Zeitschrift fur Hautkrankheiten最新文献

Among the therapeutical modes of psoriasis, sea-water baths with salts from the Dead Sea in combination with ultraviolet light (Tomesa therapy) play an important part. In a previous paper, we showed that treatment of isolated murine skin with Tomesa salt solutions resulted in an irreversible decrease of ATPase-positive epidermal Langerhans' cells. Our present study is concerned with the treatment of healthy persons and psoriasis patients with baths containing Tomesa salts, which lead to reduced amounts of detectable Langerhans' cells in the epidermis, as well. Baths containing sodium chloride in comparable concentrations, however, were without effect at all. Our findings demonstrate that the antipsoriatic activity of Tomesa therapy is not only due to physical effects but may also be the result of definable pharmacological actions of the salts on skin cells.

10 male test persons with androgenetic alopecia (Hamilton stage IV) were topically treated with an alcoholic 17 alpha-propylmesterolone solution (PM, 3%) for 3 months. Before and after treatment, we took deep biopsies from the fronto-temporal scalp region. Microsurgically, we isolated anagen hair bulbs, connective tissue with epidermis, and fat from the biopsy samples in order to determine cell cycle kinetics by means of DNA-flow cytometry. By comparison, cell cycle kinetics of the pre- and post-treatment samples did not show any significant changes with regard to connective tissue and fat, whereas in anagen hair bulbs, we found a significant increase of both S-phase cells (%) and the proliferation index (%). These results imply that PM, if topically applied, enhances the proliferative activity of hair matrix cells.

A profound knowledge of specific genetically determined anomalies of the hair may be of considerable value in the diagnosis of genetic syndromes. We give a review of a few recent developments in the field of genetic hair diseases. For example, the brittle hair due to sulphur deficiency (trichothiodystrophy) is nowadays regarded as genetically heterogeneous; three different syndromes can be distinguished: BIDS syndrome, Tay syndrome, and PIBIDS syndrome. Polarization microscopy revealed a striking resemblance of the hair anomalies found in trichothiodystrophy syndromes and those in acrodermatitis enteropathica. This surprising result indicates similar pathophysiological mechanisms. The Comèl-Netherton syndrome--long regarded as representing two different diseases--has recently been recognized as a clinically variable, but genetically homogeneous syndrome, which is most likely based on a single mutation ("lumping"). Minor's sweat test allows the recognition of women heterozygous for X-linked hypohidrotic ectodermal dysplasia and may help to appreciate seemingly non-specific hair findings, such as diffuse alopecia.

Disorders of the thyroid function and abnormalities of the scalp hair growth are frequently associated. Former studies were based on clinical findings and trichorhizogram evaluation. Our present study making use of DNA-flow cytometry demonstrates the influence of thyroid hormones on the proliferative activity of anagen hair bulbs in patients suffering from disorders of the thyroid function. In comparison with a healthy control group (n = 20), the mean proliferative activity (S- and G2+M-%) was found 15% lower in hypothyroid patients (n = 6), whereas in hyperthyroidism (n = 6) we observed an increase of the corresponding values of about 30%. Our data might suggest a direct correlation between S-phase percentages and plasma T3 levels, but this assumption could not be proved by statistical methods.

In general, the diagnosis of alopecia areata is not difficult. In children, we have to consider trichotillomania as a differential diagnosis; in adult patients pseudopelade and syphilis have to be taken into account. Investigation of the nails may support the diagnosis and help to assess the degree of activity of the disease. The efficacy of topical immunotherapy using diphencyprone or squaric acid dibutylester has been proved by various study groups. Unilateral comparative studies supported our assumption that the therapeutic response is most probably due to a local immunomodulation. The applicability of this method is limited by the fact that the toxicological data available on the contact allergens used are still incomplete.