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Biomedical subjects

M Stücker

Publications and source records attributed to M Stücker.

At least 73 records · Page 4Linked to original sources
PubMed1999

[Severe course of a mutilating pansclerotic circumscribed scleroderma in childhood. Clinical aspects and therapy].

Disabling pansclerotic morphea of childhood is the most severe variant of localized scleroderma. It is characterized by rapid progression of deep cutaneous fibrosis expanding over large areas of body surface. The prognosis in terms of normal life activity is poor and the disease may even take a fatal course. Presented is a case with extremely severe and rapidly progressive lesions resulting in cutaneous ulcerations joint contractures, and multilaing deformities of the extremities. Histopathological analysis revealed extensive intravascular calcinosis of the small vessels, which may be an important factor in the pathogenesis of this poorly understood disease. UVA1-phototherapy was performed and induced a softening of sclerosis and a distinct decrease of skin thickness. Based on these observations UVA1-phototherapy may be promising in the treatment of extensive sclerotic disease of this kind, and possibly other diseases accompanied by excessive sclerosis.

Adolescent↗
PubMed1999

[Prevalence of psychological symptoms in dermatologic patients of an acute clinic].

There is a lot of information in the literature about psychological disturbances in somatic diseases. For dermatological patients such data are not available. In early spring 1998 we studied the psychological changes in 247 hospitalized patients in the dermatological department of the Ruhr University Bochum. We used the German version of the internationally accepted Hospital Anxiety and Depression Scale. We found the prevalence of psychological alterations ranged between 25.9% and 31%. The prevalence of psychological disturbances was a little higher than that seen in oncological, cardiological or neurological patient populations. Surprisingly skin cancer patients were less affected than patients with chronic inflammatory or angiological diseases. These results underline the necessity of improved psychological therapeutical strategies which must be standardized and evaluated.

Adult↗
PubMed1999

[Correlation between epiluminescence microscopy characteristics of malignant melanomas and Clark's level of invasion].

Many epiluminescence microscopy (ELM) characteristics of malignant melanoma support the differential diagnosis of pigmented skin tumors. A preinvasive evaluation of level of invasion would be valuable for planning the excision margins. Since sonography for tumor thickness measurement is rarely available in a practice we searched for specific ELM criteria correlating with Clark's level of invasion. In our retrospective study of 120 malignant melanomas of 30 ELM features were studied for their correlation and the association was significant for 15 features.The following criteria were found only in level III-IV melanomas: intralesional horizontally elongated blood vessels, spontaneous microhemorrhages, plaster-of-Paris-like lacunae, grey-blue/yellowish-brown/reddish saccular pattern and eccentric nodes (reddish, livid, blue). 7 characteristics were predominantly found in level III-IV melanomas and seldom in "thin" melanomas (level I-II): deeply localized gray-blue/-brown fragmentary network, whitish-opaque septa, whitish- or bluish-opaque veil, negative pigmented network, areola with evenly arranged capillaries, polymorphic capillaries. Perivascular melanophages, eccentric dark blotches, pseudotrabeculae of melanophages and greyish-blue annular perifollicular pigmentations were the most significant association of ELM criteria in "thin" melanomas (level I-II). Epiluminescence microscopy is not only a tool for the differentiation of melanocytic lesions but also for a preinvasive evaluation of Clark's level of invasion.

Adult↗
PubMed1999

[Tazarotene increases the antipsoriatic effect of dithranol in chronic psoriasis].

We examined whether it is possible to increase the antipsoriatic action by combining dithranol with a retinoid (tazarotene). In a randomized, open, prospective study with 50 psoriatic patients (22 females, 28 males, PASI>10) the antipsoriatic effectiveness of dithranol monotherapy to was compared combined therapy with dithranol and retinoid. The combination dithranol/retinoid (collective 2, reduction of the PASI from 17,2 to 2,8) revealed a significantly faster healing than the dithranol monotherapy (collective 1, reduction of the PASI from 18,5 to 4,8). The irritation of the combination therapy as evaluated with clinical score and laser doppler imaging was increased. Anti-psoriatic effectiveness of dithranol can be increased by combining it with tazarotene.

Anthralin↗
PubMed1999

Blood flow compared in benign melanocytic naevi, malignant melanomas and basal cell carcinomas.

Histologically, increasing malignancy is reflected by increased tumour vascularization. We therefore assessed whether laser Doppler perfusion imaging might allow differentiation between different types of skin tumour. The perfusion patterns of 27 melanocytic naevi, 16 basal cell carcinomas and six malignant melanomas were examined with a laser Doppler perfusion imager before excision for precise diagnosis. Malignant melanomas were significantly more perfused than basal cell carcinomas and tended also to be more so than melanocytic naevi. Further, for the first time, the perfusion pattern of the entire tumour area was visualized two-dimensionally; it was higher in the centre of the tumours than at the periphery for malignant melanomas and melanocytic naevi but was the same throughout for basal cell carcinomas. Laser Doppler perfusion imaging can thus provide information to assist in the differential diagnosis of skin tumours. In addition, with increases in resolution of the technique such data may well become steadily more useful in the future.

Basal Cell Carcinoma↗
PubMed1999

[Ranking of 20 MHz sonography of malignant melanoma and pigmented lesions in routine diagnosis].

PURPOSE: Eleven dermatology clinics from all over Germany took part in our multicenter prospective study with the aim of evaluating 20 MHz sonography in the preoperative diagnosis of malignant melanomas and other pigmented skin tumours. It was to be assessed how effective sonographic measurement of thickness would compare to histology and the clinical palpation of tumour thickness and also the significance of differential diagnosis in sonography of malignant melanomas. METHOD: The prospective multicenter study proceed as follows. To the end of August 1997 264 patients with a primary malignant melanoma and 417 patients with benign skin tumours were examined via 20 MHz sonography. Two different examiners estimated the clinical thickness of the tumour by palpation. The tumour was then excised and examined for postoperative correlation with the histology sections. RESULTS: The final results showed good correlation between the histological and sonographic estimation of tumour thickness (r = 0.97). Estimation of tumour thickness by palpation showed no correlation with the histology (r = 0.59). Most of the benign (44%) and malignant tumours (38.7%) were spindle shaped. There was no significant difference between the benign and malignant tumour groups in relation to the sonographic presented shapes or echo signs. No different diagnosis could be made. CONCLUSION: The technique of high frequency sonography in relation to preoperative diagnosis of malignant melanomas has high priority. In contrast to clinical estimation of tumour thickness, sonography provided a good correlation to histology. The effectiveness of sonography with regard to the valence of the skin tumours is limited and there is no possibility of differentiating between malignant and benign tumours from the morphological face value. Hence, there is a demand for developing a 150 MHz apparatus which will be able to supply evidence regarding the valence of skin tumours.

Diagnostic Tests, Routine↗
PubMed1999

Sweat gland proliferations in scleromyxedema.

Eccrine sweat duct proliferations may be found in various inflammatory and neoplastic skin lesions. We report a patient with scleromyxedema with extensive proliferations of intradermal sweat ducts. Three-dimensional reconstruction demonstrated extensive coiling and branching of the sweat ducts leading into cystic lacunae. In contrast to the basal cell carcinoma that had grown within the scleromyxedematous skin, the ducts close to the lumen stained positive for carcinoembryonic antigen and could therefore be differentiated from basal cell carcinoma. In micrographically controlled surgery of cutaneous epithelial tumors that are located in chronically inflamed skin, such sweat gland proliferations have to be considered as differential diagnosis.

Carcinoembryonic Antigen↗
PubMed1999

Femtosecond two-photon excited fluorescence of melanin.

Fluorescence of synthetic melanin in dimethyl sulfoxide has been excited by two-photon absorption at 800 nm, using 120 fs pulses with photon flux densities > or = 10(27) cm-2 s-1. The shortest main component of the three-exponential decay of fluorescence is 200 +/- 2 ps. The overall spectral shape is red-shifted with respect to the 400 nm excited fluorescence. Two-photon excited melanin fluorescence also has been measured from excised samples of healthy human skin tissue. Because of the selectivity of melanin excitation via resonant two-photon absorption, it is hypothesized that fluorescence excited in this way may yield information on malignant transformation.

Humans↗
PubMed1998

[Mometasone and calcipotriol optimize the initial therapeutic effect of dithranol in chronic persistent psoriasis].

In a randomized study 30 patients with chronic stationary psoriasis were treated with 3 different topical schemes. Group 1 (n = 10) received monotherapy (dithranol (D) twice a day, D/D), group 2 (n = 10) calcipotriol mornings/dithranol evenings (calcipotriol (C)/dithranol (D) C/D) and 3 (mometasone (M) mornings/dithranol (D) evenings, M/D). During the therapy period of 4 weeks we documented the PASI-Score as well as infiltration, erythema and desquamation weekly. The M/D group revealed in the first week a significantly faster reduction of the PASI-score (5.3) than in the D/D group (PASI 13.22). The C/D group (PASI 10.5) show a not significantly faster reduction. After 4 weeks of treatment and after a follow period of 6 weeks there were similar PASI-Scores in all groups. There were less side-effects in the M/D group than in the others. The beginning, more anti-psoriatic effectiveness was achieved by the mometasone/dithranol combination than the other schemes. In the long term, the effects were similar.

Administration, Topical↗
PubMed1998

Rhythmical variations of haemoglobin oxygenation in cutaneous capillaries.

The consequences of rhythmical arteriolar vasomotion for nutrition and the tissue oxygen supply to human skin are largely unknown. In the study presented here, the periodic variations of haemoglobin oxygenation in the small cutaneous vessels have been evaluated with a new reflection spectrophotometer. For the assessment of spatial variations, we examined 24 different sites in 20 healthy volunteers. For quantification of the relatively long duration of periodic variations, a Digital Fourier Transformation with a specially programmed filter was used. In 265 out of 480 spectra (55.2%), periodic variations of the haemoglobin oxygenation were found. The average of the main frequency of waves was 7.0 +/- 2.5 cycles per minute. The occurrence of variations of haemoglobin oxygenation depended on the measuring site. In the gluteal region, variations were observed in 17 out of 20 subjects, on the palms in 16 out of 20, at the foot plantar in 18 out of 20 in comparison to the cheek (8/20), the lip (5/20) and the eyelid (6/20). On the head we observed significantly more variations per minute than in the lower extremities. Because these variations, with duration of up to 30 s, have a relatively slow dynamic compared with heart rate and breathing frequency, consequences for the cutaneous diffusion and metabolism of other substrates are very likely.

Adult↗
PubMed1998

Comparison of skin atrophy and vasoconstriction due to mometasone furoate, methylprednisolone and hydrocortisone.

BACKGROUND/AIMS: Topical glucocorticoids with improved benefit/risk ratio are of great interest in dermatology, but there are very few trials directly comparing the efficacy and side-effects of these new preparations. In our study the vasoconstrictor effect and side-effects of two of these new glucocorticoids were evaluated and blanching effect was determined by two-dimensional laser scanning. METHODS: In a randomised, double blind intra-individual comparative trial, 10 subjects were treated with various glucocorticoids or drug-free vehicle. The test drugs were mometasone furoate (MF), methylprednisolone aceponate (MP) and hydrocortisone (OH-C). The preparations were tested for a period of 3 weeks with occlusion on the flexor side of the forearm. Skin thickness and vasoconstriction were determined using 20 MHz ultrasound scanning, laser Doppler scanning (LDS) and chromometry. RESULTS: No adverse effects were observed during the observation period. Only partial vasoconstriction occurred in most cases during the observation period. MP and MF produced maximal blanching between days 3 and 5 of treatment, while with OH-C clinically visible blanching did not occur. Ultrasound evaluation of skin thickness showed similar behaviour for all three steroids tested: there were no signs of skin atrophy in any of the cases. LDS evidenced hypoperfusion of a test area on the perfusion image in only a few patients and there were no significant differences between the steroids tested. On evaluation of vasoconstriction caused by the steroids tested using chromometry there was a significant difference between MF and OH-C on the L*a*b* scale (P < 0.005). Only at day 3 was a blanching effect caused by MP and MF demonstrable (a-value, P < 0.05). CONCLUSION: In summary, the synthetic steroids MF and MP presented side-effects similar to those of OH-C but much greater vasoconstrictor effect; after an application period of over 5 days under occlusion a blanching effect in our model was not demonstrable by means of chromometry. Two-dimensional laser scanning offers no advantage in the evaluation of the blanching effect in comparison to one-dimensional laser fluxmetry (LDF).

Administration, Topical↗
PubMed1997

[Health consciousness and risk behavior of prostitutes].

Regular examinations of prostitutes may reduce the incidence of sexually transmitted diseases in this high risk group. Therefore since April 1988 regular mandatory examinations have been offered by the regional health office in cooperation with the Department of Dermatology of the Ruhr-University of Bochum. The aim of this study was to evaluate the acceptance and efficiency of such an examination. The study was based on anonymous questionnaires. Mean age of the 80 prostitutes was 31.4; 67 of then were born in Germany. 78 of the women always used condoms, while 71 thought that condoms prevent STDs. Three women suffered from a STD in the last 12 months. The majority the women (75 from this 80 prostitutes) did not perceive the examination as discrimination, while 71 felt the examinations were of high quality. These results indicate that regular mandatory examinations should be part of health prevention care of prostitutes and that they are well accepted and tolerated by these women.

Adult↗
PubMed1997

[Keratosis palmoplantaris maculosa seu papulosa (Davies-Colley) simulating multiple cornua cutanea].

Patient with extensive keratosis palmoplantaris maculosa seu papulosa (Davies-Colley) presented with multiple cutaneous horns. The clinical picture, the histology, the electro microscopic examination, the negative tumor screening and the viral classification in the tissue allowed the differentiation from other palmoplantar keratoses. The patient was treated successfully using a combination of acitretin with physical and chemical measures.

Callosities↗
PubMed1997

Intracutaneous histamine injection can detect damage of cutaneous afferent fibres in postherpetic neuralgia.

BACKGROUND: The axon reflex response in diseased skin of patients with postherpetic neuralgia may be significantly impaired. OBJECTIVE: In the present study we introduced a simple test for quantifying the decreased axon reflex flare response in the clinical routine. METHODS: Histamine was intradermally applied to the diseased dermatome as well as to the corresponding dermatome of the contralateral side of the body. Ten minutes after application, skin blood flow and the extension of the hyperaemic response were assessed by means of laser Doppler scanning. RESULTS: In the skin region affected by the postherpetic neuralgia, the hyperaemic area was significantly smaller than in the healthy skin. The mean flux values did not differ significantly between the two sites. There was no correlation between the hyperaemic response and the intensity of pain sensation assessed by a clinical visual analogue score. CONCLUSION: The smaller hyperaemic area in the dermatome with postherpetic neuralgia strongly indicates a C fibre or C nociceptor damage. We consider histamine injections as a useful tool in the differential diagnosis of postherpetic neuralgia.

Aged↗