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Biomedical subjects

P Elsner

Publications and source records attributed to P Elsner.

At least 163 records · Page 9Linked to original sources
PubMed1994

[Current eczema therapy].

The diagnostic term eczema refers to a group of skin diseases defined by the morphological criteria of erythema, papules, papulovesicles and, in the chronic stage, lichenification and desquamation. While the diagnostic workup should lead to a more specific diagnosis (irritant or allergic contact dermatitis, atopic, seborrheic or nummular dermatitis), the therapeutic approach is similar for most forms of eczema. In the present review, traditional and innovative therapeutic options are presented and discussed.

Combined Modality Therapy↗
PubMed1994

[Fulminant purpura in Still's disease and bacteremia with Xanthomonas maltophilia and coagulase-negative staphylococci].

We describe the case of a 31-year-old man with a long history of juvenile rheumatoid arthritis who was admitted to the hospital because of painful purple skin lesions on hands and feet. On admission he presented the classical picture of "purpura fulminans" with extensive acrocyanosis and large blisters on the lower limbs which evolved into symmetrical peripheral gangrene. Laboratory findings revealed activated intravascular coagulation and bacteremia with coagulase-negative staphylococci and Xanthomonas maltophilia which was thought to be catheter-related. His condition improved markedly under therapy with antibiotics, intravenous heparin, iloprost and intensive local debridement including amputation of several toes. Coagulation studies two months after the acute phase of the disease revealed chronic activated coagulation with a significant protein S deficiency. Clinical findings, etiology, significance of impaired coagulation and therapeutic action in "purpura fulminans" are discussed.

Adult↗
PubMed1994

Quantification of protein turnover in primary cultures of rat hepatocytes.

1. A radioactive tracer method, based on [3H]valine, for determination in parallel experiments of degradation of cellular proteins and synthesis of both cellular and secreted proteins in cultured rat hepatocytes was developed with special emphasis on methods of calculation, the number of protein pools and maintenance of nitrogen balance. 2. An extracellular concentration of 2 mM valine ensured a specific activity of the precursor pool for protein synthesis, which was constant during the experimental period and practically identical to that of extracellular valine. 3. Amino acid concentrations in the culture medium used were not rate-limiting for the synthesis of proteins. 4. The rate of labelling of the cellular protein pool during 8 days was in accordance with first-order saturation kinetics, which together with a constant ratio between labelling of soluble and membrane bound proteins, is compatible with a single pool of cellular proteins. 5. Protein degradation can be accurately measured by the release from prelabelled proteins of [3H]valine in the presence of 2 mM extracellular valine, if a 1 h chasing period is included in the experimental design. 6. The constancy of the degradation constant (kd) during protein labelling for up to 8 days, is in accordance with the existence of only one pool of cellular protein. 7. The cultured hepatocytes were in nitrogen balance during the experimental period of 8 days as reflected in a constant protein content per cell. The absolute rates of degradation and synthesis of cellular protein were identical, which confirm the validity of the method described.

Animals↗
PubMed1994

[Allergic and irritative textile dermatitis].

Textile dermatitis is only one example of adverse health effects due to clothing. It may present with a wide spectrum of clinical features, but the main mechanisms are irritant dermatitis, often observed in atopics intolerant to wool and synthetic fibers, and allergic contact dermatitis, usually caused by textile finishes and dyes. The newer azo dyes Disperse Blue 106 and 124 in particular are potent sensitizers that have caused significant problems, most recently in the form of "leggins dermatitis". Although severe textile dermatitis appears to be a rare event, more systematic population-based research is needed since many oligosymptomatic cases are probably overlooked. Criteria for healthy textiles are an optimum combination of efficacy (regulation of skin temperature and humidity and protection from environmental damage) and safety (lack of carcinogenicity, toxicity and allergenicity). If potentially allergenic substances are used in textiles, they should be declared as in the case of cosmetics.

Coloring Agents↗
PubMed1994

Casein and soya-bean protein have different effects on whole body protein turnover at the same nitrogen balance.

The present study examined whether different proteins have different effects on whole-body protein turnover in adult rats. The rats were either starved, given a protein-free but energy-sufficient diet (1 MJ/kg body weight (BW) per d) or a diet containing intact casein, hydrolysed casein, or hydrolysed soya-bean protein at a level of 9.1 g/kg BW per d. The diets, which were isoenergetic with the same carbohydrate: fat ratio, were given as a continuous intragastric infusion for at least 4 d. During the last 19 h 15N-glycine (a primed continuous infusion) was given intragastrically and 15N was recovered from urinary ammonia and urea during isotope steady state for measurement of protein synthesis and protein degradation. Compared with starvation the protein-free diet decreased N excretion by 75%, probably by increasing the rate of reutilization of amino acids from endogenous proteins for protein synthesis. The protein diets produced a positive N balance which was independent of the protein source. Intact and hydrolysed casein increased protein synthesis 2.6- and 2.0-fold respectively, compared with the protein-free diet. Protein degradation increased 1.4- and 1.2-fold respectively. Hydrolysed soya-bean protein did not increase protein synthesis but decreased protein degradation by 35% compared with the protein-free diet. Compared with the hydrolysed soya-bean protein, intact casein resulted in 2.2- and 2.8-fold higher rates of protein synthesis and degradation respectively. These results are not easily explained by known sources of misinterpretation associated with the 15N-glycine method. Hydrolysed casein and hydrolysed soya-bean protein produced similar concentrations of insulin-like growth factor-1, insulin, glucagon, and corticosterone. The difference in amino acid composition between the dietary proteins was reflected in plasma amino acid composition and this is suggested to be responsible for the different effect on protein turnover. Preliminary results from this study have previously been published in abstract form (Nielsen et al. 1991).

Amino Acids↗
PubMed1994

Skin irritant reactivity following experimental cumulative irritant contact dermatitis.

Despite the frequency of irritant contact dermatitis, very little is known about the duration of barrier function impairment following cumulative irritant contact dermatitis. We studied post-irritation irritant reactivity by assessing the response to SLS irritation in previously irritated sites. Cumulative irritant contact dermatitis was induced on the forearms of 15 volunteers aged 18 to 50 years by repeated occluded application of 0.5% SLS 1 h per day over 3 weeks. 3, 6 and 9 weeks later, previously irritated and unirritated control sites were challenged with 2% SLS under occlusion for 23 h. Irritation was assessed by visual scoring, transepidermal water loss (TEWL) as an indicator of epidermal barrier function, and capacitance as a parameter of epidermal water content. While no difference in irritant reactivity between pre-irritated and unirritated sites was observed 3 weeks following irritant contact dermatitis, there was a significant hyporeactivity of previously irritated skin as expressed by clinical scores, TEWL and capacitance at 6 and 9 weeks. Our results indicate that epidermal barrier function remains altered even 9 weeks after cumulative irritant contact dermatitis. With regard to patch testing, post-irritation hyporeactivity might be a cause of false-negative tests on previously irritated sites.

Adolescent↗
PubMed1994

Hypersensitivity to molybdenum as a possible trigger of ANA-negative systemic lupus erythematosus.

After implantation of two metal plates a 24 year old woman developed fever of unknown origin and successively more symptoms of an ANA-negative systemic lupus erythematosus (SLE). These symptoms resolved after removal of the plates and recurred during patch testing of the metal components, which showed a reaction to molybdenum. A lymphocyte transformation test indicated a delayed-type hypersensitivity to molybdenum. Subsequent progressive flare ups of SLE appeared without molybdenum reexposure. This is the first report suggesting the existence of a hypersensitivity to molybdenum, which may act as another environmental trigger for SLE.

Adult↗
PubMed1994

Eruptive hamartomatous clear-cell acanthomas.

This is a report on a 38-year-old female, suffering from over 100 solid papules arising on her legs, arms and trunk during the past 10 years. The histology shows the typical feature of clear-cell acanthoma (CCA). Extensive investigations did not reveal any extracutaneous abnormalities. This case is exceptional because of the high number of hamartomatous CCA which exceeds the maximal number of about 20 seen in multiple CCA so far and therefore is referred to as eruptive hamartomatous CCA.

Adult↗
PubMed1994

Irritant dermatitis in the workplace.

Irritant contact dermatitis is the most frequent occupational skin disease resulting in considerable morbidity and economic losses to workers, employers, and insurers. This article reviews pathogenesis, epidemiology, diagnosis, and treatment of irritant dermatitis at the workplace and stresses the importance of integrated preventive measures that must be implemented by companies and employees to achieve optimal efficacy.

Dermatitis, Irritant↗
PubMed1993

[Latex allergy--an increasing problem in clinical practice].

In the last few years the allergenic potential of rubber has been receiving more and more attention. Its widespread application in medical devices and everyday objects has increased exposure to this allergen. The central role of rubber in the prevention of HIV infection has certainly played a part in this development. Latex allergy manifests itself as immediate type allergy (type I), delayed type allergy (type IV) or as a combination of both types of hypersensitivity. In this review the different types of latex allergy are illustrated by means of selected case reports. Immediate type allergy to latex leads to contact urticaria, but it may also cause generalized urticaria, bronchial asthma or even anaphylactic reactions (contact urticaria syndrome). Hence, not only dermatologists and allergologists are confronted with latex allergy. Immediate type hypersensitivity can be proven by skin prick test and RAST (radio allergosorbent test). Contact dermatitis in patients using rubber gloves is generally due to delayed type hypersensitivity to rubber additives. However, a recently observed case suggests the possibility of isolated delayed type hypersensitivity to natural latex.

Adolescent↗
PubMed1993

Allergic contact dermatitis from natural latex without contact urticaria.

During the last decade, there have been many reports of immediate-type hypersensitivity to natural latex, resulting in contact urticaria, generalized allergic reactions such as urticaria and Quincke's edema, and asthmatic or anaphylactic reactions. Moreover, delayed-type hypersensitivity to rubber additives such as thiuram and carbamate derivatives is acknowledged to be the main cause of dermatitis in patients working with rubber gloves. We here report on a patient who developed severe dermatitis on his hands and forearms 3 months after he had started working with rubber gloves. Patch tests with rubber additives, skin prick tests and RAST to natural latex were negative. However, a delayed type of hypersensitivity to latex could be shown by a positive patch test. To our knowledge this is the 1st case reported of an isolated contact dermatitis from natural latex without contact urticaria to latex or hypersensitivity to rubber additives. We therefore propose that not only patch tests with rubber additives, but also skin prick and patch tests with latex should be performed in contact dermatitis patients working with rubber gloves.

Adult↗
PubMed1993

Generalized eczematous skin rash possibly due to HMG-CoA reductase inhibitors.

We report on 3 patients who developed a generalized eczematous skin rash under treatment with simvastatin and pravastatin for hypercholesterolemia. These drugs are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors and suppress cholesterol synthesis in the liver. Based on experimental data from the literature that showed eczematous changes in mice treated topically with the HMG-CoA reductase inhibitor lovastatin, we suspect that the rash observed in our patients may be a consequence of skin barrier dysfunction following inhibition of cholesterol biosynthesis.

Anticholesteremic Agents↗
PubMed1993

Irritant reactivity is a better risk marker for nickel sensitization than atopy.

In order to optimize patch test strategies and counselling in occupational dermatology, it is important to identify risk markers of contact sensitization. Since nickel is the most frequent contact allergen in European countries, we studied the potential of the irritant response to sodium lauryl sulfate (SLS) to predict nickel sensitization. In 100 patients subsequently tested in our patch test clinic with the standard patch test series of the German Contact Dermatitis Group (DKG), the atopy score as described by Diepgen et al. was determined and an SLS patch test was performed. Relative transepidermal water loss (TEWL), expressed as the ratio between the TEWL of the SLS-irritated and the control site, atopy score, age and sex were tested by logistic regression analysis for their association with patch test-proven nickel sensitization. Age, sex and relative TEWL were found to be significant predictors of nickel sensitization, whereas the atopy score was not. Patients with nickel sensitization were significantly younger (mean age 35.0 +/- 4.1 versus 46.2 +/- 2.1 years), more frequently of female gender (28.6% versus 3.9%) and had a significantly higher relative TEWL following SLS exposure (471.0 +/- 40.8% versus 344.0 +/- 16.2%). The mean atopy score of nickel-sensitized patients was slightly higher than that of patients not sensitized (6.0 +/- 1.3 versus 5.3 +/- 0.5), but the difference was not significant. In previous studies on larger patient samples, atopy was found to be a predictor of nickel allergy. This discrepancy may be explained by the smaller statistical power of our study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Treatment of bacterial sexually transmitted diseases.

Sexually transmitted diseases (STD) cause significant morbidity in the industrialized nations and, even more so in third world countries. Genital ulcerative STD such as herpes genitalis, syphilis, and chancroid have been identified as important risk factors for the spread of human immunodeficiency virus infection. Efficient and safe therapeutic regimen are therefore essential to cure the individual and to prevent spread of STD in the community. In this review, the current treatment guidelines for the bacterial STD gonorrhoea, chlamydial infections, syphilis, and chancroid are summarized and recent therapeutic developments are discussed.

Anti-Bacterial Agents↗