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  • 1
    Digitale Medien
    Digitale Medien
    Incidence of skin cancer in 5356 patients following organ transplantation (2000)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 143 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background  Skin cancer following solid organ transplantation is an important cause of morbidity in long-term survivors. This risk is well known but imprecisely quantified. Objectives We aimed to determine: (i) the skin cancer risks in transplant patients more precisely; (ii) whether the risk of malignant melanoma is altered; and (iii) whether the risk of epithelial cancers occurring at non-exposed sites is comparable with that seen in sun-exposed sites. Methods We linked a population-based cohort of 5356 patients who had received organ transplants in Sweden between 1970 and 1994 with the compulsory Swedish Cancer Registry, to identify all cancer cases except basal cell carcinomas, which are not registered. Results After a mean follow-up of 5·6 years post-transplantation, 172 of 5356 patients developed 325 non-melanoma skin cancers (excluding basal cell carcinomas) and six malignant melanomas. The relative risk of non-melanoma skin cancer was 108·6 [95% confidence interval (CI) 94·6–123·1] for men and 92·8 (95% CI 73·2–116·0) for women. The highest risks were noted for upper limbs, and the risk increased with time. No significant increase in malignant melanomas was noted: the relative risk was 1·6 (95% CI 0·5–3·7) for men and 0·5 (95% CI 0·0–2·6) for women. Except for the lip, which is also sun-exposed, other epithelial sites did not show comparable increases in cancer risk. Conclusions We conclude that organ transplant recipients are at a highly increased risk for non-melanoma skin cancer and must be closely followed throughout their lives. Cancer risk associated with transplantation is higher for sun-exposed than for non-sun-exposed epithelial tissues, even among populations living in regions with low solar insolation.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2133.2000.03703.x
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  • 2
    Digitale Medien
    Digitale Medien
    Risk factors associated with onychomycosis (2004)
    Oxford, UK : Blackwell Publishing Ltd.
    Journal of the European Academy of Dermatology and Venereology 18 (2004), S. 0 
    Details
    ISSN: 1468-3083
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Objective  To examine possible risk factors related to onychomycosis.Background  Onychomycosis is a common disease with multifactorial aetiology, but little is known about the risk factors for this disease.Patients and methods  Questions related to signs, symptoms and possible risk factors associated with onychomycosis were sent to 3992 persons aged 16 years and older selected randomly from the Icelandic National Registry. Patients with suspected onychomycosis, based on photographs, were offered mycological examination. Data from the questionnaire and the results of mycological examination were used to calculate the odds ratio (OR) for several factors that might be associated with onychomycosis.Results  Two thousand four hundred and eighty-six subjects responded to the questionnaire. Prevalence for mycologically determined onychomycosis was 11.1% in the Icelandic population. A history of the following factors more than doubled the risk of onychomycosis: cancer (OR 3.44; 95% CI 1.15–10.35), psoriasis (OR 2.44; 95% CI 1.61–3.72), tinea pedis interdigitalis (OR 3.93; 95% CI 3.11–4.95), the moccasin form of tinea pedis (OR 4.26; 94% CI 3.34–5.45), parents with onychomycosis (OR 2.59; 95% CI 1.89–3.53), children with onychomycosis (OR 3.48; 95% CI 2.05–5.88), spouse with onychomycosis (OR 2.53; 95% CI 1.72–3.72), regular swimming activity (OR 2.57; 95% CI 2.00–3.30) and age 50 years or older (OR 2.74; 95% CI 2.19–3.42).Conclusions  Several risk factors are associated with onychomycosis. Knowledge of these risk factors is important when treating and educating patients with onychomycosis.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1468-3083.2004.00851.x
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  • 3
    Digitale Medien
    Digitale Medien
    Circulating T Cells of Patients with Active Psoriasis Respond to Streptococcal M-Peptides Sharing Sequences with Human Epidermal Keratins (1997)
    Oxford, UK : Blackwell Science Ltd
    Scandinavian journal of immunology 45 (1997), S. 0 
    Details
    ISSN: 1365-3083
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Psoriasis is a T-cell mediated inflammatory skin disease which has been associated with group A, β-haemolytic streptococcal infections. Four 20 a.a. long M6-peptides sharing 5–6 a.a. sequences with human epidermal keratins were identified. To investigate the role of potentially cross-reactive T cells in the pathogenesis of psoriasis, interferon-γ (IFN-γ) and interleukin-4 (IL-4) responses of circulating T cells to these peptides were analysed by ELISPOT and RT-PCR in 14 psoriatic patients, 12 healthy individuals and six patients with atopic dermatitis (AD). Untreated psoriatic patients’ responses were significantly higher to these peptides than healthy and AD controls, while responses to a control M6-peptide, not sharing sequences with keratin, were negligible in all groups. No difference was found in response to streptokinase/streptodornase (SK/SD). M6-protein and peptides exclusively elicited IFN-γ production, with little IL-4 production, even in AD patients. Interferon-γ responses to all the M6-peptides were abolished after successful treatment of psoriatic patients, but responses to SK/SD were unaffected. The results indicate that active psoriasis is associated with Th1-like cells responding to streptococcal M6-peptides sharing sequences with human epidermal keratin. This is consistent with the hypothesis that psoriasis may be induced and exacerbated in susceptible individuals by M-protein specific Th1-like cells that cross-react with human epidermal keratin.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.1365-3083.1997.d01-438.x
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  • 4
    Digitale Medien
    Digitale Medien
    Cord blood IgE levels are influenced by gestational age but do not predict allergic manifestations in infants (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric allergy and immunology 5 (1994), S. 0 
    Details
    ISSN: 1399-3038
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: The predictive value of cord blood IgE (clgE) for atopy and related disorders was investigated. Samples were collected from 792 infants delivered consecutively at the National University Hospital in Reykjavik in 1987. The concentration of IgE, but not that of IgA, was found to increase with increasing gestational age at birth. There was no correlation between IgE and IgA levels in individual samples. At the age of 18–23 months 180 of these children were studied for manifestations of allergy and related disorders. Included were all available infants with detectable (≥ 23 kU/L) clgE. However, infants born by Cesarean section or with IgA exceeding 10 mg/L were excluded because of potential contamination with maternal blood. The clinical evaluation was made without knowledge of the IgE levels. Sixty-six of the 180 participants (36.6%) were judged to have had definite allergic manifestations. However, no striking correlation was found between allergic symptoms and cIgE levels in this study, nor did high levels of IgE add significantly to the predictive value of family history. Children with atopic features had more frequently been affected by otitis media. Unexpectedly, infants with intermediate cIgE levels (0.2–0.6 kU/L) were significantly less affected by otitis media than children with unmeasurable (〈 0.2 kU/L) or high (≥ 0.7 kU/L) cIgE levels. It is concluded that cord blood IgE can not be used to predict allergic manifestations in children under the age of 2 years.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1399-3038.1994.tb00211.x
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  • 5
    Digitale Medien
    Digitale Medien
    Quality of life in 6497 Nordic patients with psoriasis (2002)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 146 (2002), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary Background Disease-specific psoriasis-related quality of life (QOL) measures have recently been developed and used in several hospital-based investigations. However, little is known about the impact of psoriasis on QOL in people with psoriasis who are not referred by dermatologists. Objectives The purpose of the study was to investigate psoriasis-related QOL in a large sample of members of the psoriasis associations from the Nordic countries, and to compare the results with those from psoriasis patients recruited from Nordic dermatologists or Nordic University clinics. Patients and methods A total of 5795 association members and 702 patients rated their psoriasis severity and completed the Psoriasis Disability Index and the Psoriasis Life Stress Index. Results Patients reported greater disease severity and greater impairment of QOL than members of associations, and Norwegian participants reported greater disease severity and greater impairment of QOL than participants from the remaining Nordic countries. Older and married participants reported less impairment of QOL than younger participants and those living alone. When controlling for the influence of these and other demographic and socio-economic factors, self-reported severity emerged as the most significant predictor of psoriasis-related QOL, explaining 32–26% of the variation in QOL scores, with the remaining factors only accounting for 4–5% of the variation. Although correlated with self-reported severity, Psoriasis Area and Severity Index scores were not a significant predictor of QOL in the patient sample. Conclusions Though self-reported severity may be the most important predictor, further research is needed to determine factors explaining the remaining variance in psoriasis-related QOL.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.1365-2133.2002.04742.x
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  • 6
    Digitale Medien
    Digitale Medien
    Venous leg ulcers and squamous cell carcinoma a large-scale epidemiological study (1995)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 133 (1995), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary In order to obtain a precise estimate of the relative risk of squamous cell carcinoma (SCC) in venous leg ulcers, we matched 10913 patients with the diagnosis venous leg ulcer from the Swedish Inpatient Registry with registrations of SCC of the lower limb recorded by the Swedish Cancer Registry, and found 33 cases of non-melanoma skin cancer. After scrutinizing the pathology and case records, 17 cases of SCC were considered as being certainly secondary to venous leg ulcers, whereas in six cases of remitting/relapsing ulcers the connection was probable. The relative risk calculated on 17 cases was 5·80 (95% confidence interval = 3·08–9·29). The median duration of the ulcer before the diagnosis of cancer was 25 years. The mean follow-up time of the cohort was 8·5 years. We conclude that SCC is a complication of chronic venous leg ulcers, although the absolute risk is very small.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2133.1995.tb02707.x
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  • 7
    Digitale Medien
    Digitale Medien
    Combination therapy for onychomycosis (2003)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 149 (2003), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Combination therapy is one way of improving the cure rate of onychomycosis. The LION Study examined the efficacies of terbinafine and itraconazole. The Icelandic cohort of the study reported that after 5 years only 46% of the terbinafine-treated patients and 13% of the itraconazole-treated patients were still disease-free, suggesting that relapses and reinfections were common in the long term treatment of onychomycosis with monotherapy. Combination therapy is a well-established principle in mycology; the current strategy involves the combination of oral and topical antifungal treatments. A number of specific drug combinations have proved to be useful in the treatment of onychomycosis: tioconazole and griseofulvin, amorolfine and griseofulvin, amorolfine and terbinafine, and amorolfine and itraconazole. However, comparison of the combination trials can be difficult because of the short duration of some of the studies and variation in global cure rates. Although it is necessary to consider these factors it is clear that combination therapy offers advantages when compared with monotherapy. Combination therapy can be administered sequentially or in parallel. Parallel therapy is recommended for patients who are likely to fail therapy (e.g. patients with diabetes), whereas sequential therapy is recommended for patients who show a poor response to initial treatment.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.1365-2133.149.s65.2.x
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  • 8
    Digitale Medien
    Digitale Medien
    Chronic urticaria and cancer: an epidemiological study of 1155 patients (1990)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 123 (1990), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: To evaluate the possible association of malignant disease with chronic urticaria 1155 consecutive cases with chronic urticaria were reviewed. The Swedish Cancer Registry, Stockholm, was searched for records reporting malignancies in the study population (1958–1984), and the expected number of malignancies was calculated on the basis of age- and sex-standardized incidence data. A malignancy was diagnosed in 36 patients with urticaria and the expected number of malignancies was 41. In 23 patients the malignancy appeared during the same year as the onset of urticaria or later. The expected number was 25.6. We conclude that chronic urticaria is not statistically associated with malignancy in general.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2133.1990.tb01449.x
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  • 9
    Digitale Medien
    Digitale Medien
    Prognostic factors of mycological cure following treatment of onychomycosis with oral antifungal agents (2002)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 147 (2002), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary Background  There is considerable literature on the efficacy and safety of various drugs used in treating onychomycosis; however, little information is available regarding prognostic factors which may be associated with non-response to conventional treatment. Objectives  To identify parameters influencing mycological cure at 72 weeks following treatment of toenail onychomycosis with oral antifungal agents. Methods  Univariate and multivariate logistic regression analysis from a randomized double-blind controlled trial including 496 patients with toenail onychomycosis caused by dermatophytes. Results  Baseline parameters including patient's age, gender, weight, number of toenails involved, percentage of nail involvement, duration of infection, history of previous treatment were not associated with mycological cure. In the multivariate prognostic factor analysis based on factors assessed at week 12, positive mycological culture at 12 weeks [odds ratio (OR): 0·583; 95% confidence interval (CI): 0·370–0·918] was negatively associated with mycological cure at 72 weeks. Similarly, in the multivariate prognostic factor analysis based on factors assessed at week 24, positive direct microscopy at 24 weeks (OR: 0·373; 95% CI: 0·211–0·659) and mycological culture at 24 weeks (OR: 0·293; 95% CI: 0·168–0·513) were negatively associated with mycological cure at 72 weeks. Conclusions  Mycological culture at 12 and 24 weeks and direct microscopic examination at 24 weeks can help in early identification of patients failing to respond to conventional oral antifungal treatment.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.1365-2133.2002.05035.x
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  • 10
    Digitale Medien
    Digitale Medien
    PUVA and cancer: a case-control study (1993)
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 129 (1993), S. 0 
    Details
    ISSN: 1365-2133
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Summary A detailed case-control study was carried out on 24 PUVA-treated patients with squamous cell cancer of the skin, and on an accurately matched control population of 96 PUVA-treated patients. Possible co-carcinogens, such as prior therapy with tar, ultraviolet-B, ionizing radiation, methotrexate and arsenic, were investigated. The only statistically significant association to emerge was that of prior therapy with methotrexate: relative risk 3.5; 95% confidence interval 1.2–9.9. Our data suggest that prior therapy with methotrexate might be a risk factor for skin cancer in PUVA-treated patients.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2133.1993.tb03308.x
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