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Biomedical subjects

R Fölster-Holst

Publications and source records attributed to R Fölster-Holst.

At least 19 recordsLinked to original sources
PubMed2006

[Calcinosis cutis in Albright hereditary osteodystrophy: pseudohypoparathyroidism type Ia].

Albright hereditary osteodystrophy (AHO) is characterized by a symptom complex including short stature, brachymetacarpia, obesity, round facies, cutaneous osteomas, and mental retardation. AHO is caused by mutations in the GNAS-gene localized on chromosome 20 encoding for Gsalpha protein, a signal transducer of endocrine pathways. Therefore, AHO is often associated with endocrinopathy such as pseudohypoparathyroidism or hypothyroidism. A nine-month-old boy presented with typical features of this syndrome. The diagnosis was confirmed by biochemical and molecular analyses. An unusual feature was calcinosis cutis at such an early age, which led to extensive differential diagnostic procedures.

Calcinosis↗
PubMed2006

Prospective, randomized controlled trial on Lactobacillus rhamnosus in infants with moderate to severe atopic dermatitis.

BACKGROUND: A reduction of symptoms of atopic dermatitis (AD) in small infants by the administration of Lactobacillus rhamnosus has been reported in a few studies. One study with older children and adolescents failed to show any effect. OBJECTIVES: We conducted a prospective study to reassess the efficacy of orally administered L. rhamnosus strain GG (LGG) in infants with AD. METHODS: In a randomized, double-blind, placebo-controlled study, 54 infants aged 1-55 months with moderate to severe AD were randomized to daily 10 x 10(9) colony-forming units of LGG or to placebo during an 8-week intervention phase. Emollients, class I-II topical corticosteroids and antihistamines were permitted. RESULTS: The treatment with LGG was well tolerated. At the end of treatment there were no significant differences between the groups with respect to clinical symptoms (SCORAD, pruritus, sleep loss), the use of topical corticosteroids and antihistamines, immunological parameters, or health-related quality of life of the parents. CONCLUSIONS: Our results could not confirm LGG as an effective treatment of AD in infancy.

Child, Preschool↗
PubMed2006

Low prevalence of the intrinsic form of atopic dermatitis among adult patients.

BACKGROUND: Atopic dermatitis (AD) is a chronic inflammatory skin disease commonly associated with respiratory allergies such as rhinitis and asthma, and a high serum level of IgE. In contrast to the 'classic' IgE-mediated allergic (extrinsic) form of AD, approximately 20% of the patients are reported to show normal IgE levels, lack of sensitizations towards environmental allergens, and absence of associated respiratory allergies. Accordingly, these patients are assigned to a nonallergic (intrinsic) form of the disease. OBJECTIVES: In order to define these two forms of AD more closely, 259 adult patients with AD were investigated. RESULTS: After a thorough diagnostic workup there were 18 patients (6.9%), who fulfilled the criteria of intrinsic AD. After follow-up, four additional patients had developed respiratory allergies or IgE-mediated sensitizations resulting in an overall proportion for intrinsic AD of 5.4%. CONCLUSIONS: Based on these figures the nature and relevance of the intrinsic form of AD deserves further evaluation.

Adult↗
PubMed2005

A multicentre, randomized, double-blind, controlled study of long-term treatment with 0.1% tacrolimus ointment in adults with moderate to severe atopic dermatitis.

BACKGROUND: Atopic dermatis (AD) is a chronic disease that often requires long-term treatment. Topical corticosteroids are the usual therapy for patients with AD, but prolonged usage can result in skin atrophy and other side-effects. OBJECTIVES: In a randomized, double-blind, comparative study, to compare the efficacy and safety of a 6-month treatment period with 0.1% tacrolimus ointment vs. a corticosteroid ointment regimen in adults with moderate to severe AD. METHODS: Treatment was applied twice daily for a maximum of 6 months. Patients in the tacrolimus treatment group (n = 487) applied 0.1% tacrolimus ointment to all affected areas over the whole body. The patients treated with the corticosteroid regimen (n = 485) applied 0.1% hydrocortisone butyrate ointment to affected areas on the trunk and extremities and 1% hydrocortisone acetate ointment to affected areas on the face and neck. The study primary endpoint was the response rate, i.e. the proportion of patients with at least 60% improvement in the modified Eczema Area and Severity Index (mEASI) between baseline and month 3. RESULTS: By month 3, more patients in the 0.1% tacrolimus group responded to treatment (72.6% vs. 52.3% in the corticosteroid group, P < 0.001). The patients treated with 0.1% tacrolimus also showed greater improvement in mEASI, EASI, affected body surface area and physician and patient assessments of global response. Patients applying 0.1% tacrolimus ointment experienced more skin burning (52.4% vs. 13.8% in the corticosteroid group; P < 0.001). In most patients, skin burning was mild to moderate in severity and decreased rapidly after the first week of treatment. There was no increase in the incidence of infections or malignancies over time in either treatment group. CONCLUSIONS: Long-term treatment with 0.1% tacrolimus ointment is significantly more efficacious than a corticosteroid ointment regimen in adults with moderate to severe AD.

Adult↗
PubMed2004

[Viral exanthem].

The most frequent cause of exanthematous diseases are viral infections, which provoke skin alterations either directly or via the reaction of the immune system. In many distinct parainfectious clinical pictures, several viruses from quite different groups are able to produce a specific exanthem. Dominant pathogens for exanthematous diseases include non-polio enteroviruses, respiratory viruses, Epstein-Barr virus, HHV-6 and HHV-7 viruses as well as parvovirus B19. In many cases exanthemata present with maculate or maculopapular features in disseminated distribution. Some exanthematous diseases exhibit typical predilection sites. In addition to the clinical picture, diagnosis is based on the patient's history, observation of the patient's general condition, awareness of the season in the year, and physical examination. In uncertain cases and for scientific studies, blood analysis, smear tests, and histological investigation confirm the diagnosis. Knowledge of exanthematous disease, which usually run harmless course, is essential for differentiation of life-threatening disorders. This article presents exanthematous viral diseases depending on age at primary manifestation.

Aging↗
PubMed2004

Long-term safety and tolerability of pimecrolimus cream 1% and topical corticosteroids in adults with moderate to severe atopic dermatitis.

OBJECTIVE: This randomized, double-blind, multi-centre study compared the long-term safety and tolerability of pimecrolimus cream 1% and topical corticosteroids (TCS) in 658 adults with moderate-severe atopic dermatitis (AD). METHODS: Patients applied either pimecrolimus or TCS (i.e. 0.1% triamcinolone acetonide cream and/or 1% hydrocortisone acetate cream) twice daily to all affected areas until complete clearance or for up to 1 year. The study was approved by the institutional review board or ethics committee at each centre. RESULTS: A majority of patients treated with either pimecrolimus or TCS used the drug on a continuous basis over 1 year. In patients who had >30% of the body surface involved by AD, the incidence rate of all skin infections was significantly lower in the pimecrolimus group than in the TCS group (95% CI of the treatment difference: -25.3% to -3.4%). The most frequent application site reaction was burning (25.9% of patients on pimecrolimus and 10.9% on TCS), which was transient and mild-moderate in most cases. Three TCS-treated patients reported skin striae. There were no treatment-related serious or clinically significant systemic adverse events. Efficacy was better in patients on continuous TCS therapy, although patients completing the study were similarly well-controlled in both groups. About 42% of the pimecrolimus-treated patients were maintained for 1 year without TCS. CONCLUSION: Pimecrolimus demonstrated a favourable safety profile when used to treat adult patients with moderate-severe AD for up to 1 year. A significant proportion of patients could be maintained without TCS for a year.

Administration, Cutaneous↗
PubMed2004

Epithelial barrier function and atopic diathesis in rosacea and perioral dermatitis.

BACKGROUND: Rosacea and perioral dermatitis (PD) are common dermatoses, the aetiology and pathogenesis of which remain speculative. Objectives To investigate skin barrier function and features of atopy in both diseases. METHODS: We studied 75 patients with rosacea and 75 with PD. Transepidermal water loss (TEWL) was measured in three regions of the face (lateral chin, perinasal cheek, side of the nose) and the patients were assessed for atopy by clinical criteria, prick tests and specific IgE against a mixture of aeroallergens (CAP SX1). The control group consisted of 125 individuals with no history of rosacea, PD or active atopic disease. RESULTS: In patients with PD, TEWL was significantly increased (P < 0.001) at all measurement points in comparison with the rosacea and control groups. Significantly (P < 0.001) higher values were also found regarding history and clinical signs of an atopic diathesis, prick test reactivity and specific IgE against aeroallergens. CONCLUSIONS: PD is characterized by a skin barrier disorder of facial skin. It differs from rosacea in that it involves a significantly increased TEWL and features of an atopic diathesis. However, it remains disputed as to whether PD is an individual skin disease or a subtype of rosacea in atopic patients.

Adult↗
PubMed2002

[Gianotti-Crosti syndrome following immunization].

Four infants developed Gianotti-Crosti syndrome (GCS) 6 to 8 days after immunization. Subsequent booster vaccinations were well tolerated. Different types of viral infections have been implicated in the pathogenesis of GCS. The occurrence of GCS after vaccination is rarely described in literature. We suggest that vaccination may be a relevant etiologic factor and should be considered in infants presenting with GCS.

Acrodermatitis↗
PubMed2002

[Recurrent palmoplantar hidradenitis in childhood].

We describe five cases of recurrent palmoplantar hidradenitis in children. The pathogenesis of this highly characteristic disease presenting with painful erythematous papules and nodules involving palms of the hands, soles of the feet, or both is not clear at the moment. One possible mechanism is a temporal relationship between exposure to dampness and cold, which also applied in four of these children. The self-limited disease tends to reappear. After thoroughly informing the children and their parents on avoiding provoking factors, all children experienced freedom from the disease during a 12-month follow-up.

Child↗
PubMed2001

[Contact allergy caused by poison ivy (Toxicodendron spp].

Within 3 days two female patients presented with an eruption featuring erythema, edema, vesicles and bullae. We suspected poison ivy allergy which was subsequently proven by history and positive patch tests. In Germany the risk of specific hypersensitivity to Toxicodendron species is low, since the distribution of such plants is confined to botanical gardens. Other species belonging to the family of Anacardiaceae contain urushiols as well (e.g., mango, cashew) and may cause allergic contact dermatitis.

Adult↗
PubMed2001

Cercarial dermatitis contracted via contact with an aquarium: case report and review.

Cercarial dermatitis ('swimmer's itch') is an itchy inflammatory response to the penetration of the skin by non-human Schistosoma parasites. It is commonly contracted while swimming or wading in lakes. We report a biology teacher who developed the dermatitis after cleaning the school aquarium in which he kept a water snail and some fish.

Animals↗
PubMed2000

[Treatment of scabies with special consideration of the approach in infancy, pregnancy and while nursing].

Infestation of human skin with scabies mites remains an persistent problem in daily dermatological practice. There are several therapeutic regiments against scabies which have been proven effective and without major side effects. Because of known neurotoxicity of lindane as well as intoxication/problems following systemic absorption of benzyl alcohol (the metabolite of benzyl benzoate), these two compounds have to be considered with caution in early childhood scabies as well as during pregnancy and nursing. The pharmacology and spectrum of clinical side effects of the approved anti-scabies preparations (lindane, benzyl benzoate, crotamiton) as well as permethrin (not available in Germany) are reviewed.

Breast Feeding↗
PubMed2000

[Direct versus video-aided parent education in atopic eczema in childhood as a supplement to specialty physician treatment. A controlled pilot study].

BACKGROUND AND OBJECTIVE: Psychological problems in children and parents related to children's atopic eczema (AE) may impede the success of treatment. We studied the question, if behavior-based parental education in groups (DPE) or standardized video-education (VPE) could enhance dermatological treatment effects and reduce skin-damaging behaviors in children and stress in their mothers. PATIENTS/METHODS: 47 mothers attending the university outpatient-clinic for dermatology and their AE-children (mean age 4 years) participated in the study. 18 mothers underwent the DPE (10 sessions), 15 mothers worked with VPE at home. Dermatological standard treatment (CG; N = 14) served as control for a 16-weeks-evaluation-period. RESULTS: AE-symptoms improved overall, but the effectiveness of the treatments differed significantly, improval with parent education and was best with VPE. Psychological problems of mothers were equally reduced with DPE and VPE. CONCLUSIONS: It is suggested that VPE is a cost effective and less time consuming method for supporting dermatological therapy of AE in children.

Adult↗
PubMed1999

[Unilateral latero-thoracic exanthema in childhood. Clinical characteristics and diagnostic criteria in 5 patients].

Unilateral laterothoracic exanthem a (ULE) is a self-limited, probably infectious-allergic skin disease predominantly affecting small children. We describe five such cases. The typical unilaterally located or at least unilaterally dominant exanthem usually starts in the axillary region and is characterized by red, partly confluent papules and fine scales. Two of the children presented with atypical manifestations of ULE. Due to its asymptomatic course, therapy is not necessary in the majority of cases.

Axilla↗