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Biomedical subjects

B Kränke

Publications and source records attributed to B Kränke.

At least 19 recordsLinked to original sources
PubMed2006

Tryptase as severity marker in drug provocation tests.

BACKGROUND: In the absence of objective symptoms, it is difficult to assess an adverse reaction during drug provocation testing. We evaluated the value of serum tryptase levels to distinguish between positive, negative and, even more important, so-called 'hysterical' reactions (conversion symptoms). The latter are occasionally observed in drug provocation tests when the patient experiences ambiguous subjective symptoms. METHODS: In a prospective single-center study, 303 patients underwent 785 drug provocation tests. Blood was taken for tryptase measurement on each test day before and after drug challenge, and the changes in serum tryptase levels in patients with no reactions were compared with those who experienced immediate reactions to a drug. RESULTS: Thirty-four of 785 drug provocations were clinically judged as being positive. Despite objective symptoms, median serum tryptase values in the afternoon were even lower than baseline levels. However, this decrease was not statistically significant. In the 751 patients suffering no objective reactions, the median values of post-testing tryptase values were statistically significantly decreased as compared with pretesting values. CONCLUSIONS: The measurement of serum tryptase levels does not appear to be helpful to differentiate mild allergic or nonallergic reactions from 'hysterical' ones. The milder decrease in the group with objective drug reactions might indicate slight mast cell activation in some patients. More severe clinical drug reactions led to stronger mast cell degranulation. Mild reactions did not increase the tryptase levels consistently.

Acetaminophen↗
PubMed2006

Vascular pattern of the palms--a clinical feature of atopic skin diathesis.

BACKGROUND: Atopic skin diathesis is a clinical term to describe skin atopics with previous, present or future atopic eczema/dermatitis syndrome (AEDS). In clinical practice, an unequivocal assessment of atopic skin diathesis in non-eczematous patients may be difficult. The majority of the known clinical features included in diagnostic scores are characteristic, but not specific markers of atopy. Especially, the vasoreactivity of atopic skin is disturbed. This is manifested by white dermographism, an irregular vascular response to thermal stimuli, and paradoxic skin reactions to histamine, cholinergic agents, and nicotinates. OBJECTIVE: The aims of our study were to investigate the clinical morphology of palmar vascular reactions in skin atopic and non-atopic individuals, and to determine whether this abnormal vascular reaction is more pronounced in skin atopic individuals. METHODS: Forty persons, 20 of them skin atopics, assessed by the Erlangen Atopy Score and an elevated serum IgE level (>150 U/ml), were included in a prospective single-centre study. Standardized digital photographs of the palms were presented in a blinded manner to five dermatologists in random order by means of the computerized imaging analysis system KS400 3.0. RESULTS: Evaluation of the original rgb (red, green, blue) color images and modified gray-level images showed that a pronounced reticular pattern of erythema of the palms was significantly (P < 0.0001) more common in skin atopics (72% and 69.6%, respectively). CONCLUSION: The gross vascular pattern of the palm might be an additional diagnostic feature of atopy, and further studies are needed to establish its exact prevalence.

Dermatitis, Atopic↗
PubMed2003

[Epidemiologic surveillance of contact allergens. The "monitoring series" of IVDK (Information Network ofDermatologic Clinics for Detection and Scientific Evaluation of Contact Allergy].

The selection of the most important contact allergens is subject to a continuous change. Several factors may influence the sensitization rates and thus the decision, which substances to include in the standard series of the most frequent allergens. The Information Network of Departments of Dermatology adds substances of interest for a certain time period to the standard series in order to evaluate parameters such as sensitization rate, grade of reaction, and clinical relevance of positive reactions. In 6 testing periods starting in 1996, 13 test substances were evaluated. Due to the results, propolis, compositae mix, and bufexamac were included in the standard series in 1999, while lyral was added in 2002. Sorbitansesquioleat, dispers blue mix, and iodopropynyl butylcarbamate are under further discussion. Substances such as glutaraldehyde and p-aminoazobenzole should be tested in certain risk groups only, whereas the steroids budesonide and tixocortol should be tested when clinically suspected.

Allergens↗
PubMed2003

[Anal and palmar contact dermatitis caused by iodopropynyl butylcarbamate in moist sanitary wipes].

A 63-year old man developed severe perianal and palmar contact dermatitis caused by sensitization to iodopropynyl butylcarbamate in moist sanitary wipes. Iodopropynyl butylcarbamate is increasingly employed as preservative in common cosmetic formulations and moist sanitary wipes as substitute for the previously frequently used sensitizers isothiazolinones and methyldibromoglutaronitrile. The allergic potential of diverse preservatives is a serious problem for the cosmetic industry, since truly hypoallergenic preservatives are not available but products such as moist sanitary wipes in large packages definitely require some form of protection.

Allergens↗
PubMed2001

IgG antibodies typical for extrinsic allergic alveolitis--an inter-laboratory quality assessment.

BACKGROUND: Determination of specific IgG antibodies is important for the diagnosis of extrinsic allergic alveolitis (EAA). Various evaluations have however shown, that current methodology lacks sufficient standardization in that the employment of different sources of extracts and techniques makes a comparison of data from one laboratory to another almost impossible. OBJECTIVE: The aim of this study is to establish an external quality control system and to analyse, what the explanations for the different outcomes from various laboratories might be. METHODS: In the past 4 years 5 sera from patients suffering from EAA or healthy controls were sent every 6 months to 11 different allergy laboratories in Austria. The determination of specific IgG antibodies against antigens that are typical for this disease were requested. Results were gained with the method routinely used in the respective laboratory, and then sent back to the reference center for statistical evaluation. Precipitating techniques were used in 8 laboratories during the first mailings, but were gradually exchanged by automated ELISA systems being employed in 8 laboratories in the last mailing. RESULTS: 1127 values were determined in 105 expectedly positive sera and 1003 in 94 negative samples. Of the 562 values obtained with precipitation techniques in positive sera, only 52.0% were reported to be positive, and the results varied considerably among laboratories and antigens. In contrast, 93.3% were positive with commercially available ELISA techniques, with 92.3% for the EnzyDex System and even 95.5% for the UniCAP System. Regarding the specificity however, 93.0% of the expected negative results were correct negative using precipitation methods, whereas merely 75.2% were negative with the EnzyDex System and only 22.5% using the UniCAP System. Moreover 35.8% of the results using this latter method were false-positive. CONCLUSIONS: The traditional precipitation techniques proved not only technically difficult to perform, but also unreliable, difficult to reproduce, insensitive and impractical in daily laboratory work. They suffer from that many draw backs, that their use in daily routine cannot be recommended any more. Automated ELISA systems seem to fulfill the criteria for a routine technique concerning handling, automation, and quality criteria like sensitivity quite well, but not for specificity. Both techniques urgently need external standardization in order to make the results comparable among the different systems and methods; the danger of potentially false-positive results, pretending sensitizations that might be clinically irrelevant in several cases, is high.

Alveolitis, Extrinsic Allergic↗
PubMed2001

Anaphylaxis to 5-methoxypsoralen during photochemotherapy.

Photochemotherapy is very effective for the treatment of skin diseases such as psoriasis, as well as for the prophylactic 'hardening' therapy of patients suffering from polymorphic light eruption. The photosensitizers most widely used for oral photochemotherapy are the furocoumarins 8-methoxypsoralen and 5-methoxypsoralen. Beside light-induced phototoxic reactions due to the photosensitizing activity of psoralens, side-effects after the oral intake of psoralens are nausea and vomiting, headaches, anxiety and sleeplessness. We report a rare case of anaphylaxis to 5-methoxypsoralen that developed during prophylactic 'hardening' therapy in a 36-year-old woman suffering from polymorphic light eruption. Anaphylaxis to 5-methoxypsoralen was established by placebo-controlled oral provocation tests.

5-Methoxypsoralen↗
PubMed2001

Pigmented purpuric contact dermatitis from Disperse Blue 106 and 124 dyes.

The diagnosis of purpura pigmentosa progressiva in a female patient had to be changed to purpuric contact dermatitis after patch testing with textile dyes. A modified patch test performed in the area in which most of her skin lesions were located revealed a petechial reaction to the azo dye Disperse Blue 124/106. For evaluation of purpura pigmentosa progressiva we suggest a patch test with potential allergens, and, especially for textile dyes, a patch test at the lesion site may be helpful.

Allergens↗
PubMed2001

Resolution of granulomatous rosacea after eradication of Helicobacter pylori with clarithromycin, metronidazole and pantoprazole.

The aetiopathogenetic role of Helicobacter pylori in rosacea remains controversial. We report a 27-year-old man with a 4-year history of intractable rosacea. Histopathology showed epithelioid granulomas. H. pylori infection was proven directly on gastroscopy and by serological testing. Treatment with clarithromycin, metronidazole and pantoprazole eradicated H. pylori. Skin changes were markedly improved by the end of this therapy and had resolved completely 2 months later. The patient has been followed up, and has remained free of symptoms for 3 years. We suggest that H. pylori may be involved in the aetiopathogenesis of granulomatous rosacea.

2-Pyridinylmethylsulfinylbenzimidazoles↗