was found between the individual skin specimens. CONCLUSION: This new method seems to be well suitable for UV transmission measurements of small skin specimens. As UVA radiation has a much deeper penetration depth and in in vivo situations dermal hemoglobin could have an effect on UV penetration, the present method is better suitable for the investigation of UVB-induced biological adaptation mechanisms and the impact of topical agents on UVB transmission of the epidermis.

Aged↗
PubMed1999

[Phototherapy in severe atopic dermatitis. Comparison between current UVA1 therapy, UVA1 cold light and combined UVA-UVB therapy].

Severe atopic dermatitis, especially when involving the face, does not respond well to conventional therapy. In the present prospective randomized trial, we compared therapeutic efficiency of medium-dose UVA1, medium-dose cold light UVA1 (15 treatment courses with 50 J/cm2 each) and combined UVA-UVB phototherapy. Four (13.3%) of 30 UVA1 treated patients, one (3.4%) of 30 UVA1 cold light treated patients and three (30%) of 10 patients treated with combined UVA-UVB discontinued therapy course before finishing treatment protocol because skin status did not improve or even deteriorated. In the other patients treated over a period of three weeks, skin status improved significantly or even cleared completely in 80.8% of UVA1 treated and in 89.7% of UVA1 cold light treated patients resulting in a significant decrease of the SCORAD-Score (UVA1 group from 68.6 +/- SD 10.9 to 29.8 +/- SD 7.1 and UVA1 cold light group from 72.5 +/- SD 13.4 to 23.8 +/- SD 11.6; p < 0.05 each). In the UVA-UVB treated group, the SCORAD-Score also decreased (from 71.0 +/- SD 9.4 to 41.6 +/- 10.5), but significantly less than in both UVA1 treated groups (p < 0.05 each). Four weeks after completing therapy UVA1 treated patients showed a prolonged therapy benefit as compared to UVA-UVB treated patients. Plasma levels of eosinophil cationic protein and soluble interleukin-2 receptor significantly decreased under UVA1 phototherapy but not under UVA-UVB therapy. Compared to conventional UVA1 phototherapy, UVA1 cold light phototherapy showed advantages due to the absence of potentially proinflammatory effects based on temperature-induced increase of skin blood flow (quantified by Laser doppler scanning) and increased sweat production (determined by the patient using a visual analog scale).

Adolescent↗
PubMed1999

[Cyclical intravenous antibiosis as an effective therapy concept in chronic recurrent erysipelas].

The treatment of choice for prevention of recurrent erysipelas is the long-term therapy with intramuscular penicillin. The results are often unsatisfactory. Usually erysipelas recurs when the treatment is stopped. The aim of the present study was to evaluate a new treatment regimen, consisting of intravenous penicillin combined with lymphatic drainage. Fifteen patients who had suffered from three or more episodes of erysipelas within the last two years received 10 Mega I.U. of penicillin per day over ten days every third month over a one year period (patients who were allergic to penicillin received erythromycin). Use of intravenous penicillin was combined with lymphatic drainage performed by a sequential pneumatic compressing device. The treatment results were assessed by clinical examination and laboratory tests as well as by laser Doppler imaging every third month. During the one year treatment period and a further year of follow-up, 14 of 15 patients had no recurrent erysipelas. Only a 65 year old patient suffering from Parkinson heart failure, chronic lymphedema and an extensive stasis ulcers had recurrent erysipelas. The present treatment regimen appears to be an effective therapy for prevention of recurrent erysipelas.

Adult↗
PubMed1999

[Severe course of a mutilating pansclerotic circumscribed scleroderma in childhood. Clinical aspects and therapy].

Disabling pansclerotic morphea of childhood is the most severe variant of localized scleroderma. It is characterized by rapid progression of deep cutaneous fibrosis expanding over large areas of body surface. The prognosis in terms of normal life activity is poor and the disease may even take a fatal course. Presented is a case with extremely severe and rapidly progressive lesions resulting in cutaneous ulcerations joint contractures, and multilaing deformities of the extremities. Histopathological analysis revealed extensive intravascular calcinosis of the small vessels, which may be an important factor in the pathogenesis of this poorly understood disease. UVA1-phototherapy was performed and induced a softening of sclerosis and a distinct decrease of skin thickness. Based on these observations UVA1-phototherapy may be promising in the treatment of extensive sclerotic disease of this kind, and possibly other diseases accompanied by excessive sclerosis.

Adolescent↗
PubMed1999

[Depression and suicidal intentions as a side effect of high dosage interferon-alpha therapy--two cases].

Adjuvant therapy with interferon for malignant melanoma causes neurotoxic side effects such as depression. The biochemical mechanisms are unknown. We report two cases with both depression and amnesia. In one case, attempted suicide was accompanied by 7 h of amnesia. The diagnostic classification and possible explanations for the amnesia secondary to interferon therapy are reviewed.

Adjuvants, Immunologic↗