Search

In this pilot-study we enrolled 12 patients including 4 squamous cell carcinomas, 6 basal cell carcinomas and 2 actinic keratoses. After histological confirmation of the diagnosis, treatment was performed 3 times weekly, applying imiquimod 5% cream (Aldara®) to the tumour site. 2 weeks after the last dosis of imiquimod 3 mm punch biopsies were obtained. Interest was payed as well to the histological regression of the tumour as to the quantitative and qualitative change in infiltrating cells under the therapy with imiquimod. In addition to a hematoxylin and eosin staining the paraffin sections were stained using a standard avidin-biotin-peroxidase technique for CD 3 (pan t-lymphocytes), CD 20 (b-lymphocytes), CD 56 (natural killer cells) and CD 68 (monocytes/macrophages). 10 out of the 12 enrolled cases experienced complete resolution of the tumour (83,3%). The number of infiltrating cells showed a great inter-individual variety for all marked cell-types before and after the end of therapy. In the collective of responders to therapy T-cells decreased over 68%, B-cells decreased over 37,5%, natural killer cells over 77,6% and monocytes/macrophages decreased over 41,3%. In contrast the two non-responders showed a mean increase in T-cells of 145%, in B-cells an increase of 190,4%, in natural killer cells an increase of even 974% and monocytes/macrophages an increase of 110,7%. Respecting the mechanism of action of imiquimod we should have expected an increase in inflammation cells in successfully treated tumours. The clinical control of the enrolled cases leads to the assumption that the responders to therapy had experienced an increase of inflammating cells to one point of treatment that had undergone our histological control. The individual different development of infiltrating cells might indicate an interindividual difference in the temporal course of induced cellular reactions. A high number of infiltrating lymphocytes before treatment might have a positive predictive value for a fast development of a sufficient immunreaction. Imiquimod proved to be an effective alternative to surgical treatment. [ABSTRACT FROM AUTHOR]

Acute respiratory infections (ARIs) are the most common childhood illnesses worldwide whereby the reported frequency varies widely, often depending on type of assessment. Symptom diaries are a powerful tool to counteract possible under-reporting, particularly of milder infections, and thus offer the possibility to assess the full burden of ARIs. The following analyses are based on symptom diaries from participants of the German birth cohort study LoewenKIDS. Primary analyses included frequencies of ARIs and specific symptoms. Factors, which might be associated with an increased number of ARIs, were identified using the Poisson regression. A subsample of two hundred eighty-eight participants were included. On average, 13.7 ARIs (SD: 5.2 median: 14.0 IQR: 10-17) were reported in the first two years of life with an average duration of 11 days per episode (SD: 5.8, median: 9.7, IQR: 7-14). The median age for the first ARI episode was 91 days (IQR: 57-128, mean: 107, SD: 84.5). Childcare attendance and having siblings were associated with an increased frequency of ARIs, while exclusive breastfeeding for the first three months was associated with less ARIs, compared to exclusive breastfeeding for a longer period. This study provides detailed insight into the symptom burden of ARIs in German infants.

Background: Progressive facial hemiatrophy (PFH) is characterized by a slowly progressive atrophy of soft tissues and in some cases bony structures. Coexisting features of localized scleroderma (LS) are commonly observed, indicating the close nature of both disorders., Objective: We sought to investigate clinical, serological, and radiographic findings in PFH from 278 patients with LS and to discuss the relationship to linear scleroderma en coup de sabre (LSCS)., Method: A total of 12 patients with PFH were retrospectively evaluated on the basis of clinical, serological, and radiographic findings., Results: Five patients (42%) presented with complete PFH, and 7 patients (58%) with partial PFH involving either cheek or forehead. Five of the patients (42%) had a coexisting LSCS lesion, and 3 of them (25%) had concomitant LS of the trunk. Intraoral involvement was present in 6 cases. Neurological involvement was common, in particular, epileptic seizures. Serologic investigations showed neither evidence for infection with Borrelia burgdorferi nor any other indication of underlying systemic immunological disorders., Limitations: There were a relatively small number of patients in a retrospective study., Conclusion: The reported cases suggest a close relationship between PFH and LSCS. PFH might appear as two different subtypes, one involving cutaneous structures and presenting with clinical features similar to LSCS, one being strictly restricted to subcutaneous structures, primarily affecting the cheek area. The manifold clinical features of central nervous system involvement indicate the pathogenetic importance of neurological involvement in the development of PFH. Magnetic resonance imaging should be included in the tools of standard diagnostic procedures in patients with PFH. The etiologic relevance of autoimmunity as well as preceding trauma should be investigated in larger collective studies.

Skin involvement in chronic renal failure is characterised by a multitude of different aspects. Apart from the typical yellow-brown discolouration of the skin, most often patients complain of pruritus and xerosis cutis. A marked actinic elastosis is noticed. Dialysis treatment alters and partly aggravates these pre-existing skin conditions. When chronic renal failure leads to a kidney transplantation, some of the reversible skin pathology, e.g. pruritus, xeroderma, tends to ameliorate, but a high tendency to develop malignancies becomes prominent., (Copyright 2002 S. Karger AG, Basel)

Background: Lichen sclerosus (LS) is a chronic inflammatory skin disease in which numerous therapies have been used, with only limited success. Because low-dose UVA1 phototherapy has been shown to be an effective treatment option for localized scleroderma, which shares several similar clinical and histologic features with LS, we initiated a clinical trial with this phototherapeutic modality in patients with LS., Methods: Ten patients suffering from extragenital LS were treated with low-dose UVA1 phototherapy 4 times weekly with single UVA1 doses of 20 J/cm(2). Forty treatment sessions were performed within 10 weeks, resulting in a cumulative UVA1 dose of 800 J/cm(2)., Results: Low-dose UVA1 phototherapy resulted in a marked reduction of the clinical score and a significant (P <.05) decrease of ultrasonographically measured skin thickness as well as a highly significant (P <.001) increase of dermal density. The patients reported a remarkable softening and repigmentation of the affected skin., Conclusion: Analogous to the treatment results in localized scleroderma, low-dose UVA1 phototherapy seems to be an effective and well-tolerated treatment option for extragenital LS.