Biomedical subjects
J Dissemond
Publications and source records attributed to J Dissemond.
Sneddon's syndrome: cardiac involvement detected by magnetic resonance imaging.
Explore the source record for details and available documents.
[Physical exercise in thte treatment of ulcus cruris venosum].
As an adjuvant measure, physical exercise should be recommended for all patients with an ulcus cruris venosum, and should be a permanent part of the patient's lifestyle on completion of wound healing. Although clinical studies have shown that physical exercise has a positive effect on numerous factors of relevance for the development of an ulcer, sports activities undertaken for therapeutic and prophylactic purposes are still made little use of by patients.
[Leg ulcers: current aspects in diagnostic].
Explore the source record for details and available documents.
[Human beta defensins: a new perspective in acne treatment?].
Explore the source record for details and available documents.
[Comparison of the minimal erythema dose for narrowband UV-B and broad spectrum UV-B using a new UV hand-held device].
BACKGROUND: Phototherapy requires an individually adapted therapeutic regime that is based upon the minimal erythema dose for each patient. Whereas this is well established for UV-B broadband, so far no standardized equipment existed that allowed for determination of the MED for UV-B 311 nm narrowband irradiation. Thus, the starting dose for UV-B 311 nm is usually adjusted to the clinical skin type or the MED for broad-spectrum UV-B irradiation. PATIENTS AND METHODS: We determined the MED for UV-B 311 nm in a cohort of 110 healthy test persons with a newly constructed hand-held UV-light source and compared it to UV-B broadband MED. RESULTS: For UV-B broadband, the MEDs ranged from 46.2 to 210.9 mJ/cm(2) with an average value of 108.45 mJ/cm(2). For the MED of narrowband UV-B 311 nm, the values ranged from 300.9 to 1.386.0 mJ/cm(2) with an average value of 838.88 mJ/cm(2). Concerning the factor of the MED UV-B broad-spectrum related to MED UV-B 311 nm narrowband, values from 4.01 to 13.68 with a average value of 7.91 resulted. No significant differences could be detected for the MED of UV-B broad-spectrum and narrowband in correlation to age, sex or clinical skin type. CONCLUSION: Our data emphasize the presence of extensive inter-individual differences in the MED of both UV-B-spectra and point to the necessity to test patients before the first irradiation.
[Multiple subcutaneous painful hyperpigmented nodules on both lower limbs].
Explore the source record for details and available documents.
[Antimicrobial peptides. A perspective for the treatment of chronic wounds?].
Human antimicrobial peptides play a substantial role in the immune response to various dermatological diseases, such as acne, atopic dermatitis and psoriasis vulgaris, and even mucosal HIV-protection is mediated inter alia by antimicrobial peptides. In wound healing, the antimicrobial and immune-modulating properties of, in particular, human defensins and cathelicidins can affect important controlling factors. For example, the interaction between different antimicrobial peptides and growth factors supports neoangiogenesis. Although further clinical investigations are necessary to identify the exact effects of antimicrobial peptides in chronic wounds, such peptides could be a promising therapeutic option in the near future for the treatment of patients with chronic wounds by promoting endogen expression or exogenous supplementation.
[Calciphylaxis in terminal renal failure as a rare manifestation of leg ulcers].
Calciphylaxis is a potentially life-threatening disease that occurs up to 4% of patients with chronic terminal renal failure and secondary hyperparathyroidism. Clinical symptoms are painful skin erythema and ischemic necrosis as a result of calcification of the small and medium-sized arteries of the subcutaneous tissues. The mortality of the disease is as high as 87% mainly due to sepsis from superinfection. We report on a 59-year-old patient with chronic renal failure and normal calcium-phosphate-product with leg ulcers as a rare manifestation of a calciphylaxis. In spite of an early parathyroidectomy and a temporary complete wound-healing the death because of calciphylaxis could not be prevented.
Successful infliximab therapy of psoriasis vulgaris and psoriatic arthritis in a patient with cirrhosis.
Explore the source record for details and available documents.
Increased activity of factor VIII coagulant associated with venous ulcer in a patient with Klinefelter's syndrome.
Klinefelter's syndrome is the most frequent major abnormality of sexual differentiation in men with two or more X chromosomes. Recurrent venous ulcers as a result of a post-thrombotic syndrome are a well known symptom in patients with Klinefelter's syndrome. Until now the underlying pathomechanisms are not completely understood. Platelet hyperaggregability, factor V Leiden mutation and abnormalities in fibrinolysis were implicated as possible contributing factors. Here we describe the detection of an increased activity of factor VIII coagulant (factor VIII:C). This is the first case report on increased factor VIII:C activity associated with venous ulcers in a patient with Klinefelter's syndrome. Elevated factor VIII plasma levels are gradually accepted to be associated with an increased risk for venous thromboembolism. Therefore, we discuss that the examination of factor VIII:C may help in clarifying individual thromboembolic risks, especially in patients with Klinefelter's syndrome.
Successful treatment of a leg ulcer occurring in a rheumatoid arthritis patient under leflunomide therapy.
OBJECTIVE: We report the case of a leg ulcer in a rheumatoid arthritis (RA) patient under treatment with leflunomide, discuss the influence of the drug on the aetiopathogenesis of the ulcer and describe its successful treatment. CASE SUMMARY: A 68-year-old woman with a 12-year history of RA developed a leg ulcer after 4 months of leflunomide treatment. Other ulcerogenic factors were ruled out. There were some clinical hints for rheumatoid vasculitis. The ulcer was resistant to ambulant conservative phase adapted wound bed preparation and a split skin transplantation failed. After omission of leflunomide and washout procedure with cholestyramine a second split skin transplantation resulted in complete healing. DISCUSSION: Leflunomide inhibits the division of activated T cells and thus inhibits among others the production of proinflammatory cytokines and the adhesion of cells to the endothelium. These mechanisms may partly explain the possible influence of leflunomide on the perpetuation of the ulcer. Until now, occurrence of vasculitis and leg ulcers has been described in one case each for the novel immunomodulator leflunomide. No successful treatment of a leg ulcer under leflunomide has been described yet. Omission of leflunomide and a washout treatment in our case led to a complete healing. This may indicate a critical role of leflunomide in the maintenance of this slow healing ulcer. CONCLUSIONS: An association between leflunomide intake, occurrence of leg ulcers in RA patients and delayed wound healing should be considered.
[Basal cell carcinoma -- An overview].
Explore the source record for details and available documents.
[Syphilis -- the return of the "scourge of humanity"].
Explore the source record for details and available documents.
[Innovative therapeutic options for psoriatic arthritis: TNFalpha inhibitors].
Explore the source record for details and available documents.
[Methicillin-resistant Staphylococcus aureus (MRSA)--an interdisciplinary challenge].
Explore the source record for details and available documents.
[Bureau-Barrière syndrome of the hand. A case report on an unusual localization].
The Bureau-Barrière syndrome is described as an acral ulcer with mutilating osteolysis of the limbs that is nonfamiliar, non-sex-specific, induced by many factors, and elicited by sensory-trophic polyneuropathy. Often a bilateral location at the lower limb of male alcoholics has been described. We report about a 76-year-old diabetic women with unilateral mutilating acroosteolysis and ulceration of one finger and discuss the relevant clinical aspects of the Bureau-Barrière syndrome.
[Bacterial colonization of chronic wounds. Studies on outpatients in a university dermatology clinic with special consideration of ORSA].
In this retrospective investigation, we documented the bacterial colonization of 79 patients with chronic wounds, who had been treated between January 2002 and May 2003 in an outpatient wound healing clinic of a university dermatology program. We isolated 106 facultative pathogenic bacterial strains of which 56 were Staphylococcus aureus, 19 Pseudomonas aeruginosa, 11 Escherichia coli, 4 Proteus mirabilis, 4 Enterobacter cloacae, 2 Serratia marcescens, 2 Streptococcus group G und 8 further species. 68 of these bacterial strains were gram-positive and 46 gram-negative. Moreover we identified one patient with Candida parapsilosis. Therefore, 70.8% of all patients showed Staphylococcus aureus in their chronic wounds. Determination of the specific resistances showed 17 patients to be colonized with oxacillin- resistant Staphylococcus aureus (ORSA) strain; this corresponds to 21.5% of all patients. Consequently, 30.4% of all Staphylococcus aureus isolates were ORSA strains. All of the ORSA isolates were sensitive to vancomycin. Sensitivity to tetracycline was documented in 15, to amikacin in 13, to clindamycin in 7, to gentamicin and erythromycin in 6 of the ORSA-positive patients. In the case of trimethoprim/sulfamethoxazole, 10 were sensitive and 3 were intermediate in sensitivity. Beside the obligate resistance to oxacillin, penicillin G, ampicillin, cefuroxime and imipenem, none of the ORSA was sensitive to ofloxacin. The results of our investigations demonstrate the actual spectrum of bacterial colonization in chronic wounds of patients in an university dermatologic wound clinic and underline the growing problem of ORSA.