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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Hautarzt 45 (1994), S. 827-833 
    ISSN: 1432-1173
    Keywords: Schlüsselwörter: Autoimmunität – Desmoplakine – Desmosomen – Immunfluoreszenz – Paraneoplastische Syndrome – Pemphigus ; Key words: Autoimmunity – Desmoplakins – Desmosomes – Immunofluorescence – Paraneoplastic syndrome – Pemphigus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract. Paraneoplastic pemphigus (PP) is a newly reported autoimmune disease, which is always associated with an underlying neoplasia. It is characterized by painful mucosal erosions and ulcerations, and by polymorphous skin lesions reminescent of erythema multiforme, pemphigus vulgaris and lichen planus pemphigoides. These patients have autoantibodies that bind to a distinct complex of epidermal proteins, including desmoplakin I (250 kD), major bullous pemphigoid antigen (230 kD), desmoplakin II (210 kD) and a 190-kD and a 170-kD protein, neither of which has yet been further characterized. Histological findings include acantholysis, epidermal cell necrosis, vacuolar interface changes and, sometimes, lichenoid infiltrates of the upper dermis. Direct immunofluorescence shows an intercellular deposition of immunoreactants in the epidermis and granular deposits at the dermal-epidermal junction. Indirect immunofluorescence with rodent bladder as substrate shows an intercellular pattern. This method is the most convenient and cost-effective method of screening for PP, since antigens of both pemphigus vulgaris and pemphigus foliaceus are not expressed in this tissue.
    Notes: Zusammenfassung. Der paraneoplastische Pemphigus (PP) ist eine neue Autoimmundermatose, die obligat mit einem Tumor assoziiert ist. Klinisch kommt es zu schmerzhaften Erosionen der Konjunktival- und Mundschleimhaut unter Einbeziehung der Lippen. An der Haut finden sich polymorphe Veränderungen, die an ein Erythema exsudativum multiforme (EEM), einen Pemphigus vulgaris und bei manchen Patienten auch an einen Lichen planus pemphigoides erinnern. Die Seren der Patienten weisen Autoantikörper auf, die in der Immunpräzipitation von Keratinozytenextrakten an einen distinkten Proteinkomplex binden. Dieser besteht aus Desmoplakin I (250 kD), dem bullösen Pemphigoid-Hauptantigen (230 kD), Desmoplakin II (210 kD), sowie einem 190- und 170-kD-Protein, die bislang noch nicht näher charakterisiert wurden. Histologisch finden sich Akantholyse, Einzelnekrosen, vakuolige Basalzelldegenerationen und in manchen Präparaten lichenoide Infiltrate im oberen Korium. In der direkten Immunfluoreszenz sieht man interzelluläre epidermale Ablagerungen und granuläre Ablagerungen an der Basalmembran. Verwendet man Harnblase von Nagetieren als Substrat für die indirekte Immunfluoreszenz, erkennt man interzelluläre IgG-Ablagerungen. Anders als der Antigenkomplex des PP werden die Antigene des Pemphigus vulgaris und des Pemphigus foliaceus in Harnblasenepithel nicht exprimiert. Dies ist daher die einfachste und kostengünstigste Untersuchungsmethode zur Diagnose eines PP.
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  • 2
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Malignes Melanom ; Epidemiologische Entwicklungen ; Aktuelle Therapie ; Key words Malignant melanoma ; Epidemiological trends ; Present therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The Central Malignant Melanoma Registry of the German Dermatological Society was founded in 1983 and has meanwhile developed into a major continuously updated multicentre project. Up to June 1994, 19250 reports of cutaneous melanoma had been received, from 41 departments of dermatology in the former Federal Republic of Germany, from 14 departments in the former German Democratic Republic, from 2 departments in Austria, and from 1 department in Switzerland. Analysis of the data revealed some epidemiological trends over time during the years 1983 to 1993. (1) During the last 10 years the percentage of male patients has steadily increased, from an average of 38% in the year 1983 to 46% in 1993. (2) Early diagnosis of malignant melanoma improved during the period of time investigated. The percentage of diagnoses of primary tumour alone increased between 1983 and 1993. The mean tumour thickness (Breslow) decreased in the West Germany from 1.8 mm to 1.3 mm and in East Germany from 2.5 mm to 1.7 mm. The proportion of nodular melanoma decreased correspondingly from 29% to 14% in the former Federal Republic of Germany and from 40.6% to 22.6% in the former Germany Democratic Republic. During the years 1990 and 1993, 64% of melanoma patients with the primary tumour alone were operated on in two consecutive sessions in the former Federal Republic of Germany and 34.2% of those in the former Germany Democratic Republic. During this period 73.7% of all melanoma patients were operated on under local anaesthesia. In recent years surgical operations were more often performed in two consecutive sessions, mostly under local anaesthesia and with decreasing safety margins, in keeping with the decrease in tumour thickness. The present analysis shows that the Central Malignant Melanoma Registry is an important instrument for investigating trends in clinical epidemiology and treatment of malignant melanoma in the German-speaking countries.
    Notes: Zusammenfassung Das Zentralregister Malignes Melanom der Deutschen Dermatologischen Gesellschaft hat seine Arbeit 1983 aufgenommen und sich seitdem zu einem kontinuierlich fortgeführten multizentrischen Projekt entwickelt. Insgesamt wurden bis Juni 1994 die Daten von 19.250 Patienten aus 41 Kliniken der alten Bundesländer, 14 Kliniken der neuen Bundesländer, zwei Kliniken aus Österreich und einer Klinik aus der Schweiz gemeldet. Die Auswertung der Daten läßt mehrere epidemiologische Trends im Zeitraum von 1983–1993 erkennen. a) Es fand sich eine kontinuierliche Zunahme des Anteils der Männer an den Melanom-Patienten, der im Mittel von 38% im Jahre 1983 auf 46% im Jahre 1993 anstieg. b) Die Früherkennung maligner Melanome wurde im untersuchten Zeitraum verbessert. Die Diagnosen im Stadium des Primärtumors stiegen im untersuchten Zeitraum an. Die mittlere Tumordicke nach Breslow nahm in den alten Bundesländern von 1,8 mm auf 1,3 mm und in den neuen Bundesländern von 2,5 mm auf 1,7 mm ab. Entsprechend verringerte sich der Anteil nodulärer Melanome in den alten Bundesländern im Mittel von 29,3% auf 14,1% und in den neuen Bundesländern von 40,6% auf 22,6%. In den Jahren 1990–1993 wurden in den alten Bundesländern 64% und in den neuen Bundesländern 34,2% aller primären malignen Melanome zweizeitig operiert. Insgesamt wurden 73,7% der Patienten in Lokalanästhesie operiert. In den letzten Jahren wurde vermehrt in Lokalanästhesie und zweizeitig operiert, wobei entsprechend der Abnahme der Tumordicke die endgültige Versorgung häufiger mit kleinerem Sicherheitsabstand erfolgte. Die vorliegende Analyse zeigt, daß das Zentralregister Malignes Melanom ein wichtiges Instrument zur Untersuchung von Entwicklungen der klinischen Epidemiologie und der Therapie des malignen Melanoms im deutschsprachigen Raum ist.
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  • 3
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Mikrozystisches Adnexkarzinom ; Sklerosierendes Schweißdrüsengangkarzinom ; Mikrographische Chirurgie ; Histogenese ; Differentialdiagnose ; Key words Microcystic adnexal carcinoma ; Sclerosing sweat duct carcinoma ; Micrographic surgery ; Histogenesis ; Differential diagnosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Microcystic adnexal carcinoma is a rare semimalignant cutaneous neoplasm characterised by slow but locally aggressive growth. Its histogenesis and nomenclature are still a subject of controversy. Under-recognition and the tumour's bland cytologic features lead to frequent misdiagnoses. In addition, subclinical tumour invasion explains the high incidence of local recurrence. Thus, the tumour makes great demands on the planning of its surgical removal. We report the case of an 81-year-old woman with a microcystic adnexal carcinoma of the lower lip, which was treated by micrographic surgery. On the basis of this case, differential diagnoses, histogenesis and micrographic surgery as the treatment of choice are discussed.
    Notes: Zusammenfassung Das mikrozystische Adnexkarzinom ist ein seltener semimaligner Hauttumor, der sich durch langsames, aber lokal aggressives Wachstum auszeichnet. Histogenese und Nomenklatur werden noch immer kontrovers diskutiert. Der niedrige Bekanntheitsgrad und das benigne anmutende zytologische Bild führen zu häufigen Fehldiagnosen. Dies wie auch die schwere Abgrenzbarkeit erklären die hohe Rezidivneigung des Tumors, der daher besondere Anforderungen an die Operationsplanung stellt. Wir berichten über eine 81jährige Patientin mit einem mikrozystischen Adnexkarzinom an der Unterlippe, welches aufgrund seiner Lokalisation in intraoperativer mikrographischer Chirurgie entfernt wurde. Anhand des Fallberichtes werden Differentialdiagnosen, Histogenese und die mikrographische Chirurgie als optimale Therapieform diskutiert.
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  • 4
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Pilomatrikom ; Pilomatrixkarzinom ; Key words Pilomatricoma ; Plomatrix carcinoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 58-year-old man developed an extensive pilomatrical carcinoma in the left axilla. Clinically, a squamous cell carcinoma was suspected. Histological examination revealed the presence of proliferating basaloid cells with many atypical mitoses and mass necrosis infiltrating into the subcutaneous tissue. The tumor was removed by micrographic surgery with a 2 cm safety margin. Histological examination of 2 regional lymph nodes as well as further diagnostic procedures ruled out metastases. We review the clinical and histopathological differences between pilomatricoma and pilomatrical carcinoma, as well as the published cases of the malignant variant.
    Notes: Zusammenfassung Wir berichten über einen 58jährigen Patienten mit einem ausgedehnten Pilomatrixkarzinom in der linken Axilla. Klinisch wurde zunächst ein Plattenepithelkarzinom vermutet. Erst die histologische Aufarbeitung ergab die Diagnose eines Pilomatrixkarzinoms mit infiltrierendem Wachstum bis ins subkutane Fettgewebe, proliferierenden basaloiden Zellen, zahlreichen atypischen Mitosen und Massennekrosen. Der Tumor wurde mit einem Sicherheitsabstand von 2 cm mikrographisch kontrolliert entfernt. Die histologische Untersuchung zweier in gleicher Sitzung exstirpierter Lymphknoten sowie die zusätzliche apparative Diagnostik ergaben keinen Anhalt für Metastasierung. Anhand dieses Falls möchten wir auf klinische und histologische Unterscheidungsmerkmale zwischen Pilomatrikom und Pilomatrixkarzinom hinweisen und eine Übersicht über die bislang publizierten Fälle der malignen Form geben.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Atopisches Ekzem ; Neurodermitis ; Sondersprechstunde ; Management ; Key words Atopic dermatitis ; Neurodermatitis ; Outpatient clinic ; Management
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Due to its high prevalence, atopic dermatitis is an important problem in the dermatologic practice. The chronicity of the disease together with numerous triggering factors of varying individual impact create a complex situation which is difficult to manage under the current circumstances in our health care system. We describe the concept of an outpatient clinic especially for atopic dermatitis as established in our Department of Dermatology. A high degree of standardization is combined with a high measure of individual care. The aims of this clinic are an optimized outpatient management of atopic dermatitis, the gathering of epidemiologic data, the performance of controlled studies, and potentially the reduction of costs.
    Notes: Zusammenfassung Aufgrund seiner hohen Prävalenz nimmt das atopische Ekzem einen großen Stellenwert in der dermatologischen Praxis ein. Der chronische Krankheitsverlauf und die Vielzahl individuell unterschiedlich relevanter Provokationsfaktoren bedingen eine komplexe Gesamtsituation, der in der Praxis kaum mehr Rechnung getragen werden kann. Wir beschreiben das Konzept einer Sondersprechstunde, welche an unserer Klinik etabliert wurde. Es wurde versucht, ein hohes Maß an Standardisierung mit einem großen Aufwand an individueller Beratung zu kombinieren. Ziele dieser Institution sind eine optimierte Betreuung von Patienten mit atopischem Ekzem im ambulanten Bereich, das Erheben epidemiologischer Daten, die Durchführung kontrollierter Studien sowie das Prüfen von kostendämpfenden Maßnahmen.
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 35 (1996), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 7
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Contact dermatitis 33 (1995), S. 0 
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 117 (1987), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We describe a 13-year-old girl with multiple pigmented nodules and plaques arranged in a cluster in the right lumbar region, which had developed since infancy.Eleven of 15 lesions which were examined histologically were found to be Spitz naevi. The remaining four lesions were compound naevocellular naevi, and two of them showed focal dysplasia. Eight Spitz naevi were investigated immunohistologically with monoclonal antibodies against HLA-antigens and malignancy-associated melanocytic antigens which are rarely present in common naevi. Naevus cells in all lesions expressed HLA-ABC antigens, but lacked HLA-DR antigens in seven of the eight lesions. All naevi were positive for ‘constitutive’ (KG-6-56) and ‘early’ (K-i-2) markers of nacvomelanocytic cells. In five of the eight Spitz naevi, at least one of the three malignancy-associated melanocytic antigens PAL-M1, A-1-43 and A-10-33 was found.The expression of malignancy-associated antigens in multiple agminate Spitz naevi is at variance with their benign clinical course.
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  • 9
    ISSN: 1574-695X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology , Medicine
    Notes: Dendritic cells (DCs) are major antigen-presenting cells of the immune system, which need to be activated in order to initiate an immune response. Here, we describe the immunostimulatory effects on human monocyte-derived DCs observed upon infection with Listeria monocytogenes or after treatment with listerial lipoteichoic acid (LTA) and lipopolysaccharide (LPS), respectively. All stimuli caused upregulation of costimulatory molecules, induced T-cell proliferative responses and secretion of cytokines in vitro. Infection of DCs with L. monocytogenes induced release of interleukin (IL)-12 and IL-18. In contrast treatment with purified listerial LTA yielded high levels of IL-18 release, but only minimal IL-12 production. Treatment of DCs with LPS conversely induced significant amounts of IL-12 production, but no IL-18. The release of both stimulating cytokines IL-12 and IL-18 upon infection with entire bacteria suggests that attenuated strains of L. monocytogenes may be a valuable tool for subunit vaccine delivery.
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  • 10
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Experimental dermatology 3 (1994), S. 0 
    ISSN: 1600-0625
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract A variety of tumors are potentially immunogenic but do not stimulate an effective antitumor immune response in vivo. Tumors may be capable of delivering antigen-specific signals to T cells, but may not deliver the costimulatory signals necessary for full activation of T cells. In this regard, we recently reported that a human melanoma cell line (sMC) expressing MHC class II, was able to induce clonal anergy in a specific, MHC-restricted CD-4+ T cell clone (sTC3). We used this system to investigate the influence of interleukin (IL)-12 on induction of this T cell unresponsiveness. The presence of 10 to 100 U IL-12 during the induction phase of anergy leads to a primary proliferative response of sTC3, which was significantly higher than that induced by IL-12 alone; however, in the absence of IL-12 no proliferation was seen during the induction of anergy. Subsequent optimal stimulation of IL-12 treated cells, but not of those cultured without IL-12, led to substantial IL-2 production and cell proliferation. This indicates that induction of the unresponsive state could be inhibited by IL-12. In addition, we have recently demonstrated that anergic T cell clones can produce high amounts of 1L-10 and that this event was correlated with their impaired ability to produce IL-2. This marked induction of IL-10 can be suppressed if IL-12 is present during initiation of unresponsiveness. However, IL-12 was not able to prime the T cell clone, sTC3, to become resistant against the anergizing stimulus, as this cytokine was only effective when present at the time of anergy induction. These findings indicate that IL-12 is very effective in preventing anergy when present at the same time as the anergizing stimulus, but is unable to prime T cells to resist anergy induction in this system.
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