PubMed Health⌕ Search

Biomedical subjects

U Runne

Publications and source records attributed to U Runne.

At least 19 recordsLinked to original sources
PubMed1992

Psoriatic alopecia: acute and chronic hair loss in 47 patients with scalp psoriasis.

Symptomatic hair loss and alopecia were seen in psoriatic lesions of the scalp in 47 patients. Remarkably, in 66% of the cases it was an inaugural manifestation, and in 36% the scalp was exclusively involved. Therefore 34% of the patients presented with a primary manifestation of isolated scalp psoriasis. Hair loss varied in intensity from protracted to moderate and massive (36% in tufts). It presented as acute (51%), chronic (36%) or chronic recurrent (13%). Thirteen patients (28%) became aware of the hair loss with the beginning of therapy. The alopecia was found to be circumscribed in 75% of the cases and diffuse in 25%. In 2 cases psoriatic alopecia also manifested itself at sites other than the scalp. The telogen count was found to be increased up to 25-86% in the florid stage. Examinations under the light microscope showed a patchy perifollicular lymphohistiocytic infiltrate in the upper and middle dermis with adnexotropia in several cases. This infiltrate can alter the follicle epithelium and may lead to a granulomatous foreign-body reaction with destruction of the hair follicle. After topical antipsoriatic treatment, most of the reexamined patients showed complete hair regrowth, while 5 developed a residual scarring. Therefore, in the patient with circumscribed or diffuse symptomatic alopecia, with or without scarring, psoriatic alopecia should be considered.

Acute Disease↗
PubMed1992

Sequential concentration of chloroquine in human hair correlates with ingested dose and duration of therapy.

Human scalp hair was analyzed for chloroquine using gas-chromatography. In 5 patients it was demonstrated that the amount of uptake of chloroquine into the hair varied proportionally with the dosage (from 500 mg/week to 10 g single dose) and with the time of administration. The chloroquine concentrations ranged from 8 to 1100 micrograms/g hair. Chloroquine could be determined quantitatively after a single toxic dosage used in a suicidal attempt and also after low therapeutic doses. The sequential examination of the hair shaft allows an assessment of the chloroquine amount taken over time, the individual dosage, the initiation and termination of therapy. As hairs can be collected easily, they are a unique specimen for investigation, and it is suggested that they can virtually be used as a "tachogram" of chloroquine drug-therapy or intoxication.

Adult↗
PubMed1991

[Subacute chloroquine overdosage].

Owing to a misunderstanding a 26-year-old man took for malaria prevention 2 tablets (1.0 g) chloroquine daily instead of the recommended dose of two tablets weekly. After 2 weeks he developed vertigo, generalized weakness and, after sun-bathing, severe bullous light reaction. After 4 weeks generalized hair depigmentation occurred. Two weeks later abnormal accommodation and double vision set in so that he lost distant and near vision. All these signs disappeared after the drug was discontinued (vertigo, weakness and abnormal accommodation within 2 weeks; hair regrew in normal colour after 8 weeks). This case shows the whole spectrum of subacute chloroquine overdosage.

Accommodation, Ocular↗
PubMed1991

[Chloroquine and hydroxychloroquine: side effect profile of important therapeutic drugs].

Precise knowledge of the undesirable effects of chloroquine and hydroxychloroquine allows better exploitation of their therapeutic effects. Retinopathy can be avoided by observing a maximum daily dosage of 3.5-4 mg/kg ideal body weight for chloroquine and 6-6.5 mg/kg for hydroxychloroquine. In this way, both can be used for long-term therapy. The pharmacokinetics of chloroquine (storage in deep compartments with long plasma half-life) means that it can cumulate, especially with higher dosages and in the presence of renal or hepatic insufficiency. A high plasma concentration reinforces the side-effects without reinforcing the therapeutic effects. Besides subjective symptoms (e.g. anorexia, diarrhoea, nausea), the following undesirable reactions are significant. On the skin exanthema, hyperpigmentation and photodynamic reactions can develop. The hair can become white in blonde and red-haired men. In the eye, chloroquine deposits in the cornea and disturbances of accommodation can occur, besides retinopathy. Neuromyopathy and central nervous system disturbances (e.g. psychosis) are rare, as is impairment of auditory function or blood cells. During pregnancy there is a risk of potential fetal damage (hearing loss, abortion). An acute overdose is extremely dangerous: the lethal dose is 1 g for children and 4 g for adults. As death occurs rapidly, chloroquine has to be stored where it is absolutely inaccessible to children.

Chloroquine↗
PubMed1990

Interleukin-2 in combination with interferon-alpha in disseminated malignant melanoma and advanced renal cell carcinoma. A phase I/II study.

In vitro, the combination of interleukin-2 (Il-2) with interferon-alpha (IFN-alpha) seems to act synergistically on the generation of lymphokine activated killer (LAK) cells. Due to this fact two clinical trials with the combination of Il-2 and IFN-alpha were initiated in malignant melanoma (MM) and renal cell cancer (RCC). Patients with disseminated MM were treated by a sequential application of 10 x 10(6) U/m2 rIFN-alpha 2b s.c. on days 1-7 followed by continuous intravenous infusion of 3 x 10(6) U/m2 rIl-2 on days 8-13 and 15-20. After a pause of 4 weeks the cycle was repeated. In advanced or disseminated RCC, the patients were treated with a daily alternating scheme of 10 x 10(6) U/m2 rIFN-alpha and rIl-2 as 1 h infusion 1 x /day for 14 days. The rIl-2 escalates intra- and interindividually beginning with a dose of 3 x 10(6) U/m2. The cycles were repeated after a pause of 3 and 4 weeks, respectively. The preliminary results show that the schedules are practicable and that the toxicity of the combination of rIl-2 and IFN-alpha does not accumulate. Within the MM group 3/11 evaluable patients achieved partial remission and 2/11 stable disease. In the RCC-group 2/5 evaluable patients achieved partial remission and 2/5 had stable disease so far.

Carcinoma, Renal Cell↗
PubMed1989

[Psoriatic alopecia manifestation, course and therapy in 34 patients].

We report on a long-term clinical study on 34 patients (aged 6 to 88) suffering from psoriasis vulgaris capillitii with ensuing loss of hair and alopecia. Most patients showed heavy hyperkeratosis. The loss of hair was either massive (sometimes in tufts) or moderate; its course was acute in 53%, chronically recurrent in 15%, and chronically progressive in 32% of the cases. The psoriatic alopecia was circumscribed in 80% (from the size of a coin up to that of a palm of a hand; thinned out or bare) and diffuse in 20% of the patients. Alopecia was only observed in psoriatic lesions, but not necessarily in every plaque. Thus, psoriasis of the entire scalp did either result in circumscribed or in diffuse alopecia. The trichogram taken from regions next to alopecic areas revealed a telogen rate between 25 and 86%, according to the respective progression of the disease. The light microscope showed the typical features of psoriasis associated with distinct follicular hyper-(para-)keratosis; in some of the histologic sections, we saw a well-defined perifollicular adnexophilic infiltration of lymphocytes and histiocytes, which could cause alterations of the follicular epithelium and sometimes even destroy it altogether. In due course, these alterations resulted in granulomatous foreign-body reaction with scar formation. After topical anti-psoriatic treatment, we noticed regrowth of hair in more than 70% of the patients, whereas 25% developed scarring alopecia. - What we call psoriatic alopecia is the symptomatic loss of hair in psoriatic lesions of the scalp. In most of the cases, it can easily be identified on account of the underlying psoriasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

[Therapy of oral hairy leukoplakia with acyclovir].

Oral hairy leukoplakia was treated in six patients with (a) acyclovir (i.v. or p.o.), (b) 0.1% vitamin-A acid solution or (c) human beta-interferon-gel (10(5) I.E./g) in a total of 23 therapeutic courses. In 5/6 patients, acyclovir (7.5 mg/kg every 8 h i.v. or 5 x 400 mg p.o. over 5-10 days) led to partial (n = 1) or complete (n = 4) remission. After 1-6 months, however, the leukoplakia recurred in all cases. Vitamin-A acid solution (n = 3) led to remission in one and to improvement in the others. Human beta-interferon gel (n = 3) had no visible effect. The efficacy of acyclovir is further evidence of the concept that the Epstein-Barr virus is a major cause of oral hairy leukoplakia.

AIDS-Related Complex↗
PubMed1988

[Chloroquine retinopathy: preventable by monitoring the maximum daily dose].

Decisive for the development of chloroquine retinopathy is not the total cumulative dose. Recent findings indicate that retinopathy develops if daily dosages are too high. Therefore, daily dosages of 4 mg chloroquine/kg ideal body weight and 6.5 mg hydroxychloroquine/kg body weight, respectively, should not be exceeded. If these maximum daily dosages are observed, long-term therapy over periods of months or even years seems to be safe.

Chloroquine↗
PubMed1986

[Acute exanthematous eruption of multiple Kaposi sarcomas of the AIDS type in a female drug-addict. Successful chemotherapy with vincristine, bleomycin and dactinomycin].

In a 30-year-old German women who appeared to be in good general health, numerous Kaposi sarcomas of the AIDS type appeared on her face and trunk within a few days. Her arms, legs and oral mucosa were also affected. The patient has been a prostitute for more than 10 years and an i.v. drug addict for 5 years. Her face and upper trunk were densely covered with livid red tumors that were up to the size of coffee beans, with a longitudinal axis that followed the relaxed skin tension lines. HTLV III antibodies were present. No severe cellular immune defect could be demonstrated (OKT4 + to OKT8 + cell ratio 1.15; later control = 2.4). Recall antigens were negative. Since no severe immune defect was present, cytostatic therapy with vincristine, bleomycin and dactinomycin was carried out. Infiltrates began to regress after just one cycle. After four cycles, the facial lesions had completely disappeared. On the chest slight erythemas remained, but there were no histological signs of Kaposi sarcoma. On the legs there were still some solitary brown infiltrates. It was shown that the AIDS type of Kaposi sarcoma responds to combined chemotherapy.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Changes in telogen rate, hair density, hair diameter and rate of growth in androgenetic alopecia of the male. Simultaneously a contribution to the significance of dysplastic hair].

In a pilot study, comparative measurements of frontal and occipital trichograms, hair density, hair diameter and hair growth rate were performed on 26 male volunteers (ages 20-33 years) with androgenetic alopecia between stages II and V (Norwood scale). In the frontal region, the proportion of telogen hair was, in general, pathologically higher and increased according to stage. The density of the frontal hair was significantly lower (166 +/- 28/cm2) compared with that of the occipital region (193 +/- 24/cm2) and decreased according to stage. The average hair diameter in the higher Norwood stages decreased similarly in both the frontal and occipital regions, as shown by the correspondence between the two measurement points (frontal, 0.068 +/- 0.011 mm; occipital, 0.069 +/- 0.010 mm). Anagen and dysplastic hair from both the frontal and occipital regions was significantly thicker than telogen hair (0.07 mm vs 0.05 mm). The frontal growth rate (0.355 +/- 0.024 mm/day) was significantly lower than that of the occipital region (0.389 +/- 0.021 mm/day). In addition, the frontal growth rate decreased according to stage. Dysplastic hair exhibited high growth rates and diameters similar to those of typical anagen hair. In our opinion, dysplastic hair is growing hair, the roots of which have been artificially modified by plucking. - These intra-individual comparisons of frontal and occipital regions showed a reduction in the anagen phase, density, diameter and growth rate of the endangered frontal hair. A reduction in the size and dividing activity of the matrix is indicated by our data. It seems that these regressive changes occur primarily without a prior indication of accelerated hair growth.

Adult↗
PubMed1985

Severe polyneuropathy in Tangier disease mimicking syringomyelia or leprosy. Clinical, biochemical, electrophysiological, and morphological evaluation, including electron microscopy of nerve, muscle, and skin biopsies.

Polyneuropathy in Tangier disease can be divided into three clinical types. The most severe form (type III) with a syringomyelia-like syndrome has been described in three cases only. Here, a fourth case of this type is presented. Because of unusual trophic disturbances even leprosy was suspected. Electrodiagnostic findings, including evoked cerebral potentials in this case, were suggestive of a generalized neuropathy with some degree of primary or secondary demyelination and implied possible impairment of central structures. Sural nerve biopsy, including electron microscopy and quantitative analysis, revealed a predominant reduction of smaller myelinated and unmyelinated fibres. The main morphological feature was the abundance of abnormal non-membrane-bound vacuoles in Schwann cells, mostly of the unmyelinated type, and in some endoneurial fibroblasts, macrophages and perineurial cells. There was no inverse relationship between lipid vacuoles and axons in Schwann cell complexes as suspected by others. An excess of endoneurial collagen as well as an increased fascicular area were obvious. In five skin biopsy specimens of different regions typical vacuoles were noted in Schwann cells, histiocytes, nevus cells, and rarely in perineurial cells.

Adult↗
PubMed1979

[Double flap method in the frontal and temporal area to cover larger defects left by surgery].

Regional flaps are often necessary to cover defects left after operations in the forehead and temple area, since the skin of the scalp does not stretch well and because of the likelihood of dislocation of the eyebrow. We find the double advancement-flap technique using curving incisions of great use in this area. These curved flaps margins follow the wrinkles of the forehead and the relaxed skin tension lines. This contributes to easy healing and inconspicous scars. At the same time undersired facial asymmetry or disturbance of expression can be avoided.

Facial Asymmetry↗
PubMed1979

[Treatment of psoriasis using vitamin A, vitamin A acid and oral retinoids].

Vitamin A, Vitamin A acid (retinoic acid) and their synthetic derivatives were variously applied in the management of psoriasis with different therapeutic results. Obviously, they influence the proliferation rate and the differentiation of human keratinizing epithelia and have beneficial effects on skin diseases with disturbances of keratinization, including psoriasis. Systemic application of Vitamin A has been yet largely abandonned since high dosages leading to clearing develop evident systemic toxicity. The anti-psoriatic effect of Vitamin A acid is either moderate or restricted, because of side effects. Only its combined local application with topical corticosteroids may be considered. Oral application of newly synthesized retinoids, however, was beneficial in psoriasis, particularly in erythrodermic or pustular types. With this group of retinoids new pathways were opened in dermatotherapy which may help to replace cytostatic drugs in these cases. Additionally, oral retinoid treatment may be introduced as an adjuvans in the management of widespread psoriasis, in order to enhance the effect of anthralin, PUVA or UVB treatments.

Female↗
PubMed1978

[Subungual malignant lentigo with longitudinal nail pigmentation--diagnosis and surgical treatment].

A subungual Lentigo maligna was found to be the cause of a longitudinal melanotic stripe in the thumbnail of a 45-year old male. Because of the possibility of a malignant process, a histological diagnosis must be made in all cases of pigmented nail stripes. The best procedure is complete excision of the lesion in a bloodless field, followed immediately by frozen section analysis. According to the result either a larger operation is made during the same session or the wound closed. This procedure enables a specific therapy of pigmented subungual lesions, and contributes to the early recognition and prophylaxis of subungual malignant melanomas.

Amputation, Surgical↗
PubMed1978

[Severe generalized courses of zoster due to cellular immunologic defects. Importance of an absolute or relative T-cell deficiency].

Four patients with chronic lymphatic leukaemia, M. Hodgkin and metastatic breast carcinoma developed particularly severe generalised herpes zoster, with complications of herpes zoster pneumonia, signs of encephalitis and phrenic nerve paresis. Virus specific complement-fixing antibodies increased regularly or delayed, without strict correlation to the clinical course. However, in all these cases there was a relative or absolute deficiency of T-lymphocytes in the peripheral blood, as a result of the underlying illness and of treatment with cytostatic agents. Because of the vital role of cell-mediated immunity in the control of the varicella-zoster virus (VZV), the observed T-cell deficiency seems to be an important pre-condition for the development of severe generalised herpes zoster.

Adult↗