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  • 1
    Online Resource
    Online Resource
    Medical Photography: Documentation, Art, and the Expression of Human Emotions
    S. Karger AG ; 2016
    In:  Case Reports in Dermatology Vol. 8, No. 3 ( 2016-9-12), p. 227-238
    Details
    In: Case Reports in Dermatology, S. Karger AG, Vol. 8, No. 3 ( 2016-9-12), p. 227-238
    Abstract: Medical photography is the state of the art for the documentation of dermatological disease. Experienced photographers take pictures of the most typical skin lesions in order to assist the clinician in assessing disease morphology and activity. In this study, we present 6 individuals with a variety of dermatoses and the expression of the patients’ emotions. The patients were asked to show their diseased skin and to present typically involved areas in the respective disease. The feelings expressed by their body movements and positions are viewed and interpreted. The patients’ history will be reported retrospectively. The aim of the report is to show that the art of medical photography does not only document skin lesions but also the disease burden and the associated impairment of quality of life. Moreover, dermatologic photography is a sensitive intervention for patients viewed in the light of teaching and patient care.
    Type of Medium: Online Resource
    ISSN: 1662-6567
    URL: Article
    DOI: 10.1159/000449034
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2016
    detail.hit.zdb_id: 2505300-0
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  • 2
    Online Resource
    Online Resource
    Extravascular Necrotizing Granuloma Induced by Mineral Wool in Circumscribed Scleroderma Lesions
    S. Karger AG ; 2002
    In:  Exogenous Dermatology Vol. 1, No. 5 ( 2002), p. 253-259
    Details
    In: Exogenous Dermatology, S. Karger AG, Vol. 1, No. 5 ( 2002), p. 253-259
    Abstract: Cutaneous extravascular necrotizing (Churg-Strauss) granulomas have been described as a special tissue reaction pattern in patients with immunoreactive or infectious diseases. A patient with 〈 i 〉 Borrelia burgdorferi 〈 /i 〉 s.l., genospecies 〈 i 〉 Borrelia afzelii 〈 /i 〉 -induced circumscribed scleroderma developed symmetrical erythematous papules after exposure to mineral wool, a man-made silicon fibre. Histology of skin biopsies of papular skin lesions revealed vessel necrosis, eosinophilic collagen necrosis and extravascular palisading granulomas with high amounts of eosinophils. Amorphous vitreous particles, 1–10 µm in size and identical to agar-embedded mineral wool, were detected within necrotizing palisading granulomas by polarized light. Transmission electron microscopy and X-ray microanalysis revealed electron-dense particles showing spectra of silicates and silica consistent with mineral wool. The observation that exposure to mineral wool can induce Churg-Strauss-like granulomas in the skin of predisposed individuals can serve as a model for the pathogenesis of allergic granulomatosis.
    Type of Medium: Online Resource
    ISSN: 1424-4616 , 1424-4624
    URL: Article
    DOI: 10.1159/000068800
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2002
    detail.hit.zdb_id: 2061890-6
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  • 3
    Online Resource
    Online Resource
    Adrenal Insufficiency as a Result of Long-Term Misuse of Topical Corticosteroids
    S. Karger AG ; 2014
    In:  Dermatology Vol. 228, No. 4 ( 2014), p. 289-293
    Details
    In: Dermatology, S. Karger AG, Vol. 228, No. 4 ( 2014), p. 289-293
    Abstract: The treatment of chronic inflammatory skin disease is associated with the use of topical corticosteroids. Their efficacy, tolerability and adverse effects depend on several factors, specifically potency, type of preparation, extemporaneous dilutions, quantity used, magnitude of the treated body surface, frequency of application, location, patient age, method of application and condition of the skin barrier. We report on two men suffering from chronic inflammatory skin disease, who presented with fatigue and cushingoid appearance after prolonged self-application of potent corticosteroids. Impairment of the skin barrier due to their underlying skin disease, frequent self-application of topical steroids and repeated application of the entire body led to extensive absorption of these substances, eventually culminating in the suppression of the pituitary-hypothalamic-adrenal axis. In conclusion, topical corticosteroids are effective and well-established therapeutic modalities. However, inappropriate use of topical corticosteroids can cause side effects.
    Type of Medium: Online Resource
    ISSN: 1018-8665 , 1421-9832
    URL: Article
    DOI: 10.1159/000358427
    RVK:
    XA 37700
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1482189-8
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  • 4
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    Online Resource
    Asymptomatic Sensitization to Hymenoptera Venom Is Related to Total Immunoglobulin E Levels
    S. Karger AG ; 2009
    In:  International Archives of Allergy and Immunology Vol. 148, No. 3 ( 2009), p. 261-264
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 148, No. 3 ( 2009), p. 261-264
    Abstract: 〈 i 〉 Background: 〈 /i 〉 The detection of specific serum immunoglobulin E (sIgE) to Hymenoptera venoms is an established diagnostic tool to diagnose insect venom hypersensitivity. However, the specificity of sIgE detection is a debated issue. 〈 i 〉 Methods: 〈 /i 〉 In 145 subjects, total IgE (tIgE) and sIgE to Hymenoptera venoms as well as sIgE to rapeseed as a marker of cross-reactive carbohydrate determinants were measured. In addition, an atopy score was determined for each patient. We looked for a possible association between tIgE and the presence of sIgE in subjects with a negative history of large local or systemic reactions to insect stings. 〈 i 〉 Results: 〈 /i 〉 Fifteen of 65 subjects (23.1%) with low levels of tIgE ( 〈 50 kU/l) had sIgE for bee or wasp venom, and 23 of 47 subjects (48.9%) with a tIgE from 50 to 250 kU/l showed sIgE. The highest rate of asymptomatic sensitization (22 of 33; 66.7%) was found in patients with tIgE levels higher than 250 kU/l. Median sIgE was approximately 4.8 times higher in subjects with tIgE levels above 250 kU/l than in those with tIgE levels 〈 50 kU/l. Interestingly, a significant difference in median tIgE was recorded between individuals with and without sIgE to rapeseed [776.5 kU/l (25, 75% percentiles: 252.5, 2,000.0) vs. 50.5 kU/l (20.1, 172.0), respectively; p 〈 0001]. 〈 i 〉 Conclusion: 〈 /i 〉 Specific antibodies are frequently seen in individuals with high tIgE, but appear to be largely irrelevant in clinical terms. This might lead to misdiagnosis in persons with an inconclusive sting history.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000161586
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482722-0
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  • 5
    Online Resource
    Online Resource
    Bees and Wasps May Be Dangerous, but Who Is at Risk?
    S. Karger AG ; 2010
    In:  International Archives of Allergy and Immunology Vol. 153, No. 2 ( 2010), p. 107-108
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 153, No. 2 ( 2010), p. 107-108
    Type of Medium: Online Resource
    ISSN: 1423-0097 , 1018-2438
    URL: Article
    DOI: 10.1159/000312627
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2010
    detail.hit.zdb_id: 1482722-0
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  • 6
    Online Resource
    Online Resource
    Erysipelas of the Thigh and the Gluteal Region: Retrospective Multicenter Analysis of a Very Rare Entity in 39 Patients
    S. Karger AG ; 2012
    In:  Dermatology Vol. 225, No. 3 ( 2012), p. 277-283
    Details
    In: Dermatology, S. Karger AG, Vol. 225, No. 3 ( 2012), p. 277-283
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Erysipelas of the thigh and the gluteal region are rarely described and not well characterized. Therefore we aim to describe the prevalence, clinical characteristics, and risk factors of these erysipelas types. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The files of 1,423 patients with erysipelas were analyzed. Data from patients with erysipelas of the thigh or the gluteal region were compared between the two groups and with a control group with erysipelas of the lower leg. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The thigh was exclusively affected in 2.1%, and the gluteal region in 0.6% of erysipelas patients. Gluteal erysipelas had conspicuous irregular borders and sometimes appeared bilaterally. Major risk factors for erysipelas of both sites were previous surgical interventions. Gluteal erysipelas was common in patients with the metabolic syndrome and required a more intense antibiotic therapy. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Erysipelas of the thigh and the gluteal region are rare and significantly associated with prior surgical disruption of lymphatic vessels.
    Type of Medium: Online Resource
    ISSN: 1018-8665 , 1421-9832
    URL: Article
    DOI: 10.1159/000345619
    RVK:
    XA 37700
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2012
    detail.hit.zdb_id: 1482189-8
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  • 7
    Online Resource
    Online Resource
    Acne excoriata – Look for Allergy!
    S. Karger AG ; 2001
    In:  Dermatology Vol. 203, No. 3 ( 2001), p. 256-257
    Details
    In: Dermatology, S. Karger AG, Vol. 203, No. 3 ( 2001), p. 256-257
    Abstract: Acne excoriata (AE) is a frequent variant of self-inflicted skin conditions, which occurs predominantly in females. The condition seems to be almost always found in persons with psychological problems. Therapeutic approaches are often unsatisfying since this special group of patients typically does not recover with dermatological treatment. We report a 37-year-old female patient who had suffered for 5 years from AE. Exact history taking revealed that her manipulations were correlated with episodes of contact with bird products like feathers and eggs. The diagnosis of a bird egg syndrome could be proved by skin prick tests (ALK Abello, Denmark) as well as laboratory results (CAP FEIA, Pharmacia, Sweden), and consequent avoidance of handling bird products was the only but effective therapeutic measurement. In patients with suspected artefactual diseases, we strongly recommend to listen to the patients’ complaints in order to make the correct diagnosis and not to overlook a potential stimulus.
    Type of Medium: Online Resource
    ISSN: 1018-8665 , 1421-9832
    URL: Article
    DOI: 10.1159/000051760
    RVK:
    XA 37700
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2001
    detail.hit.zdb_id: 1482189-8
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  • 8
    Online Resource
    Online Resource
    Evaluation of a Self-Test Device Used in Allergic Contact Dermatitis
    S. Karger AG ; 2015
    In:  Skin Pharmacology and Physiology Vol. 28, No. 5 ( 2015), p. 257-263
    Details
    In: Skin Pharmacology and Physiology, S. Karger AG, Vol. 28, No. 5 ( 2015), p. 257-263
    Abstract: Considering the scarcity of dermatologic resources in many parts of the world, self-testing by patients is not only of interest for internal medicine but also for dermatology. In this open, nonrandomized, multicenter diagnostic trial involving subjects with suspected contact sensitization to nickel and/or a fragrance mix, we assessed the agreement of self-testing by subjects with readings made by dermatologists. The self-test product (Nixema 〈 sup 〉 TM 〈 /sup 〉 ) is based on Thin-Layer Rapid Use Epicutaneous Test (TRUE Test®) technology. One hundred and sixty-five subjects self-tested the ready-made patch-test product. The test was applied for 48 h and then read after 3 or 4 days. It was also evaluated independently by experienced dermatologists after 3 or 4 days. In the 162 evaluable subjects, the proportion of agreement for both allergens together was 89.5% [95% confidence interval (CI) 83.7-93.8], the sensitivity was 97.5 % (95% CI 86.8-99.9) and the specificity was 86.9% (95% CI 79.6-92.3). Cohen's kappa was also high at 0.749 (95% CI 0.637-0.862). Discrepancies between the subjects' readings and the dermatologists' readings were mainly due to the subjects interpreting reactions of ‘irritant' or ‘doubtful' as ‘positive'. Apart from itching and burning sensations and tape irritation, no side effects were observed. In conclusion, this study showed a high rate of agreement between the self-reading of the upper arm and the readings made by the dermatologists. The upper arm proved to be an appropriate area for self-testing. Self-testing may improve the screening for contact sensitization for patients, particularly where dermatologic health resources are scarce.
    Type of Medium: Online Resource
    ISSN: 1660-5527 , 1660-5535
    URL: Article
    DOI: 10.1159/000437017
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1483572-1
    SSG: 15,3
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  • 9
    Online Resource
    Online Resource
    Hymenoptera Venom Allergy: Time Course of Specific IgE Concentrations during the First Weeks after a Sting
    S. Karger AG ; 1999
    In:  International Archives of Allergy and Immunology Vol. 120, No. 2 ( 1999), p. 166-168
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 120, No. 2 ( 1999), p. 166-168
    Abstract: Detection of IgE antibodies specific to honeybee or Vespula venoms is an important criterium firstly for the diagnosis of sensitization and secondly for the indication for a specific immunotherapy. Some authors recommend to postpone blood analysis after an insect sting for a certain time because circulating IgE antibodies might be consumed by the allergic reaction, which would result in a false–negative test outcome. We investigated IgE concentrations during the first weeks after an insect sting in 31 patients with an unequivocal history of an anaphylactic reaction after a honeybee (n = 13) or Vespula (n = 18) sting. Blood samples for analysis of specific IgE concentrations (CAP system, Pharmacia Diagnostics, Sweden) were collected within 2 weeks and 5±2 weeks after the insect sting. 12/13 patients with honeybee venom and 14/18 patients with Vespula venom sensitization had CAP classes 1 or higher within the first 2 weeks. Those 5 patients with CAP class 0 within the first 2 weeks had detectable IgE concentrations a few weeks later. We conclude that testing for specific IgE to hymenoptera venoms is in most cases useful even during the first 2 weeks after the hymenoptera sting. This allows early decisions on further diagnostic procedures and the therapeutic way to choose. Patients with no detectable IgE should, however, be retested after a few weeks.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000024235
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1999
    detail.hit.zdb_id: 1482722-0
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  • 10
    Online Resource
    Online Resource
    Treatment of HAE Attacks in the Icatibant Outcome Survey: An Analysis of Icatibant Self-Administration versus Administration by Health Care Professionals
    S. Karger AG ; 2015
    In:  International Archives of Allergy and Immunology Vol. 167, No. 1 ( 2015), p. 21-28
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 167, No. 1 ( 2015), p. 21-28
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Icatibant, a selective bradykinin B2 receptor antagonist for the treatment of acute hereditary angio-oedema (HAE) attacks in adults, can be administered by health care professionals (HCPs) or self-administered. This analysis compared characteristics and outcomes of acute HAE attacks treated with self-administered and HCP-administered icatibant in a real-world setting. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The Icatibant Outcome Survey (Shire, Zug, Switzerland; NCT01034969) is an international observational study monitoring the safety and effectiveness of icatibant treatment. Descriptive retrospective analyses were performed (February 2008 to December 2012). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Icatibant was used in 652 attacks in 170 patients with HAE type I/II. Most icatibant injections were self-administered (431/652, 68.5%). The proportion of self-treated attacks increased over time (40.3% in 2009 vs. 89.7% in 2012). The median time to administration was significantly shorter in self- versus HCP-treated attacks (1.5 vs. 2.4 h; p = 0.016). Earlier treatment ( 〈 2 h after onset) was significantly associated with a shorter median time to resolution (2.5 vs. 5.0 h; p = 0.032) and attack duration (3.0 vs. 14.0 h; p 〈 0.0001), regardless of administration method. Patients self-administered icatibant for attacks of all severities; overall, 34.7% of severe and 30.2% of very severe attacks were HCP treated. Logistic regression analysis did not find use of long-term prophylaxis, attack location or gender to be predictive for self-administration. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 The proportion of HAE attacks treated with self-administered icatibant increased over time. Patients successfully self-administered icatibant for a wide variety of HAE attacks, demonstrating that icatibant is generally well tolerated and effective for self-administration. Self-administration of icatibant provides a complementary option to HCP administration, enabling optimization of patient care.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000430864
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1482722-0
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