Toxic epidermal necrolysis (TEN) is very rare in the newborn period. So far, three cases of TEN in newborns have been reported worldwide. We report a premature infant of 27 weeks' gestational age with TEN at 4 weeks of age. Sepsis treated by an antibiotic combination regimen preceding the TEN was a common feature of all four cases. In our patient, coagulase-negative staphylococci could be identified by blood culture, whereas the previously reported patients suffered from Klebsiella pneumoniae sepsis or Escherichia coli sepsis. Possibly, the uniform association with septic infection in the cases of TEN in the neonatal period might hint at a causal association, thus differentiating it from TEN in older children or adults.

Anti-Bacterial Agents↗

PubMed2004

[Special emergencies in dermatology].

Emergency cases in dermatology are rare but potentially life-threatening conditions. They comprise a broad spectrum of diseases which require immediate hospitalization or even intensive care. A rapid diagnosis and appropriate therapy is necessary since some of these emergency cases are associated with a high mortality and with severe disabling complications. Typical examples are: the bacterial infections Waterhouse-Friderichsen syndrome, necrotizing erysipelas and necrotizing fasciitis, as well as staphylococcal and streptococcal toxic shock syndromes. Another special emergency situation is venomous snake bites.

Dermatology↗

PubMed2004

[Neurocutaneous melanosis and malignant melanoma].

A 36-year-old man presented with a giant congenital melanocytic nevus and multiple disseminated melanocytic nevi. After he had developed neurological symptoms (grand mal seizures), a cerebral metastasis of a malignant melanoma without a primary melanoma was found. The patient was diagnosed as having a neurocutaneous melanosis with a cerebral metastasis. In spite of a variety of therapeutic attempts (surgery, radiation therapy and chemotherapy) he followed a rapidly progressive, lethal course with increased intracranial pressure, hydrocephalus and spinal metastases.

Adult↗

PubMed2004

[Eruptive xanthomas].

A 41-year old male patient presented with yellowish papules on the elbows, upper arms, back and the buttocks, as well as yellow streaks in the palmar creases. Laboratory examination revealed Fredrickson type IIb hyperlipidemia. Histologic changes were consistent with eruptive xanthomas. Treatment was started with HMG-CoA reductase inhibitors and dietary measures were taken to lower serum levels of cholesterol and triglycerides. Hyperlipidemia is the cause of eruptive xanthomas and strongly increases the risk of cardiovascular diseases.

Adult↗

PubMed2004

[Ulcus terebrans. Therapy options and their limits].

Basal cell carcinoma (BCC) is the most common tumor in humans and is defined as a slow-growing, locally invasive, epithelial skin tumor which rarely metastasizes. The first line treatment is surgical excision with histologic examination of the tumor margins, but numerous alternative therapies are available. A 75-year old patient with the most destructive form of BCC, ulcus terebrans, involving the scalp and invading the frontal bone. We discuss the problems and therapeutic limitations for this unusual BCC variant.

Aged↗

PubMed2003

[Management of dermatologic industrial accidents. Skin burns by bitumen as an example].

Hot bitumen burns, although rare, usually occur in workers in the paving or roofing industries. When bitumen is heated to high temperatures it can cause deep burns, and its incorrect removal often causes further skin damage. Application of butter has been proven to be very effective to remove bitumen from the skin. Further clinical and legal safety guidelines for occupational injuries are described.

Accidents, Occupational↗

PubMed2001

[Malignant melanoma: epidemiological data from the Düsseldorf area].

Malignant melanoma represents only 1.5-2.5% of malignant neoplasms in Europe. Since 1990 the clinical data of melanoma patients are registered at the clinic for dermatology university Düsseldorf. 925 patients were treated between 1990-1996 (not including in situ melanomas, extracutaneous melanomas and multiple melanomas). In 1996 the incidence was 15 cases/100,000 habitants. A worldwide doubling of the morbidity is expected every ten years especially in the caucasian population.

Adolescent↗

PubMed2001

[Adjuvant therapy of malignant melanoma].

Malignant melanoma is resected with curative intent in 80-85% of the patients. In case of tumor thickness according to Breslow of > 4 mm and metastatic regional lymph nodes a high relapse rate and mortality of 50-90% is observed. Single agent chemotherapy with DTIC is effective as combination regimen, however does not significantly improve the relapse-free interval respectively the overall survival or quality of life. Several attempts with other adjuvant treatment modalities (e.g. BCG immunotherapy) are not convincing as well. The best results of adjuvant treatment in high-risk resected melanoma were published in 1996 by Kirkwood, who used interferon-alfa 2b. He could demonstrate a prolonged relapse free and overall survival. It does represent the current standard adjuvant treatment. However, the costs and toxicities of IFN are barriers to its widespread use.

BCG Vaccine↗

PubMed2001

Surgical pearl: The close-fitting ear cover cast--a noninvasive treatment for pseudocyst of the ear.

Explore the source record for details and available documents.

Cysts↗

PubMed2001

Aminolevulinic acid (Levulan) in photodynamic therapy of actinic keratoses.

The role of photodynamic therapy (PDT) in the treatment of in situ neoplasias and tumors of the skin is steadily increasing. Its principles of photodynamic action include an intratumoral enriched photosensitizer and light activation. Aminolevulinic acid (ALA) has demonstrated highest efficacy in topical PDT, and has become the most clinically useful. For actinic (solar) keratoses, topical ALA-PDT using Levulan Kerastick (20% topical solution, DUSA Pharmaceuticals) is already postulated to be the treatment of choice. In December 1999, the US FDA approved this topical product for the treatment of actinic keratoses. Levulan is well tolerated and leads to excellent cosmetic results with only minor side effects.

Administration, Topical↗

PubMed2000

[Thromboangiitis obliterans].

Thromboangiitis obliterans (Buerger disease) is a rare vascular disease, characterized by a multilocular, segmental, non-arteriosclerotic, thrombotic inflammation of small and medium size arterial and venous vessels and nerves. The precise etiology is unknown, but there is a cause-effect relationship with tobacco smoking. Autoimmunological, immunogenetic, infectious and hemostatic processes have been discussed as pathogenetic factors. The clinical picture is typically characterized by acrally localized, non-healing ulcerations, which frequently prompt patients to see a dermatologist. We present two patients with thromboangiitis obliterans and discuss the clinical features, the resulting differential diagnostic spectrum and possible therapeutic approaches.

Adult↗

PubMed2000

Allelic losses on chromosome arm 10q and mutation of the PTEN (MMAC1) tumour suppressor gene in primary and metastatic malignant melanomas.

Malignant melanomas frequently show loss of alleles on the long arm of chromosome 10. The PTEN (MMAC1) gene has been identified as a tumour suppressor gene at 10q23.3 that is mutated in various types of advanced human cancers. We have investigated a series of 40 sporadic melanomas from 37 patients (15 primary cutaneous melanomas and 25 melanoma metastases) for allelic losses on chromosome 10, as well as for deletion and mutation of the PTEN gene. Microsatellite analysis revealed loss of heterozygosity at loci located on 10q in tumours from 15 of 34 patients investigated (44%). Somatic PTEN mutations were identified in melanomas from 4 of 37 patients (11%), all of whom had metastatic disease. In two of these patients, the tumours had additionally lost one PTEN allele, indicating complete loss of wild-type PTEN in the tumour cells. Our findings corroborate that loss of heterozygosity on chromosome 10 is a frequent aberration in malignant melanomas and implicate PTEN as a tumour suppressor gene inactivated by somatic mutation in a fraction of these tumours.

Adult↗