Zeitschrift fur Hautkrankheiten最新文献

In a study on 30 patients suffering from arterio-venous leg ulcers, we found an increased blood level of 2,3biphosphoglycerate (10.33 mumol/ml; control group: 5.16 mumol/ml). This difference, which is statistically significant (p less than 0.001), shows that the blood oxygen pressure is lower both in the tissue of the leg ulcer (literary communication) and in the whole body.

Between 1984 and 1988, 44 patients suffering from cheilitis abrasiva praecancerosa were treated with cryosurgery using a nitrous oxide cryoprobe. A single treatment proved sufficient in 35 patients (80%). 9 patients (20%) developed a recurrent lesion 4 to 28 months after cryosurgery. All recurrences appeared within the first year. On account of the recidivity of the disease, we recommend a careful follow-up of the patients. On the other hand, cryosurgery has the advantage that it can be applied in elderly persons as well as in patients with concomitant internal diseases. In pracancerous lesions, the common drawbacks of a surgical therapy such as diminution of the lower lip and impairment of the superficial sensitivity can be avoided with the help of this technique. Invasive carcinomas of the lower lip, however, should not be treated with cryosurgery.

We report on a 21-year-old man professionally exposed to mercury, who developed lichen planus. This case must be regarded as a dispositional reaction and is in Germany entitled to indemnification in terms of a "quasi-occupational disease". The clinical signs and the probably non-allergic pathomechanism are comparable with those of lichen planus induced by gold. In diseases due to occupational intoxication, we face an individual disposition regarding the degree of clinical symptoms, which has to underly any expert opinion on indemnity.

The knowledge about the influence of chloroquine phosphate (CQ) on the iron metabolism in porphyria cutanea tarda (PCT) is still insufficient. In a study on 138 PCT patients treated with CQ, we observed decreasing serum iron concentration, transferrin saturation, and hepatic siderosis, as well as an increasing level of transferrin. After a one-year therapy with CQ, the patients showed normal porphyrinuria. Since there were no statistical correlations between the degree of hepatic siderosis and porphyrinuria, and since we repeatedly found remission of the PCT in spite of the continued existence of hepatic siderosis, the removal of iron cannot be regarded as the only principle of action in CQ therapy. In comparison with chloroquine, phlebotomy obviously has--even with regard to the iron deposits--no decisive advantages.

Sunscreens in cosmetics may trigger off photoallergic contact dermatitis. In addition, they can induce allergic, irritant, or phototoxic dermatitis. Adverse reactions may also be caused by fragrances, preservatives, and other ingredients in light-protective cosmetics. We give a survey on 87 publications dealing with this issue, which appeared from 1947 through 1989. The survey comprises information on the nature of the sunscreen or other ingredient as well as the type of reaction observed in 357 patients. We also refer to the sex distribution and summarize the reasons for using products absorbing UV light. Aside from commercial preparations, all UV filters currently in use should be tested in photopatch tests in order to improve the diagnostic tools.

Severe chronic anemia, transitory aplastic crisis (TAC), and lethal hydrops fetalis may be due to an infection with parvovirus B19 i.e. the causative agent of erythema infectiosum. 80% of the patients infected with B19 develop clinical symptoms and typically show the picture of erythema infectiosum--as one of our case reports (daughter) is going to illustrate. Part of the cases, however, take a course without the characteristic slapped-face rash; here we frequently find acute arthritis and arthralgia, as well as fever and rubella-like or purpura-like rashes, predominantly on the smaller joints (mother). In immuno-compromised patients, those with hematologic disorders, as well as in pregnancy, the diseases may take a life-threatening course. In the cases without the characteristic rash, the diagnosis has to be proved by the detection of either antibodies against parvovirus B19 or the virus itself; however, the test kits required are not readily available. Since there is no generally accepted treatment of the infection, as yet, the most important measure on the medical side is the prevention of the infection by means of isolation and other procedures. The problem we face here, however, is the fact that the danger of infection is highest during the viremic phase of the disease, when the patient is still asymptomatic.

We report on a female patient suffering from tuberculosis cutis colliquativa. The skin lesions were caused by hematogenic dissemination of mycobacteria tuberculosis spreading from the affected urogenital tract. The diagnosis was confirmed by culturing. Combined treatment with tuberculostatic agents for 5 months resulted in complete remission of the tuberculosis.

We report on a 27-year-old male patient suffering from multiple trichoepitheliomas, which first appeared on his face at the age of 15 and later spread to his upper extremities and back. Multiple trichoepitheliomas are benign tumors of the skin appendages with autosomally dominant heredity. Clinically, these lesions have to be differentiated from other adnexal tumors, adenoma sebaceum, as well as basal cell nevus syndrome (Gorlin-Goltz's disease).