Zeitschrift fur Hautkrankheiten最新文献

The relation between bowenoid papules and Bowen's disease is characterized by largely corresponding histological pictures and diverging clinical-epidemiological features. In bowenoid papules and Bowen's disease, 5 cases each, compared with 5 cases of common condylomata acuminata, we determined the DNA by means of Feulgen's cytophotometry in visible light after Feulgen's staining. The following results were obtained: The average DNA content in bowenoid papules equals that in Bowen's disease, but it is significantly higher than in condylomata acuminata. What is different between the two groups "bowenoid papules" and "Bowen's disease" is the distribution of DNA: In Bowen's disease, DNA spreads into higher ranges of polyploidy. If we take recent molecular biological/virological findings into account, this result can be interpreted as a transition towards carcinoma in situ.

We give a comparative survey of preparations absorbing UV light, based on data collected in 1988 (740 products) and in 1989/90 (988 products). Regarding the ingredients and the way of labelling of these preparations, our study yielded the following results: 1. With regard to the labelling of all ingredients according to CTFA, the number of sunscreen products increased from 11% in 1988 to 21% in 1989/90, that of cosmetics containing light filters from 26% to 28%. 2. Since, during the period studied, the ingredients of 50% of the preparations were changed, we call for the obligation to make a declaration. 3. Only 14 out of 42 UV filters registered in Europe are used in more than 1% of the preparations. In sunscreen products, UV-A filters increased from 51% to 61%, whereas in cosmetics, they decreased from 46% to 37%. In the 1990 list, the UV-B filters most frequently found in sunscreen products were cinnamates (70%), those least common were PABA and PABA derivatives (19%). 4. Since hazardous UV filters, such as 4-isopropyl-dibenzol methane and 3-(4-methyl-benzylidene) camphor, were eliminated from some of the preparations, the prevalences of individual filter substances have changed between 1988 and 1989/90. 5. Only those UV filters that are currently in use should be checked in the photopatch test. 6. Close cooperation between physicians and manufacturers resulted in making products absorbing UV light safer.

Dependent on the nature and intensity of the causative damage, the clinical picture of diffuse loss of hair varies considerably. We give a review on 4 typical clinical forms with different courses and degrees of hair loss. The differentiation of these variants may help to estimate the possible causes and prognosis and avoid unnecessary investigations.

22 female patients suffering from idiopathic hirsutism were treated according to Hammerstein's reversed sequential scheme over 12 months. During each treatment cycle of 21 days, the daily medication consisted of 1 coated tablet containing 0.035 mg ethinyl estradiol and 2 mg cyproterone acetate (Diane-35); in addition, the patients received one i.m. injection of 300 mg cyproterone acetate (Androcur-Depot) on the first day of each cycle. This therapy resulted in improvement of the disease in 19 of our patients (86.4%). The transitory, mild side effects observed did not require interruption of the treatment. The reversed sequential scheme making use of the depot form of CPA can successfully be administered in patients with hirsutism.

Adverse drug reactions on the hair are common side effects. The spectrum of loss of hair reaches from diffuse telogen effluvium up to circumscribed or diffuse alopecia on the scalp, sometimes also including other body areas. Other side effects observed are the stimulation of hair growth with hypertrichosis and induction or worsening of hirsutism, as well as changes of the structure or color of the hair. In most cases--other than those treated with cytostatics, androgens, or hormonal contraceptives with some androgenic effect--it is rather difficult to determine the time of onset and primary cause, since the diffuse types often start subclinically, and other factors may play an additional part. As a rule, adverse drug reactions are reversible provided the causative drug is avoided.

With regard to hair growth induced by therapeutics, we have to consider various aspects of the activity of the hair follicle. This means that a study on the efficacy of hair growth therapeutics requires a selective investigation of different kinds of follicular activity. The decision which of the non-invasive, semi-invasive or invasive techniques available should be applied in a specific case depends on the reliability of the method in relation to the technical requirement, on the one hand, and the acceptance by the volunteer as well as the clinical type and degree of hair loss, on the other. Trichorhizogram results as the only means of evaluating the efficacy of hair growth therapeutics seem problematical, since an increase of the anagen rate does not absolutely correlate with a prolongation of the anagen phase.

In women, hirsutism and male pattern baldness are due to an enhanced effect of androgens on the hair follicle, which in turn can be caused by an increased supply of bio-available androgens and/or an increased sensitivity of the target organ to androgens. There are no definite correlations between circulating androgens and the degree of their biological effects. Although in most cases the hyperandrogenemia is not severe, the patients should be treated with antiandrogens in order to avoid progression of the disturbance and its consequences on metabolism and fertility. Sometimes hirsutism can be observed as a clinical sign of a defect in the steroid biosynthesis or of Cushing's syndrome. In severe hyperandrogenemia with a testosterone level of more than 2 ng/ml and a DHEA-S level of more than 8000 ng/ml, tumors of the ovaries or the adrenal glands have to be excluded.

25 male patients suffering from acne vulgaris were examined by means of endocrinological, morphological, and 5 psychometric procedures in order to check the correlations and interactions between the psychological and dermatological aspects of the disease. In comparison with a control group, the acne patients did not show any striking endocrinological abnormalities; we found no correlation between the extensiveness of the lesions and the level of DHEA sulphate. All the psychological tests yielded results deviating from those achieved by the representative controls, but they were comparable with those of other patients suffering from psychosomatic diseases. The individual feeling of being "disfigured" found its expression in self-consciousness, lack of trust in his/her own body, as well as the clinically relevant difference between his/her conception of self and the ideal of self. During times of enhanced psychosocial strains subjectively assumed by the patients, the lesions increased and the patients were disturbed in social interaction and communication. Surprisingly, we did not find any correlation between the clinical status and significant psychometric findings. Our results show that in acne vulgaris, the individual experience of wanting physical attractiveness, associated with a predominantly neurotic depressive personal structure, may play a central part in a disturbed process of interaction with the environment and suggest the influence of psychic factors in the pathogenesis of acne vulgaris.

Patients with the following diagnoses were presented: pyoderma gangraenosum in a patient with myelodysplastic syndrome passing into an acute myelomonocytic leukemia and specific cutaneous infiltration, primary genital infection with herpes simplex virus, type 1 (HSV-1) in an adult patient, pellagroid, Sweet's syndrome with follicular involvement, Sweet's syndrome in a patient with cancer of the breast, lichen amyloidosus, angiolymphoid hyperplasia with eosinophilia, Darier's disease 1. associated with basal cell carcinoma 2. with specific cutaneous infiltrations in a patient with acute myeloid leukemia, body building, anabolic steroids and fertility, multiple trichodiscomas and perifollicular fibromas, Buschke's scleroedema adultorum, extensive necrobiosis lipoidica without diabetes mellitus, extramammary, multifocal type of Paget's disease.

Glycoconjugates in the cell membranes of the outer and the inner root sheath of human anagen hair follicles were histochemically characterized by means of the following lectins: UEA-I, DBA, PNA, WGA, SBA, RCA, and Con A (avidin-biotin technique, counter-staining with methyl green). We observed intense labeling of the outer root sheath with UEA-I, DBA, Con A, and PNA, whereas the other markers were only weakly positive. VEA-I, DBA and SBA labeling was confiried to the upper two thirds of the outer root sheath. As to the inner root sheath, we found intense labeling with UEA-I, WGA, RCA, and SBA; all other lectins were only weakly represented. Our results suggest that the cell membranes of the outer and inner root sheaths of human hair follicles are characterized by the prevalence of different glycoconjugates; moreover, labeling with UEA-I, SBA, and DBA is obviously related to the process of differentiation within the follicle.