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Biomedical subjects

R Feldmann

Publications and source records attributed to R Feldmann.

At least 19 recordsLinked to original sources
PubMed1996

[Postmenopausal frontal fibrosing alopecia].

We report on two patients with postmenopausal frontal fibrosing alopecia. This recently described disease affects postmenopausal women and is characterized by progressive recession of the frontotemporal and parietal hair margins. It leads to a symmetrical band-like scarring area of alopecia 3-6 cm wide. Histological examination shows perifollicular fibrosis and lymphocytic inflammation concentrated around the isthmus and infundibular areas of the follicles. One of our two patients also had vulvar lichen sclerosus et atrophicus. An effective treatment for this type of postmenopausal alopecia is yet not known, but the course of the disease seems to be self-limited.

Aged↗
PubMed1996

[Postoperative infection with Mycobacterium chelonae].

A 70-year-old patient developed Mycobacterium chelonae infection at a donor vein graft site following cardiac bypass surgery. The infection presented as fibrinous, necrotic ulcerations in the scar area. Mycobacterium chelonae and mycobacterium fortuitum are atypical mycobacteria and have been described previously causing infections after injections or surgical procedures. Infection of donor vein graft site is a rare complication after cardiac surgery. As mycobacterium chelonae cannot be cultivated on normal culture media, delayed wound healing might be disinterpretated as a primary wound healing disorder. Treatment of atypical myobacteriosis includes antibiotics, local heat therapy and surgical excision. Clarithromycin is the antibiotic of choice. We obtained complete healing after two months of Clarithromycin treatment, combined with heat therapy.

Aged↗
PubMed1996

Psychoeducational training for schizophrenic patients: background, procedure and empirical findings.

As neuroleptic therapy alone still fails to other effective relapse prevention in schizophrenic patients, psychoeducational therapeutic approaches have been developed as an additional aid for patients and their families. This article details the central characteristics of these approaches. A psychoeducational group program for schizophrenic outpatients, the efficacy of which was investigated within the scope of a German controlled intervention study on 191 patients, is also presented. The article describes in detail the methods used and the therapeutic objectives, reporting on changes in the attitudes of patients to their medication. At the end of the training program, patients who had attended regularly showed significantly better medication compliance and were more reserved with respect to their medication self-management. After 1 year the positive effects had diminished. However, booster sessions or participation of the psychiatrist in charge as group therapist would have had longer lasting effects.

Adult↗
PubMed1996

Coexistence of atopic dermatitis and lichen nitidus in three patients.

Lichen nitidus (LN) is an uncommon skin disorder. We observed 3 patients with an association of lichen nitidus and atopic dermatitis (AD), which to the best of our knowledge has not been previously reported in the literature. It remains to be evaluated whether the association of LN and AD is fortuitous or not.

Adult↗
PubMed1995

[The clinical spectrum of focal dermal hypoplasia].

Focal dermal hypoplasia (FHD) is an X chromosomal dominant inherited disease with unknown gene defect. FDH is characterized by ectodermal and mesodermal malformations. It is thought to be lethal in males; however, males may survive as mosaics or possibly as Klinefelter syndrome (XXY). When mosaicism involves the gonads the disease may be transmitted from father to child. In females, the abnormal phenotype is thought to be expressed in a blaschkoid pattern because of random X chromosome inactivation. We have collected eight cases of which three were males. We present the typical clinical dermatological feature and draw attention to cases with minimal skin involvement.

Adolescent↗
PubMed1995

[Skin symptoms in diabetic metabolism].

Diabetes mellitus is a common disease, and the cutaneous manifestations of it are frequently encountered. Some skin diseases have a strong association with diabetes, as necrobiosis lipoidica and diabetic bullae. They can be regarded as a cutaneous marker for diabetes. Other disorders--for example shin spots--also occur in the nondiabetic population. Cutaneous infections may be a sign of poorly controlled diabetes.

Acanthosis Nigricans↗
PubMed1994

The association of the two antimalarials chloroquine and quinacrine for treatment-resistant chronic and subacute cutaneous lupus erythematosus.

Antimalarials are the first line in the treatment of chronic and subacute cutaneous lupus erythematosus (LE). However, some patients show either no or only minor improvement on antimalarial monotherapy. We treated 14 patients (9 with chronic LE and 5 with subacute cutaneous LE) who had poorly responded to chloroquine or hydroxychloroquine with an association of chloroquine and quinacrine. The initial dose was: chloroquine 100 mg 3x/day and quinacrine 65 mg 3x/day. The skin lesions improved significantly or cleared totally in 5 of the 9 patients with chronic LE and in all the 5 patients with subacute cutaneous LE. These findings suggest that a chloroquine-quinacrine combination may sometimes be superior to the usual antimalarial monotherapy, especially for subacute LE. If chloroquine or hydroxychloroquine fails to control chronic or subacute cutaneous LE, chloroquine-quinacrine is worthy to be tried.

Adult↗
PubMed1994

Papular-purpuric 'gloves and socks' syndrome: not only parvovirus B19.

We previously described an acute dermatosis characterized by pruritic erythematous and slightly papular lesions on the hands and feet in a 'gloves and socks' distribution associated with oral aphthoid lesions and fever (papular-purpuric 'gloves and socks' syndrome = PPGSS). We strongly suspected a viral origin, but serologic tests for a large panel of viruses remained negative. Subsequently, 2 cases of PPGSS with serologic evidence of a parvovirus B19 infection have been reported in the literature. Since then we observed 5 additional patients with a PPGSS. Parvovirus B19 infection could be confirmed in only 2 cases. Our findings suggest that the PPGSS can be another, yet undescribed manifestation of parvovirus infection. However, this cannot be shown in all the cases. As the papular acrodermatitis of childhood, this syndrome may be caused by various viral agents.

Adolescent↗
PubMed1993

Distribution of myocardial beta-adrenoceptor subtypes and coupling to the adenylate cyclase in children with congenital heart disease and implications for treatment.

In congestive heart failure, down-regulation of myocardial beta-adrenoceptors (beta-AR) due to an elevated sympathetic tone is well known. In infancy and childhood, heart failure is usually related to congenital heart disease (CHD). Therefore, 71 samples of right atrial tissue of infants and children with CHD undergoing cardiac surgery were studied for beta-adrenoceptor density and distribution of the beta 1-/beta 2-AR subtypes. In 49 cases, the coupling of the beta-AR to the adenylate cyclase (AC) was examined. In a further study of 19 myocardial samples, AC was selectively stimulated with beta 1- or beta 2-AR whereas the other subtype was blocked by an antagonist. The following results were obtained: (1) Infants and children with severe acyanotic or cyanotic CHD had severely reduced beta-AR densities. (2) In most of the cases, the beta-AR down regulation is beta 1-subtype selective, but in critically ill newborns with congenital aortic valve stenosis or transposition of the great arteries, there is additional significant beta 2-AR down-regulation. In Fallot patients treated with the beta-antagonist propranolol, a significant increased beta-AR number compared with untreated Fallot patients was found. (3) beta-Adrenoceptor reduction in CHD is correlated with elevated noradrenaline plasma levels, thus proving a sympathetic dysregulation. (4) In CHD with moderate hemodynamic load, beta 2-AR coupling to AC was markedly more efficient than beta 1-AR coupling. The small number of myocardial beta 2-AR produced most of the cyclic adenosine monophosphate. (5) In severe acyanotic and cyanotic CHD, a partial decoupling of the beta 2-AR to the AC occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenylyl Cyclases↗
PubMed1993

Small fibre function in primary autonomic failure.

A case of primary autonomic failure (AF) with uncomplicated Parkinson's disease is presented with clinical and neurophysiological data. Special emphasis is placed on new methods of examining impairment of unmyelinated sympathetic and afferent C-fibres. Sympathetic vasoconstrictor responses in the skin induced by deep inspiration were examined quantitatively with laser Doppler flowmetry. The vasoconstriction was markedly depressed in primary AF compared with healthy controls and similar to secondary forms of AF. Peripheral nociceptive C-fibre function was quantitatively assessed by measurement of axon reflex vasodilatation induced by histamine iontophoresis. The axon reflex vasodilatation was completely intact in primary AF in contrast to patients with secondary peripheral small fibre neuropathy. The results indicate that sympathetic C-fibres are considerably affected by the degenerative disease, whereas the afferent C-fibres seem to be totally preserved. Modern neurophysiological methods of testing sympathetic and afferent small fibre function in combination with other neurophysiological tests, e.g. brain-stem auditory evoked potentials, might help to diagnose and differentiate primary AF in early stages and make it easier to distinguish between secondary autonomic neuropathies of unknown origin that often also involve unmyelinated afferent fibres.

Afferent Pathways↗
PubMed1993

Histamine release from basophils in childhood: age dependency and inhibition by pertussis infection and pertussis toxin.

The influence of childhood pertussis infection and of purified pertussis toxin on histamine release from human basophil leucocytes was investigated. Three different stimuli, the peptide N-formyl-Met-Phe (NFMP), anti-IgE, and the calciumionophore A23187 were used to challenge the cells. When NFMP was the stimulus, histamine release in the control group (age 0.5-17 years) increased in an age-dependent fashion, whereas anti-IgE and A23187 stimulated release did not vary with age. During the convulsive state of pertussis infection there was a significant reduction of histamine release in response to 10 microM NFMP (from 9.5 +/- 1.4 [n = 21] to 6.7 +/- 1.5 [n = 19], P < 0.05) and in response to 800 and 80 U/ml anti-IgE (from 28.5 +/- 5 [n = 19] to 16.3 +/- 5 [n = 13], P < 0.05, and from 6.9 +/- 1.7 [n = 16] to 2 +/- 0.8 [n = 13], P < 0.01), whereas histamine release stimulated by A23187 was unchanged compared to release in control children. In vitro pretreatment of basophils from healthy children and adults with pertussis toxin also inhibited histamine release. When NFMP was the stimulus, release was completely blocked by pertussis toxin with an IC50 of about 11 ng/ml, whereas anti-IgE stimulated release was only inhibited by 20%-30% and release induced by A23187 was reduced to 40%-50% by toxin treatment. In conclusion we have demonstrated a functional impairment of histamine release during the convulsive state of pertussis and that this inhibition is likely to be mediated by pertussis toxin.

Adolescent↗
PubMed1993

[Multiple filiform hyperkeratoses].

We report on a 41-year-old female patient who presented with a 3-year history of multiple filiform hyperkeratoses on the trunk. The family history revealed that her uncle had similar skin lesions. Another patient presented with filiform hyperkeratoses only on the palms of the hands and soles of the feet. This condition, referred to in English as multiple minute digitate hyperkeratoses, is a rare, mostly hereditary, disorder of cornification. As yet there is no official name for this dermatosis in German; we propose "multiple filiforme Hyperkeratosen".

Adult↗
PubMed1992

Orbital and palpebral paraffinoma.

Paraffinoma is a well-recognized complication of paraffin injection. We describe a 44-year-old man who had an ethmoidectomy for chronic sinusitis. A communicating fracture of the ethmoid bone into the orbit occurred intraoperatively. The nasal cavity was subsequently packed with gauze containing a petrolatum-based antibiotic ointment. Bilateral, periocular swelling developed 1 week later. Optical and electron microscopic studies revealed a paraffinoma.

Administration, Intranasal↗
PubMed1992

Fox-Fordyce disease: successful treatment with topical clindamycin in alcoholic propylene glycol solution.

We report a 66-year-old woman with a 3-year history of intensely pruritic follicular papules in the axillar, pubic and inguinal areas. Previous treatment with topical fusidic acid and gentamicin sulfate was ineffective. The clinical and histological examination was consistent with Fox-Fordyce disease. Application of clindamycin in an alcoholic propylene glycol solution led to the clearing of the lesions within 1 month. Nine months later, the treatment was stopped, and no recurrence was observed.

1-Propanol↗
PubMed1991

[The significance of protein C deficiency in dermatology].

The protein C system is a physiological inhibitor of coagulation and is important for the regulation of hemostasis. Protein C deficiencies can be inherited or acquired, and they lead to enhanced thrombophilia. A number of clinical entities that are also of interest to dermatologists have been related to protein C deficiency. Inherited protein C deficiency can become manifest in various ways, e.g. as purpura fulminans neonatalis, as recurrent episodes of thrombosis and as coumarin necrosis. Acquired protein C deficiency can be observed in the course of purpura fulminans, disseminated intravascular coagulation, hepatic failure or in the presence of antiphospholipid antibodies. The clinical features, the possible pathogenesis and the therapy of these manifestations are briefly discussed.

Humans↗