Zeitschrift fur Hautkrankheiten最新文献

Acrosyringium and infundibulum are epidermal structures with different morphology, but functional similarities regarding re-epithelialization, transport of antigens, and attraction of infiltrates. Immunomorphologically, the infundibula revealed an immunoreactivity of Langerhans cells and keratinocytes comparable with that of the interfollicular epidermis, whereas the acrosyringia reacted differently because of the permanent expression of MHC class II antigens and reduced Langerhans cells in the perisyringial region. Our findings suggest that these epidermal compartments differ with regard to their individual immunologic situations. While the mechanisms of epidermal immunity known from the interfollicular epidermis are possibly the same in the infundibula, we have to expect a basically different immunologic situation in the acrosyringia.

In the Case of tumor excision in the lateral parts of the upper lip, the ensuing defect is usually closed by a rotation flap from the cheek. As a rule this procedure results in altering the nasolabial sulcus--one of the very striking natural structures of the face. We describe and compare the outcome of 3 different techniques of flapping (Burow's method, Schrudde's rotation flap, and pedicled flapping).

The vast majority of minor burns requiring treatment are best managed by clear rational concepts of therapy. If these burns are either treated less than optimal or overtreated, complications like infections or delayed wound healing may ensue. In order to draw conclusions from data obtained in studies on patients with minor burns, we need cohort studies making use of clearly defined therapeutic concepts.

ArF and XeCl excimer lasers were compared with argon ion and Nd: YAG lasers regarding their respective cutting characteristics in human skin. Our light and SEM microscopic findings revealed that all lasers except the ArF excimer laser caused thermal damage to the skin.

The structure of the weight-bearing plantar skin and the subcutaneous cushion is adapted to mechanical loads of 3-10 kp/cm2 under walking conditions. Such loads, however, are only tolerated when compensated by constant alternation of loaded points. If the surgical therapy with free skin grafts or pedicled flaps does not take into account the vascular and neural architecture of the plantar skin, healing without problems may result--but only for a short time. As a rule, such grafting is later followed by painful keratotic lesions or non-healing "trophic" ulcers, which are caused by loss of sensitive innervation, changing of loaded points as well as the specific subcutaneous architecture. Therefore, reconstructive surgery of loaded plantar skin often requires innervated musculo-cutaneous flaps. Plantar warts or other benign lesions with possible regression are not indications for grafting at all.

Using the PAP technique, paraffin-embedded and formalin-fixed tissue sections taken from 11 patients suffering from Paget's disease (5 mammary, 6 extramammary cases) were stained with antibodies against keratin, actin, S 100 protein, CEA, HMFG 1, cytokeratin 6 and 18 (Dako-CK-1), as well as the lectin SBA. We did not find any differences between mammary and extramammary Paget's disease. In both forms of the disease, all tumor cells showed reaction to antibodies against HMFG 1 and CEA and, in 50 to 100%, to the lectin SBA. The other antibodies investigated did not react with Paget's cells. Since HMFG 1 and Dako-CK-1 are selective markers of apocrine and eccrine sweat gland structures, respectively, our results suggest apocrine differentiation of both mammary and extramammary Paget's disease. At the same time, our findings rule out a possible histogenesis of Paget's cells from melanocytes (positive for S 100 protein) or keratinocytes (positive for Dako-CK-1 and antikeratin).

In facial dermatosurgery, the addition of sympathomimetics to local anesthetics produces a desirable topical effect as they provide an almost bloodless operation field due to temporary vasoconstriction. In an 87-year-old woman, who had lost her left sight owing to a meningoma, we removed a basal-cell carcinoma from the right side of her nose. The local anesthetic applied contained noradrenaline at a concentration of 1:50,000. After the operation, the patient complained of a headache and a transitory loss of sight. We suppose that noradrenaline reached the arteria centralis retinae via arterial periorbital anastomoses, thus causing a vasoconstriction of this artery. As far as dermatosurgery of the middle and upper face is concerned, patients with severe vision disorders should be considered as a risk group; in local anesthesia of those patients an addition of sympathomimetics should be avoided.

We studied the binding of EGF receptors (EGF-R) in 19 basal cell carcinomas, 8 squamous cell carcinomas, and 9 malignant melanomas. Specific binding of EGF-R was detected in 10 of the basal cell carcinomas, and in all the 8 squamous cell carcinomas. None of the malignant melanomas showed EGF-R binding. A comparative study of the receptor status vs. clinical prognostic data, such as grading and clinical course, did not reveal any significant differences, whereas in ovarian carcinomas, the EGF receptor correlated with the prognosis.

Several attempts have been made to optimize the efficiency of topical glucocorticoids (GC) and, at the same time, to minimize their side effects. In this respect, we should first consider attenuated GC. Dependent on the urea concentration, hydrocortisone (HC) in combination with urea results in both a considerable increase of the HC liberation from the ointment base, as well as an increased penetration rate of HC into the individual skin layers. If we apply these mechanisms to a preparation containing low HC concentrations, a given therapeutic effect can be obtained with definitely reduced HC concentrations. On the other hand, the therapeutic efficiency or the penetration rate of GC can not be deduced from the galenic formulation, the drug concentration, or the amount of urea.

We report on a 20-year-old women, who suffered from discoid lupus erythematosus (DLE) beginning on her eyelids with dyschromia and cutaneous infiltration. Similar signs appeared on the top of her nose, her nostrils, and her lower lip. Simultaneously with these alterations, we found a superficial exulceration on her hard palate, which histologically proved typical for DLE. After therapy with chloroquine for 3 weeks, the alterations disappeared.