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Biomedical subjects

S Wever

Publications and source records attributed to S Wever.

9 recordsLinked to original sources
PubMed2000

[Scabies epidemic in a sheltered workshop--what should be done?].

Scabies is an infectious parasitic skin disease with a notable rising incidence in Germany. The disease is usually transmitted by close physical contact, but indirect spread e.g. by bedding is also possible. Due to its contagiousness, introduction of scabies into crowding living facilities, such as dormitories or kindergartens, can easily cause an epidemic outbreak. We describe an epidemic of scabies in a workshop for handicapped people in February 1998. A worker with severe scabies reported that numerous colleagues in both workshop and the associated hostel had complained of pruritus for months and that some of them already had undergone scabicide treatment. The number of contacts (staff, colleagues, friends, attendants, family) of our patient and the other already affected people was more than 460. The management of the workshop asked for help in handling the epidemic. We describe the cooperative efforts of the management, as well as hospital and private dermatologists, to evaluate all potential contacts and present a concept of treatment for the termination of such an epidemic outbreak of scabies.

Animals↗
PubMed1995

[Herpes gestationis. Clinical spectrum and diagnostic possibilities].

Herpes gestationis (HG) is a rare autoimmune disease of pregnancy. We report on five patients in whom the clinical diagnosis was confirmed by histology, immunofluorescence and immunoblot studies. The time of onset ranged from the 8th week of pregnancy to the 1st day post partum. In one patient erosions and ulcerations of the oral cavity predominated while the remainder of the skin was nearly unaffected. One patient had intense pruritus without any skin eruptions during the final 8 weeks of her pregnancy, developing bullous lesions on the 1st day post partum. The other patients initially suffered from pruritic polymorphic skin lesions, followed by vesiculae and bullae. In the serum of all patients, the complement-fixing HG factor was found. Immunoblot studies with epidermal and dermal extracts demonstrated the binding of the antibodies to a 180-kD protein of the epidermis. All patients improved markedly with medium dosages of systemic corticosteroids. In four cases the newborns were healthy and mature, and in one case, the infant met all criteria for a "small-for-dates" baby. We discuss both clinical spectrum and diagnostic options of HG and review new aspects related to the pathogenesis of this disease.

Adult↗
PubMed1995

[Cicatricial pemphigoid--a therapeutic problem].

Cicatricial pemphigoid is an autoimmune subepidermal blistering disease of the skin and mucous membranes. We report on eight patients in whom the clinical diagnosis was confirmed by direct immunofluorescence. The patients' age averaged 69 years; seven were female and one male. Initial symptoms were erosions of the oral mucous membranes in four patients, skin blisters in three patients, and in one patient an ocular involvement was the first manifestation of the disease. Indirect immunofluorescence on NaCl-split human skin revealed circulating IgG antibodies binding to the roof of the artificial blister in three patients. Immunoblotting of epidermal and dermal extracts disclosed binding of IgG antibodies of one of these patients to an epidermal 230-kD protein, whereas IgA-antibodies showed no specific binding. In four of five patients with a strong ocular involvement IgA deposits were found by direct immunofluorescence. These studies were done on biopsies of perilesional skin or oral mucous membranes, and they were positive in one patient even before the first ocular lesions appeared. Therefore, finding of IgA deposits by direct immunofluorescence may be taken as a prognostic criterion allowing selection of the proper treatment. We treated six patients with a dexamethasone-cyclophosphamide pulse therapy, while two patients received dapsone orally. The involvement of skin and oral mucous membrane responded well to both regimens, whereas the ocular lesions were progressive, except in one patient. On the basis of our eight cases, we discuss both options and limitations in the treatment of cicatricial pemphigoid and review new aspects of the pathogenesis of this disease.

Aged↗
PubMed1995

[Bullous pemphigoid simulation subacute simple prurigo].

Bullous pemphigoid (BP) is a bullous autoimmune disease of the elderly; it is characterized by tense bullae on both erythematous and otherwise apparently normal skin. Several clinical variants of BP have been described, and we now add our observations of two BP cases mimicking subacute prurigo. Both patients had suffered from intensely pruritic excoriated papules for several months before presentation. Blisters had never developed and did not occur during follow up. Histology showed changes of chronic dermatitis. In the serum of both patients, indirect immunofluorescence on NaCl-separated human skin revealed the presence of circulating antibodies binding to the roof of the artificial blisters. Perilesional skin biopsies showed linear IgG or C3-deposits in the basement membrane zone. Immunoblotting of epidermal and dermal extracts demonstrated the binding of the antibodies to an epidermal 230-kD protein, which is the known major bullous pemphigoid antigen. These cases are described as a basis for discussion of the clinical spectrum of bullous pemphigoid.

Acute Disease↗
PubMed1995

[Trichophyton soudanense as the pathogen of tinea corporis et capitis].

Tinea capitis and corporis caused by Trichophyton soudanense were identified in a 6-year-old coloured boy who was born in Zaire and had been living for 3 years in Germany. This dermatophyte is very rarely seen outside the region in Africa where it is endemic. The disease is frequently overlooked at diagnosis because of the pathogen's capacity for causing chronic and oligosymptomatic infections. In our case the tinea did not a become apparent until the patient had been in Germany for 3 years. No-one else in his family had any comparable scalp or skin lesions. Consistent therapy with itraconazole (Sempera) dosed at 3 mg/kg body weight per day over a period of 4 weeks led to a permanent cure.

Black People↗