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Biomedical subjects

P Altmeyer

Publications and source records attributed to P Altmeyer.

At least 91 records · Page 5Linked to original sources
PubMed2002

Topical calcipotriol plus oral fumaric acid is more effective and faster acting than oral fumaric acid monotherapy in the treatment of severe chronic plaque psoriasis vulgaris.

BACKGROUND: Calcipotriol is an established topical therapy for psoriasis vulgaris. OBJECTIVE: This study aimed to investigate whether the addition of calcipotriol to fumaric acid ester (FAE) monotherapy had an additive efficacy and an FAE-sparing effect in patients with severe plaque psoriasis. METHODS: This multicentre, randomised, double-blind, vehicle-controlled study included 143 patients for up to 13 weeks treatment. Group A received FAE tablets (Fumaderm) with an increasing daily dosage from 105 to 1,075 mg + ointment vehicle. Group B received FAE tablets + calcipotriol ointment (50 microg/g). Ointments were applied twice daily. Clinical response was assessed using percentage changes in the Psoriasis Area and Severity Index (PASI), from baseline to treatment end. RESULTS: The mean percentage change in the PASI was -76.1% in group B and -51.9% in group A, the difference between treatments was -24.2% (95% CI from -34.2 to -14.2%; p < 0.001). Group B responded more rapidly to treatment. Investigators' and patients' overall efficacy assessments were significantly more favourable for group B (p < or = 0.001). Group B was prescribed less FAE than group A. This difference was greatest at the last visit (mean daily dose 529 and 685 mg, respectively; p = 0.006). Overall adverse events in the two groups were similar. CONCLUSION: This study shows that the combination of calcipotriol and FAEs is significantly more effective and faster acting than FAE monotherapy in the treatment of severe plaque psoriasis. The combination has a slight FEA-sparing effect and therefore a superior benefit/risk ratio.

Administration, Oral↗
PubMed2001

Bilateral linear scleroderma "en coup de sabre" associated with facial atrophy and neurological complications.

BACKGROUND: Linear scleroderma "en coup de sabre" (LSCS) usually affects one side of the face and head in the frontoparietal area with band-like indurated skin lesions. The disease may be associated with facial hemiatrophy. Various ophthalmological and neurological abnormalities have been observed in patients with LSCS. We describe an unusual case of LSC. CASE PRESENTATION: A 23 year old woman presented bilateral LSCS and facial atrophy. The patient had epileptic seizures as well as oculomotor and facial nerve palsy on the left side which also had pronounced skin involvement. Clinical features of different stages of the disease are presented. CONCLUSIONS: The findings of the presented patient with bilateral LSCS and facial atrophy provide further evidence for a neurological etiology of the disease and may also indicate that classic progressive facial hemiatrophy (Parry-Romberg syndrome) and LSCS actually represent different spectra of the same disease.

Adult↗
PubMed2001

Serum folate levels after UVA exposure: a two-group parallel randomised controlled trial.

BACKGROUND: Photodegradation of certain vitamins such as riboflavins, carotinoids, tocopherol, and folate has been well-documented. Previous observations suggest that ultraviolet (UV) radiation may cause folate deficiency. This is of great importance since folate deficiency is also known to be linked with the development of neural tube defects. To investigate the influence of UVA radiation on serum folate levels in vivo, we conducted a two-group randomised controlled trial on healthy subjects. MATERIAL AND METHODS: Twenty-four healthy volunteers with skin type II were enrolled into the study. Eight volunteers of the study population were randomly assigned to the control group. UVA irradiation was administered with an air-conditioned sunbed. Blood samples were taken from all volunteers at baseline (T1), 30 min after the first UVA exposure (T2), and at the end of the study 24 h after the sixth UV exposure (T3). The volunteers had two UVA exposures weekly within three weeks (cumulative UVA dose: 96 J/cm2). Volunteers of the control group had no UVA exposures. Serum folate was analysed with an automated immunoassay system. RESULTS: At all times of blood collection the differences between serum folate levels were insignificant (P > 0.05), except of the non-exposed controls at T2 (P < 0.05). We did not observed significant differences of folate levels between UVA exposed and non-exposed volunteers (P > 0.05). CONCLUSIONS: Our data suggest that both single and serial UVA exposures do not significantly influence serum folate levels of healthy subjects. Therefore, neural tube defects claimed to occur after periconceptual UVA exposure are probably not due to UVA induced folate deficiency.

Adult↗
PubMed2001

Protection against ultraviolet radiation by commercial summer clothing: need for standardised testing and labelling.

BACKGROUND: The use of clothing as a means of sun protection has been recommended in recent education campaigns. Contrary to popular opinion, however, some fabrics provide insufficient ultraviolet (UV) protection. MATERIAL AND METHODS: We investigated 236 apparel textiles of the spring/summer collections 2000 and 2001. In accordance with the forthcoming European standard the UV protection factor (UPF) of the fabrics was determined spectrophotometrically. RESULTS: Seventy-eight (33%) fabrics had UPF < 15, 45 (19%) had UPF = or > 15 and < 30, and 113 (48%) had UPF = or > 30 (30+). More than 70% of the wool, polyester, and fabric blends, and only less than 30% of the cotton, linen, and viscose fabrics had UPF values of 30+. Fabrics with black, navy-blue, white, green, or beige colours provided most frequently UPF values of 30+. CONCLUSIONS: It is difficult for the sun-aware consumer to choose the 'right' garment, with a third of summer clothing providing insufficient UV protection and only half of the fabrics having UPF 30+, the UPF recommended by the European standard. Therefore, apparel summer fabrics should be measured and labelled in accordance with a standard document.

Adult↗
PubMed2001

[Occult dermal primary melanoma in congenital nevus-cell nevus].

Malignant melanomas normally arise at the dermoepidermal junction. Development of these tumours in deeper layers of the dermis without having contact with the junction is rare. A small congenital melanocytic nevus localized in the region of the waist band was excised because of mechanical irritation; it had not shown any changes over years. A thorough examination of the whole body did not give any clue to a malignant melanoma. Histologically a compound nevus with the typical architecture of a congenital melanocytic nevus was found. In the deeper dermis there was an isolated nodule of extremely atypical melanocytes with minimal pigmentation of melanin. S100 antigen could be demonstrated throughout the whole tumour whereas HMB45 was only found at the dermoepidermal junction. There was no marking of the tumour cells with a pancytokeratin antibody. A histological relationship between the new tumour and a mixed tumour of the left testicle, which had been excised 3 years ago, could be excluded. We did not find any metastases neither by image-aided methods nor by sentinel lymph node biopsy.

Adult↗
PubMed2001

[What remains of the skin after 2000 years in a bog?].

BACKGROUND AND OBJECTIVE: Mummies have an important place in the study of archaeology and paleopathology because they are so well preserved. For the first time skin samples of six 2300-1600 year old bog bodies from North Germany were examined by histology, transmission electron microscopy and immunohistology. METHODS: For histology the samples were stained with H&E and van Gieson elastic stain. Fixation and embedding in epoxy followed for the transmission electron microscopy. Specific antibodies directed to type IV collagen and S-100 were used. RESULTS: Histologically it was possible to observe collagen bundles in the dermis, with a density similar to recently stained samples. Epidermis was not preserved. The electron microscopy showed collagen fibrils with a diameter of 45-110 nm and the characteristic axial periodicity. Throughout the dermis, a number of spores of bacteria with a diameter of 0.83 +/- 0.051 micron and an electron dense core were found. No activity against the used antibodies could be detected. CONCLUSIONS: Histology and electron microscopy demonstrate the excellent conservation of the dermal collagen in the bog. In contrast to ice mummies like "Otzi" and mummies from Egypt, no cellular elements could be found in the skin of bog bodies.

Collagen↗
PubMed2001

[Correlation between histopathology and epiluminescent microscopy in nonmelanocytic skin lesions].

Epiluminescence microscopy techniques make surface and subsurface structures accessible to visual examination in vivo. The visualization of a multitude of special morphological features, such as blood vessels, adnexa and deposits of pigments in normal and pathologically changed skin allows a reproducible and topographical stratification. There is a chance of identifying the architecture of the stratum corneum, the epidermis and the papillary bodies. Changes in the amount of melanin can be individually assessed in the stratum corneum and the deeper layers extending into the upper dermis. It is possible to differentiate the orientation, size and color of the blood vessels of the cutaneous vascular plexus, involving the capillaries of the stratum papillare and the subpapillary plexus.

Equipment Design↗
PubMed2001

Opposing effects of UVA1 phototherapy on the expression of bcl-2 and p53 in atopic dermatitis.

Recently, medium-dose UVA1 phototherapy (50 J/cm2) has been introduced as an effective treatment for severe atopic dermatitis (AD). In order to further elucidate the mechanisms by which medium-dose UVA1 irradiation leads to an improvement in skin status in patients with AD, biopsy specimens from ten patients before and after treatment were analysed immunohistochemically for features of apoptosis. We sought to determine the extent to which UVA1 irradiation was able to modulate the balance between p53 and bcl-2 expression in vivo using monoclonal antibodies labelling these proteins. As compared with lesional skin of patients with AD before UVA1 irradiation, the number of dermal cells, apparently lymphocytes, that were positive for p53 had significantly increased after treatment and, in addition, some basal keratinocytes showed slight positive staining for p53. An increased expression of the bcl-2 gene before treatment in predominately dermal lymphocytes was significantly downregulated by UVA1 therapy. The increase in p53+ cells and the decrease in bcl-2+ cells were closely linked to a significant reduction in dermal T cells (CD3+) and a substantial clinical improvement in skin condition. In summary, medium-dose UVA1 irradiation led to a marked modulation of the expression of p53 and bcl-2, and this plays a key role in regulating UVA1-induced apoptosis.

Aged↗
PubMed2001

Balneophototherapy of psoriasis: highly concentrated salt water versus tap water--a randomized, one-blind, right/left comparative study.

BACKGROUND/PURPOSE: Apart from climatotherapy and spa therapy, combined treatment with salt water baths and artificial UV radiation (balneophototherapy) has been advocated for the treatment of psoriasis. As there is a lack of controlled studies on balneophototherapy (BPT), we conducted a randomized, one-blind, right/left comparison with salt water versus tap water in order to investigate the significance of the salt concentration in the efficacy of BPT. METHODS: Ten psoriasis patients with chronic plaques on the elbows were included in the study. One elbow was soaked in 24% NaCl solution and the other in tap water. Subsequently, broadband UVB irradiation was administered. BPT was performed 4 times weekly with a total of 30 treatments. RESULTS: A highly significant (P<0.001) decrease of the clinical baseline score was observed after 30 treatments; however, there was no significant (P>0.5) difference in clearance of the psoriatic lesions between the sites soaked in salt water and tap water. CONCLUSION: Our results suggest that any additional benefit of soaking in salt water and tap water in BPT are unlikely to be due to the salinity of the liquids.

Adult↗
PubMed2001

Effects of low dose ultraviolet A-1 phototherapy on morphea.

AIM: The effects of low dose ultraviolet A-1 (UVA-1) phototherapy on different clinical stages of morphea (localized scleroderma) were analyzed in this case study. Based on these data, the different types of phototherapy described in the literature and currently used for treatment of morphea are compared. METHODS: Three patients with severe plaque type morphea in different stages were studied: one patient with late-stage lesions having stable sclerotic plaques; another patient with active inflammatory lesions; and a third patient with late-stage lesions associated with overlying lichen sclerosus et atrophicus (LSA). The treatment given was low dose UVA-1 phototherapy with single doses of 20 J/cm2 administered four times a week for 6 weeks, and once a week for another 6 weeks. RESULTS: Following UVA-1 phototherapy, the sclerotic plaques resolved, leaving smooth and soft tanned skin with normal structure, consistency and folding capability. In morphea with overlying LSA the elastic fibers did not completely return to the superficial papillary dermis despite the clinical clearance of both morphea and LSA. These data suggest that low dose UVA-1 phototherapy may improve, but not completely reverse, the histopathological changes of LSA. No side effects were observed during or after treatment. CONCLUSION: Our observations show in three patients that low-dose UVA-1 phototherapy is highly effective for treatment of all stages of morphea, including early inflammatory and late sclerotic lesions, and morphea with overlying lichen sclerosus et atrophicus. Because of its safety and efficacy, low dose UVA-1 phototherapy appears to be the treatment modality of choice.

Adult↗
PubMed2001

Repeatability of in vitro measurements of the ultraviolet protection factor (UPF) by spectrophotometry with automatic sampling.

BACKGROUND/AIMS: Spectrophotometric assessment (in vitro) is the most established method for determining the ultraviolet protection factor (UPF) of textiles. Apart from stringent requirements for measurement precision, practical methods are required for the routine determination of the UPF. We report here spectrophotometric measurements of textiles using a newly developed autosampler. Measurement precision was evaluated under repeatable conditions. METHODS: Fifteen different textiles were spectrophotometrically assessed for the determination of the UPF. Sample handling inside the spectrophotometer was performed with a computer-controlled sampling device, capable of loading and unloading a textile sample from a magazine as well as rotating the sample perpendicular to the spectrometer beam. In order to evaluate the repeatability of measurements, one sample of each textile was assessed eight times under the same conditions in the same laboratory. RESULTS: A mean percentage of the standard error of 1% [E(UPF)] was calculated for the UPF measurements. For UPFs >30, a significantly higher E(UPF) was found (r=0.78; P<0.001). E(UV) (3.9%) of ultraviolet A (UVA) transmission differed significantly from E(UV) (1.1 %) of ultraviolet B (UVB) transmission (P<0.05). CONCLUSIONS: Though a slight decrease of repeatability was observed for UVA transmission measurements and UPFs higher than 30, our data indicate a high measurement precision under repeatable conditions. In conclusion, spectrophotometric measurements of textiles with the aid of the autosampler presented have been shown to be highly practical, time saving and precise.

Automation↗
PubMed2001

Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome.

We present a 35-year-old patient with acquired immunodeficiency syndrome who had demodicidosis on his face, characterized by multiple papules and papulopustules, associated pruritus, numerous mites on skin-surface biopsy and in biopsy specimens, and rapid response to topical treatment with permethrin. It seems likely that Demodex infestation does not manifest unless local or systemic immune function is altered, leading to the proliferation of the organism and subsequent disease.

AIDS-Related Opportunistic Infections↗