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Biomedical subjects

B Konz

Publications and source records attributed to B Konz.

At least 19 recordsLinked to original sources
PubMed1995

Carbon dioxide laser therapy of a widespread epidermal nevus.

BACKGROUND AND OBJECTIVE: The treatment of epidermal nevi is difficult and often unsatisfactory. Many therapeutic approaches have been tried, of which the surgical methods including lasers aim to avoid recurrences and hypertrophic scarring. Here we report the case of a widespread, life-impairing epidermal nevus, summarize the available treatment modalities, and discuss CO2 laser therapy with respect to the clinically soft variants of these developmental defects. STUDY DESIGN/PATIENTS AND METHODS: A patient with a widespread, recurrent, biopsy-proven epidermal nevus was treated with a 10,600-nm CO2 laser. After test treatments in local anaesthesia, four sessions were performed under general anaesthesia each with a follow-up time of 4 years to date. RESULTS: CO2 laser vaporization resulted in complete removal of the treated nevus without any obvious scarring. The patient is free of recurrence 4 years postoperatively. CONCLUSION: CO2 laser treatment of epidermal nevi is a useful modality in selected variants.

Adult↗
PubMed1995

[Skin ulcers in rheumatoid arthritis].

The appearance of severe ulceration of the skin in patients with rheumatoid arthritis is often associated with a tendency to progression of the underlying disease, involvement of internal organs and increased mortality. In the pathogenesis of such ulceration there are multiple causes for their development, persistence and tendency to poor healing. They include localized or generalized immune complex vasculitis, treatment with anti-inflammatory drugs and their side effects following the treatment, arterial and venous insufficiency, and mechanical factors. The management of severe ulceration requires stabilization of the underlying autoimmune disease, e.g. with high doses of glucocorticosteroids or other immunosuppressive drugs or plasmapheresis. Adjuvant treatment of pain with analgesics, improvement of blood perfusion and anti-inflammatory drugs should accompany the topical therapy of ulcers. After suppression of the local inflammatory reaction surgical intervention becomes necessary in most of the patients, and vascularized muscle flaps should be used in preference to meshgrafts or split skin grafts for extensive ulceration in rheumatoid arthritis. A hopeful perspective in the treatment of severe rheumatoid arthritis might be opened up with immunotherapy using monoclonal antibodies.

Aged↗
PubMed1995

[Micrographic surgery. A current methodological assessment].

Micrographic surgery is one of the most effective methods in the treatment of basal cell carcinoma. In the last 20 years this method has been further developed and modified. Three kinds of micrographic surgery are now available: the Mohs method, the margin strip method ("Tübingen torte") and the "Munich" method. All three variants have the same goal; radical tumour removal with optimal sparing of surrounding tumour-free tissue. They differ, however, in the technique of tumour excision, the preparation of the histological specimens and the interpretation of the slides. In this paper the authors take stock of the methods available and describe the differences, advantages and disadvantages.

Basal Cell Carcinoma↗
PubMed1994

Chronic cutaneous damage after accidental exposure to ionizing radiation: the Chernobyl experience.

BACKGROUND: The hazards of acute radiation exposure are well known. Bone marrow failure from total body gamma or neutron irradiation is the most clinically relevant aspect of acute radiation disease. With nonhomogeneous exposure, as is characteristic in accidents, other organ systems, such as the skin, may be more important in determining clinical prognosis. This became obvious in the two worst radiation accidents since 1945, the Chernobyl accident in April 1986 and the Goiania accident in September 1987. OBJECTIVE: Our purpose was to describe the characteristic chronic sequelae of accidental cutaneous radiation in a group of patients who survived the Chernobyl nuclear power plant accident. METHODS: Fifteen patients with the delayed type of the cutaneous radiation syndrome were examined between September 1991 and January 1992. All patients had a history of acute radiation disease. The exposure pattern was characterized by partial body exposure with high doses of beta and gamma irradiation from radioactive water, steam, or dust. RESULTS: Radiation-induced lesions were confined primarily to the legs and distal arms, but sometimes involved up to 50% of the total body surface. In addition to telangiectases, radiation keratoses, and radiation ulcers, hemangiomas, hematolymphangiomas, splinter hemorrhages in the distal nail bed, lentiginous hyperpigmentation, and severe subcutaneous fibrosis were noted. No malignant transformation could be detected. Associated diseases included cataracts, chronic hepatitis, and recalcitrant bacterial and herpesvirus infections. CONCLUSION: After accidental partial body exposure to high doses of beta and gamma irradiation, the predominant involvement of the skin, described as the cutaneous radiation syndrome, can become the characteristic feature. This causes longlasting, serious diagnostic and therapeutic problems.

Accidents↗
PubMed1990

[Oculoplastic therapy in generalized nevus verrucosus].

The clinical and histopathological picture of a 27-year-old patient with generalized nevus verrucosus is described. The oculoplastic treatment performed in this patient consisted in lid plasties, surgical excision, cauterization and cryotherapy. The different therapeutic techniques were applied over a period of 2 years. Nearly all papillomatous lesions were removed without impairing lid contour or lid function.

Adult↗
PubMed1989

Excisional biopsy as the first therapeutic procedure versus primary wide excision of malignant melanoma.

The five-year disease-free rate (5-y-DFR) and five-year survival rate (5-y-SR) of 319 melanoma patients with a narrow excisional biopsy in local anesthesia as the first procedure followed by delayed wide excision, were compared with 5-y-DFR and 5-y-SR of 635 primary radically treated patients. Five-y-DFR and 5-y-SR did not differ in either group of patients. Furthermore, the time interval (less than or equal to 21 days versus greater than 21 days) between excisional biopsy and delayed wide excision had no influence on the outcome of the patients. Based on the results of the study and the literature, excisional biopsy of malignant melanoma followed by delayed wide excision is a safe procedure.

Adolescent↗
PubMed1988

[Multiple BCG-induced ulcers after subcutaneous vaccination in the framework of immunochemotherapy in malignant melanoma].

Immunochemotherapy combining dacarbazine with BCG is a possible therapeutic method for the adjuvant treatment of malignant melanomas. The routes of application of BCG, however, vary. As the case of a 61-year-old female shows, subcutaneous injection can lead to severe ulcerations, which respond to tuberculostatic therapy. Therefore scarifications seems to be preferable.

BCG Vaccine↗
PubMed1986

[Therapy and prognosis of malignant melanoma of the skin].

Since 1967 a total of 2403 patients with malignant melanoma have been treated according to a standardized regimen. The five-year survival rate for all patients in stage I was 79%. It was clearly dependent on tumour thickness or prognostic index, respectively. If tumour thickness was less than 0.75 mm or the prognostic index under 6, more than 90% survived for five years. With a tumour thickness of more than 3 mm or a prognostic index of greater than 13 the survival rate decreased to about 50%. Irrespective of tumour thickness the first signs of progression were local recurrence (20%), lymph-node metastases (50%), or distal metastases (30%). In case of progression symptoms recurred in about 80% within the first three years after tumour removal, in about 90% within five years. However, some 10% of progression signs occurred after more than five years. Prognosis was not significantly improved in stage I by adjuvant treatment with dacarbazine and BCG. In stage II the five-year survival rate was still about 30%. But in stage III only those patients with exclusively cutaneous distal metastases had a somewhat better prognosis. Only a few patients lived more than three years after the occurrence of organ metastases.

Adult↗
PubMed1983

[Malignant melanoma in lupus (tuberculosis cutis luposa)].

We report on a 72 years old man showing a strikingly fast spreading malignant melanoma developing on a lupus vulgaris which had existed since childhood. The coincidence of both diseases is obviously extremely rare. A pathogenetic relationship between melanoma and lupus vulgaris, such as claimed for carcinoma in lupo, especially after X-ray irradiation, is not inferable.

Aged↗
PubMed1982

[Congenital giant nevi. Clinical picture and therapy].

Congenital giant nevi are rare. There is high risk of malignant melanoma in large congenital nevi. Therefore the early operative removal is advised, not only for the prevention of malignant tumors, but also for psychologic and social reasons. The surgical and reconstructive methods include serial excisions, free skin-grafts and local pedicled flaps. The special advantages of free full-thickness grafts in the treatment of giant nevi in the facial region are outline.

Adult↗
PubMed1982

[Possibilities for tattoo removal. Report of experiences].

Different motivations are seen in patients with tattoos, which can be seen in a tattooed picture. Two kinds of tattoos can be distinguished: Professional and self-made tattoos. In general, patients with self-made tattoos call for their removal, because the private situation has changed. These tattoos are more difficult in treatment than professional ones, because the colour is located in the whole dermis. The method of treatment depends on size, form and shape of the tattoo. For treatment simple excision of small tattoos, dermabrasion in one or two sessions are recommended. Own experiences and results in 121 patients with tattoos are reported and discussed.

Dermabrasion↗
PubMed1982

[Coincidence of multiple cylindroma and trichoepitheliomas (Brooke-Spiegler-Syndrome)].

The coincidence of cyclindromas and trichoepitheliomas has been subject of a rather broad discussion for its principal pathogenetic aspects. Clinical cases, however, have only rarely been observed. Therefore, a case-report is given. Although the heredity of the Brooke-Spiegler syndrome seems well established by now, there is no anamnestic data in our case.

Adult↗
PubMed1981

Histological and cytological criteria in the diagnosis of malignant melanomas by cryostat sections.

Although cryostat sections in general allow a distinction to be made between malignant melanomas and other pigmented lesions in clinically doubtful cases, the differential diagnosis may be difficult. The histological and cytological criteria taken into account can be classified as major, minor, and insufficient. Knowing the diagnostic value of each makes a conventionally established diagnosis safer. Variance analysis does not contribute to the problem but it can nevertheless be shown that the evaluation of six major criteria makes a quick and reliable cryostat section diagnosis possible. If these results are confirmed in a prospective study it would be a decisive step on the way to a quicker and safer cryostat section diagnosis of malignant melanoma, even for the less experienced histopathologist.

Analysis of Variance↗
PubMed1980

[Diagnosis by intra-operative cryostatic section in suspected malignant melanoma (author's transl)].

In 233 (40.6%) of 535 patients referred for hospital treatment with a strong suspicion of melanoma, a diagnosis of malignant melanoma could be established on the grounds of the macroscopic clinical picture alone. In 302 patients (56.5%) a clinical diagnosis was not possible so that an intra-operative cryostatic section investigation was necessary to determine future operative measures. This gave a clear diagnosis of malignant melanoma in 101 (34.4%) patients and a benign pigmented skin tumor was established in 171 (56.6%) patients. In 14 cases (4.64%) no diagnosis could be made from the cryostatic investigation. In 16 (5.3%) patients diagnosis from cryostatic section had to be corrected after analysis of paraffin sections. Altogether an accuracy of over 85% was achieved.

Cryosurgery↗