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Biomedical subjects

P Elsner

Publications and source records attributed to P Elsner.

At least 55 records · Page 3Linked to original sources
PubMed2000

[Mucocutaneous candidosis in a patient with Sjögren syndrome].

Oral candidiasis is common among patients with Sjögren's syndrome. For the first time we report on a 60-year-old female patient, who developed a non-familiar chronic mucocutaneous candidiasis of later life. She presented with the following symptoms: oral candidiasis and glossitis, angulus infectious, vulvovaginitis, lichen planus-like onychodystrophy of the finger-nails and chronic nail bed inflammation of the nails of the big toes. The knowledge of chronic mucocutaneous candidiasis is of prognostic and therapeutic relevance, since topical treatment often fails.

Candidiasis, Chronic Mucocutaneous↗
PubMed2000

[Not Available].

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis.

The actual advantage of barrier creams over bland emollients for skin protection is still hotly debated. In a randomized, double-blinded study, a newly-introduced barrier cream and its moisturizing vehicle were compared regarding their skin compatibility, efficacy and resulting acceptance. Thus, 2 panels of 25 hospital nurses with mild signs of skin irritation were asked to use 1 of the test products provided (verum or vehicle) over a period of 4 weeks. Effects of both types of preparations were studied weekly by clinical examination and the instrumental assessment of bioengineering parameters. Results showed no significant differences between barrier cream and vehicle. In both groups, clinical skin status improved and stratum corneum hydration increased significantly during the study period. Both preparations were tolerated and accepted well, thus showing both skin protection and skin care. These results contribute to the debate as to whether a strict distinction between "skin care" and "skin protection" products is justified. The vehicle alone is capable of positively influencing skin status. Emphasis must be laid on regular, frequent, and correct application of a product for it to be effective.

Adult↗
PubMed2000

Multicentre study for the development of an in vivo model to evaluate the influence of topical formulations on irritation.

Although skin protective products to prevent irritant skin reactions are in wide use, neither standardized test models to prove differences in efficacy exist, nor has the quality or the reproducibility of results been evaluated in a multicentre approach. This should be mandatory when developing or testing skin care products. Therefore, we have designed a multicentre study in an approach to find a standardized test procedure for the evaluation of skin protective products. In this irritation study, a repeated short-time occlusive irritation test (ROIT) with a standardized protocol has been evaluated in 2 phases (12 days and 5 days protocol) in 4 (n=20) respectively 6 (n=33) skilled centres. The skin reaction was induced by 2 irritants (0.5% aq. SLS and toluene, 2x a day for 30 min). Its modification by 3 different cream bases with different hydrophilicity was analyzed. The irritation was monitored by bioengineering methods (TEWL measurement, colorimetry) and by clinical scoring. The evaluation showed that significant results could already be achieved with the 5-day protocol. Furthermore, in spite of the expected inter-centre variations due to heterogeneity of the individual threshold of irritation, interpretation of clinical score, and inter-instrumental variability, the ranking of the vehicles regarding reduction of the irritant reaction was consistent in all centres.

Administration, Topical↗
PubMed2000

Hand eczema in metalworker trainees--an analysis of risk factors.

The present study, as part of PROMETES (Swiss Prospective Metal Worker Eczema Study), was performed to examine risk factors for the development of occupational hand dermatitis in metal-worker trainees. Since this disease is very common, a high standard of preventive measures is necessary, especially for persons with an endogenous disposition for the development of eczema, e.g., atopics. Within the cohort of 201 healthy young men, 47 (23%) showed at least mild signs of hand eczema at 1 point of the 2.5 year observation period. Various occupational and domestic exposures, skin protection behaviour, regeneration time, and smoking habits, as well as atopic disposition, were studied with regard to their influence on the skin condition of the metalworker trainees. By multivariate analysis, we determined 3 important risk factors for the development of hand eczema in the cohort. (i) We showed once more the important influence of an atopic disposition as a major risk factor for occupational contact dermatitis. (ii) Furthermore, the results suggest that, apart from chemical irritants, mechanical factors should not be underestimated in their role as irritants to the epidermal barrier. (iii) Additionally, an insufficient amount of skin recovery time seems to support a cumulative sub-irritant effect on the skin, which may lead to irritant contact dermatitis.

Dermatitis, Occupational↗
PubMed2000

Experimental irritant contact dermatitis due to cumulative epicutaneous exposure to sodium lauryl sulphate and toluene: single and concurrent application.

In clinical practice, cutaneous exposure to a variety of irritants such as surfactants and solvents is frequent. Although the induction of irritant dermatitis by single irritants has been extensively studied in recent years, our knowledge of the effects of simultaneous application of different irritants is limited. Using non-invasive techniques for measurements of transepidermal water loss (TEWL) and skin colour reflectance, we quantified the irritant effects of single and concurrent application of 0.5% sodium lauryl sulphate (SLS) and undiluted toluene (TOL) in vivo. The irritants were applied twice daily for 30 min to the volar forearms of 20 volunteers. Repeated application of SLS and TOL induced an irritant reaction, as indicated by an increase in TEWL and skin redness. In contrast to SLS alone, the application of TOL alone induced only a moderate increase in TEWL, confirming previous results. Concurrent application of SLS/TOL and TOL/SLS induced significantly stronger reactions than those caused by twice daily application of each irritant on its own. Our results demonstrate that a mixed application of an anionic detergent and an organic solvent has an additive effect on skin irritation. It is suggested that pretreatment with SLS causes an increased susceptibility to TOL irritation and vice versa. Thus, the necessity for special precautions against skin absorption of TOL when handling detergents such as SLS is emphasized.

Administration, Cutaneous↗
PubMed2000

Allergic contact dermatitis in patients with anogenital complaints.

OBJECTIVE: Allergic contact dermatitis is a common anogenital disease. STUDY DESIGN: The results of patch testing performed on 1,008 patients evaluated for allergic anogenital contact dermatitis from 21 dermatologic departments in the Information Network of Departments of Dermatology (IVDK) from 1992 to 1997 were analyzed. RESULTS: A final diagnosis of allergic contact dermatitis was made in 351 patients (34.8%). Irritant contact dermatitis was diagnosed in 230 patients (22.8%) and other, nonspecified forms of perianal eczema in 228 patients (22.6%). The remaining cases were due to other distinct dermatologic diseases. Analyzing patch test data from this large group of patients showed that the allergen spectrum resembled that of all patients (54,000) tested from 1992 to 1997. However, dibucaine HCl ranked fourth among contact allergens in the study population. Positive reactions to (chloro-)-methyl-isothiazolinone and to benzocaine were observed more frequently among patients with anogenital complaints as compared to the total IVDK population (3.7% vs. 2.5% and 2.7% vs. 1.5%, respectively). In general, active agents of topical medications and popular remedies, preservatives and ointment bases appeared to cause allergic reactions most frequently. CONCLUSION: Patients with chronic anogenital diseases seem to have a high risk of becoming sensitized. For patch testing we recommend the standard series, dibucaine HCl, propolis, bufexamac and other ingredients from topical preparations according to the patient's history.

Adult↗
PubMed2000

[Monascus purpureus: a new fungus of allergenic relevance].

Anaphylactic reactions to food containing allergens in the consumption or preparation of food are well known. However, allergy in the preparation of sausages have rarely been described. In the present study a 26-year-old butcher was investigated who had a severe anaphylactic reaction developing sneezing, rhinitis, conjunctivitis, generalised pruritus, followed by widespread urticaria, Quincke's oedema and dyspnoe after starting to prepare sausages containing red yield rice. Red yield rice is produced from polished and washed rice by means of the fungus Monascus purpureus. It was the first time that Monascus purpureus could be shown as allergic agent by means of prick-to-prick test, Cellular Antigen Stimulation Test (CAST) and different other immunoblots.

Adult↗
PubMed1999

[A severe epicutaneous test reaction to the bufexamac in a hemorrhoidal therapeutic preparation].

HISTORY AND FINDINGS: A 49-year-old woman presented with acute perianal vesicular/bullous contact dermatitis. Other areas were over the trunk, face, neck and wrists. She reported occasional application of an ointment (Mastu S) to treat her hemorrhoids. INVESTIGATION: Patch tests (basic series, anal block, own ointment, local anesthetic, cosmetics) provoked strong vesicular and bullous reactions of persisting crescendo type, spreading far beyond the site of application, to Bufexamac, to a derivative of hydroxxamine acid, and to local applied ointment with mild or moderate antiinflammatory action. TREATMENT AND COURSE: A week after the patch tests there was a flare-up of the previous foci of dermatitis. These reactions subsided two days later after intravenous injection of prednisolone. The skin lesions healed after rapid reduction of the systemic treatment and local application of corticosteroids, bathing with tanning substances and basic preparations. CONCLUSION: While Bufexamac is not absorbed when applied rectally, perianal contamination may not be avoidable on intra-anal application and can produce sensitization.

Acute Disease↗
PubMed1999

[Giant condylomata acuminata (Buschke-Löwenstein tumor)].

HISTORY AND ADMISSION FINDINGS: A 59-year-old woman had for 3 weeks been suffering from painful, moist skin changes on the external genitals, for 3 months having noticed vegetations in the anogenital and perineal region. She had been fatigued and lacking in energy since then. Her last gynecological examination had been 20 years ago. Examination of the skin on admission revealed extensive plaque and cauliflower-like warts and large areas of maceration in the anogenital region, the labia and perineum, with large areas of maceration. Nodules were clearly palpable in the left labium majora: the inner aspects were markedly reddened and had some cutaneous erosions. These findings suggested giant condyloma (GC; Buschke-Löwenstein tumour). INVESTIGATIONS: Biopsy showed marked condylomatous epithelial proliferations which, with the formation of markedly thickened epithelial cones, had reached the stage of a verrucous carcinoma. TREATMENT AND COURSE: Under local anti-inflammatory and adstringent medications the inflammatory reaction quickly subsided. Vulvectomy was performed to remove the tumour. CONCLUSION: Giant condyloma (Buschke-Löwenstein tumour) is a rare pseudocancereous lesion. If human papilloma viruses of type 16 or 18 is demonstrated in the lesions, malignant degeneration should be considered. Histological examination is essential to differentiate it from squamous cell carcinoma.

Carcinoma, Verrucous↗
PubMed1999

[Prevention of allergy by protective skin creams: possibilities and limits].

Despite promising efficacy data for protective creams and many scientifically proven advances that have been achieved concerning the prevention of irritative contact dermatitis, protection against sensitising substances remains a particular problem due to the minimal amounts of allergen that trigger allergic contact dermatitis. Therefore, specific allergen-blocking substances have been tested which are designed to prevent sensitising processes and in particular avoid occurrence of contact dermatitis in already sensitised individuals. In this review, we present the results of current studies mainly focussed on preventing occupational contact dermatitis caused by metal salts, using different chelating agents. In the United States allergic contact dermatitis is often due to strongly sensitising plant allergens of Toxicodendron species, a factor of importance in outdoor professions. Therefore, attempts have been made to use linoleic acid dimers and organoclay materials such as quaternium-18 bentonite for prophylaxis in topical treatments. Most studies investigate effectiveness against experimentally induced allergic contact dermatitis in sensitised volunteers using standardised allergen extracts. Although several preparations showed some benefit by possibly preventing certain quantities of allergen from penetrating the epidermis, further effort will be required before sufficient protective creams with allergen-blocking properties are available for workplaces.

Adrenal Cortex Hormones↗
PubMed1999

[Acquired reactive perforating collagenosis in diabetes mellitus].

HISTORY AND ADMISSION FINDINGS: A 70-year-old woman with type 2B diabetes mellitus was referred to the dermatology department because of inflammatory skin changes of unknown origin over the trunk and limbs. On admission follicular and parafollicular livid-red papulae with central crusts and reddened margins were noted over the lower legs and the lumbosacral region. INVESTIGATIONS: Further physical examination revealed no additional abnormalities. Erythrocyte sedimentation rate was 41/79 mm. The day-time blood-glucose profile was raised (10.2, 12.6 and 8.6 mmol/l), as was the glycosylated haemoglobin HbA1c (9.0%). Swabs from fresh lesions gave no evidence of fungal or bacterial infection. Biopsies revealed areas of widened epidermis with central ulceration filled with fibrin, granulocytes and collagen fibres. DIAGNOSIS, TREATMENT AND COURSE: The clinical and histological findings indicated an acquired reactive perforating collagenosis (dermatosis) which should be judged in relation to the long-standing diabetes mellitus. The cutaneous changes were covered with salicylate- and steroid-containing preparations, while individual lesions were excised or removed by curettage. CONCLUSION: The condition of acquired reactive perforating collagenosis is, like Kyrle's disease (perforating follicular and parafollicular hyperkeratotic dermatosis), perforating serpiginous elastosis and perforating folliculitis classified among the perforating dermatoses. In the presence of renal failure and (or) diabetes mellitus these dermatoses must be thought of in the differential diagnosis, in addition to the more frequent pruriginous conditions, if there are corresponding skin changes.

Administration, Cutaneous↗
PubMed1999

Kinetics of lactate and pyruvate transport in cultured rat myotubes.

Skeletal muscle transport of lactate and pyruvate was studied in primary cultures of rat myotubes, applying the pH-sensitive fluorescent indicator 2', 7'-bis(carboxyethyl)-5(6)-carboxyfluorescein. The initial rate of decrease in intracellular pH (pHi) upon lactate or pyruvate incubation was used to determine total transport (carrier mediated and diffusion). Both lactate and pyruvate transport could be inhibited by a combination of 0.5 mM 4,4'-diisothiocyanostilbene-2, 2'-disulfonic acid, 5 mM mersalyl and 10 mM alpha-cyano-4-hydroxycinnamate. The kinetic parameters, Km and Vmax, for carrier-mediated transport of lactate were 9.9+/-1.1 mM and 0. 69+/-0.02 mmol l-1 s-1, respectively. For pyruvate, Km and Vmax were 4.4+/-1.3 mM and 0.30+/-0.05 mmol l-1 s-1, respectively. The diffusion component of the total transport was 0.0040+/-0.0005[S] (n=4) and 0.0048+/-0.0003[S] (n=4) for lactate and pyruvate, respectively. Furthermore, it was observed that the two monocarboxylate transporter isoforms present in mature skeletal muscles, MCT1 and MCT4 (formerly called MCT3 (M.C. Wilson, V.N. Jackson, C. Heddle, N.T. Price, H. Pilegaard, C. Juel, A. Bonen, I. Montgomery, O.F. Hutter, A.P. Halestrap, Lactic acid efflux from white skeletal muscle is catalyzed by the monocarboxylate transporter isoform MCT3, J. Biol. Chem. 273 (1998) 15920-15926)), were also expressed in primary culture of myotubes.

Animals↗
PubMed1999

[Melatonin in dermatology. Experimental and clinical aspects].

Melatonin (N-acetyl-5-methoxytryptamine) is a hormone with multiple functions in humans, produced by the pineal gland and stimulated by beta-adrenergic receptors. Serum melatonin levels exhibit a circadian rhythm with low levels during the day, rise in the evening and maximum levels at night between 2 and 4 a.m. Melatonin participates in the regulation of several physiological processes such as seasonal biological rhythm, daily sleep induction, aging and modulation of immunobiological defence reactions. Furthermore, melatonin has a highly lipophilic molecular structure facilitating penetration of cell membranes and serving as an extra- and intracellular free radical scavenger. Melatonin seems to quench mainly hydroxyl radicals, the most damaging of all free radicals. Melatonin may play a role in the etiology and treatment of several dermatoses e.g. atopic eczema, psoriasis and malignant melanoma. The influence of melatonin on hair growth is another aspect. Topical application of melatonin inhibits the development of UV-erythema. Penetration through skin after topical application and oral bioavailability auxit further investigations on the pharmacokinetic and pharmacodynamic actions of melatonin.

Animals↗
PubMed1999

[An unusual hemorrhagic variant of Stevens-Johnson syndrome in an HIV-infected patient].

Cutaneous adverse drug reactions in HIV-positive patients with their wide spectrum of manifestations remain a diagnostic and therapeutic challenge. Skin diseases as erythema multiforme, Stevens-Johnson syndrome and toxic epidermal necrolysis belong to this group. The typical primary lesions are erythematous macules and papules, which rapidly extend to the entire body and may be accompanied by a extensive epidermal detachment. Diagnosis and immediate therapy is indispensable because of the possible fulminant course of the disease. We report a HIV-positive patient with a cutaneous adverse drug reaction showing predominantly hemorrhagic lesions.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Occupationally-induced contact dermatitis and bronchial asthma in a unusual delayed reaction to hydroxychloroquine].

We report the case of a a 60 year-old worker in the pharmaceutical industry who suffered from recurring contact dermatitis. Initially the contact dermatitis was limited to the hands; later on it became generalized. The patient had been working on a drug filling line in a pharmaceutical plant for more than 20 years. Eight years after starting this job he had developed allergic hand dermatitis to 2,6-diaminopyridine (patch test positive); this healed upon cessation of exposure. Ten years later he again developed hand dermatitis which progressed to generalized dermatitis and conjunctivitis. Under systemic and local therapy with corticosteroids and cessation of work, it healed nearly completely. Four months after returning to work, the patient experienced a first episode of severe asthma and generalized dermatitis with conjunctivitis following exposure to hydroxychloroquine the day before. The asthma and dermatitis improved after systemic corticosteroid therapy and stopping work. His condition continued to fluctuate, when though the patient was transferred at work and now wore rubber gloves. Eight months later he again developed a generalized dermatitis. Patch testing revealed delayed-type sensitizations to hydroxychloroquine (tested in concentrations of 0. 1%, 0.5%, 1% and 2%). Equivalent tests in five healthy volunteers were negative. The patch test reactions were pustular, while a biopsy was interpreted as a multiform contact dermatitis reaction. Bronchial exposure with hydroxychloroquine dust produced a delayed bronchial obstruction over the next 20 hours, which progressed to fever and generalized erythema (hematogenous contact dermatitis). After removing exposure to 2,6-diaminopyridine and hydroxychloroquine, the patient went on to develop a contact dermatitis to latex (patch test positive). However, skin prick tests with latex and patch tests with rubber additiva were negative. Hydroxychloroquine is well known to cause drug reactions. To our knowledge, contact dermatitis to this substance has not yet been reported. It is noteworthy that the patch test reactions were pustular and of multiform morphology and that bronchial exposure to the allergen resulted in asthma and a generalized drug reaction. Pathogenetically the asthmatic reaction seems to be on a delayed-type mechanism as is also seen with ampicillin, cobalt and nickel induced asthma.

Asthma↗