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Biomedical subjects

G K Steigleder

Publications and source records attributed to G K Steigleder.

At least 19 recordsLinked to original sources
PubMed1995

Low-dose short-term cyclosporine versus etretinate in psoriasis: improvement of skin, nail, and joint involvement.

BACKGROUND: High-dose cyclosporine therapy significantly alleviates psoriasis within 2 to 4 weeks but is associated with a high rate of side effects. Reports are conflicting on the frequency and promptness of relapse after discontinuation of cyclosporine therapy. OBJECTIVE: Our purpose was to compare the efficacy and safety of low-dose cyclosporine with that of etretinate and the stability of remission after replacing cyclosporine therapy with topical anthralin during tapering of cyclosporine. METHODS: In a multicenter study 210 patients with moderate to severe chronic plaque-type psoriasis were randomly assigned to treatment with cyclosporine or etretinate. The initial dosages were 2.5 mg/kg/day for cyclosporine and 0.5 mg/kg/day for etretinate, which could be individually adjusted to 5.0 and 0.75 mg/kg/day, respectively. After a treatment phase of 10 weeks (phase 1) patients receiving cyclosporine were again randomly assigned to a group in which cyclosporine was replaced by topical dithranol (anthralin), or to another group in which the drug was tapered during the next 12 weeks (phase 2). All patients treated with etretinate discontinued therapy after 10 weeks and used topical dithranol. RESULTS: Mean Psoriasis Area and Severity Index decreased by 71% in the cyclosporine group and by 47% in the etretinate group during phase 1. After 10 weeks of treatment 47% of the patients treated with cyclosporine and 10% of those treated with etretinate showed a reduction of more than 80% in skin involvement. Sixty-four percent of the cyclosporine group and 48% of the etretinate group did not require an increase in the initial dosage, resulting in a mean daily dose of 3.0 and 0.53 mg/kg, respectively. There was significant alleviation of nail involvement and joint complaints in both groups. In phase 2 the increase in mean Psoriasis Area and Severity Index and the incidence of relapse were significantly higher in patients in whom cyclosporine was discontinued and replaced by dithranol than in patients in whom cyclosporine was tapered or who were pretreated with etretinate. During treatment four patients from the cyclosporine group and three patients of the etretinate group discontinued the study because of side effects. CONCLUSION: Low-dose short-term cyclosporine therapy for psoriasis is, in comparison with etretinate, highly effective and well tolerated. Individually adjusted cyclosporine therapy allows the majority of patients to continue the low dosage of 2.5 mg/kg/day and still achieve a good clinical response. Remission can be better preserved by tapering the drug than by discontinuing treatment abruptly.

Administration, Cutaneous↗
PubMed1991

PIXE analysis in uninvolved skin of atopic patients and aged skin.

PIXE (proton-induced X-ray emission) analysis was used to determine the elemental distribution in normal-appearing skin of patients suffering from atopic eczema and in the skin of elderly people. With this technique, elements with atomic numbers greater than or equal to 14 can be detected simultaneously in cryosections of skin biopsies down to a concentration of 1 ppm. Compared with a control group, the epidermal concentrations of Zn and Cu, which are constituent parts of a variety of enzymes, were increased in uninvolved skin of patients with atopic eczema. An increased concentration of these two metals might indicate that even in the epidermis of clinically normal skin of atopic patients, the content of certain enzymes is increased. In the epidermis of elderly people the level of K was lower and that of Ca was higher than in the epidermis of a younger age group. The decreased K level may reflect a reduction of the intracellular volume in the epidermis of aged skin. As high Ca concentrations inhibit the proliferation of and promote the differentiation of keratinocytes, elevated Ca levels may be of importance for the age-associated decrease in epidermal turnover rate.

Adult↗
PubMed1990

[Is involvement of skin appendages or thickness of the epidermis an aid in differential diagnosis between lentigo maligna melanoma and superficially spreading melanoma in situ?].

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.

Biopsy↗
PubMed1989

[Cytokinetics and keratins of keratinocytes from skin of the elderly].

Regarding the keratin pattern of non-exposed skin, we found no significant qualitative or quantitative differences between 6 old persons (mean age 85 years) and 4 young adults (mean age 20 years). There was, however, a slight increase of proliferation keratins (K6, K16) in aged skin. In non-exposed skin taken from 6 old (mean age 70 years) and 5 young persons (mean age 37 years), longterm primary submersion cultures of keratinocytes did not show any significant differences as far as the classical parameters of growth behavior were concerned (i.e. plating efficiency, cell count, and labeled thymidine incorporation). In accordance with these findings, daily measurements of the thymidine kinase activity in the supernatants revealed discrete but not significant differences between keratinocytes in aged people and those in young persons.

Adolescent↗
PubMed1989

[The occurrence of polymorphonuclear leukocytes in normal human skin].

We studied the occurrence and quantity of polymorphonuclear leucocytes (PMNL) in normal human skin of various sites and age groups. There were no PMNL in the horny layer and the deeper layers of the epidermis. Very few PMNL were found in the dermis of persons of various age groups and in various localizations.

Adult↗
PubMed1989

[Malignant melanoma and HIV infection].

Among 1000 patients with HIV infection consecutively examined at our dermatological department during the last 3 years, we diagnosed 4 cases of malignant melanoma. This figure is clearly higher than the statistical incidence of 4-13 cases per 100.000 people a year observed in West Germany. The mean age of our 4 patients and 3 additional cases reported in the literature is 10 years less than the average age found in melanoma patients without HIV infection. These findings indicate an increased risk of malignant melanoma in patients with HIV infection. In most of our patients, the cellular immunity was only marginally impaired, corresponding to the stages WR1 and WR2 (Walter Reed classification). Tumor formation, therefore, does apparently not depend on the severity of decompensation of the immunity.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[The atypical course of syphilis in HIV infection].

We report on 3 HIV patients showing atypical courses of syphilis. Both the history and serology of the first patient proved a recent re-infection with T. pallidum, whereas the histopathological findings corresponded to an advanced stage of the disease (S II-III). The second patient showed the clinical picture of syphilis maligna with slowly converting and slightly positive serological reactions. The third patient had a refractory syphilis and an early relapse. Our observations suggest that syphilis might take an unusual course in HIV patients. Considering our total HIV clientèle (800 patients greater than or equal to WR 2) the frequency of these atypical cases must be rated very low (0.38%).

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Aseptic skin necrosis after subcutaneous injection of alpha interferon].

Aseptic necrosis of the skin developed in two patients with HIV-associated disseminated Kaposi's sarcoma after subcutaneous injection of recombinant interferon-alpha. Both patients were given it at a daily dosage of 20 x 10(6) IU/m2 body surface area. One of the patients, after full remission had been achieved, received a reduced dosage of 3 x 10(6) IU/m2, twice weekly. The clinical picture and course of the changes were similar to those of embolia cutis medicamentosa (Nicolau's syndrome), which can occur after injection of various drugs, intended to be intramuscular but by mistake given intra-arterially.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Striated nail discoloration caused by zidovudine].

We report on 2 male patients treated with zidovudine (azidothymidine), who developed longitudinally striated coloration of their nails and lentigines. Both patients are suffering from advanced HIV disease with opportunistic infections. Following treatment with zidovudine 1200 mg daily for 3 and 6 months resp., we observed longitudinal streaks of brownish color in both patients; they did not receive any other drugs known to induce discoloration of the nail plate. Our cases possibly reflect antiproliferative effects of zidovudine at the particularly susceptible nail matrix.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Wound treatment with autogenous epidermal cell expansion culture].

Sheets of autologous epidermal cells grown by expansion culture were used to cover small skin defects in seven patients with postoperative necroses, necroses due to temporal arteritis, varicose ulcers or after tangential excision of tattoos. Several transplantation techniques were used: backing of the cultured epithelia with vaseline gauze, Surfasoft, Adaptic, Silastic foil, culturing directly from Petriperm-foil. Meshed Silastic-foil proved to give the best support. Optimal take of the in-vitro epithelia (more than 80% of their surface area) was achieved only for fresh dermal wound-beds. The take was only moderate on chronic granulation tissue, but the transplants reduced the formation of fibrinous-necrotic material and favoured the formation of fresh granulation tissue.

Adult↗
PubMed1988

[Keratosis palmoplantaris diffuse circumscripta (Thost-Unna) with micropenis].

We report on a 2-year-old boy showing diffuse palmoplantar keratoderma (Thost-Unna's disease) in association with congenital penis hypoplasia. Family history research proved palmoplantar keratoderma autosomally dominant over 5 generations. The boy's 6-month-old brother also shows penis hypoplasia, as yet, however, without signs of palmoplantar keratoderma. So far we are not able to settle the question whether this case represents a clinical entity of its own or merely a chance association of rare symptoms.

Child, Preschool↗