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PubMed2000

Predictors of the use of sunscreen in dermatological patients in Central Europe.

BACKGROUND: There is mounting evidence that sun exposure is a cause of skin cancer. Therefore, the focus of skin cancer prevention is on sun protection. The present study investigated the use of sunscreens in a sample from the adult Central European population. METHODS: As part of a case-control study of cutaneous melanoma, a total of 498 controls with classical dermatological disorders were selected from hospitals in Central Europe. All people underwent whole-body skin examinations and were interviewed using a standardized questionnaire. RESULTS: Overall, 40.8% of the people never used sunscreen and of the 281 persons who used sunscreen, 41.5% applied it only once per sun bath. Persons who did not use sunscreen tended to be older (P<0.0001) and of male gender (P = 0.0004). Young people, women, and people who expressed a positive attitude to the sun spent more time in the sun and were more likely to apply sunscreens. People who worked almost always outdoors had a six times increased odds ratio of not using sunscreens (P<0.0001) compared to people who worked always indoors. CONCLUSIONS: Men, older people, and outdoor workers should be targeted in health education campaigns. On the other hand, people who apply sunscreen as a means of sun protection should be advised about adequate usage.

Adult↗
PubMed1993

Methodological aspects on immunohistochemistry in dermatology with special reference to neuronal markers.

In an attempt to optimize the immunohistochemical procedure for visualizing neuronal markers, such as neuropeptides, in the human skin, different alternatives in all steps of the process were compared. We have studied the influence of type of immunohistochemical method, the biopsy technique, including the size of the punch biopsy, anaesthesia, the choice of fixative and the time of fixation, the storage process, the sectioning parameters, incubation procedure, the type of fluorophore-conjugated antibody and its dilution, mounting and storage, and, finally, microscopical examination. The following procedure was found to give the best result: punch biopsies of 3 mm, taken under local anaesthesia using lidocaine injected into the dermis-subcutis at the place of biopsy; fixation by a buffered 10% formalin solution containing 14% of saturated picric acid for 2 h at 4 degrees C; storage in 10% sucrose buffer for at least 24 h up to 1 month at 4 degrees C or deep-frozen to -70 degrees C for 2 months (with only a minor structural deterioration); cryostat sectioning of the biopsies with a section thickness of 14 microns and with the cutting edge perpendicular to the skin surface; rhodamine (TRITC)-conjugated, instead of fluorescein-isothiocyanate (FITC)-conjugated, secondary antiserum, since it gives a lower background fluorescence; and for the incubation and mounting procedures, our standard laboratory routines were applied. The result is an optimal indirect immunofluorescence technique, to be applied in dermatology. We also found that biopsies taken under local anaesthesia with chloroethyl spray lost almost all immunofluorescence for several neuronal markers in the epidermis-upper dermis.

Anesthesia, Local↗
PubMed1981

Arotinoids. A new class of retinoids with activities in oncology and dermatology.

Arotinoids are a new class of retinoids with particular biological properties. Arotinoid Ro 13-6298 in minute quantities leads to regression of chemically induced papillomas of the skin of mice. The ratio between the antipapilloma effect and the toxic syndrome of hypervitaminosis A is very favorable. Ro 13-6298 also has a therapeutic influence on chemically induced skin carcinomas in mice. As the papilloma model has proved to be suitable for screening for antipsoriatic and antikeratinizing properties as well as for antineoplastic screening, arotinoids might be useful in human clinical dermatology and oncology.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1982

Dermatologic radiotherapy and breast cancer. Dose measurements and risk quantification.

This study was set up to provide quantitative data to evaluate unsubstantiated claims that improper dermatologic radiation techniques may cause breast cancer. A thin mylar window ionization rate meter placed at the location of the right breast of an Alderson-RANDO anthropomorphic phantom was used to measure direct and scatter radiation reaching the female breast during radiotherapy of the facial region (as given for acne). The results indicate that scatter doses are very small; they are influenced by radiation quality and the use or nonuse of a treatment cone. Quantitative risk estimates show that the very small risk of breast cancer induction can be reduced even further by the use of proper radiation protection measures.

Acne Vulgaris↗
PubMed1999

The Swiss Network of Dermatology Policlinics HIV prevalence study: rationale, characteristics and results (1990-1996).

The Swiss Network of Dermatology Policlinics (SNDP) has monitored the prevalence of HIV among patients treated for a sexually transmitted disease (STD) since January 1990. A questionnaire was sent to each policlinic in the network (Basel, Bern, Geneva, Lausanne, and two in Zurich) to collect information on their participation in this study and the characteristics of the network. The responses reveal that the six policlinics followed the HIV prevalence study protocol in a uniform manner and had similar logistical and organisational characteristics HIV prevalences in this population were high (1.6% among heterosexuals, 24.0% among male homo/bisexuals, and 35.7% among injecting drug users), have remained stable, and vary considerably by policlinic. In conclusion, we found that the policlinics have correctly implemented the HIV prevalence study and that the SNDP is a homogeneous sentinel surveillance system. Knowledge of the organisation and characteristics of the SNDP has allowed us to better interpret and present our data, and we recommend that other sentinel surveillance systems of this type collect this sort of information.

Ambulatory Care Facilities↗
PubMed1979

[Cefaclor in dermatological therapy (author's transl)].

Thirty patients suffering from bacteriogenic skin diseases were given cefaclor, in most cases simultaneously with classical external dermatological therapy. The results of therapy were satisfactory in 29 of the 30 patients. Only in one relatively severe case of erysipelas did the disease continue to spread despite the daily doses of 3 x 500 mg of oral cefaclor prescribed by the dosage regimen. Side-effects observed consisted of diarrhoea in one patient, and a transient slight increase of SGOT or alkaline phosphatase in another six patients.

Alkaline Phosphatase↗
PubMed1983

Clinical and dermatologic aspects of the hereditary intestinal polyposes.

Distinctive cutaneous lesions frequently accompany and occasionally precede the intestinal lesions in Gardner's syndrome, Peutz-Jeghers syndrome, and Muir's syndrome. Awareness of the dermatologic manifestations of these entities may facilitate early diagnosis in these potentially life-threatening hereditary disorders.

Adenoma↗
PubMed2001

The morbid anatomy of the dermatologic genome: an update for the third millennium.

BACKGROUND: Much progress has been made in recent years in the identification of genes underlying many hereditary skin diseases. OBJECTIVE: To provide an update on the status of the identification of genes involved in hereditary skin disorders and to compare the current standing with that in the last decade. METHODS: A review of the literature is presented here in a series of lists describing the chromosomal location, specific gene, clinical relevance, and availability of molecular-based genetic tests for each genodermatosis. RESULTS: Progress has been made in identifying the genes underlying many disorders of cornification, genodermatoses with malignant potential, bullous disorders, pigmentary disorders, disorders affecting the epidermal appendages and the dermis, and other miscellaneous genodermatoses. CONCLUSION: The great progress made toward the completion of the human gene sequence and the continued efforts of many clinical and molecular scientists to identify disease genes will make diagnosis of hereditary dermatological disorders more precise and allow accurate family counseling as well as possibly leading to more targeted therapies during this millennium.

Cell Transformation, Neoplastic↗
PubMed2001

[Factitious disorders. Hematologic, neurologic and dermatologic symptoms in a physician with factitious disorder].

HISTORY AND FINDINGS: A 38-year-old female physician was admitted with the suspected diagnosis of a myelodysplastic syndrome. The self-reported history was inconsistent and incoherent. On physical examination neurological and dermatological disorders could be found. EXAMINATIONS: A bone marrow puncture revealed a toxicity-induced bone marrow damage. Extensive examinations to evaluate the neurological symptoms did not show any pathological findings. A toxicological screening identified opioids, benzodiazepines and promethazine. TREATMENT AND COURSE: Because of the inconsistent history and the contradictory results of our clinical tests, we asked in other hospitals for past admissions and were thus able to have insight into a hospital career that grasped numerous different admission diagnoses. All presented symptoms, especially the bone marrow damage, were self-induced by the patient. CONCLUSIONS: For the first time in this patient's history, a factitious disorder was diagnosed after a hospital career of almost 10 years. In this publication, the case is thoroughly presented. Additionally, the current literature is reviewed with latest recommendations for therapeutic strategies about this poorly understood disorder.

Adult↗
PubMed1994

[Self-help groups in dermatology].

In Western Germany there are at least 2000 self-help groups concerned with dermatological conditions. Besides therapeutic functions, self-help groups deal with prophylaxis and public relations. Interaction between self-help groups and doctors is biased by expectations of support on the self-help groups' side and fears and prejudices on the doctors' side. Thus, for the benefit of their own patients doctors should be well informed about self-help groups working in their region, as the quality of help received from these groups varies widely. In this paper we have listed super-regional contact addresses of self-help groups.

Adaptation, Psychological↗
PubMed1994

[Carboxyhemoglobinemia caused by dichloromethane exposure with dermatologic effects].

In seven winter seasons a young watchmaker was severely disabled by the development of swelling and reddening of the skin, blistering and paraesthesiae affecting his hands. Hospital examination led to a diagnosis of "Raynaud syndrome of undetermined origin". Treatment with corticosteroids was unsuccessful. Not until the young man changed his job did the disorder disappear for good. Investigations at his place of work revealed that the man had inhaled dichloromethane fumes (methylenchloride; CH2Cl2) while cleaning watch parts in a small room that was not ventilated during the winter months. This led to endogenous carboxyneogenesis and subsequently to chronically recurring carboxyhaemoglobinaemia (13%, 10% and 10.7% COHb in three different blood samples). The significance of dichloromethane-induced CO poisoning in the development of dermatological changes is still the subject of controversial discussion.

Adult↗
PubMed2002

[CO(2) and Er:YAG lasers in dermatology and aesthetic surgery].

In the past few years, the spectrum of indications for ablative lasers in dermatology and aesthetic medicine has been expanded due to technological innovations. In the following, technical basics, laser-tissue interactions, indications for the CO(2) and Er:YAG laser and laser treatment management are described. In addition, side effects and reactions associated with the use of these laser systems are listed and compared.

Humans↗
PubMed2002

[Significance of immunologic tolerance in dermatology].

The immunological tolerance processes enable the organism to distinguish between self and non-self and are, therefore, critical for an efficient immune system. Exogenous or endogenous factors that disturb tolerance mechanisms induce uncontrolled activation of the immune system and the development of autoimmune diseases. In the field of dermatology, the most relevant autoimmune diseases are connective tissue diseases and autoimmune bullous skin disorders. In contrast, increased activity of tolerance shuts down parts of the normal immune response and thus facilitates the development of neoplasia and microbial infections in the skin and other organs. Immunological mechanisms for the induction of tolerance have been studied with the help of experimental models of tolerance to contact allergens. T- and B-cells, as well as antigen presenting cells, in particular dendritic cells, are involved in the immunological mechanisms of tolerance. The modification of autologous immune cells of patients with malignant tumors, allergic and autoimmune diseases might have potential for the development of new therapies.

Animals↗
PubMed2002

[Triclosan, a topical dermatologic agent. In vitro- and in vivo studies on the effectiveness of a new preparation in the New German Formulary].

BACKGROUND AND OBJECTIVE: Triclosan (2,4,4'-trichloro-2'-hydroxydiphenyl ether) is an antiseptic suitable for formulation as a W/O emulsion. The objective of the present study was to explore its potential utility in atopic dermatitis and prophylactic skin care following leg eczema and leg ulcer treatment. SUBJECTS AND METHODS: We performed in vitro susceptibility testing using the agar diffusion test on 602 isolates from swabs of our institution's Division of Dermatology. Additionally in an in vivo study with 15 healthy volunteers, the occlusion test and the expanded flora test were performed following the application of Hydrophobic Triclosan Cream 2% NRF (New German Formulary) 11.122. (TC) versus untreated, triclosan-free vehicle, 1% chlorhexidine digluconate solution, and ethanol 70%. RESULTS: In vitro susceptibility testing showed excellent activity against Staphylococcus aureus, Klebsiella species, and Proteus species. TC had little or no effect on Pseudomonas, beta-hemolytic streptococci, enterococci, and Candida species. In the in vivo study, TC produced a highly significant, quantitatively substantial reduction in aerobic bacterial counts versus untreated and versus vehicle. The 1% chlorhexidine digluconate solution was significantly more effective than TC in the expanded flora test. CONCLUSIONS: As S. aureus is a relevant pathogen in atopic dermatitis, and gram-negative organisms, including Klebsiella and Proteus species, as well as S. aureus play a major role in the prophylactic skin care after leg eczema and leg ulcer treatment, TC appears to be suitable for maintenance therapy in these indications.

Administration, Topical↗
PubMed2003

[Medical dermatologic laser therapy. A review].

The medical indications for laser therapy have been somewhat overlooked, perhaps because of the success of cosmetic laser therapy. As a result, many effective medical treatments are not covered by insurance companies. Lasers are helpful in many aspects of dermatologic treatment. Examples include pigmented lesions (Becker nevus), benign tumors (organoid nevi, adenoma sebaceum), dyschromias (traumatic tattoos), inflammatory diseases of the skin and subcutaneous tissue (lupus erythematosus, scars), hypertrichosis, premalignant lesions, and vascular lesions (hemangiomas and malformations). The various disorders which can effectively be treated with lasers are reviewed.

Adenoma↗
PubMed2004

[The excimer laser in dermatology and esthetic medicine].

First reports about the use of the excimer laser in dermatology date back to 1997. It is seen as an improvement on conventional phototherapy and photochemotherapy because of the lower cumulative UV-dose involved, the shorter time frame required for treatment and the option of targeting individual lesions without affecting the surrounding healthy skin. In addition to the indications of psoriasis vulgaris, vitiligo and atopic eczema (for which there is now FDA approval in the US), the spectrum of possible uses for the excimer laser is growing rapidly, especially in the field of light-sensitive dermatoses. Case studies so far have ranged from post-operative hypopigmentation to acne vulgaris and from alopecia areata to parapsoriasis en plaque. The foremost priorities in the future will be to evaluate reproducible therapeutic regimens with realistic prospects of success in large-scale studies; assess potential iatrogenic risks in treatment; develop pathogenetic models for the mechanism of action; and define therapeutic approaches to new indications. This paper summarizes the publications to date and discusses our observations and experiences.

Acne Vulgaris↗
PubMed2006

[Generalized purpura as dermatologic manifestation of thrombcytopenia].

A 72-year old patient was initially misdiagnosed with allergic vasculitis. He rapidly developed petechiae and mucosal bleeding. There were no other abnormal physical findings and the patient was otherwise in good physical condition. There was no history of trauma or infectious disease. The patient's complete blood count showed a marked thrombocytopenia of 2000/nl. A bone marrow biopsy confirmed the initial diagnosis of idiopathic thrombocytopenic purpura (ITP). The number of thrombocytes increased and the skin lesions resolved shortly after the patient was put on oral prednisone. This case emphasizes the importance of dermatologic symptoms in diagnosing severe systemic disease.

Aged↗
PubMed2006

[Vascular emergencies in dermatology].

Life-threatening vascular complications of the skin are rare and usually reflect underlying systemic diseases. Lesions are sudden in onset, become necrotic and may be severe or life-threatening. Effective management requires an understanding of the underlying medical condition, such as arterial thrombosis, temporal arteritis, calciphylaxis and purpura fulminans. In contrast, the acute painful symptoms of erythromelalgia often lead to an urgent dermatologic consultation but pose no acute risk.

Acute Disease↗