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The defined threepart triage levels are urgent, priority and deferrable with a corresponding maximum time target before treatment of 1, 8 and 60 days respectively.

Methods: from February to August a sample of outpatient electronic medical records cases were randomly retrieved. Referral diagnoses with their corresponding triage codes were recorded.

Urgent visits were further analyzed according to the referring physician. The appropriateness of the referral was determined on the basis of the published state law diagnostic guidelines.

Data were statistically analyzed using the 2-tailed Pearson Chi2 test or the Fisher exact test. Results: Overall, Conclusion: The triage system according to clinical need is safe, no urgent cases are overseen.

Frequency of diagnoses differ significantly in the three triage levels, this in general points to an operating allocation system.

In the north Italian province of South Tyrol waiting times for non urgent dermatological specialist referrals and requests for specialist care are monitored centrally by the local government.

Methods: We performed a retrospective study regarding the correlation between monthly waiting time and number of access requests for the city of Bolzano, where the basin comprises approximately The monitored time included data from November to July provided by the central monitoring agency.

Results: The results of the analysis showed that the median waiting time for a non urgent dermatology referral was 57 days in the first year of the monitoring and was slowly increasing: it was 30 days at the begin of the year and 61 days at the end of the year.

Due to staff shortage waiting time increased sharply at the end of until reaching a maximum of days in January With the allocation of new physicians, waiting time then decreased to 49 days in July Not surprisingly waiting time correlates strongly negative with requests for access in specialist health care.

Allocation of adequate human resources reduces waiting time, but augments requests for specialist consultations. Anamnestisch starker Nicotinabusus.

Neben einer Psoriasis vulgaris wird auch die Verdachtsdiagnose eines Bazex-Syndrom gestellt und eine Tumor-Suche begonnen.

Epicutantest und Pilzkultur blieben ebenfalls ohne Ergebnis. Diskussion: Die Acrokeratosis paraneoplastica Bazex ist eine sehr seltene, obligate Paraneoplasie und tritt vor allem im Zusammenhang mit Plattenepithelkarzinomen des aerodigestiven Traktes auf; in der Literatur findet sich jedoch auch ein Auftreten bei anderen Neoplasien, z.

Beschrieben wurde das Bazex-Syndrom bisher v. Die typische Klinik umfasst schuppende, unscharf begrenzte, symmetrische, psoriasoforme Erytheme an den Akren sowie distale Hyperkeratosen und Rhagaden.

Weiters sind typisch eine Onychodystrophie, sowie Hyperkeratosen an den Ohren, und evt. LE-artige Gesichts-Erytheme. Als Differentialdiagnosen kommt neben einem Ekzem vor allem eine Psoriasis palmoplantaris vom keratotischen Typ in Frage.

Die Pathogenese ist weitgehend unbekannt. Die Therapie liegt in erster Linie in einer Malignomsanierung. Bull Soc Franc Derm Syph, Acrokeratosis paraneoplastica Bazex syndrome.

JEADV, Therefore, we studied the expression and localization of those and other inflammation and fibrosis markers in scarring and non scarring skin of RDEB patients and healthy donors by sqRT-PCR, immuno blots, and IF microscopy.

Conclusion: Our results point to an important role of inflammation and fibrosis in impaired wound healing, finger contractures and pseudosyndactyly in RDEB.

The role of myofibroblasts is unclear. This study revealed potential therapeutical targets to improve wound healing and finger contractures in RDEB.

Reportedly, topical antibiotics, corticosteroids and calcineurin inhibitors only have temporary efficacy. Patients and methods: Four male patients with a history of surgical and conservative topical treatment for in situ squamous cell carcinomas of the scalp, were admitted because of recurrent pustular flares, erosions and crusts restricted to the bald scalp, recalcitrant to multiple topical therapies.

Direct immunofluorescence was negative in all. Results: After initial improvement all pts developed recurrences under consecutive dapsone therapy, thus it was discontinued after four weeks.

In contrast, subsequent treatment with a topical classsteroid mometasonfuroat induced complete remissions within weeks, but all pts developed relapses following cessation of therapy.

Nevertheless, all recurrences could rapidly be managed by reintroduction of this regimen, moreover, further relapses were completely prevented by intermittent application of mometasonfuroat times per week.

Conclusion: Here we show that topical treatment with dapsone-gel was not effective in our pts. Dramatic improvement was achieved with a topical classsteroid, but long term remissions required continuous, intermittent therapy, which underscores the recalcitrant nature of the disease.

Since surgical treatment in one pt led to a long lasting disease free period, this approach may represent an interesting alternative in severe cases.

Pathogenesis is poorly understood and the clinical course of PG is impredictable. The disease might regress spontaneously, stay inactive for months or progress and worsen after trauma, surgical interventions or even without triggers.

No gold standard has been established for the treatment of PG. The role of surgical interventions and Negative Wound Pressure Therapy NWPT is controversially discussed in the literature as these procedures might pose a trigger to further aggravate the condition.

Material and methods: We report 10 consecutive patients affected by PG, three males and six women median age 65, range from 26 - The extremely painful ulcers were all situated on the lower extremities, except of one case of post augmentation mastopexy pyoderma and measured from 8 x 4 cm to 45 x 25 cm.

All patients were hospitalized prior to surgical intervention and received methylprednisolone and in most cases further immunosuppressive or immunomodulatory therapy including dapsone, ciclosporine, infliximab, methotrexate or pentoxyphylline.

NWPT was applied up to one week prior further surgical interventions. Gentle surgical debridement of the wound bed and wound borders was performed in local tumescence anesthesia and 0,3 mm thickness skin grafts STSG were transferred and secured by NWPT.

One case was not grafted because it showed fast intrinsic healing with good epithelialization under NWPT and the mammary case was grafted without applying NWPT.

All cases of PG did markedly improve with the application of NWPT, as with the surgical intervention, no case of pathergy was observed, neither from application of NWPT nor from skin grafting.

Discussion: This is the largest case series of surgical treatment for PG reported in the literature. Blister formation can also be induced via autoimmune reactions directed against self antigens as known for bullous pemphigoid.

In either case the structural integrity of the integument is affected, which leads to blistering. The primary genetic causes of epidermolyis bullosa may induce secondary effects that aggravate the disease phenotype by activating the expression of factors that degrade extra-cellular matrix components and thereby further weaken the structural integrity of the skin.

Methods: We analysed the gene expression profiles of patient derived EB-simplex Dowling-Meara cell lines in vitro as well as the composition of blister fluids of different EB subtypes in vivo.

Results: Gene expression profiles of EB-simplex Dowling-Meara cell lines revealed increased expression of matrix metalloproteinase-9 and interleukin We identified high levels of these two factors in all blister fluid samples compared to healthy controls.

Due to the fact that these two factors are causally responsible for blister formation, and that they are also expressed in high levels in epidermolysis bullosa skin, they constitute potential therapeutic targets for small molecule based therapies.

Nevertheless, they both exhibit increased plasma IgE and numbers of mast cells in the upper dermis, indicating an atopic predisposition. Women with PCOS may have enlarged ovaries that contain small collections of fluid -called follicles -located in each ovary as seen during an ultrasound exam.

Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome.

It is well known that hyperandrogenism and insulin-resistance with or without compensatory hyperinsulinism are closely associated, but the Rotterdam Consensus has concluded that principally obese women with polycystic ovary syndrome PCOS should be evaluated for the metabolic syndrome.

We present the case of 24 year old female patient with hirsutism. She was underweight, had acne and positive family history for hirsutism and diabetes.

She was evaluated to identify etiology, and was diagnosed as a case of PCOS with insulin resistance. It is very rare case when PCOS women with insulin resistance is underweight.

She was treated according to underlying pathology and improvement was significant after 6 month. Etablierte Therapien der GM umfassen Methotrexat ev.

Die Evaluierungen erfolgten vor Therapiebeginn Baseline sowie unmittelbar und sechs Monate nach Therapieabschluss.

Ergebnis: Unmittelbar nach der Therapie war der Bewegungsumfang nahezu aller Gelenke verbessert. Die Handkraft hingegen nahm weiter zu li. Weiters konnte ein nachhaltiger Effekt bis 6 Monate nach Therapieende beobachtet werden.

Sie sind zumeist durch hohe Temperaturen gekennzeichnet. Differentialdiagnostisch wurden Diabetes mellitus, eine Venenthrombose, eine Uveitis sowie ein Irvine-Gass-Syndrom ausgeschlossen.

Dies unter anderem durch die Inhibition von NK-kB. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. Br J Dermatol.

Dimethylfumarate is a potent inducer of apoptosis in human T cells. J Invest Dermatol. J Immunol. Suppression of VEGFR2 expression in human endothelial cells by dimethylfumarate treatment: evidence for anti-angiogenic action.

Fumarate esters as angiogenesis inhibitors: key to action in psoriasis? Leonardi C et al. Louis University School of Medicine, St. LY Greater clinical response is associated with improved patient reported outcomes: results from a phase 2 study in patients with moderate to severe psoriasis treated with ixekizumab.

The pathogenesis of Schnitzler-Syndrom is currently under investigation and is supposed to be related to excessive interleukin-1, which is further evidenced by the good and rapid clinical response to ILblockade.

Methods: A year old female patient suffered from intermittent urticaria combined with fever and strong arthralgia as well as increased levels of CRP since Over the years a lot of diagnostic investigations were done without concrete findings, and therapuetic attempts with anti-histamines and classical immunosuppressants failed.

The decision to start monotherapy with interleukin-1 receptor antagonist anakinra; mg subcutaneously every 24 hours was made in October At that time the patient had severe symptoms and histology revealed a leukocytoclastic vasculitis, compatible with urticaria-vasculitis for the first time.

After starting anakinra, symptoms disappeared within 24 hours. An interruption of therapy in November resulted in a rapid return of symptoms.

These suggested the diagnosis of Schnitzler-Syndrom. Today, 5 months after starting continuous therapy with anakinra, the patient is free of symptoms and beside mild dermatitis at the injection site no adverse drug effects have been registered.

Results: Monotherapy with the interleukin-1 receptor antagonist anakinra is a highly effective therapeutic option in Schnitzler-Syndrom.

Other IL-1 inhibiting agents, such as rilonacept, are currently under investigation. Rezente Erkenntnisse zeigen uns, dass Psoriasis eine Systemerkrankung ist.

Seit ca. In den abgenommenen Blutkulturen kam es zum Wachstum von E. Unter Antibiotikatherapie Ciprofloxacin i.

Aufgrund des klinischen Verlaufs wurde von weiteren invasiven Untersuchungen Abstand genommen. Schlussfolgerung: Da es sich bei Psoriasis um eine Systemerkrankung handelt ist ein Zusammenhang mit neutrophiler Cholangitis sehr wahrscheinlich.

Literatur: 1 P. Dieude, E. Sbidian, M. Viguier, E. Zafrani et al. Neutrophilic cholangitis in psoriasis vulgaris and psoriatic arthritis.

British Association of Dermatologists ; , 2 M. Allez, ME Roux, P. Bertheau et al. Recurrent cholestatic jaundice associated with generalized pustular psoriasis: evidence for a neutrophilic cholangitis.

J Hepatol ; Viguier, M. Allez, AM Zagdanski et al. High frequency for neutrophilic involvement oft he biliary tract.

Hepatology ; Isse, K. Harada, Y. IL-8 expression by biliary epithelial cells is associated with neutrophilic infiltraion an reactive bile ductules.

Liver Int ; Marrakchi, P. Guigue, B. Renshaw et al. Interleukin receptor antagonist deficiency causes generalized pustular psoriasis.

N Engl J Med ; Kane, J. Roth, M. Frosch et al. Increased perivascular synovial arthritis. Arthtitis Rheum ; Results: The data from patients 66 women, men with altogether ustekinumab treatment cycles during patient-years of follow-up were analyzed.

At first treatment cycle, the median age of the patients was 43 years range and the median disease duration was 16 years range Methoden: Bienen- und Wespengiftallergiker wurden in die Studie eingeschlossen und mit Hilfe eines standardisierten Fragebogens zu Stichlokalisation und Symptomen befragt.

In einem zweiten Schritt untersuchten wir die Hypothese, ob Stiche in gut durchblutete Hautareale mit schweren Reaktionen assoziiert sind.

Das Eindringen des Stachel in unterschiedliche Regionen der Dermis war jedoch nicht mit dem Schweregrad der systemischen Reaktion assoziiert.

Aufgrund der idealen Aerodynamik stellen die Setae eine potente aerogene Noxe dar. Entwicklung eines Diagnoseverfahrens, 3.

Schwellenwertbestimmung, 5. Einen weiteren Sammler positionierten wir unmittelbar vor die Nester. Die drei fix verorteten Sammler wurden in die Auswertung miteinbezogen.

Zur Simulation des Befalls eines Menschen positionierten wir eine mit 26 96 Poster Messstreifen beklebte erwachsene Schaufensterpuppe in der Hauptrichtung des Luftstroms cm vom Nest.

Es gab zwei Varianten teilzunehmen: 1. Teilnahme ohne Blutabnahme. Blutabnahmen erfolgten zu Beginn und am Ende der Untersuchung, sowie bei jedem Alerting.

Die Korrelation mit klimatologischen Daten ist in Bearbeitung. Zwei davon gaben Atemprobleme an, die aber nach kompletter pulmologischer Untersuchung nicht im Zusammenhang mit dem EPS standen.

In one case, hospitalization and systemic corticosteroid treatment was required. In addition bacterial smear tests of eyelids and conjunctiva were performed.

The history revealed in one patient that she had colored his eyebrows one day before the onset of eczema and the other colored her eyelashes.

Diagnostic work-up for identification of the causative compound in the dyes were planned. Methods: Patch tests with the European standard series and hairdresser materials were performed in both ladies.

In one patient additionally textile dyes were tested. In hairdresser materials, one patient reacted positive to p-Toluylendiamin, p-Aminophenol, 3-Apinophenol the second patient to p-Aminophenol, Hydrochinon and Dispersionsorange 3.

After that, she only once dyed her hair and developed ear swelling. However, both patients had not yet consulted any allergist for these reactions and did not know that in all cases the causative substance was PPD.

Thus, all henna-tattoo- or PPD-allergic patients should also be made aware of an allergic reaction to eyelash and eyebrow dyes.

It may be associated to inflammatory diseases and resembles genital warts or squamous cell carcinoma SCC. Histopathological examination is usually needed to exclude SCC.

Reflectance confocal microscopy RCM is an in vivo imaging method to get morphologic information about the skin. We performed physical-, dermoscopical-, RCM- and histopathological examination.

Results: Physical examination revealed a solitary, well defined, red to yellowish patch, 2 cm of maximum diameter, with a shiny, verrucous surface.

Dermoscopy showed multiple yellowish globules and small dotted vessels on a structureless pink background and an increased number of linear and coiled vessels on the periphery.

RCM examination disclosed well demarcated borders and bulbous islands of pleomorphic keratinocytes in the epidermis. We observed a loss of honeycomb pattern and high reflectant single keratinocytes agglomerated in clusters surrounded by a hyporeflectant rim of cells.

The dermal-epidermal junction DEJ and the upper dermis showed dilated papillae with round vessels and slightly reflectant, homogeneous material in the spaces between.

The surrounding uninvolved epidermis had a nucleated honeycomb pattern. Perilesional big dentritic and hyperreflectant cells were also seen at the basal layer level.

DEJ was flattened and the upper dermis showed dilated, round, longitudinal and coiled vessels. The histopathological examination revealed an epidermal hyperplasia with dermal papillae filled by histiocytic cells with foamy cytoplasm.

Conclusions: The dermoscopic feature of yellowish globules correlates to the dermal foamy histiocytes. In RCM the loss of typical honeycomb pattern and the hyperreflectant clustered keratinocytes correlate to injured epidermis.

The bright to dark homogeneous material found within the dilated papillae corresponds to the foam cells. It is also possible to distinguish these features from atypical or disarranged honeycomb pattern commonly seen in carcinoma in situ.

We have shown some new aspects of the use of dermoscopy and RCM on genital skin. Recognition of genital VX by non-invasive imaging techniques may avoid unnecessary aggressive diagnostic or therapeutic surgical procedures of this benign lesion.

Es wird zur i. Die Bilder wurden digital erfasst und Kapillardichte und Kapillarweite wurden gemessen. Seine wichtigsten biologischen Funktionen sind: 1.

Aktivator des Immunsystems 5. Innerhalb von 14 Tagen kam es zu einer deutlich sichtbaren Verbesserungen der Effloreszenzen bei Akne und bei der toxischer Kontaktdermatitis.

In the literature evidence concerning patients with this condition is poor, and no generally accepted guidelines how to treat these patients have been established.

Method: In this prospective randomized study 40 consecutive outpatients were randomized either to the surgery group or to the sclerotherapy group.

Follow-up was performed 1 and 3 years after intervention. The main outcome measure was duplexsonographic recurrence after 3 years. Secondary outcomes were duplexsonographic recurrence after 1 year, clinical recurrence as well as neovascularisation in the sapheno-femoral junction after 1 and 3 years.

Results: 38 patients 5 males and 33 females completed the study: 20 in the sclerotherapy group and 18 in the surgery group. Conclusion: Surgery was better than sclerotherapy in elimination of reflux in patients with isolated AAGSV varicosis after 1 and 3 years, but the difference was only after 1 year statistically significant.

The purpose of this study is to describe cutaneous adverse events AE and their possible correlation with treatment response.

Methods: We reviewed charts from cancer patients who were treated with MK in two different clinical trials at University of California, San Francisco.

We included all patients who received at least one cycle of MK and had at least one follow-up visit. Results: We included 83 patients in our study.

The median follow up was 15 weeks range weeks. Thirty-five patients All seven patients who developed hypopigmentation were treated for melanoma.

There were no grade 4, and two patients had grade 3 cutaneous AE. Survival analyses showed that patients who developed cutaneous SE had significantly longer progression free intervals compared with patients who did not develop cutaneous AE.

Conclusion: MK shows a favorable cutaneous safety profile. The development of cutaneous AE, especially of hypopigmentation in melanoma patients, could be a positive prognostic sign.

However, anti-lymphangiogenic factors are poorly characterized. Activin A is known to reduce blood vessel formation, but the effects on lymphangiogenesis are unknown.

Here we show that human primary melanoma expresses significantly higher levels of activin A and lower levels of FST compared with nevi and melanoma metastasis.

Results: We found both activin A and Wnt1 to reduce lymphangiogenesis. However, whereas Wnt1 also reduced metastasis, this was not seen with activin A.

In vitro, activin A phosphorylated SMAD2 in both melanoma and lymphatic endothelium but, although it reduced sprouting of lymphatic endothelium, it enhanced the migration of melanoma cells.

In conclusion, activin A is an anti-lymphangiogenic factor, but because of its pleiotropic effects on cell mobility it appears not suitable as a pharmacological target.

Thomas Kocher 1, Ulrich Koller 1, J. This disease is generally caused by mutations in genes encoding for structural proteins within the basal membrane zone of the skin, leading to a lack of stability of the microarchitecture to connect the dermis with the epidermis and can be inheritated in a dominant or recessive way depending on its subform.

We want to identify optimal repair molecules for collagen 7, collagen 17, plectin and keratin 5, underlying different types of EB and generate cells in which we can easily test repair molecules for all types of EB.

The repair molecule will be extracted and adapted for the repair of genes in patient cells. Methods: In our previously developed fluorescence-based screening system, a high GFP expression upon trans-splicing correlated with a high efficiency of the RTM.

In order to obtain more reliable and reproducible results we have improved this screening model by generating stable target cell lines, mimicking an endogenous setting for four genes, as well as randomly generated RTM binding domains for the respective targets.

We have compared and analysed cells expressing high GFP levels after transfection of the respective RTM library, as well as cells expressing low levels of the GFP-reporter in order to identifiy the most functional RTM binding regions.

We assume that these regions demonstrate the most potent binding sequences for efficient trans-splicing. Our screening system thus facilitates the construction of highly functional RTMs for endogenous RNA-repair approaches.

They are composed of membrane-spanning proteins, such as junctional adhesion molecules JAMs , claudins and occludin, as well as a plethora of associated cytosolic tight junctional plaque proteins.

Cingulin is a cytosolic adaptor protein reported to link tight junctional ZO-proteins to the cytoskeleton. Although the lack of cingulin in epithelial cells leads to a down-regulation of claudin-2, it fails to have an effect on baseline permeability.

Also endothelial cells build barriers involving tight junctional proteins. However the role of cingulin in endothelial cells has not been investigated yet.

Methods and Results: We find cingulin expressed in vascular structures of skin, lung and brain tissue and confirm its localization in endothelial tight junctions by co-localization with ZO-1, but not VE-cadherin.

Moreover, cells derived from different vascular beds, express different levels of cingulin. Pulmonary endothelial cells express the highest level of cingulin, whereas cells derived from the umbilical vein HUVEC express no full-length cingulin.

Conclusion: The differential expression of cingulin might be one aspect of tissuespecific differences seen in endothelial barrier regulation.

From a previous study there is evidence that IR might enhance the development of non-epithelial skin cancer and possibly also of melanoma.

The aim of the present study was to evaluate the impact of IR on UVR-induced apoptosis and DNA repair in normal human melanocytes since malignant transformation depends on the balance between these two effects.

UVBinduced DNA damage was detected applying South-Western dot blot analysis using antibodies against cyclobutane pyrimidine dimers 6 hours after exposure.

It mediates this effect at least in part via a modification of the expression of apoptosis-related proteins. Taken together, the observed effects might enhance the survival of severely UVR-damaged melanocytes which eventually could contribute to melanomagenesis.

There are several strategies for EB gene therapy under investigation. We are using the Spliceosome Mediated RNA Trans-splicing SMaRT technology, which has the main advantage - compared to full length cDNA therapy - that only parts of the gene of interest are replaced, thereby circumventing viral packing limitations.

In previous studies we tested two randomly designed binding domains hybridizing to intron 33 of COL17A1, that had shown high trans-splicing efficiencies in a fluorescence based FACS screen.

Alltogether, we designed a set of eigth different RTMs. Successful trans-splicing was detected by sqRT-PCR analysis using primers specific for the fusion product and sequencing analysis of the products was performed.

As a next step the two identified best RTMs will be integrated into primary immortalized junctional EB patient cell lines and can then be tested for trans-splicing on endogeneous level.

Ein Hauptziel stellte dabei die Identifizierung von altersregulierten Genen dar, die vor allem im intrinsischen Alterungsprozess eine wesentliche Rolle spielen.

Die Daten liefern somit neue Biomarker, die eine direkte Verbindung zu intrinsisch gealteter Haut aufweisen. Nach Analyse der Interaktionsmuster und Eigenschaften der einzelnen Gene, Poster erscheint vor allem Pleiotrophin, als multifunktioneller Heparin-bindender Wachstumsfaktor, ein vielversprechender Aging-Kandidat zu sein.

However, their biological functions have remained incompletely understood. Methods: Genome sequences of fish, amphibians, reptiles and birds were screened for genes that encode SFTPs.

Amino acid sequences of SFTPs were deduced from the coding sequences of these genes, and antisera were generated against distinct protein epitopes.

Results: Orthologs of mammalian cornulin and a novel trichohyalin-like SFTP, that we named scaffoldin, were identified in reptiles and birds whereas filaggrin homologs were absent in non-mammalian amniotes.

Scaffoldin of the chicken is expressed in the periderm of the embryonic epidermis, the epithelium underneath the forming tips of the claws and the epithelial sheath around the growing feathers.

This expression pattern is similar to that of mammalian trichohyalin which is present in the nail apparatus and the inner root sheath of the hair.

These results suggest an evolutionary origin of SFTPs in a common ancestor of mammals and sauropsids and define conserved roles of trichohyalin-like proteins in human and chicken skin.

Our data establish an evolutionary-developmental link between the periderm, a transient layer of the embryonic epidermis, and scaffolding epithelia that support the growth of hard skin appendages in adult amniotes.

Activation of Ppars promotes lipid synthesis, it inhibits skin inflammation and it accelerates epidermal barrier recovery. Loss-of-function mutations in filaggrin cause ichthyosis vulgaris IV and predispose for AD development.

This demonstrates that besides immune- also barrier-driven mechanisms play a role in the pathogenesis of AD. IV is a chronic cutaneous barrier disorder characterized by dry and scaly skin.

Triglyceride levels are decreased in both mouse models. These results correlate with reduced levels of elox and 5-lox, key enzymes in the synthesis of eicosanoids.

Narzt 1,4, Ionela M. Extrinsic oxidative stress promotes the accumulation of reactive lipid oxidation products. Polyunsaturated fatty acids of phospholipids PL are easily oxidized by extrinsic stressors that promote skin aging, and the resulting lipid mediators elicit stress responses.

Methodology: To study in keratinocytes, which oxidation products are generated upon environmental UV stress and to study the kinetics of intrinsically generated and extrinsically added oxidized PL, we performed lipidomic analysis.

Levels of dicarboxylic acid containing PL returned to baseline after 24h, while significantly increased PL-hydroxide levels persisted.

The transcriptomic and proteomic profiling of the stressed KC performed in parallel indicated that part of the observed changes in the lipid profile after 24h would be compatible with the transcriptional modulation of enzymes regulating prostanoid metabolism, like prostaglandin F synthase.

As isoprostanes and isoprostane containing PL are correlated to aging also of the skin , the modulation of isoprostane levels by UVA may be a novel mechanism contributing to photoageing.

Skin is the most commonly involved target organ in both of them. Recent studies have shown that increased levels of the keratinocyte-derived elastase inhibitor elafin in the peripheral blood are diagnostic of cutaneous aGVHD.

Methods: In this study, we addressed the question whether the analysis of elafin expression in the skin would allow to distinguish aGVHD from drug hypersensitivity rashes DHR.

In addition, we investigated whether the analysis of cutaneous elafin expression could be a useful tool to stratify GVHD patients according to their disease severity or prognosis.

As far as clinical parameters are concerned, elafin expression was not associated with a more severe form of the disease.

In conclusion, our study suggests that the analysis of elafin expression in the skin is not a useful diagnostic tool but helps to identify patients with a poor prognosis in both cutaneous aGVHD and cGVHD.

The aim of this study was to obtain insights into the evolution of the EDC and the conservation of EDC genes in non-mammalian species. Methods: Publicly available genome sequences of fish, amphibians, reptiles and birds were subjected to comparative genomics.

The genomic regions around SA genes, which flank the EDC in mammals, were investigated by sequence similarity screenings and by de novo gene prediction.

Gene candidates were analyzed by reverse-transcription PCR in reptilian and avian tissues. Results: In contrast to fish and amphibians, reptiles and birds have a genomic locus homologous to the mammalian EDC.

Examples of SEDCs are loricrin, which is conserved in amniotes, involucrin, and small proline-rich proteins. Strikingly, the socalled beta-keratins, which are known as the main structural components of the reptilian and avian epidermis, have an evolutionary origin as SEDCs.

Other previously uncharacterized SEDC genes of lizards and chicken encode proteins with amino acid compositions and sequence motifs similar to those of mammalian SEDCs.

Like their mammalian counterparts, the reptilian and avian EDC genes are specifically expressed in the epidermis and in skin appendages.

Taken together, our data suggest that adaptations of the EDC were crucial for the evolution of both mammalian and non-mammalian skin barriers.

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Little data is available on the role of mast cells in primary cutaneous T-cell lymphomas CTCL , a heterogeneous group of non-Hodgkin lymphomas with initial presentation in the skin.

The aim of the development was to establish a new tissue analysis method on virtual slides for skin sections stained with immunohistochemistry.

The analysis method was designed to set results into a structural context of cell location and of morphological appearance reflecting a certain state of mast cell activation.

Mast cell degranulation was estimated based on the number of connected brown spots for each cell. In addition, an algorithm for the automatic detection of the area of the epidermis was developed, as well as density based CTCL areas.

Furthermore distance between each cell and its closest CTCL area was calculated. Up to mast cells per sample were found in dermis area between 1 and 49mm2.

The presented algorithms provided new data insight of context-based and functional characteristics and could generate surrogate markers for further stratification of CTCL.

In melanoma, the amount of VEGF-C expression, tumour lymphangiogenesis and metastasis to sentinel lymph nodes shows a striking correlation.

Methods: We approached this issue by selecting 22 human melanoma cell lines from primary tumours, skin, lymph node and brain metastasis with a wide spectrum of constitutive VEGF-C production.

We correlated VEGF-C, with expression of target genes of various cell signalling pathways, using the gene expression arrays from these cell lines.

The modulation of the cell signalling pathways was performed with various kinase inhibitors as well as with plasmid constructs.

To substantiate this finding, melanoma cells were treated with various kinase inhibitors targeting components of the MAPK-pathways.

Similar results were obtained when this kinase pathway activity was inhibited with lentiviral shRNA constructs. Eisendle 1 1 Department of Dermatology, Venereology and Allergology.

MAC most often presents as a scar-like papule or plaque on sun-exposed skin and is characterized by aggressive local infiltration, including a high propensity for perineural invasion.

Histologically it might be easily confused with benign adnexal tumours, especially when punch biopsies are performed and first wrong diagnoses of trichoepithelioma, trichoadenoma and syringoma often lead to inappropriate initial treatment.

Tissue invasion by MAC frequently extends far beyond the clinical margins of the tumor recurrence is high. Although metastasis and death from MAC are rare events, significant morbidity can occur as a result of deep local tissue destruction.

Complete surgical removal of the tumour is the treatment of choice. Recent preliminary studies point to higher cure rates with Mohs micrographic surgery.

A year-old healthy female presented with an almost 3 year history of an asymptomatic slowly progressing skin mass on her left eyebrow.

On examination there was a firm nodule measuring 2. Cervical lymphadenopathy was absent. Two deep punch biopsies 4 mm showed a poorly circumscribed, deeply infiltrative tumour with basaloid aspect and perineural invasion confirming MAC.

The patient underwent surgical excision with 1. Histopathology revealed an lateraly and deep incomplete removed tumor R1 infiltrating the muscle bundles with perineural invasion.

A second stage surgery was necessary with lateral and deep enlarging of the defect including the removal of the frontal periostium.

Clear histological margins were achieved and the final surgical defect was 6 x 7 cm. The eyebrow defect was finally reconstructed by a modified AT flap combined with full thickness skin transplantation 56 Poster of the flap dog ears.

The cosmetic outcome was satisfactory, no occurrence was observed after 9 moth follow-up. Conclusion: We confirm the histological difficulties diagnosing this tumour entity and the deep infiltration of MAC.

Removal deep including the periostium might be necessary to completely remove the tumour. They are characterized by aggressive local infiltration but rarely metastasize.

Local recurrence invariably follows inadequate removal. Surgery remains the first-line treatment for both sarcomas and wide surgical excision with a margin between 2 and 4 cm has been recommended.

Mohs Micrographic Surgery has been reported as effective in reducing the rate of local recurrence. Immediate reconstruction with autologous split-thickness skin graft STSG secured by negative wound pressure therapy VAC was performed in all cases.

One case received a porcine xenograft EZ Derm on top of the free Achilles tendon prior autologous split-thickness skin grafting. Application of STSGs instead of flap surgery was performed because it allows immediate closure and fast recognition of local recurrence.

Results: All patients achieved tumor free margins with the first surgical intervention. No local recurrence or distant metastasis occurred Median follow up Functional results were all good and the esthetic outcome was satisfactory.

Because of the lack of excess skin in the areas between the lip and nose, many reconstructions for this area use medial cheek advancement flaps. Superficial defects of the lateral upper lip may be closed primarily according the skin tension lines and defects closer to the nasolabial fold may be closed primarily within this fold 1.

Case report: In the present article the authors discuss a year-old man who presented to Dermatology Service with a basal cell carcinoma located on the right lateral upper lip.

Tumor size was 12x12 mm; the lesion was excised with security margins determined by polarized light epiluminescence dermoscopy.

The final surgical defect size was 15x18 mm. Results: Although transgressing the facial subunits, eight weeks after surgery, this subcutaneous advancement flap provided a good functional and aesthetic acceptable reconstruction.

The typical presentation is with solitary or few rapidly growing erythematous or bluish plaques or tumors on one leg rarely both legs.

Plaques and tumors may even ulcerate and may be clinically difficult to differentiate from venous leg ulcers. Methods: We describe for the first time 3 patients with pcDLBCL and an atypical early presentation characterized by macules instead of plaques, tumors or ulcers.

All three patients reported a history of long standing lesions since 6, 9 and 18 months, respectively without a history of rapid enlargement.

Conclusions: pcDLBCL,leg may rarely manifest at presentation with annular erythematous macules instead of plaques or tumors simulating granuloma annulare, necrobiosis lipoidica, sarcoidosis, erythema chronicum migrans, erythema annulare centrifugum or erythema marginatum.

Inoperable Tumoren wurden bislang bestrahlt. Einleitung einer Therapie mit Vismodegib im Februar Allerdings kam es im 5. Behandlungsmonat zum neuerlichen Tumorwachstum.

Bereits nach 1 Monat deutliche Tumorregression, nach 5 Monaten war weder klinisch noch bioptisch Tumorgewebe nachweisbar.

Aim of this study was evaluation of 11 body areas for predicting hirsutism in Kosovar population. Materials and Methods: In this prospective diagnostic study we selected women, with hirsutism and 25 as control group, age years.

Height, weight and a calculation of BMI was obtained. The Ferriman-Gallwey score is used in evaluation of hirsutism. The examiner scored the subjects on a scale of for terminal hair growth on eleven different body areas according to the Ferriman-Gallwey FG scoring system.

An FG score of 8 or more was considered diagnostic of hirsutism. A thorough physical examination with specific emphasis on signs of virilization including frontal baldness, loss of female body contours, increased muscularity, acne, clitoromegaly, and atrophy of breast was done in all patients.

Results: The age group with highest scoring were women under 20 years and age group years on average value The range of average scoring in different parts of the body was: 3.

Conclusion: The FG scoring system was found to be clinically useful. The feet, thighs, arms and chin were observed to have the highest score of androgen sensitive area of the body.

The FG scoring system has great significance and value to establish the diagnosis of hirsutism and is an acceptable screening method.

Key words: hirsutism, evaluation, Ferriman-Gallwey score. In prior studies, the most common treatment emergent neuropsychiatric adverse events for ATR included abnormal dreams and dizziness.

W96 safety and efficacy were secondary endpoints presented here. Conclusion: EPA demonstrated non-inferior efficacy and a favorable safety profile versus ATR with fewer discontinuations due to adverse events and fewer neuropsychiatric adverse events including abnormal dreams and dizziness.

We report the safety and tolerability profiles of STB vs comparators through W Methods: We report results from prospective, randomized, open-label, Phase 3b trials of regimen switching to STB.

STB was safe and well-tolerated with similar rates of AEs. Liu 10, David Piontkowsky 10, Martin S. Similar to ritonavir, cobicistat inhibits renal creatinine secretion, leading to a small increase in serum creatinine, without affecting the actual GFR.

Results: Rates of renal discontinuations were STB 1. Of those, 0. All PRT cases improved after study drug discontinuation. Tubular abnormalities were similar between treatment groups regardless of baseline eCrCL.

Insgesamt wurden Patienten getestet, an der Klinik und im niedergelassenen Bereich. Eine Aufnahme dieser Erkrankungen in eine nationale Leitlinie ist anzustreben.

Capecitabine as well as the widely used blood pressure regulating angiotensin converting enzyme inhibitors ACEIs are prone to cause severe coutaneous side effects.

In the present study, we sought to evaluate the potential influence of ACEIs on the appearance and severity of capecitabine-induced HFSR in breast cancer patients.

Patients who received chemotherapy bevacizumab and capecitabine and treatment with ACEIs were evaluated for incidence and intensity of capecitabine-induced HFSR.

Results: HFSR was observed in In South Tyrol a threepart triage system to gain faster treatment for urgent and emergent cases of dermatology outpatients has been introduced by the Provincial Government.

The defined threepart triage levels are urgent, priority and deferrable with a corresponding maximum time target before treatment of 1, 8 and 60 days respectively.

Methods: from February to August a sample of outpatient electronic medical records cases were randomly retrieved.

Referral diagnoses with their corresponding triage codes were recorded. Urgent visits were further analyzed according to the referring physician.

The appropriateness of the referral was determined on the basis of the published state law diagnostic guidelines. Data were statistically analyzed using the 2-tailed Pearson Chi2 test or the Fisher exact test.

Results: Overall, Conclusion: The triage system according to clinical need is safe, no urgent cases are overseen. Frequency of diagnoses differ significantly in the three triage levels, this in general points to an operating allocation system.

In the north Italian province of South Tyrol waiting times for non urgent dermatological specialist referrals and requests for specialist care are monitored centrally by the local government.

Methods: We performed a retrospective study regarding the correlation between monthly waiting time and number of access requests for the city of Bolzano, where the basin comprises approximately The monitored time included data from November to July provided by the central monitoring agency.

Results: The results of the analysis showed that the median waiting time for a non urgent dermatology referral was 57 days in the first year of the monitoring and was slowly increasing: it was 30 days at the begin of the year and 61 days at the end of the year.

Due to staff shortage waiting time increased sharply at the end of until reaching a maximum of days in January With the allocation of new physicians, waiting time then decreased to 49 days in July Not surprisingly waiting time correlates strongly negative with requests for access in specialist health care.

Allocation of adequate human resources reduces waiting time, but augments requests for specialist consultations. Anamnestisch starker Nicotinabusus.

Neben einer Psoriasis vulgaris wird auch die Verdachtsdiagnose eines Bazex-Syndrom gestellt und eine Tumor-Suche begonnen.

Epicutantest und Pilzkultur blieben ebenfalls ohne Ergebnis. Diskussion: Die Acrokeratosis paraneoplastica Bazex ist eine sehr seltene, obligate Paraneoplasie und tritt vor allem im Zusammenhang mit Plattenepithelkarzinomen des aerodigestiven Traktes auf; in der Literatur findet sich jedoch auch ein Auftreten bei anderen Neoplasien, z.

Beschrieben wurde das Bazex-Syndrom bisher v. Die typische Klinik umfasst schuppende, unscharf begrenzte, symmetrische, psoriasoforme Erytheme an den Akren sowie distale Hyperkeratosen und Rhagaden.

Weiters sind typisch eine Onychodystrophie, sowie Hyperkeratosen an den Ohren, und evt. LE-artige Gesichts-Erytheme. Als Differentialdiagnosen kommt neben einem Ekzem vor allem eine Psoriasis palmoplantaris vom keratotischen Typ in Frage.

Die Pathogenese ist weitgehend unbekannt. Die Therapie liegt in erster Linie in einer Malignomsanierung. Bull Soc Franc Derm Syph, Acrokeratosis paraneoplastica Bazex syndrome.

JEADV, Therefore, we studied the expression and localization of those and other inflammation and fibrosis markers in scarring and non scarring skin of RDEB patients and healthy donors by sqRT-PCR, immuno blots, and IF microscopy.

Conclusion: Our results point to an important role of inflammation and fibrosis in impaired wound healing, finger contractures and pseudosyndactyly in RDEB.

The role of myofibroblasts is unclear. This study revealed potential therapeutical targets to improve wound healing and finger contractures in RDEB.

Reportedly, topical antibiotics, corticosteroids and calcineurin inhibitors only have temporary efficacy. Patients and methods: Four male patients with a history of surgical and conservative topical treatment for in situ squamous cell carcinomas of the scalp, were admitted because of recurrent pustular flares, erosions and crusts restricted to the bald scalp, recalcitrant to multiple topical therapies.

Direct immunofluorescence was negative in all. Results: After initial improvement all pts developed recurrences under consecutive dapsone therapy, thus it was discontinued after four weeks.

In contrast, subsequent treatment with a topical classsteroid mometasonfuroat induced complete remissions within weeks, but all pts developed relapses following cessation of therapy.

Nevertheless, all recurrences could rapidly be managed by reintroduction of this regimen, moreover, further relapses were completely prevented by intermittent application of mometasonfuroat times per week.

Conclusion: Here we show that topical treatment with dapsone-gel was not effective in our pts. Dramatic improvement was achieved with a topical classsteroid, but long term remissions required continuous, intermittent therapy, which underscores the recalcitrant nature of the disease.

Since surgical treatment in one pt led to a long lasting disease free period, this approach may represent an interesting alternative in severe cases.

Pathogenesis is poorly understood and the clinical course of PG is impredictable. The disease might regress spontaneously, stay inactive for months or progress and worsen after trauma, surgical interventions or even without triggers.

No gold standard has been established for the treatment of PG. The role of surgical interventions and Negative Wound Pressure Therapy NWPT is controversially discussed in the literature as these procedures might pose a trigger to further aggravate the condition.

Material and methods: We report 10 consecutive patients affected by PG, three males and six women median age 65, range from 26 - The extremely painful ulcers were all situated on the lower extremities, except of one case of post augmentation mastopexy pyoderma and measured from 8 x 4 cm to 45 x 25 cm.

All patients were hospitalized prior to surgical intervention and received methylprednisolone and in most cases further immunosuppressive or immunomodulatory therapy including dapsone, ciclosporine, infliximab, methotrexate or pentoxyphylline.

NWPT was applied up to one week prior further surgical interventions. Gentle surgical debridement of the wound bed and wound borders was performed in local tumescence anesthesia and 0,3 mm thickness skin grafts STSG were transferred and secured by NWPT.

One case was not grafted because it showed fast intrinsic healing with good epithelialization under NWPT and the mammary case was grafted without applying NWPT.

All cases of PG did markedly improve with the application of NWPT, as with the surgical intervention, no case of pathergy was observed, neither from application of NWPT nor from skin grafting.

Discussion: This is the largest case series of surgical treatment for PG reported in the literature. Blister formation can also be induced via autoimmune reactions directed against self antigens as known for bullous pemphigoid.

In either case the structural integrity of the integument is affected, which leads to blistering. The primary genetic causes of epidermolyis bullosa may induce secondary effects that aggravate the disease phenotype by activating the expression of factors that degrade extra-cellular matrix components and thereby further weaken the structural integrity of the skin.

Methods: We analysed the gene expression profiles of patient derived EB-simplex Dowling-Meara cell lines in vitro as well as the composition of blister fluids of different EB subtypes in vivo.

Results: Gene expression profiles of EB-simplex Dowling-Meara cell lines revealed increased expression of matrix metalloproteinase-9 and interleukin We identified high levels of these two factors in all blister fluid samples compared to healthy controls.

Due to the fact that these two factors are causally responsible for blister formation, and that they are also expressed in high levels in epidermolysis bullosa skin, they constitute potential therapeutic targets for small molecule based therapies.

Nevertheless, they both exhibit increased plasma IgE and numbers of mast cells in the upper dermis, indicating an atopic predisposition.

Women with PCOS may have enlarged ovaries that contain small collections of fluid -called follicles -located in each ovary as seen during an ultrasound exam.

Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can all occur in women with polycystic ovary syndrome.

It is well known that hyperandrogenism and insulin-resistance with or without compensatory hyperinsulinism are closely associated, but the Rotterdam Consensus has concluded that principally obese women with polycystic ovary syndrome PCOS should be evaluated for the metabolic syndrome.

We present the case of 24 year old female patient with hirsutism. She was underweight, had acne and positive family history for hirsutism and diabetes.

She was evaluated to identify etiology, and was diagnosed as a case of PCOS with insulin resistance. It is very rare case when PCOS women with insulin resistance is underweight.

She was treated according to underlying pathology and improvement was significant after 6 month. Etablierte Therapien der GM umfassen Methotrexat ev.

Die Evaluierungen erfolgten vor Therapiebeginn Baseline sowie unmittelbar und sechs Monate nach Therapieabschluss. Ergebnis: Unmittelbar nach der Therapie war der Bewegungsumfang nahezu aller Gelenke verbessert.

Die Handkraft hingegen nahm weiter zu li. Weiters konnte ein nachhaltiger Effekt bis 6 Monate nach Therapieende beobachtet werden.

Sie sind zumeist durch hohe Temperaturen gekennzeichnet. Differentialdiagnostisch wurden Diabetes mellitus, eine Venenthrombose, eine Uveitis sowie ein Irvine-Gass-Syndrom ausgeschlossen.

Dies unter anderem durch die Inhibition von NK-kB. Prevalence of age-related macular degeneration in the United States.

Arch Ophthalmol. Br J Dermatol. Dimethylfumarate is a potent inducer of apoptosis in human T cells. J Invest Dermatol. J Immunol. Suppression of VEGFR2 expression in human endothelial cells by dimethylfumarate treatment: evidence for anti-angiogenic action.

Fumarate esters as angiogenesis inhibitors: key to action in psoriasis? Leonardi C et al. Louis University School of Medicine, St.

LY Greater clinical response is associated with improved patient reported outcomes: results from a phase 2 study in patients with moderate to severe psoriasis treated with ixekizumab.

The pathogenesis of Schnitzler-Syndrom is currently under investigation and is supposed to be related to excessive interleukin-1, which is further evidenced by the good and rapid clinical response to ILblockade.

Methods: A year old female patient suffered from intermittent urticaria combined with fever and strong arthralgia as well as increased levels of CRP since Over the years a lot of diagnostic investigations were done without concrete findings, and therapuetic attempts with anti-histamines and classical immunosuppressants failed.

The decision to start monotherapy with interleukin-1 receptor antagonist anakinra; mg subcutaneously every 24 hours was made in October At that time the patient had severe symptoms and histology revealed a leukocytoclastic vasculitis, compatible with urticaria-vasculitis for the first time.

After starting anakinra, symptoms disappeared within 24 hours. An interruption of therapy in November resulted in a rapid return of symptoms.

These suggested the diagnosis of Schnitzler-Syndrom. Today, 5 months after starting continuous therapy with anakinra, the patient is free of symptoms and beside mild dermatitis at the injection site no adverse drug effects have been registered.

Results: Monotherapy with the interleukin-1 receptor antagonist anakinra is a highly effective therapeutic option in Schnitzler-Syndrom.

Other IL-1 inhibiting agents, such as rilonacept, are currently under investigation. Rezente Erkenntnisse zeigen uns, dass Psoriasis eine Systemerkrankung ist.

Seit ca. In den abgenommenen Blutkulturen kam es zum Wachstum von E. Unter Antibiotikatherapie Ciprofloxacin i. Aufgrund des klinischen Verlaufs wurde von weiteren invasiven Untersuchungen Abstand genommen.

Schlussfolgerung: Da es sich bei Psoriasis um eine Systemerkrankung handelt ist ein Zusammenhang mit neutrophiler Cholangitis sehr wahrscheinlich.

Literatur: 1 P. Dieude, E. Sbidian, M. Viguier, E. Zafrani et al. Neutrophilic cholangitis in psoriasis vulgaris and psoriatic arthritis.

British Association of Dermatologists ; , 2 M. Allez, ME Roux, P. Bertheau et al. Recurrent cholestatic jaundice associated with generalized pustular psoriasis: evidence for a neutrophilic cholangitis.

J Hepatol ; Viguier, M. Allez, AM Zagdanski et al. High frequency for neutrophilic involvement oft he biliary tract. Hepatology ; Isse, K. Harada, Y.

IL-8 expression by biliary epithelial cells is associated with neutrophilic infiltraion an reactive bile ductules.

Liver Int ; Marrakchi, P. Guigue, B. Renshaw et al. Interleukin receptor antagonist deficiency causes generalized pustular psoriasis. N Engl J Med ; Kane, J.

Roth, M. Frosch et al. Increased perivascular synovial arthritis. Arthtitis Rheum ; Results: The data from patients 66 women, men with altogether ustekinumab treatment cycles during patient-years of follow-up were analyzed.

At first treatment cycle, the median age of the patients was 43 years range and the median disease duration was 16 years range Methoden: Bienen- und Wespengiftallergiker wurden in die Studie eingeschlossen und mit Hilfe eines standardisierten Fragebogens zu Stichlokalisation und Symptomen befragt.

In einem zweiten Schritt untersuchten wir die Hypothese, ob Stiche in gut durchblutete Hautareale mit schweren Reaktionen assoziiert sind.

Das Eindringen des Stachel in unterschiedliche Regionen der Dermis war jedoch nicht mit dem Schweregrad der systemischen Reaktion assoziiert.

Aufgrund der idealen Aerodynamik stellen die Setae eine potente aerogene Noxe dar. Entwicklung eines Diagnoseverfahrens, 3.

Schwellenwertbestimmung, 5. Einen weiteren Sammler positionierten wir unmittelbar vor die Nester. Die drei fix verorteten Sammler wurden in die Auswertung miteinbezogen.

Zur Simulation des Befalls eines Menschen positionierten wir eine mit 26 96 Poster Messstreifen beklebte erwachsene Schaufensterpuppe in der Hauptrichtung des Luftstroms cm vom Nest.

Es gab zwei Varianten teilzunehmen: 1. Teilnahme ohne Blutabnahme. Blutabnahmen erfolgten zu Beginn und am Ende der Untersuchung, sowie bei jedem Alerting.

Die Korrelation mit klimatologischen Daten ist in Bearbeitung. Zwei davon gaben Atemprobleme an, die aber nach kompletter pulmologischer Untersuchung nicht im Zusammenhang mit dem EPS standen.

In one case, hospitalization and systemic corticosteroid treatment was required. In addition bacterial smear tests of eyelids and conjunctiva were performed.

The history revealed in one patient that she had colored his eyebrows one day before the onset of eczema and the other colored her eyelashes.

Diagnostic work-up for identification of the causative compound in the dyes were planned. Methods: Patch tests with the European standard series and hairdresser materials were performed in both ladies.

In one patient additionally textile dyes were tested. In hairdresser materials, one patient reacted positive to p-Toluylendiamin, p-Aminophenol, 3-Apinophenol the second patient to p-Aminophenol, Hydrochinon and Dispersionsorange 3.

After that, she only once dyed her hair and developed ear swelling. However, both patients had not yet consulted any allergist for these reactions and did not know that in all cases the causative substance was PPD.

Thus, all henna-tattoo- or PPD-allergic patients should also be made aware of an allergic reaction to eyelash and eyebrow dyes.

It may be associated to inflammatory diseases and resembles genital warts or squamous cell carcinoma SCC. Histopathological examination is usually needed to exclude SCC.

Reflectance confocal microscopy RCM is an in vivo imaging method to get morphologic information about the skin.

We performed physical-, dermoscopical-, RCM- and histopathological examination. Results: Physical examination revealed a solitary, well defined, red to yellowish patch, 2 cm of maximum diameter, with a shiny, verrucous surface.

Dermoscopy showed multiple yellowish globules and small dotted vessels on a structureless pink background and an increased number of linear and coiled vessels on the periphery.

RCM examination disclosed well demarcated borders and bulbous islands of pleomorphic keratinocytes in the epidermis. We observed a loss of honeycomb pattern and high reflectant single keratinocytes agglomerated in clusters surrounded by a hyporeflectant rim of cells.

The dermal-epidermal junction DEJ and the upper dermis showed dilated papillae with round vessels and slightly reflectant, homogeneous material in the spaces between.

The surrounding uninvolved epidermis had a nucleated honeycomb pattern. Perilesional big dentritic and hyperreflectant cells were also seen at the basal layer level.

DEJ was flattened and the upper dermis showed dilated, round, longitudinal and coiled vessels. The histopathological examination revealed an epidermal hyperplasia with dermal papillae filled by histiocytic cells with foamy cytoplasm.

Conclusions: The dermoscopic feature of yellowish globules correlates to the dermal foamy histiocytes.

In RCM the loss of typical honeycomb pattern and the hyperreflectant clustered keratinocytes correlate to injured epidermis. The bright to dark homogeneous material found within the dilated papillae corresponds to the foam cells.

It is also possible to distinguish these features from atypical or disarranged honeycomb pattern commonly seen in carcinoma in situ. We have shown some new aspects of the use of dermoscopy and RCM on genital skin.

Recognition of genital VX by non-invasive imaging techniques may avoid unnecessary aggressive diagnostic or therapeutic surgical procedures of this benign lesion.

Es wird zur i. Die Bilder wurden digital erfasst und Kapillardichte und Kapillarweite wurden gemessen. Seine wichtigsten biologischen Funktionen sind: 1.

Aktivator des Immunsystems 5. Innerhalb von 14 Tagen kam es zu einer deutlich sichtbaren Verbesserungen der Effloreszenzen bei Akne und bei der toxischer Kontaktdermatitis.

In the literature evidence concerning patients with this condition is poor, and no generally accepted guidelines how to treat these patients have been established.

Method: In this prospective randomized study 40 consecutive outpatients were randomized either to the surgery group or to the sclerotherapy group.

Follow-up was performed 1 and 3 years after intervention. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website.

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