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Biomedical subjects

W Hartschuh

Publications and source records attributed to W Hartschuh.

At least 19 recordsLinked to original sources
PubMed2005

[Sunlight-induced granulomatous reaction to permanent lip liner].

The demand for permanent make up and especially permanent lip liner has increased in recent years in Germany. Information about complications is not available in the medical literature, because tattooing is a trade whose results and problems are not monitored and documented, as is the case for medical procedures. A female patient with permanent lip liner experienced no complications for one year. Then, after intensive sun exposure she developed solid, linear papules along the outer margin of her lips. Histology revealed a granulomatous tissue reaction with a marked lymphohistiocytic infiltrate including epithelioid histiocytes. Treatment with topical steroids over three weeks led to a complete healing without relapse. To the best of our knowledge this is the first report on UV-light-induced granulomatous reaction to permanent lip liner.

Female↗
PubMed2004

[Perianal dermatitis and its benign simulants].

Perianal dermatitis is one of the most common proctological disorders. Concerning the etiology, three different types of dermatitis must be distinguished-the most common irritative contact dermatitis, atopic dermatitis and allergic contact dermatitis. The correct diagnosis is essential for adequate and successful treatment. A variety of benign and malignant disorders must be considered in the differential diagnosis of anal dermatitis. Dermatitic clinical disorders which do not respond to therapy should always be biopsied.

Adult↗
PubMed2004

[Differential diagnosis of chronic perianal dermatitis. Premalignant and malignant disorders].

Several premalignant and malignant neoplasms clinically appear as chronic eczematous lesions of the perianal region and have to be distinguished from benign processes. Anal intraepithelial neoplasia (AIN) presenting as bowenoid papulosis and perianal Bowen disease is a precursor lesion for invasive squamous cell carcinoma. When AIN is widespread, persistent or progressive, an underlying immunosuppression should get excluded. Verrucous carcinoma of the perianal region is a highly differentiated variant of squamous cell carcinoma characterized as a slowly growing but locally invasive tumor. Extramammary Paget disease (EMP) is an intraepithelial adenocarcinoma of the skin with apocrine differentiation. Along with EMP, basal cell carcinoma, Langerhans cell histiocytosis and cutaneous T-cell lymphoma should be included in the differential diagnosis for lesions simulating chronic perianal dermatitis. In such situations, biopsies and histopathologic examination are imperative to avoid delayed diagnosis and assure prompt therapy.

Adult↗
PubMed2004

Bizarre annular lesion emerging as tinea incognito.

Tinea incognito has first been described in 1968. The term describes a tinea infection whose clinical morphology has been modified by the application of topical corticosteroids. The clinical manifestation can masquerade a number of other dermatoses and leads to misdiagnosis of annular eruptions. We describe a patient who showed a bizarre appearance of annular, inflammatory skin lesions at the umbilical region. Mycological culture yielded Microsporum canis.

Administration, Topical↗
PubMed2003

[Facial folliculo-sebaceous cystic hamartoma. Treatment with CO2 and Er:YAG lasers].

Folliculo-sebaceous cystic hamartoma (FCH) is defined as an adnexal hamartoma. The histopathological findings of FCH are equivalent to a very late stage of trichofolliculoma. The clinical appearance of FCH is unspecific. For this reason in the majority of cases it is only the histopathological examination that leads to the diagnosis of FCH. Up to now FCH has been treated with surgical procedures. We combined the use of both CO2 and Er:YAG lasers to treat a facial FCH.

Combined Modality Therapy↗
PubMed2003

[Possibilities and limits of early photography in dermatology. The "Clinique photographique de l'hôpital Saint-Louis" von 1868].

Photographic images are an intrinsic part of modern dermatology, essential for documentation, publication and teaching. Although there were no strong technical obstacles to prevent the use of black and white photographs in the atlases of the late 19th century, famous works such as Kaposi's "Handatlas der Hautkrankheiten" still utilized hand-colored copper etchings for illustration. Nevertheless, M.A. Hardy and M.A. de Montméja made an effort to introduce photography into dermatology as early as 1868. In their "Clinique photographique de l'hôpital Saint-Louis" of 1868 we find a variety of dermatological diseases, discussed and illustrated with 50 black and white photographs. The majority of these pictures were then modified with hand coloring in various shades of intensity. The authors insisted on this technique to assure the diagnostic value of the pictures. Besides an extensive review of the Atlas, we discuss the limits and perspectives of early photographic images in the "Clinique photographique" compared to the detailed hand-colored copper etchings of that time, as well as to modern color photographs.

Dermatology↗
PubMed2003

[Severe allergic contact dermatitis with generalized spread due to bufexamac presenting as the "baboon" syndrome].

HISTORY AND CLINICAL FINDINGS: A 48-year-old woman presented with acute, pruritic, sharply demarcated, erythematous, maculopapulous exanthem in the anogenital area with disseminated maculae over the back. Several days before, the patient had applied as topical treatment a bufexamac-containing ointment to the anal region. INVESTIGATIONS: The patch test showed an allergic test reaction to bufexamac. DIAGNOSIS: The case presents a serious allergic contact dermatitis with generalization, imitating a baboon syndrome, unequivocally linked to the previous topical treatment. CONCLUSION: During the last 10 years allergic reactions to bufexamac have increasingly been reported, sometimes with erythema multiforme-like reactions. Because of the high rate of sensitization, the serious clinical course of bufexamac allergy and the insidious symptoms of this side effect, sometimes mimicking the disease to be treated, the substance should be used neither for proctological nor for dermatological diseases, even more as these patients are considered to be at high risk of developing allergic contact dermatitis because of the abnormal skin barrier. Considering the data presented, the use of bufexamac should be critically reassessed.

Administration, Topical↗
PubMed2003

[Heinrich Köbner and the "isomorphic phenomenon". History and review of the literature].

The isomorphic phenomenon belongs to the probably most well-known entities of dermatology and is closely connected to the man who was the first to describe it. Today the Koebner phenomenon is well documented in a number of skin diseases and still of considerable interest. Heinrich Koebner first reported his observation in 1872 and caused considerable diverse discussion about the origin of psoriasis in the following years. Heinrich Koebner is not only well known as "father" of the Koebner phenomenon, but also as a founder of the university dermatology clinic and pioneer of dermatology in Breslau. We not only describe the life of Heinrich Koebner, but also discuss the evolution of the term "Koebner phenomenon" and its current status.

Dermatology↗
PubMed2003

[Benign cellular fibrous histiocytoma with erosion of the phalanx].

Fibrohistiocytic tumors are characterized by the presence of fibroblast like spindle cells and histiocytes. The benign fibrous histiocytoma (dermatofibroma, BFH) as well as the malignant dermatofibrosarcoma protuberans (DFSP) and the malignant fibrous histiocytoma (MFH) belong to this group. A recurrent painful, hard 2 cm tumor on the left hallux of a 54-year-old woman led to an erosion of the underlying phalanx. The patient had suffered from ingrown toenails for more than 10 years. Histologically there was a deep penetrating fibrohistiocytic tumor that grew in a storiform pattern with interspersed foam cells. The tumor was CD34 negative and mitoses were scarce. The diagnosis was benign cellular fibrous histiocytoma (BZFH). BZFH belong to the group of BFH with a high recurrence rate especially after incomplete removal. Damage to the underlying bone has not been reported so far.

Female↗
PubMed2003

[Merkel cell carcinoma. Clinical and histological differential diagnosis, diagnostic approach and therapy].

Merkel cell carcinomas are rare tumors of the skin with an aggressive behavior and frequent regional and distant metastases. Typically, the primary is a fast-growing, painless, reddish nodule with an iceberg-like effect, broadening in the depth. On the trunk and the buttocks, deep clinically rather inconspicuous nodules can occur. The clinical differential diagnosis of the Merkel cell carcinoma includes skin metastases, malignant lymphomas, malignant adnexal tumors and cysts when the tumor is located deep in the soft tissue (e.g. on the buttocks). Histological and immunohistochemical analysis is necessary for the diagnosis. The demonstration of cytokeratin 20 in the typical globular distribution pattern is of main importance in the diagnosis of Merkel cell carcinoma. Because they are very rare, Merkel cell carcinomas are infrequently diagnosed clinically, in spite of the rather characteristic picture. Diagnostic excision with a safety margin of 3 cm is recommended followed by an adjuvant radiotherapy. The radiation field should include the area of the draining vessels and the first regional lymph nodes. There are some reports concerning the advantage of sentinel lymph node biopsy. In distant metastases, the therapy is multimodal and palliative including surgery, radiation and chemotherapy. Because of the high incidence of regional and distant metastases, regular follow-up is important.

Adult↗
PubMed2003

Somatostatin analogue scintigraphy in Merkel cell tumours.

BACKGROUND: Merkel cell tumours are rare neoplasms of the skin with frequent regional and distant metastases. Scintigraphy with the radiolabelled somatostatin analogue octreotide is a possible method for in vivo localization of the primary tumour and its metastases. OBJECTIVES: To estimate the diagnostic value of indium (111) -octreotide scintigraphy (Octreoscan in detecting metastases. METHODS: Scans of 11 patients with Merkel cell carcinoma were evaluated, in whom scintigraphy was performed in addition to the conventional investigations, chest X-ray, ultrasonography and computed tomography (CT). RESULTS: In four cases metastases were found both by scintigraphy and by conventional methods; two investigations showed a suspicious accumulation of radioactivity on scintigraphy that could not be confirmed by CT and clinical progression. In three cases CT-verified metastases were not found by scintigraphy. Two patients were found to be tumour free, i.e. free of metastases by scintigraphy and conventional methods, indicating true-negative results. CONCLUSION: These data confirm that scintigraphy with the radiolabelled somatostatin analogue octreotide is not clinically helpful in detecting metastases from Merkel cell carcinoma. In this relatively small sample the method generated false-positive or false-negative results in five of 11 cases.

Aged↗
PubMed2003

Actinic superficial folliculitis.

Actinic superficial folliculitis was first described in 1985, and since then only three reports have been published. Clinically and histopathologically this disease is very particular and has been suggested to be considered as an entity. We report on a 30-year-old man who presented with an extensive superficial follicular pustulosis on his back, shoulders and upper chest after exposure to intense heat and subsequent sweating on a sunny day. The pustules arose within 24-36 h afterwards. Histology and immunohistochemistry revealed subcorneal pustules, suppurative folliculitis and an infiltrate consisting of T cells, macrophages and neutrophils around the hair follicle, sebaceous glands and small vessels. To the best of our knowledge this is the fourth report on actinic superficial folliculitis and the first on which a characterization of the inflammatory infiltrate has been performed. Because of the impressive, unique symptoms and the characteristic histology we agree with those who have suggested that actinic superficial folliculitis is a new entity.

Acne Vulgaris↗
PubMed2002

[First descriptions in the "International atlas of rare skin diseases" of 1886].

In the history of dermatology, we find an outstanding example of scientific collaboration of leading dermatologists leading to an international publication in the late 19th century. Published by Malcolm Morris, Paul Gerson Unna, Henry-Camille Chrysostome Leloir and Louis Adolphus Duhring, the "International Atlas of Rare Skin Diseases" focused on rare and unique cases in dermatology. This concept, extraordinary for the time of publication, was found to be very successful. Numerous first descriptions are found in the "International Atlas", such as porokeratosis of Mibelli, acanthosis nigricans of Pollitzer and Janovsky and also psorospermosis of Darier. The focus on distinct and detailed descriptions to promote progress in the science of dermatology sets this effort apart from all previous atlases. Therefore, the "International Atlas was one of the first steps leading to the modern concepts of scientific publication in dermatology.

Anatomy, Artistic↗
PubMed2002

PTEN/MMAC1 expression in melanoma resection specimens.

PTEN/MMAC1, a tumour suppressor gene located on chromosome 10q23.3, has been found to be deleted in several types of human malignancies. As the chromosomal region 10q22-qter commonly is affected by losses in melanomas, we addressed this gene as tumour suppressor candidate in melanomas. Investigating PTEN/MMAC1 expression at mRNA level by semi-quantitative reverse transcription-polymerase chain reaction, we did not find a statistically significant down-regulation in melanoma resection specimens in comparison to acquired melanocytic nevi from which melanomas quite often are known to arise. Upon immunohistochemistry, PTEN/MMAC1 protein expression in melanomas was not lost. Sequencing the PTEN/MMAC1 cDNAs in 26 melanoma resection specimens (21 primary melanomas, five metastases), we detected three point mutations and two nucleotide deletions which did not represent genetic polymorphisms. With respect to the predicted protein sequences, all three point mutations were silent whereas the two frame shifts at the extreme C-terminus resulted in a loss of the putative PDZ-targeting consensus sequence. As loss of this motif possibly impairs localization and function of PTEN/MMAC1 in the two corresponding primary tumours, alterations of this tumour suppressor protein may participate in some melanomas.

Adult↗
PubMed2002

Carcinoma-like vascular density in atypic keratoacanthoma suggests malignant progression.

Differential diagnosis between keratoacanthomas and well differentiated squamous cell carcinomas based on clinical and histomorphological data is problematic. Recent findings of cellular atypia in a large proportion of keratoacanthomas indicated that these potentially 'self-healing' cutaneous neoplasms had the potential for malignant progression. Another malignancy-associated criterion is enhanced angiogenesis with increased microvessel density. To provide further diagnostic markers for keratoacanthomas we examined microvessel density on paraffin sections of 13 keratoacanthomas in comparison with 10 normal skin biopsies and 16 late-stage skin squamous cell carcinomas by counting and by computer-assisted image analysis of CD31-immunostained vessels. A significant increase of microvessel density in 'hot spots' was observed in keratoacanthomas as compared to normal skin. Furthermore, when keratoacanthomas were subdivided into tumours with and without malignancy-associated atypic areas, only those with atypia (n=6) were significantly better vascularised than normal skin and had a mean microvessel density in the range of late-stage squamous cell carcinomas. Both keratoacanthoma subtypes revealed comparable levels of inflammatory cell infiltration, tumour cell proliferation and vascular endothelial growth factor expression (mRNA and protein). Thus, in addition to malignancy-associated cellular atypia, increased microvessel density may serve as further diagnostic parameter to discriminate keratoacanthomas with a potential to progress to malignancy.

Biopsy↗
PubMed2002

Analysis of losses of heterozygosity of the candidate tumour suppressor gene DMBT1 in melanoma resection specimens.

Deleted in malignant brain tumours 1 (DMBT1), a candidate tumour suppressor gene located on chromosome 10q25.3-q26.1, has recently been identified and found to be deleted in several different types of human tumours. In melanomas, the chromosomal region 10q22-qter is commonly affected by losses, hence we screened primary melanoma samples for losses of heterozygosity (LOH), and acquired melanocytic naevi and melanomas for transcription of DMBT1 and protein expression. Of 38 informative melanomas, 1 nodular melanoma and 2 subcutaneous metastases showed LOH of both microsatellites flanking the gene, suggesting loss of 1 DMBT1 allele. Three further melanomas showed LOH at 1 informative locus but were heterozygous for the second marker. Applying reverse-transcription polymerase chain reaction (RT-PCR), DMBT1 transcription was not found in melanomas. However, DMBT1 transcription was also absent from the majority of naevi from which melanomas frequently arise, making down-regulation of gene transcription during transformation from naevus to melanoma unlikely. Immunohistochemistry showed nerves, sweat glands and the stratum spinosum of the epidermis to be DMBT1 protein positive, whereas the naevi and melanoma cells themselves were negative. All considered, the candidate tumour suppressor gene DMBT1 does not appear to be a major inactivation target in the development of melanomas.

Agglutinins↗