Eosinophile Dermatosen sind eine heterogene Gruppe von Krankheiten, die sich durch ein eosinophilenreiches Infiltrat und/oder die Degranulation von eosinophilen Granulozyten auszeichnen. Begleitend kann eine Bluteosinophilie nachweisbar sein. Histologisch sind sogenannte flame figures typisch, jedoch nicht spezifisch. Flame figures entstehen durch die Anlagerung der von Eosinophilen degranulierten kationischen Proteine an Kollagen und führen zu dessen Denaturierung.
{"title":"Eosinophile Hautkrankheiten","authors":"M. Peckruhn, P. Elsner, J. Tittelbach","doi":"10.1111/ddg.13943_g","DOIUrl":"https://doi.org/10.1111/ddg.13943_g","url":null,"abstract":"Eosinophile Dermatosen sind eine heterogene Gruppe von Krankheiten, die sich durch ein eosinophilenreiches Infiltrat und/oder die Degranulation von eosinophilen Granulozyten auszeichnen. Begleitend kann eine Bluteosinophilie nachweisbar sein. Histologisch sind sogenannte flame figures typisch, jedoch nicht spezifisch. Flame figures entstehen durch die Anlagerung der von Eosinophilen degranulierten kationischen Proteine an Kollagen und führen zu dessen Denaturierung.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"40 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91421226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cutaneous adverse events (CAEs) occur in up to 10 % of patients with immune‐mediated inflammatory disease (IMID) treated with antitumor necrosis factor (TNF)α agents. The aim of this clinical study was to track and observe the course of CAEs in all biologic therapies.
{"title":"Dermatological complications of therapy with biologics in inflammatory autoimmune diseases","authors":"W. Sondermann, Saskia Herz, E. Sody, A. Körber","doi":"10.1111/ddg.13964","DOIUrl":"https://doi.org/10.1111/ddg.13964","url":null,"abstract":"Cutaneous adverse events (CAEs) occur in up to 10 % of patients with immune‐mediated inflammatory disease (IMID) treated with antitumor necrosis factor (TNF)α agents. The aim of this clinical study was to track and observe the course of CAEs in all biologic therapies.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"137 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77511654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Piccolo, T. Russo, A. Ronchi, R. Alfano, G. Argenziano
{"title":"Angiomatoid nodule of the breast","authors":"V. Piccolo, T. Russo, A. Ronchi, R. Alfano, G. Argenziano","doi":"10.1111/ddg.13962","DOIUrl":"https://doi.org/10.1111/ddg.13962","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"88 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83830290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Umbruch und Aufbruch Laudatio zum 80. Geburtstag von Dr. Erich Schubert","authors":"W. Sterry, M. Reusch","doi":"10.1111/ddg.13940_g","DOIUrl":"https://doi.org/10.1111/ddg.13940_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90089171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Ansorge, Johannes M. Miocic, Dagmar Bubnoff, K. Technau‐Hafsi
Die steigenden Zahlen von Patienten, die Notfalleinrichtungen aufsuchen, sind mit einem zunehmenden Bedarf an Material und Personal verbunden. Um diese Ressourcen besser quantifizieren zu können, haben wir die diagnostischen Verfahren, die Art der Behandlung und die Anzahl und den Ausbildungsstand der Mitarbeiter untersucht, die an Notfallkonsultationen beteiligt sind.
{"title":"Für dermatologische Notfallpatienten benötigte Ressourcen: Eine zwölfmonatige prospektive Datenerhebung aus Deutschland","authors":"C. Ansorge, Johannes M. Miocic, Dagmar Bubnoff, K. Technau‐Hafsi","doi":"10.1111/ddg.13922_g","DOIUrl":"https://doi.org/10.1111/ddg.13922_g","url":null,"abstract":"Die steigenden Zahlen von Patienten, die Notfalleinrichtungen aufsuchen, sind mit einem zunehmenden Bedarf an Material und Personal verbunden. Um diese Ressourcen besser quantifizieren zu können, haben wir die diagnostischen Verfahren, die Art der Behandlung und die Anzahl und den Ausbildungsstand der Mitarbeiter untersucht, die an Notfallkonsultationen beteiligt sind.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84936076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Koga, Taichi Imamura, Kengo Urae, T. Furuta, J. Akiba, T. Nakama
The incidence of invasive pulmonary aspergillosis (IPA) has increased over the past few decades due to widespread use of immunosuppressants. Most cases have been reported in patients with hematological malignancy, especially those undergoing hematopoietic stem cell transplantation (HSCT), and in patients with chronic granulomatous diseases, chronic obstructive pulmonary disease, or those undergoing solid organ transplantation. Thus far, there is only one report of IPA in a patient with bullous pemphigoid (BP) [1, 2], the most common autoimmune blistering skin disorder [3, 4]. Here we report a case of IPA associated with BP that was treated with a moderate dose of oral prednisolone for just three weeks. A 70-year-old Japanese man was referred to our hospital for diabetic renal failure with tense blisters and erythema on his trunk and extremities. He reported skin involvement for eight months and was diagnosed with BP based on a positive chemiluminescence enzyme immunoassay (CLEIA) for BP180, which was performed at another hospital. He was taking minocycline and nicotinamide for BP and linagliptin for type 2 diabetes. Physical examination revealed tense blisters on his trunk and extremities with mild oral involvement that was not tested for a herpes virus (Figure 1). A biopsy specimen revealed subepidermal blisters with prominent eosinophilic infiltration. Direct immunofluorescence on the perilesional skin revealed linear IgG and C3 deposits at the epidermal basement membrane zone. CLEIA for BP180 (MBL, Nagoya, Japan) was 85.8 U/mL (cut-off 9 U/mL). The patient was treated with 0.5 mg/kg/day (30 mg/day) prednisolone, 200 mg/ day minocycline, and 1.5 g/day nicotinamide; linagliptin was discontinued (day 1). The BP disease area index decreased in three weeks, although mucosal involvement persisted (skin erosions/blisters, 32 to 15; skin urticaria/erythema, 21 to 0; and mucosa, 2 to 2), which resulted in tapering the prednisolone to 25 mg/day. Dialysis for renal failure was initiated on day 16, and the patient complained of general fatigue. He developed fever on day 21. Laboratory test results revealed elevated C-reactive protein and β-D glucan levels. Computed tomography of the chest revealed ground-glass opacity in the upper lobe of the right lung. Pulmonary findings worsened on day 26 (Figure 2) despite micafungin administration, and on day 27 Aspergillus fumigatus was identified with bronchoalveolar lavage. An enzyme-linked immunosorbent assay for Aspergillus was positive. Invasive pulmonary aspergillosis was diagnosed and micafungin was replaced with amphotericin B, as voriconazole could not be administered owing to the patient’s renal failure. On day 29, the patient developed disseminated intravascular coagulation and died. Autopsy findings revealed fungal invasion of the lung, heart, esophagus, liver, pancreas, and thyroid (Figure 3). To the best of our knowledge, there is one report of IPA associated with BP; in this case, the patient had rece
{"title":"Invasive pulmonary aspergillosis associated with bullous pemphigoid","authors":"H. Koga, Taichi Imamura, Kengo Urae, T. Furuta, J. Akiba, T. Nakama","doi":"10.1111/ddg.13947","DOIUrl":"https://doi.org/10.1111/ddg.13947","url":null,"abstract":"The incidence of invasive pulmonary aspergillosis (IPA) has increased over the past few decades due to widespread use of immunosuppressants. Most cases have been reported in patients with hematological malignancy, especially those undergoing hematopoietic stem cell transplantation (HSCT), and in patients with chronic granulomatous diseases, chronic obstructive pulmonary disease, or those undergoing solid organ transplantation. Thus far, there is only one report of IPA in a patient with bullous pemphigoid (BP) [1, 2], the most common autoimmune blistering skin disorder [3, 4]. Here we report a case of IPA associated with BP that was treated with a moderate dose of oral prednisolone for just three weeks. A 70-year-old Japanese man was referred to our hospital for diabetic renal failure with tense blisters and erythema on his trunk and extremities. He reported skin involvement for eight months and was diagnosed with BP based on a positive chemiluminescence enzyme immunoassay (CLEIA) for BP180, which was performed at another hospital. He was taking minocycline and nicotinamide for BP and linagliptin for type 2 diabetes. Physical examination revealed tense blisters on his trunk and extremities with mild oral involvement that was not tested for a herpes virus (Figure 1). A biopsy specimen revealed subepidermal blisters with prominent eosinophilic infiltration. Direct immunofluorescence on the perilesional skin revealed linear IgG and C3 deposits at the epidermal basement membrane zone. CLEIA for BP180 (MBL, Nagoya, Japan) was 85.8 U/mL (cut-off 9 U/mL). The patient was treated with 0.5 mg/kg/day (30 mg/day) prednisolone, 200 mg/ day minocycline, and 1.5 g/day nicotinamide; linagliptin was discontinued (day 1). The BP disease area index decreased in three weeks, although mucosal involvement persisted (skin erosions/blisters, 32 to 15; skin urticaria/erythema, 21 to 0; and mucosa, 2 to 2), which resulted in tapering the prednisolone to 25 mg/day. Dialysis for renal failure was initiated on day 16, and the patient complained of general fatigue. He developed fever on day 21. Laboratory test results revealed elevated C-reactive protein and β-D glucan levels. Computed tomography of the chest revealed ground-glass opacity in the upper lobe of the right lung. Pulmonary findings worsened on day 26 (Figure 2) despite micafungin administration, and on day 27 Aspergillus fumigatus was identified with bronchoalveolar lavage. An enzyme-linked immunosorbent assay for Aspergillus was positive. Invasive pulmonary aspergillosis was diagnosed and micafungin was replaced with amphotericin B, as voriconazole could not be administered owing to the patient’s renal failure. On day 29, the patient developed disseminated intravascular coagulation and died. Autopsy findings revealed fungal invasion of the lung, heart, esophagus, liver, pancreas, and thyroid (Figure 3). To the best of our knowledge, there is one report of IPA associated with BP; in this case, the patient had rece","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86541582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Die Zukunft der operativen Dermatologie","authors":"R. Kaufmann, T. Wetzig","doi":"10.1111/ddg.13924_g","DOIUrl":"https://doi.org/10.1111/ddg.13924_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79919608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vincenzo Piccolo, T. Russo, A. Ronchi, Roberto Alfano, G. Argenziano
{"title":"Angiomatöser Knoten auf der Brust","authors":"Vincenzo Piccolo, T. Russo, A. Ronchi, Roberto Alfano, G. Argenziano","doi":"10.1111/ddg.13962_g","DOIUrl":"https://doi.org/10.1111/ddg.13962_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"158 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79987758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Ott, S. Krengel, O. Beck, K. Böhler, Sophie Böttcher‐Haberzeth, Özlem Cangir, M. Fattouh, Beate Häberle, M. Hüging, I. Königs, F. Kosch, Kralj Rok, N. Marathovouniotis, L. Meyer, K. Neuhaus, K. Rothe, C. Schiestl, M. Sinnig, M. Theiler, Susanne der Heydt, R. Wälchli, L. Weibel, W. Wendenburg, H. Breuninger
In den letzten Jahren hat sich unser Wissensstand zu kongenitalen melanozytären Nävi (KMN) stark erweitert. Die Autoren, eine interdisziplinäre Gruppe von Ärzten und Ärztinnen mit umfangreicher Erfahrung in der Langzeitbetreuung und chirurgischen Therapie von Kindern und Erwachsenen mit KMN (Netzwerk Nävuschirurgie, NNC), geben hier eine Stellungnahme zur Indikationsstellung, Planung und Durchführung einer Behandlung unter diesen neuen Prämissen ab. Die Beratung der Eltern zum konservativen und/oder operativen Management von KMN muss im interdisziplinären Austausch stattfinden und zu einer individuellen Planung des oft mehrstufigen Prozesses führen. Hierbei steht das ästhetische Langzeitergebnis, nicht die Melanomprophylaxe, im Mittelpunkt. Bei keinem KMN gilt die Prämisse der „Entfernung um jeden Preis“. Mögliche therapiebedingte Nebenwirkungen (Hospitalisation, Wundheilungsstörungen etc.) müssen sorgfältig mit den Erfolgsaussichten abgewogen werden. Unter diesen Gesichtspunkten ist insbesondere die Methode der Dermabrasion zu hinterfragen. Auf einer Tagung des NNC im September 2018 wurde eine konsentierte Wertung erarbeitet, nach der die Dermabrasion häufig zu Wundheilungsstörungen sowie zu kosmetisch ungünstiger oder hypertropher Narbenbildung führen kann und sehr häufig mit einer oft erst Jahre später auftretenden Repigmentierung assoziiert ist. Zudem ist kein Nutzen im Sinne einer Melanomprophylaxe erkennbar. Daher sollte in Zukunft sorgfältig auf die möglichen Risiken und den oft limitierten kosmetischen Nutzen der Dermabrasion hingewiesen werden.
{"title":"Multidisziplinäre Langzeitbetreuung und zeitgemäße chirurgische Therapie kongenitaler melanozytärer Nävi – Empfehlungen des Netzwerks Nävuschirurgie","authors":"H. Ott, S. Krengel, O. Beck, K. Böhler, Sophie Böttcher‐Haberzeth, Özlem Cangir, M. Fattouh, Beate Häberle, M. Hüging, I. Königs, F. Kosch, Kralj Rok, N. Marathovouniotis, L. Meyer, K. Neuhaus, K. Rothe, C. Schiestl, M. Sinnig, M. Theiler, Susanne der Heydt, R. Wälchli, L. Weibel, W. Wendenburg, H. Breuninger","doi":"10.1111/ddg.13951_g","DOIUrl":"https://doi.org/10.1111/ddg.13951_g","url":null,"abstract":"In den letzten Jahren hat sich unser Wissensstand zu kongenitalen melanozytären Nävi (KMN) stark erweitert. Die Autoren, eine interdisziplinäre Gruppe von Ärzten und Ärztinnen mit umfangreicher Erfahrung in der Langzeitbetreuung und chirurgischen Therapie von Kindern und Erwachsenen mit KMN (Netzwerk Nävuschirurgie, NNC), geben hier eine Stellungnahme zur Indikationsstellung, Planung und Durchführung einer Behandlung unter diesen neuen Prämissen ab. Die Beratung der Eltern zum konservativen und/oder operativen Management von KMN muss im interdisziplinären Austausch stattfinden und zu einer individuellen Planung des oft mehrstufigen Prozesses führen. Hierbei steht das ästhetische Langzeitergebnis, nicht die Melanomprophylaxe, im Mittelpunkt. Bei keinem KMN gilt die Prämisse der „Entfernung um jeden Preis“. Mögliche therapiebedingte Nebenwirkungen (Hospitalisation, Wundheilungsstörungen etc.) müssen sorgfältig mit den Erfolgsaussichten abgewogen werden. Unter diesen Gesichtspunkten ist insbesondere die Methode der Dermabrasion zu hinterfragen. Auf einer Tagung des NNC im September 2018 wurde eine konsentierte Wertung erarbeitet, nach der die Dermabrasion häufig zu Wundheilungsstörungen sowie zu kosmetisch ungünstiger oder hypertropher Narbenbildung führen kann und sehr häufig mit einer oft erst Jahre später auftretenden Repigmentierung assoziiert ist. Zudem ist kein Nutzen im Sinne einer Melanomprophylaxe erkennbar. Daher sollte in Zukunft sorgfältig auf die möglichen Risiken und den oft limitierten kosmetischen Nutzen der Dermabrasion hingewiesen werden.","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83804088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Satoko Shimizu, Yuka Takashima, Yuka Maya, Fumihiro Kodama, Mayumi Yokozeki, Koki Tomizawa, Ken Muramatsu, Hideyuki Ujiie, Hiroshi Shimizu, Reine Moriuchi
{"title":"Disseminierte Mycobacterium‐intracellulare‐Infektion führt zur Diagnose einer idiopathischen CD4+‐Lymphozytopenie","authors":"Satoko Shimizu, Yuka Takashima, Yuka Maya, Fumihiro Kodama, Mayumi Yokozeki, Koki Tomizawa, Ken Muramatsu, Hideyuki Ujiie, Hiroshi Shimizu, Reine Moriuchi","doi":"10.1111/ddg.13946_g","DOIUrl":"https://doi.org/10.1111/ddg.13946_g","url":null,"abstract":"","PeriodicalId":14702,"journal":{"name":"JDDG: Journal der Deutschen Dermatologischen Gesellschaft","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82443118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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