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Biomedical subjects

P Elsner

Publications and source records attributed to P Elsner.

At least 55 records · Page 3Linked to original sources
PubMed2002

The atopy patch test -- reproducibility and comparison of different evaluation methods.

BACKGROUND: There is still a lack of standardization of the atopy patch test (APT) in test procedures and evaluation methods. Our aim was to examine the reproducibility of APT results and to compare visual evaluation to chromametry and laser Doppler imaging. METHODS: Fifty-two volunteers with atopic eczema/dermatitis syndrome (AEDS) were included. The APT was performed on tape-stripped and unstripped test fields on their backs using cat dander, house dust mite and grass pollen allergens from two different suppliers. Responders were re-tested 4-12 weeks later with the same allergens on their forearms. RESULTS: Using Allergopharma allergens, 14 (26.9%) volunteers showed one or more positive reactions. The reproducibility rate was 56.3%. The Erlangen atopy score in APT-positive and negative volunteers was 19 +/- 6 vs 15 +/- 6. The test agreement in volunteers tested with both allergens, from Allergopharma and Stallergènes, was poor. Correlation of the results between the three evaluation methods was significant (P < or = 0.001). CONCLUSIONS: The low reproducibility rate of APT results and the poor inter-test-agreement using allergens from different suppliers show that much work remains to make the APT a reliable tool in identifying relevant aeroallergens that lead to flare ups of AEDS. Compared to chromametry and laser Doppler imaging, visual scoring was superior in differentiation between irritative and allergic reactions.

Adolescent↗
PubMed2002

Natural vegetable fats in the prevention of irritant contact dermatitis.

Chronic irritant contact dermatitis (ICD) is one of the most pressing problems in occupational medicine and is common in the food processing industry. To date, protective creams that fulfil the special requirements in the foodstuffs industry have not been available. Therefore, we studied the efficacy of pre-exposure application of natural vegetable fats in the prevention of experimentally induced ICD. A panel of 20 healthy volunteers was tested with a repetitive irritation test using sodium lauryl sulfate (SLS) as a standard irritant in a randomized study. Application sites were assessed clinically and by the use of bioengineering techniques (evaporimetry, chromametry, and corneometry). Rape seed and palm fats showed significant protective potential. Gas-chromatographic analysis revealed differences in the fatty acid composition of the vegetable. Higher content of linoleic acid and lower content of oleic acid was associated with beneficial effects. Our results are a new approach in the prevention of ICD and towards the development of new protective preparations for workplaces in the foodstuffs industry.

Adult↗
PubMed2002

Tacrolimus enhances irritation in a 5-day human irritancy in vivo model.

Tacrolimus (FK 506) is a macrolide discovered in 1984 as a metabolic product of Streptomyces tsukabaensis. It has been used successfully in treating atopic dermatitis, allergic contact dermatitis, lichen planus mucosae and pyoderma gangrenosum. In the present study, we evaluated the anti-inflammatory activity of FK 506 in 2 human skin inflammation models. FK 506 as Protopic(R) cream was tested (i) in a 4-day repetitive irritation test with 2 x daily application of sodium lauryl sulphate (SLS), and (ii) in a UVB erythema model. The effect was evaluated visually and quantified by non-invasive bioengineering methods, namely chromametry and tewametry (TEWL). When FK 506 was applied 30 min after SLS irritation, an increased inflammation in comparison to controls was observed with all 3 methods, with only the TEWL data reaching statistical significance. 1 x daily application of FK 506 for 5 days, starting at the end of the 4-day irritation period, was without any effect. Similarly, no effect of FK 506 was seen in the UVB model. In conclusion, FK 506 was shown to enhance experimentally induced irritant contact dermatitis and not to accelerate healing of irritant contact dermatitis and UVB erythema.

Adult↗
PubMed2002

Inhibitory effect of terbinafine on reactive oxygen species (ROS) generation by Candida albicans.

Candida albicans, the most important opportunistic fungal pathogen, is able to generate remarkable amounts of reactive oxygen species (ROS). Since ROS are highly cytotoxic, this mechanism may contribute to the pathogenicity of this yeast, including its invasiveness and the inflammatory response of the host. Terbinafine, a synthetic antifungal agent of the allylamine class, inhibits ergosterol biosynthesis at the level of squalene epoxidase. Furthermore, there is evidence that terbinafine at therapeutic concentrations can be considered a free radical scavenger in vitro and could exert an anti-inflammatory activity in vivo. In this study we investigated whether terbinafine affects the generation of ROS by C. albicans. Blastoconidia of the C. albicans strain 3153A were cultured in YEPG-medium and, subsequently, incubated with different doses of terbinafine (1, 10 and 100 microg ml(-1)) for 10 and 60 min, respectively. ROS generation was measured by lucigenin-enhanced chemiluminescence. Formation of ROS was considerably dependent on cell number. Chemiluminescence signals were measured at a concentration > or = 1 x 10(6) cells ml(-1), with a maximum of 1 x 10(8) cells ml(-)1. Already after 10 min of incubation with terbinafine, a dose-dependent significant inhibition of ROS generation was found (P < 0.05), whereas after 60 min this effect was amplified. In conclusion, terbinafine reduced the ability of C. albicans to generate ROS. Besides the known effect on ergosterol biosynthesis, this mechanism may contribute to its antifungal action.

Antifungal Agents↗
PubMed2002

Case report. Monascus purpureus--a new fungus of allergologic relevance.

Anaphylactic reactions to food containing allergens in the consumption or preparation of food are well known. However, allergy in the preparation of sausages has rarely been described. In the present study a 26-year-old-butcher was investigated who had a severe anaphylactic reaction developing sneezing, rhinitis, conjunctivitis, generalised pruritus, followed by widespread urticaria, Quincke's oedema and dyspnoe after starting to prepare sausages containing red yield rice. Red yield rice is produced by the fungus Monascus purpureus. It was the first time that Monascus purpureus could be shown as allergic agent by means of prick-to-prick test, Cellular Antigen Stimulation Test (CAST) and different immunoblots.

Adult↗
PubMed2001

[Clinical effectiveness and tolerance of climbazole containing dandruff shampoo in patients with seborrheic scalp eczema].

Pityrosporum ovale appears to play an important role in the pathogenesis of dandruff as a symptom of seborrheic dermatitis. Climbazole is an antimycotic agent with a high in vitro and in vivo efficacy against P. ovale. In the presented work we investigated the efficacy and safety of a climbazole 0.65% shampoo on seborrheic dermatitis of 30 volunteers. Subjects were diagnosed as having moderate to severe seborrheic dermatitis of the scalp. After a 1-week washout and a 4-week treatment the clinical evaluation showed a successful reduction of dandruff, skin redness and itching in 80% of the volunteers and a mild improvement in 20% of the volunteers. The cosmetic acceptability was very good by the majority. It is concluded that the formulation tested is effective in the treatment of moderate to severe dandruff.

Adult↗
PubMed2001

[Circumscribed hypertrichosis lanuginosa in acute myeloid leukemia].

HISTORY AND CLINICAL FINDINGS: The case of a 70 year old male is presented. Past medical history revealed the following diagnoses: liver cirrhosis, splenomegaly, thrombocytopenia, macrocytic anaemia, chronic obstructive pulmonary disease, type IIa diabetes mellitus and peripheral vascular disease of the lower limbs with chronic leg ulcers. Within 6 weeks the patient developed an increasing number of pigmented lanugo type hair over both cheeks, zygomatic arches and temples. The diagnosis of circumscribed acquired hypertrichosis lanuginosa (AHL) was established. Bone marrow biopsy revealed presence of acute myeloid leukemia. THERAPY AND CLINICAL COURSE: Chemotherapy with hydroxycarbamide (Syrea) was started without effect on haematologic parameters. The patient was transferred to the oncology unit where he died soon afterwards. CONCLUSION: Acquired hypertrichosis lanuginosa (AHL) is a paraneoplastic syndrome. It is mainly associated with adenocarcinoma of lung and bowel, however other histologic types of tumours and localisations have been described. About 50 cases have been reported in the literature until 1998. To our knowledge this is the first case of AHL described in association with acute myeloid leukemia.

Acute Disease↗
PubMed2001

[Hairdex: a tool for evaluation of disease-specific quality of life in patients with hair diseases].

Because of a strong reduction of life quality in patients with hair loss, a special questionnaire was developed following the general Skindex questionnaire for dermatoses. The Hairdex was evaluated in 75 female hair patients. The aim of the study was to prove the questionnaire's statistical values, reliability, validity, general acceptance and accuracy. The clinical manifestation of hair loss was categorized as "not visible", slightly visible" and "obviously visible". The hair loss lead to great differences in the life quality of both the patients with obvious hair loss and in patients with non-visible hair loss, especially in the categories "emotions", "self-confidence" and "stigmatization". The convergent and discriminant validity of the questionnaire was satisfactory. The acceptance of the questionnaire was very good with 90%. The hairdex-questionnaire represents a reliable and patient-oriented instrument for evaluation of life quality in hair diseases. The reliability of the questionnaire concerning longitudinal therapeutic effects will need to be investigated in further studies.

Adult↗
PubMed2001

Occupational hand dermatitis in food industry apprentices: results of a 3-year follow-up cohort study.

OBJECTIVE: The aim of this prospective follow-up study was to quantify the impact of hand dermatitis (HD) in bakers, confectioners and bakery shop assistants, and to investigate related risk factors. METHOD: Bakers', confectioners' and bakery-shop assistants were included in a prospective follow-up study in the region of East Thuringia starting in August 1996. At the beginning of their vocational training 91 apprentices were interviewed and examined in a standardised way. Follow-up examinations and interviews were done after 6 months (n = 79), 12 months (n = 63) and at the end of the training (n = 69) after 36 months. RESULTS: In their case histories 3.3% (n = 3) of the apprentices reported previous HD in childhood and adolescence. The first assessment after 2 to 4 weeks of vocational training revealed HD in 17.5% (n = 16) of the individuals. At the follow-up examination after 6 months, point prevalence of HD was 29.1% (n = 23), after 12 months 27.0% (n = 17) and after 36 months 27.5% (n = 19). Mild to moderate irritant contact dermatitis was the most frequent finding. Finally, an atopic skin diathesis (> 10 points, "atopy score") (OR = 4.89; CI 95% 1.15-20.79), previous HD (OR = 41.1; CI 95% 4.99-339.13) as well as flexural dermatitis (OR = 6.8; CI 95% 1.72-27.22) proved to be predictive factors for the development of HD. No association was found to respiratory atopy (OR = 1.29; CI 95% 0.35-4.7) and metal sensitisation (OR = 1.1; CI 95% 0.29-4.35). Exogenous irritant factors did not show a strong association towards a risk increase. Wet work in general, as well as distinct occupational tasks showed only a tendency for being a risk factor for HD. However, leisure time activities, especially house building and rebuilding (OR = 5.4; CI 95% 1.05-27.81), were associated with an elevated risk. CONCLUSIONS: Endogenous and exogenous factors contribute to the development of HD in bakers' and confectioners' apprentices.

Adolescent↗
PubMed2001

Fragrance contact dermatitis: a worldwide multicenter investigation (Part II).

The purpose of this study was to determine the frequency of responses to selected fragrance materials in patients who were fragrance sensitive. 178 patients were evaluated in 8 centers worldwide with a fragrance mix (FM) and 20 other fragrance materials. Reaction to the fragrance mixture (FM) occurred in 78.7% of the subjects. Substances reacting at a rate of 2% or higher included jasmine absolute, geranium oil bourbon, l-citronellol, spearmint oil, 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta-gamma-2-benzopyran, omega-6-hexadecenlactone, dimethyltetrahydrobenzaldehyde (isomer mixture), and alpha-amylcinnamaldehyde. These chemicals should be furthur evaluated to corroborate their allergenicity. We are constantly looking for new fragrance allergens to extend the diagnostic capability of the fragrance mix (FM).

Allergens↗
PubMed2001

Cement burns: a review 1960-2000.

We review the literature on cement burns of the skin published during the last 4 decades. 51 case reports were analyzed with special regard to common modes of injury, localization of cement exposure, preventive measures taken and treatment. Cement burns are injuries concerning professionals at the workplace as well as amateurs during do-it-yourself work. In 49% of the cases, no attempt to protect the skin had been made. The majority of injuries were located on the lower legs and knees. Full-thickness burns were reported in 66% of cases. Surgery had to be performed in 34%. Cement burns can be avoided by adequate skin protection. Although acute cement injuries may seem rare, prospective studies should be carried out for correct estimation of prevalence. The need for information on the harmful properties of cement in the occupational as well as the domestic environment is emphasized.

Adult↗
PubMed2001

The prevention of occupational hand dermatitis in bakers, confectioners and employees in the catering trades. Preliminary results of a skin prevention program.

Occupational skin diseases (OSD) are among the most frequent occupational diseases (OD). Compared to other occupations, bakers, confectioners and employees in the catering trades are at a high risk of developing OSD. In January 1999, the interdisciplinary Skin Disease Prevention Program in the Baking, Hotel and Catering Industries (SDPP) conducted by the Department of Dermatology and Allergology at the Friedrich Schiller University, Jena, in cooperation with the Research Center for Applied System Safety and Industrial Medicine, Erfurt, and the technical experts at the Social Insurance for the Food Industry and Related Professions (Berufsgenossenschaft für Nahrungsmittel und Gaststätten--(BGN)), Erfurt, was initiated. Following detailed analysis of the occupational exposure of the employees and their personal occupational disease history, the patients' diagnosis and therapy was re-evaluated and supplemented if necessary. Individual skin care and protection regimes were demonstrated and practically trained. Skin care and protection products were supplied. Skin-care and protection seminars were offered to volunteering participants. From January to December 1999, 29 affected employees were examined in the OSD clinic. 22 employees (76%) suffered from irritant contact dermatitis. The follow-up data of 11 employees are available. In 8 employees (73%), the skin disease improved or disappeared. Moreover, in 1 employee (9%), the skin condition was stabilized even though he continued working. In only 2 employees (18%) did the skin condition worsen. These preliminary results showed that most of the OSD were due to lack of or unsuitable skin care and protection. The program will be extended to cover a larger number of food industry employees with OSD.

Adolescent↗
PubMed2001

Melatonin reduces UV-induced reactive oxygen species in a dose-dependent manner in IL-3-stimulated leukocytes.

Reactive oxygen species (ROS) are presumed to be involved in inflammatory UV reactions of the skin. This in vitro study was performed to investigate the suppressive effect of melatonin in interleukin-3 (IL-3) stimulated leukocytes. Neutrophilic granulocytes were isolated from EDTA-treated whole blood and placed in a phosphate-buffered saline (PBS) containing IL-3. Cell suspensions were either treated with PBS (control) or with increasing doses of melatonin (0.1, 0.5, 1, 2, 3, 5, 7.5, 10 mmol). One PBS solution was left unirradiated and the other nine solutions (PBS and melatonin) were irradiated with 750 mJ/cm2 UVB light (280-360 nm, max: 310 nm). Radical formation was measured by the chemiluminescence technique. UV-irradiated leukocytes showed a 5-fold higher radical formation than unirradiated leukocytes. Melatonin, in increasing doses in powers of ten, led to a maximum suppression of free radicals at 10 nmol (P= 0.01) and 1 mmol melatonin (P= 0.001), showing a biphasic, non-linear, dose response relationship. Melatonin, given in amounts of 0.1-10 mmol, led to a direct dose-dependent suppression of ROS. Radical formation was suppressed significantly in a range from 0.5 to 10 mmol (P= 0.001). Melatonin is known to function as a radical scavenger and antioxidant; some of these melatonin effects may be receptor independent, while others may be receptor dependent.

Dose-Response Relationship, Drug↗
PubMed2001

Strategies of coping and quality of life in women with alopecia.

BACKGROUND: Measurements of the quality of life (QoL) have recently become an integral part of dermatological studies. Our hypothesis is that QoL in patients with certain diseases can be affected by strategies of coping behaviour, as well as by personality traits. OBJECTIVES: The aim of this study was to explore the particular correlation between QoL and strategies of coping in female patients with alopecia. PATIENTS: Fifty female patients, diagnosed with either diffuse or androgenetic alopecia, were evaluated by the use of Hairdex, an instrument developed to measure QoL in patients with hair loss. Most patients also underwent additional psychological assessments. RESULTS: Findings indicated that patients with highly visible hair loss reported a more negative impact on four Hairdex dimensions (functioning, emotions, self-confidence and stigmatization) than patients whose hair loss was only slightly visible. However, a subgroup of patients, with non-visible symptoms of hair loss, showed striking signs of psychological disturbance. These disturbed patients displayed either dysmorphophobic or affective disorder tendencies. CONCLUSIONS: Future studies using QoL as an instrument in research on patients with alopecia should consider that in cases of female alopecia these measurements may be affected by psychological disturbances.

Adaptation, Psychological↗