Search PubMed⌕ Search

Biomedical subjects

W Weyers

Publications and source records attributed to W Weyers.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Balneophotochemotherapy in disseminated granuloma annulare].

A 56-year-old female patient with generalized granuloma anulare was treated with bath-PUVA therapy with 8-methoxypsoralen. Her diabetes mellitus renal insufficiency excluded oral photochemotherapy. A series of 30 treatments resulted in complete disappearance of the lesions on the trunk and neck and significant improvement of those on the limbs. No side-effects were observed. Bath-PUVA therapy seems to have positive effects not only on epidermal, but also on dermal processes.

Balneology↗
PubMed1998

LE or not LE--that is the question: an unsuccessful attempt to separate lymphocytic infiltration from the spectrum of discoid lupus erythematosus.

Lymphocytic infiltration of the skin (LIS) has been claimed to be a distinct entity that differs from discoid lupus erythematosus (DLE) by the lack of epidermal changes, negative immunofluorescence tests, and differences in the composition of the inflammatory cell infiltrate. In studies that sought to distinguish both conditions, however, cases of established lupus erythematosus without epidermal involvement have not been considered. We studied 72 patients with the clinical and histopathologic diagnosis of either LIS or DLE in regard to the same clinical, histopathologic, immunofluorescence, and immunohistochemical criteria. No significant differences were noted between cases with and without epidermal involvement on the one hand and between cases with and without immunofluorescence or clinical findings suggestive of lupus erythematosus on the other. Based on our findings, it is not possible to separate LIS from the spectrum of DLE.

Antigens, CD↗
PubMed1998

Sclerosing dermatofibrosarcoma protuberans.

Dermatofibrosarcoma protuberans is a low-grade sarcoma of the skin with well characterized clinical and histopathological features. The lesion frequently appears as a plaque on the trunk or on the extremities of middle-aged adults. Microscopically, the tumor is composed of monomorphous spindle cells arranged in storiform pattern and embedded in a sparse to moderately dense fibrous stroma. We report on two unusual cases of dermatofibrosarcoma protuberans in which neoplastic cells were diffusely replaced by sclerotic tissue in more than 50% of the entire tumor. In both cases, no external trauma or radiotherapy were recorded. Since tumor regression has been defined as a loss of tumor mass in the absence of any treatment (or trauma) we believe that sclerosis in DFSP may represent a manifestation of regression and not, as previously suggested, a new variant of the neoplasm.

Aged↗
PubMed1998

Deep dermatofibrosarcoma protuberans: a subcutaneous variant.

AIMS: Dermatofibrosarcoma protuberans (DFSP) is a distinctive cutaneous spindle cell neoplasm that invariably infiltrates the subcutaneous tissue. Other reports have suggested that exceptional cases of DFSP may be confined to the subcutaneous tissue and lack dermal involvement. We wish to confirm this observation by describing cases of a rare variant of DFSP confined to the subcutaneous tissue, and analyse possible histogenetic implications. METHODS AND RESULTS: Three cases of DFSP located in the subcutaneous tissue are reported. Multiple step sections demonstrated the lack of dermal involvement in two of them, whereas the third case infiltrated the dermis at the junction with the subcutis minimally in one of five blocks. Immunohistochemical studies using a battery of monoclonal antibodies were performed. All the tumours stained strongly for vimentin and CD34. CONCLUSIONS: Because of the lack of dermal involvement in two cases and only minimal dermal involvement in one case, we called this variant deep DFSP. Except for deep setting of the tumour, deep DFSP is indistinguishable from typical DFSP clinically, histologically and immunohistochemically. The existence of deep DFSP provides evidence that specific structures of the skin may be not involved in this tumour's histogenesis.

Adult↗
PubMed1998

Verrucous angiosarcoma of the skin: a distinct variant of cutaneous angiosarcoma.

AIMS: Cutaneous angiosarcoma is a malignant vascular neoplasm with well established clinical and histopathological features. Epidermal changes in cutaneous angiosarcoma other than atrophy and necrosis have not been described. In this study, we report three cases of a peculiar variant of angiosarcoma with striking verrucous changes of the overlying epidermis. METHODS AND RESULTS: On light microscopy, verrucous changes characterized by marked pseudocarcinomatous epithelial hyperplasia with hypergranulosis, compact orthokeratosis, and papillomatosis were present overlying an angiosarcoma in the dermis. Clinically the lesions presented as violaceous to brown scaly verrucous nodules or plaques. All lesions developed on an extremity. CONCLUSIONS: Verrucous epidermal changes seem to be a manifestation of pseudocarcinomatous hyperplasia, presumably caused by lymphoedema and the superficial setting of the tumour in the papillary dermis. It is important to be aware of this presentation of angiosarcoma because verrucous epidermal changes may be seen in a wide variety of skin diseases. Furthermore, a biopsy that includes the dermis is necessary to ensure that the angiosarcoma underlying the hyperplastic epidermis is correctly identified. The descriptive appellation verrucous angiosarcoma of the skin is proposed to designate a newly recognized variant of angiosarcoma.

Adult↗
PubMed1997

Lichen amyloidosus: a consequence of scratching.

BACKGROUND: Lichen amyloidosus (LA) is generally said to be a pruritic type of amyloidosis of unknown cause. Histopathologically, it is characterized by epidermal changes of lichen simplex chronicus and by deposits of amyloid in the papillary dermis that are derived from keratin peptides of necrotic keratinocytes. Chronic scratching is responsible for the development of lichen simplex chronicus and may lead to necrosis of individual keratinocytes. OBJECTIVE: Our purpose was to evaluate whether chronic scratching may also be responsible for the formation of amyloid in LA. METHODS: We studied patients with LA in regard to histopathologic findings, onset of pruritus, associated diseases, and response to treatment. RESULTS: In most cases, pruritus had preceded the skin lesions. Eight of nine patients suffered from diseases other than LA that may be associated with pruritus. Histopathologically, amyloid was confined to areas that also showed signs of lichen simplex chronicus. Systemic treatment with sedating antihistamines and intense local treatment with corticosteroids were found to be effective. CONCLUSION: LA is considered to be a variant of lichen simplex chronicus in which scratching leads to necrosis of keratinocytes and eventually to the formation of amyloid in the papillary dermis. Because chronic scratching seems to be the cause and not the result of the deposits of amyloid, treatment should be directed at the amelioration of pruritus.

Administration, Cutaneous↗
PubMed1997

Dermatofibrosarcoma protuberans with fibrosarcomatous areas: a clinico-pathologic and immunohistochemic study in four cases.

Dermatofibrosarcoma protuberans (DFSP) with fibrosarcoma (FS)-like areas (DFSP-FS) is a peculiar neoplasm that combines microscopic findings of DFSP and FS. Because of the scarce number of cases published, tumor prognosis remains controversial. The clinical histories and the histologic material of 27 cases of DFSP were reviewed. Four of them showed fibrosarcomatous areas. Follow-up data, ranging from 12 to 125 months, were obtained in all four cases. Two patients had repeated local recurrences. One patient developed pulmonary metastases and died of disease 49 months after diagnosis. In the other two patients, no recurrences or metastases were detected at 12 and 70 months after local excision, respectively. Progressive increase of FS areas, cellular density, cellular atypia, and mitotic activity were observed during the recurrences. All cases showed diffuse positive immunostaining for CD34 in DFSP areas. Three cases were also CD34-positive in FS areas. Based on a careful review of the literature and our personal experience, we conclude that DFSP-FS is a rare variant of DFSP with a higher rate of local recurrences and more distant metastases than typical DFSP.

Adult↗
PubMed1996

[Skin infections caused by Mycobacterium gordonae. Case report and review of the literature].

Mycobacterium gordonae is an atypical mycobacterium of very low pathogenic potential. It is widely distributed in soil and water and often detected on the mucous membranes of healthy persons. In recent years, there have been numerous reports of infections by M. gordonae in immunocompromised patients. In contrast, only four cases of skin infections by M. gordonae in immunocompetent patients have been published. We report on another patient without evidence of immunodeficiency who developed an atypical mycobacteriosis after a thorn injury during gardening. M. gordonae was isolated by tissue culture. The skin lesion cleared completely after treatment with doxycycline for three months.

Bacteriological Techniques↗
PubMed1996

Melanoma in situ versus melanocytic hyperplasia in sun-damaged skin. Assessment of the significance of histopathologic criteria for differential diagnosis.

For differentiation of melanoma in situ (MIS) from melanocytic hyperplasia (MH) in sun-damaged skin, several criteria have been proposed. To assess sensitivity and specificity of those criteria, we examined the epidermis adjacent to 50 consecutive basal cell carcinomas and 50 MISs in skin with significant solar elastosis. The most valuable criteria for the diagnosis of MIS, as opposed to MH, were presence of nests of melanocytes, irregular distribution of melanocytes, descent of melanocytes far down adnexal epithelial structures, irregular distribution of pigment, presence of melanocytes above the junction, a high number of melanocytes, pleomorphism of melanocytes, and atypical nuclei of melanocytes. Other criteria, e.g., collapse of cytoplasm around nuclei of melanocytes; flattening of rete ridges; differences in the area, shape, and contour of nuclei of melanocytes as assessed by nuclear morphometry; and presence of melanocytes stained by HMB-45 and Ki-67/MIB-1 monoclonal antibodies, were found to be of low or no value for differential diagnosis.

Antigens, Neoplasm↗
PubMed1996

[Differentiation of lupus erythematosus and lymphocytic infiltration].

Lymphocytic infiltration and lupus erythematosus have many features in common. The main distinguishing factor is the lack of epidermal involvement in lymphocytic infiltration, as compared to the frequent presence of epidermal changes in discoid lupus erythematosus. Other factors claimed to differentiate between both conditions are lack of antinuclear antibodies, negative immunofluorescence findings, and the more frequent presence of plasmacytoid monocytes in lymphocytic infiltration. To evaluate the significance of those findings, we studied cases of lymphocytic infiltration and lupus erythematosus with and without epidermal changes, using the same set of clinical, histopathological, and immunological criteria. No differences were found between lymphocytic infiltrates in cases with and without epidermal involvement. Based on those findings, lymphocytic infiltration seems to be a morphological variant of lupus erythematosus, rather than a distinct entity.

Diagnosis, Differential↗
PubMed1996

[Differential diagnosis of interface dermatitis].

Interface-dermatitis is defined as a type of cutaneous inflammation in which the dermo-epidermal junction is obscured. It is associated with vacuolar alteration at the dermo-epidermal junction, necrosis of individual keratinocytes, and melanophages in the papillary dermis. Differentiation between the large number of diseases characterized by an interface dermatitis can be accomplished by analysis of the density, localization, and composition of the infiltrate, number and localization of necrotic keratinocytes, and alterations of the epidermis (hyperplastic vs. atrophic). Several methods for a systematic approach to the diagnosis of interface dermatitides have been proposed; an own scheme combining different aspects of those methods is presented.

Dermatitis↗
PubMed1995

[Lichen amyloidosus--disease entity or the effect of scratching].

In current textbooks of dermatology, lichen amyloidosus is said to be a papular, intensely pruritic type of amyloidosis of unknown aetiology. When this concept was developed, there was no way of discriminating between the different types of amyloid. It is now known that amyloid in lichen amyloidosus is not derived from immunoglobulins or serum proteins, as it is in systemic amyloidoses, but from keratin peptides of necrotic keratinocytes. Even several years ago, chronic scratching was invoked as a possible cause of damage to keratinocytes in lichen amyloidosus. In support of this hypothesis, four cases are presented. Apart from amyloid in the papillary layer, all biopsy specimens revealed histopathological signs of chronic scratching (epithelial hyperplasia with hypergranulosis and compact orthokeratosis, coarse collagen in vertical streaks in the stratum papillare), such as are also found in prurigo nodularis and lichen simplex chronicus. Lichen amyloidosus is considered to be a variant of these conditions. Just as in prurigo nodularis and lichen simplex chronicus, pruritus seems to be the cause and not a symptom of the papular skin lesions. Consequently, treatment of lichen amyloidosus should not be directed at removing amyloid, but at improving the pruritus.

Aged↗
PubMed1993

Spiradenomas in Brooke-Spiegler syndrome.

Brooke-Spiegler syndrome is an autosomal dominantly inherited disease characterized by the development of multiple trichoepitheliomas and cylindromas. Among other neoplasms that may also occur in Brooke-Spiegler syndrome are basal cell carcinomas and spiradenomas. Spiradenomas and cylindromas have so many features in common that they have been regarded as variants of the same neoplasm. This assumption was supported by the occurrence of both types of lesions in Brooke-Spiegler syndrome. We report a case of Brooke-Spiegler syndrome in which spiradenomas were found in the immediate vicinity of trichoepitheliomas and in continuity with follicles. Because of the embryonic relationship between follicles and apocrine glands, these features indicate that spiradenomas are apocrine neoplasms. We conclude that Brooke-Spiegler syndrome is an inherited disease that affects the folliculosebaceous apocrine unit.

Adenoma, Sweat Gland↗
PubMed1993

[Multiple familial glomangioma].

Multiple familial glomangiomas are rare vascular tumours, which are inherited as an autosomal dominant trait. They usually arise at puberty or later, and may involve all parts of the skin. In contrast to solitary glomangiomas, they are not painful. Histopathologically, they are characterized by widely dilated vascular spaces, surrounded by only a few glomus cells. In a report on two patients, the clinical, histopathological and immunocytochemical features and the differential diagnosis of multiple familial glomangiomas are discussed.

Adult↗
PubMed1993

[Surgical treatment and regional chemotherapy in melanoma of the extremities].

Since 1979, our treatment protocol for extremity melanoma includes wide local excision, regional lymph node dissection and hyperthermic limb perfusion. We report on the results of a follow-up of the patients treated in the first decade (n = 451). According to the UICC Classification of 1987, 4% of our patients were in stage I, 36% in stage II, 50% in stage III and 9% in stage IV. The respective 5-year survival rates were 93%, 91%, 49%, and 20%. We conclude that regional chemotherapy appears to be beneficial even for stage II patients, as 5-year survival rates of more than 90% can be achieved.

Adolescent↗
PubMed1991

Immunocytochemistry of eruptive haemangiomas (pyogenic granulomas).

Eight eruptive haemangiomas (pyogenic granulomas) were stained immunocytochemically. Many of the cells reacted with markers for endothelial cells. The reactions with anti-vWF antibody were weaker than those with UEA-I-lectin and with the monoclonal antibody BMA 120. These results probably reflect reduced capability for storage of vWF by proliferating endothelial cells. Many cells were negative for endothelial-cell markers, and they reacted with a monoclonal antibody against muscle actin. These cells may be myofibroblasts and pericytes. The studies indicate that eruptive haemangiomas are composed of pericytes, myofibroblasts and endothelial cells.

Hemangioma↗
PubMed1990

[Satellite recurrence of eruptive angioma. A clinical, histologic and immunocytochemical study].

Some weeks after operative removal of an eruptive angioma, satellite angiomas may develop within and around the scar. During the further course they remit spontaneously. So far these recurrences have been observed almost exclusively on the trunk in children and young adults, especially in male patients. Four new cases are reported. The course is consistent with earlier observations. Histologically, the cell proliferations follow the ramifications of afferent arteries. In older satellites, there are focal changes of intravascular papillary endothelial hyperplasia. These are interpreted as regression phenomena. Immunocytochemically, desmin-negative cells positive for muscle-actin are found in addition to endothelial cells. They are considered to be pericytes and myofibroblasts. Because of the close relationship with the afferent arterioles, disturbances in the vascular system are thought to be responsible for the development of angioma. If such underlying vascular disorders are not corrected by primary excision, satellite recurrences may occur. Because of their tendency to spontaneous remission, active therapeutic measures are not recommended.

Actins↗