Zeitschrift fur Hautkrankheiten最新文献

The nails are the largest appendage of the skin. They provide protection of the tactile regions of the fingers; moreover, well cared-for nails are an attribute of beauty. Operations of the nails should, therefore, regard both functional and cosmetic aspects. Surgical procedures are indicated in the case of nail deformities, bacterial or mycotic infections, as well as pigmentation of the nail wall or plate, and periungual or subungual tumors, which are always suspicious of malignant melanoma. All operations of the nail region can be performed in Oberst's anesthesia. We recommend the preoperative application of a tourniquet to stop the blood flow.

We report on the typical case of a 71-year-old male patient suffering from herpetiform dermatitis. Histological investigation and immunofluorescence revealed the characteristic features of pemphigus. The symptom disappeared after therapy with corticoids.

In an 80-year-old woman, retired farmworker, we observed lupus vulgaris extending over more than half of her leg. The extreme size of the affected area made us talk of a giant form in this case. Bacteriological investigation revealed Mycobacterium bovis. The minimal amount of tuberculin required to induce a positive intradermal reaction was 10 IU (GT Behring). Another case with similar dimensions (reported by Christiansen in 1967) had been caused by Mycobacterium avium and developed over a period of at least 5 years. The vast cutaneous affection of our patient, in contrast, had developed within only one year, starting from a brownish macula of the size of a palm on her upper leg. This macula - presumably the manifestation of quiescent lupus vulgaris - had not changed for more than 40 years. This late exacerbation of post-primary tuberculosis might have been favored by the patient's reduced immunologic resistance on account of her advanced age. In addition, local cofactors - namely ankylosis of her knee and contact eczematous dermatitis - have to be considered. In accordance with the resistogram, the disease responded to monotherapy with isoniazide.

In patients suffering from atopic dermatitis (AD), we often find intolerance reactions against wool, whereas irritation by synthetic fibers is still a matter of discussion. In a randomized clinical study on 55 patients with AD and 31 healthy controls, we investigated the irritative capacity of poncho-like shirts made of 4 different materials (A: cotton; B, C, D: synthetics of different fiber structure). The intensity of itching or discomfort due to repeated wearing of these shirts was evaluated by means of a point system (max.comfort = 10 points, max. discomfort = 1 point). Our study clearly showed that the irritative capacity of synthetic shirts is significantly higher in patients with AD, while cotton shirts were best tolerated. We also observed significant difference regarding the surface structure and diameter of the synthetic fibers under investigation.

Endocervical biopsies taken from 74 female patients with gonorrhea and 18 healthy women were investigated by means of fluorescence with regard to the evidence of IgA, IgG, IgM, C3, C4, fibrinogen, lysozyme, and N. gonorrhoeae. Whereas C3, C4, fibrinogen, lysozyme, and N. gonorrhoeae were especially observed in the early stages of the disease, the amount of plasma cells producing IgA and IgG were found increased in the advanced stages of gonorrhea.

We present an unusual case of cutaneous leishmaniasis with subcutaneous nodules. Treatment with ketoconazole over 5 weeks resulted in major improvement of the lesions.

Neither the involvement of hairfollicles nor of the ducts of the sweat glands by melanoma cells nor the thickness of the epidermis are helpful in differential diagnosis of lentigo maligna melanoma and superficial spreading melanoma in situ. The epidermis was thinner in LMM, however, LLM is mostly localized in the face where the epidermis is thinner than in other areas of the integument.

In 23 patients with psoriatic arthritis and 9 patients with psoriasis without joint involvement, we took bone biopsies from the iliac crest. Histomorphometrical investigations showed that the volume density of the bone was not decreased in either group of patients, but we found a high rate of turnover remodelling. An elevated rate of bone turnover is regarded as the characteristic principle of "psoriatic osteopathy", which--more exactly--should be called "latent osteopathy". Deficiency of vitamin D is discussed as a possible etiological factor.

In a 20-year-old women having suffered from Crohn's disease for many years, we found granulomatous fistular ulcerations on her right distal lower leg. After histological verification of the clinical diagnosis, she was orally treated with metronidazole for 6 weeks with excellent results: The cutaneous lesions healed completely.