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T Henseler

Publications and source records attributed to T Henseler.

At least 19 recordsLinked to original sources
PubMed1995

Disease concomitance in psoriasis.

BACKGROUND: Psoriasis is a multifactorial disease of unknown origin. OBJECTIVE: Our purpose was to determine the frequency of skin disorders concomitantly seen in patients with psoriasis. METHODS: We analyzed data from more than 40,000 patients and calculated sex- and age-adjusted ratios of expected and observed incidence rates of associated disorders. RESULTS: The results demonstrate that, compared with age-matched control patients without psoriasis, cutaneous immune disorders such as allergic contact dermatitis, atopic dermatitis, and urticaria are underrepresented in patients with psoriasis. In contrast, certain systemic disorders such as diabetes, heart insufficiency, and obesity occur significantly more often in patients with psoriasis than in control subjects. Increased resistance to cutaneous bacterial infections was noted only in patients with early-onset psoriasis. CONCLUSION: Our observations show that a distinct pattern of associated diseases exists in patients with psoriasis. Although systemic disorders such as obesity, diabetes, and heart disease may be related to dietary habits and nutritional status, the relative resistance to cutaneous infections together with decreased immune responsiveness suggest a genetically determined selection.

Adult↗
PubMed1995

[Mucocutaneous candidiasis in patients with skin diseases].

We investigated skin diseases associated with mucocutaneous Candida infection by analyzing the clinical records of 44695 in-patients of the department of dermatology of Kiel. For more than eighty skin diseases the relative risk (RR) was calculated by age-and sex-adjusting methods. 1996 patients demonstrated a mucocutaneous candidosis, 14.8% of them being hospitalized because of extensive Candida infection. In patients with dermatomyositis, bullous pemphigus, tinea inguinalis, and condylomata acuminata a Candida infection was observed more than threefold than expected. Furthermore, patients with urticaria, folliculitis, and bullous pemphigoid demonstrated candidosis more than twice as often as control patients. In addition, patients with erysipelas, acne, psoriasis, and atopic dermatitis showed a candidosis significantly more often (RR between 1.3 and 1.6). Some internistic maladies were investigated, too. In patients presenting with diabetes mellitus, heart-insufficiency, hypertension, chronic tonsillitis, and urinary tract infection a mucocutaneous Candida infection was significantly increased.

Age Factors↗
PubMed1994

Reproducibility of patch tests. A multicenter study of synchronous left-versus right-sided patch tests by the German Contact Dermatitis Research Group.

BACKGROUND: The efficiency and reproducibility of patch tests remain controversial. OBJECTIVE: Our purpose was to determine the efficiency and reproducibility of patch tests and to identify factors influencing these features. METHODS: We double-tested 1285 patients concomitantly with 10 standard allergens by manually filled test chambers. Additional information was obtained from all patients with a standardized protocol. RESULTS: Patch test efficiency was good (> or = 0.94) with all 10 allergens. In contrast, nonreproducibility of patch tests was strongly allergen dependent, ranging from 0.2 for nickel sulfate to 0.6 for formaldehyde. The likelihood of nonreproducible allergic reactions increased when more than four positive reactions were seen at the same time, and with another positive reaction located in close proximity to an allergic reaction. Sex and age of patients, atopy, dermatitis at distant sites, sleeping habits, and the time of allergen exposure (24 or 48 hours) did not affect the rate of nonreproducible results. CONCLUSION: To increase patch test reproducibility, specific preparations of patch test allergens need to be improved. Furthermore, amplification effects by synchronous neighboring positive reactions should be excluded.

Allergens↗
PubMed1994

Of genes and antigens: the inheritance of psoriasis.

Psoriasis is one of a number of autoimmune diseases that display significant HLA associations. In particular, individuals with onset of disease prior to 40 years of age display striking associations with HLA-Cw6 and are much more likely to have a positive family for psoriasis. However, only about 10% of Cw6-positive individuals develop disease, suggesting that other genetic and/or environmental factors must be involved. Several compelling lines of epidemiologic evidence indicate that psoriasis susceptibility is inherited, albeit not in a simple monogenic fashion, and that genetic, rather than environmental, factors are primarily responsible for the variability in inheritance of psoriasis. Taken together, these observations suggest that one or more loci in addition to HLA are necessary for the development of psoriasis. The number of additional loci is likely to be small, because i) the disease is very common ii) substantial excess risk of psoriasis is observed in first degree relatives, and iii) nevoid variants of psoriasis have been reported, suggestive of somatic mutation of a single gene during development. The substantial homogeneity of the psoriatic phenotype and the clear evidence for increased HLA association and heritability in juvenile onset disease indicate that despite its complexity, psoriasis is a common disease whose etiology is amendable to elucidation through the techniques of modern molecular genetics.

Age of Onset↗
PubMed1994

The genetics of psoriasis.

BACKGROUND AND DESIGN: Psoriasis is a member of a class of common, HLA-associated conditions in which disease susceptibility appears to be heritable. However, the mode of inheritance of these diseases has been difficult to define in simple mendelian terms. Psoriasis displays one of the strongest HLA associations of this class of diseases. However, only a small fraction of those who carry the implicated HLA susceptibility alleles develop disease, and it has proven difficult to demonstrate that the HLA associations observed are due to formal genetic linkage between the disease and the HLA locus. Although the role of environmental factors in psoriasis and these other diseases cannot be denied, the participation of additional genes, not necessarily linked to HLA, has long been suspected. OBSERVATIONS: Epidemiologic and immunogenetic data are reviewed and analyzed, which demonstrate that a predisposition to psoriasis is heritable, and which implicate genes of the HLA locus as necessary but not sufficient determinants of psoriasis. Recent developments in human genome research are described, which make possible a systematic search for additional genetic determinants of psoriasis, including those unlinked to HLA. CONCLUSIONS: As one of the most common, most heritable, and most highly HLA-associated examples of this class of HLA-associated diseases, psoriasis represents an ideal target for the application of this emerging genomic technology.

Adolescent↗
PubMed1989

Patient subgroups and the inflammatory pattern in psoriasis.

Despite great numbers of recent studies on immunological parameters in psoriasis, the question whether psoriasis is an immunological disease is still open. Also, it is not clear how the three main abnormalities of this disease, i.e. the association with the human leukocyte antigen system, excessive epidermal new cell production and a unique neutrophilic infiltrate within the diseased epidermis, are linked together. Analysis of large patient cohorts has now shown that two types of non-pustular psoriasis exist: one showing early onset and linkage disequilibrium for human leukocyte antigen Cw6, B13, Bw57, the other type showing late onset associated with Cw2 and B27. The pathological features of increased cell proliferation and neutrophilic inflammation are likely to be regulated by potent peptide mediators some of which are mitogenic and/or proinflammatory. There are two powerful regulatory peptides (C5ades arg and neutrophil activating peptide-1), large amounts of which have now been isolated from psoriatic scale material. Both are able to stimulate other cells to migrate and to produce further signals. The initiating agent still remains an enigma.

Adolescent↗
PubMed1987

Contrasting disease patterns in psoriasis and atopic dermatitis.

In this report we investigate the simultaneous occurrence of psoriasis and atopic dermatitis (AD) as well as the association with infectious skin diseases. Among 29,159 patients hospitalized between 1953 and 1983, 8.5% (2,467 patients) were treated for psoriasis, while 1.6% (470 patients) were hospitalized for AD treatment. On the basis of incidence rates for both diseases, 36 patients (0.14%) with both psoriasis and AD were expected to be seen. However, the two conditions were simultaneously present in 2 patients only. Approximately 30% of the AD patients were suffering from either bacterial or viral infection, while this complication occurred in 6.7% of psoriatics. In addition, among 48 patients hospitalized for eczema herpeticatum 39 were atopics and none was psoriatic. The data demonstrate that the occurrence of psoriasis and AD in one and the same patient is quite rare and this may be related to conflicting immune defense patterns. Thus, increased sensitization against foreign protein together with high susceptibility to cutaneous infection present in AD is in contrast to high phagocyte responsiveness in psoriasis, where concurrent infections are rare.

Acute Disease↗
PubMed1987

Relative increase of Langerhans cells in 'banal' and dysplastic melanocytic naevi.

Langerhans cell counts were carried out in 16 normal or banal melanocytic naevi and 22 dysplastic naevi, and the numbers in the naevi compared with Langerhans cell numbers in perilesional, clinically normal, epidermis. Langerhans cell numbers were found to be raised in both types of naevi, but no significant difference between Langerhans cell numbers in the two types of naevi was found.

Adult↗
PubMed1987

Skin tumors in the European PUVA Study. Eight-year follow-up of 1,643 patients treated with PUVA for psoriasis.

In the continuation of the European PUVA Study, 1,643 patients of the original cohort of 3,175 patients enrolled in this prospective study were reevaluated for skin tumors after an average observation period of 96 months. Thirty-six patients with a total of seventy-one tumors (forty squamous cell carcinomas, twenty-three basal cell carcinomas) were observed. In contrast to the U.S. sixteen-center study, we were unable to demonstrate a clinically relevant increase in the risk of tumors induced by psoralens with ultraviolet A (PUVA), and we also failed to show a clear relationship between PUVA exposure and tumor development. Almost all patients with tumors had been exposed to various carcinogens before the initiation of PUVA. No tumors were detected in patients without such prior treatment, although 10% of the patients had received more than 3,000 joules/cm2 total cumulative phototoxic PUVA dose during the observation period. The discrepancy between the results of the U.S. study and our findings may partly be explained by a variety of factors such as a different treatment approach, a different attitude toward sun exposure, and the overall lower incidence of skin cancer in the European population.

Basal Cell Carcinoma↗
PubMed1985

[Colliquation necrosis of the skin caused by a cardiac pacemaker].

In two patients with cardiac infarction of a medical intensive care unit blisters developing into deep necroses were observed on the upper extremities and adjoining regions of the trunk within the first days of treatment. Clinical findings and histology indicated extensive caustic artefacts. The cause for the initially mysterious event was found to be a defect in the extracorporeal cardiac pacemaker. Defective isolation had lead to a continuous current potential between pacemaker cover and electrode. The resulting electrolysis caused a dramatic increase of pH on the moist body surface underneath the pacemaker. As a result of the pH shift caustic damage with extensive dermal necroses was observed.

Aged↗
PubMed1985

Psoriasis of early and late onset: characterization of two types of psoriasis vulgaris.

In 2,147 patients suffering from psoriasis, evaluation of the age of onset revealed two peaks, one occurring at the age of 16 years (female) or 22 years (males) and a second peak at the age of 60 years (female) or 57 years (males). Human lymphocyte antigen (HLA) tissue typing in 112 randomly assigned patients showed that HLA-Cw6, known to be at disequilibrium in psoriasis, is present in 85.3% of patients with early onset. In contrast, 14.7% patients with late onset showed this marker. Parents (father or mother) were affected in approximately half of the patients with early onset and in none belonging to the group with late onset. Furthermore, psoriasis in patients with early onset follows an irregular course and shows a strong tendency to become generalized. On the basis of clearly defined criteria (e.g., age of onset, heritability, and clinical course of disease), nonpustular psoriasis shows two distinct forms, one of which is hereditary, with early onset, and the other is sporadic and occurs in older age.

Adolescent↗
PubMed1984

Risk of skin tumors in psoralen- and ultraviolet A-treated patients.

From 1973 to 1981, the clinical data of 1,136 patients with psoriasis and another 1,210 with various skin tumors were accessioned with the aid of computerized data files. Skin tumors and psoriasis occurred in 48 patients. After psoralen plus 320-400 nm UV (PUVA) therapy for psoriasis was introduced in 1976, 381 patients with this disease were treated. Follow-up data revealed no change in the tumor incidence rate after this treatment began. Age-related calculations of the relative probabilities for the presence of skin cancer in patients with psoriasis after PUVA revealed a grossly normal pattern (which appeared to be unaffected by PUVA). We observed a skin tumor in 2 patients 5 years after PUVA therapy.

Adult↗
PubMed1982

[Inheritance of psoriasis. Analysis of 2035 family histories].

Detailed pedigrees were established in 2,035 families with psoriasis, including 30 twin pairs, and evaluated by means of computer analysis. The following results on the devolution of psoriasis were drawn: the hypotheses of the irregular dominant and the bifactorial recessive inheritance appear to be inacceptable. The findings suggest a multifactorial etiology of psoriasis with a polygenic mode of inheritance. The risk for relatives to be affected by psoriasis is calculated.

Adult↗
PubMed1981

Oral 8-methoxypsoralen photochemotherapy of psoriasis. The European PUVA study: a cooperative study among 18 European centres.

In a multicentre study in eighteen European cities 3175 patients were treated with photochemotherapy (PUVA) for severe psoriasis and data obtained during a period of 39 months were analysed. A response better than marked improvement was obtained in 88.8% of patients; twenty exposures and a total cumulative UVA dose of 96 J/cm2 were required for clearing, the duration of the clearing phase being 5.3 weeks. A comparison of the results of this study with those of a similar multicentre study in the United States on 1300 patients and using a different treatment protocol, revealed that while treatment results and the number of individual treatment sessions were similar the European protocol requires only half the time and less than half the total cumulative UVA dose for clearing of psoriasis. When patients in the European study who received continuous maintenance treatment were compared with patients who received no maintenance treatment the probability that a patient would remain in remission for a period of 80 weeks was the same, irrespective of whether patients received maintenance treatment or not. This study confirms the dramatic efficacy of PUVA in clearing psoriasis and contains two important messages for the reduction of possible long-term hazards of this treatment. Firstly, the total UVA energy requirements for clearing psoriasis strongly depend on the treatment schedule and can be kept low if an individual approach aimed at rapid clearing of psoriasis is used. Secondly, maintenance therapy may not significantly prevent recurrences for prolonged periods of time and may thus not be necessary in most patients.

Administration, Oral↗