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Biomedical subjects

Ulrich Hohenleutner

Publications and source records attributed to Ulrich Hohenleutner.

At least 19 recordsLinked to original sources
PubMed2006

Metastasis of a malignant melanoma 2 years after carbon dioxide laser treatment of a pigmented lesion: case report and review of the literature.

A 64-year-old woman with a clinically diagnosed 'lentigo simplex' on her right cheek was dermatologically treated several times with a CO2 laser. Three years later she showed a metastasis of a malignant melanoma in her right parotid gland. Considering this case, as well as other published cases reporting malignant melanomas occurring after laser treatment, we again underscore that naevomelanocytic lesions are not a routine indication for laser treatment.

Carbon Dioxide↗
PubMed2006

Targeting T cells to hit B cells: successful treatment of cutaneous plasmacytosis with topical pimecrolimus.

Cutaneous plasmacytosis is a rare disease predominantly found in Japanese patients. We describe the case of a 75-year-old white female with cutaneous plasmacytosis of the face and involvement of the bone marrow. In contrast to other cases of cutaneous plasmacytosis, the patient revealed hypogammaglobulinemia and elevated levels of free light chains in the urine. Treatment with topical pimecrolimus 1%, which primarily targets T cells, led to almost complete clinical and histological remission of the skin lesions. Our report indicates that the therapeutically induced disappearance of the plasma cells was due to indirect T-cell-mediated effects.

Aged↗
PubMed2005

Results of nonablative wrinkle reduction with a 1,450-nm diode laser: difficulties in the assessment of "subtle changes".

BACKGROUND AND OBJECTIVE: Nonablative resurfacing has proven its efficacy in vascular and pigmented lesions, while its capacity of substantial wrinkle reduction is still discussed controversially. We present the treatment results of a 1,450 nm diode laser for facial rhytides. METHODS: Thirty facial regions were treated with a 1,450 nm diode laser. Pre- and post treatment pictures were compared by the treating physician and two blinded observers. RESULTS: Even if mild improvement was rated in up to 35% of the post treatment pictures, a discrepancy shows up in the assessments of the three observers, presenting almost no congruency in the rating of improvement. CONCLUSIONS: Our study failed to provide convincing data on the efficacy of nonablative treatment of rhytides with the 1,450 nm diode laser. In this respect, we challenge objective judgment in the assessment of subtle changes in nonablative wrinkle reduction.

Adult↗
PubMed2005

Fibroadenoma of the axilla.

BACKGROUND: Ectopic, axillary breast tissue can develop any disease that affects the normal breast, including fibroadenoma. OBJECTIVE: To report and discuss a case of fibroadenoma of the axilla in a 23-year-old woman. METHODS: Case report and discussion of the rare entity of fibroadenoma of the axilla. RESULTS: The histology was identical to the fibroadenomas seen in the breast and those observed along the milk line. CONCLUSION: Differential diagnosis of an axillary tumor should include ectopic breast tissue.

Adult↗
PubMed2005

Comparison of two absorbable monofilament polydioxanone threads in intradermal buried sutures.

BACKGROUND AND OBJECTIVES: Two absorbable polydioxanone threads are compared regarding intraoperative handling qualities, scar dehiscence, and possible side effects. METHODS: In 30 excisions, half of each suture was performed with PDS II (Ethicon GmbH, Norderstedt, Germany), whereas the other half was closed with Serasynth (Serag-Wiessner, Naila, Germany). Clinical evaluation for scar spreading, spitting of the sutures, hypertrophic scarring, or suture granuloma was performed 3 and 6 months after surgery. RESULTS: No significant difference in scar spreading, hypertrophic scarring, or the incidence of suture granuloma was noted. A significantly lower frequency of spitting was seen with Serasynth than with PDS. The handling and suturing properties of SerasynthM were estimated to be slightly superior compared with those of PDS. CONCLUSION: Our study shows that PDS and Serasynth provide equal cosmetic results when applied in an appropriate suturing technique. Possibly owing to its better pliability, the frequency of spitting was lower with Serasynth.

Absorbable Implants↗
PubMed2005

Congenital cartilaginous rests of the neck (wattles).

BACKGROUND: Congenital cartilaginous rests of the neck (wattles) are very rare, probably branchiogenic malformations. OBJECTIVE: To discuss the clinical and histologic features and the therapy of wattles. METHODS: We report a 4-year-old patient with symmetric exophytic nodules of the neck that had been present since birth. RESULTS: The two lesions, 0.5 3 0.5 cm, were removed. The histopathologic examination confirmed ectopic cartilaginous tissue. CONCLUSION: Wattles must be excised, including their cartilaginous core, after having sonographically excluded fistulae or sinuses.

Cartilage Diseases↗
PubMed2005

Neodymium-YAG Laser for hemangiomas and vascular malformations -- long term results.

BACKGROUND: Hemangiomas and vascular malformations are the most common vascular lesions of infancy. Different lasers can be used for treatment. Nd:YAG laser photocoagulation is particularly effective because of its deep penetration into tissue. PATIENTS AND METHODS: Thirty-one patients, aged from three months to 18 years, with voluminous hemangiomas and venous malformations were treated with a cw-neodymium:YAG laser. The quartz fibre was used in percutaneous and intralesional technique. Long-term follow-up data were acquired by clinical control or a patient questionnaire for a maximal period of eight years. Twenty patients could be evaluated. RESULTS: In the group with hemangiomas (n = 15), three cases showed nearly complete remission (> 90 %), ten cases had a partial reduction in size (50 - 90 %), in one case there was stable disease and in one case tumor growth. In the group with venous malformations (n = 5) two cases showed an excellent response (> 90 %), one case a moderate response (25 - 50 %) and in two cases there was no improvement. Adverse effects included scars (40 %), hyper- and hypopigmentation (23 %), mild atrophy (20 %) and a wrinkled texture (17 %). After maximal reduction in size, 30 % of the patients were not satisfied with the laser treatment outcome and elected surgical excision of the residual lesion. CONCLUSIONS: The neodymium:yttrium aluminium garnet (Nd:YAG) laser with percutaneous or intralesional application technique is a valuable tool for selected patients with hemangiomas and venous malformations.

Adolescent↗
PubMed2005

Early recurrence of eruptive vellus hair cysts after Er:YAG laser therapy: case report and review of the literature.

BACKGROUND: Therapy of eruptive vellus hair cysts (EVHCs) often leads to unsatisfying results or recurrences. Recently, erbium:yttrium-aluminum-garnet (Er:YAG) laser therapy has been recommended in this condition. OBJECTIVE: To report the results of Er:YAG laser treatment and discuss the treatment options in EVHC, presenting a review of the literature. METHODS: Full-face Er:YAG laser therapy was performed in a 30-year-old female patient with a 15-year history of cosmetically bothersome facial EVHCs. RESULTS: Immediately after the laser treatment, the ablated skin showed an even surface, presenting no residual signs of EVHCs. After reepithelialization, however, early recurrence of EVHCs occurred. Recurrence was also observed in the previously treated test spot, where slight atrophy indicated deeper ablation. CONCLUSION: Er:YAG laser therapy might be a treatment option for distinct lesions of EVHCs but proved to be ineffective in a case of EVHCs in the face, where the depth of ablation is limited owing to the risk of atrophy or scarring and where deep enucleation of distinct single cysts was not possible owing to the dense dissemination of the lesions. Despite numerous treatment options reported in the literature, therapy for EVHCs is still challenging owing to recurrences or side effects.

Adult↗
PubMed2004

Antiangiogenic therapy with pioglitazone, rofecoxib, and trofosfamide in a patient with endemic kaposi sarcoma.

BACKGROUND: Kaposi sarcoma (KS) in patients who are seronegative and seropositive for human immunodeficiency virus is currently the most common malignant tumor in central Africa. It accounts for 50% of all tumors reported in central African countries. Owing to the rising number of patients and the limitations of current therapies, there is an urgent demand for new strategies to treat KS. OBSERVATION: We describe a 42-year-old dark-skinned patient from Mozambique with endemic KS. The tumor was first diagnosed 8 years earlier when an ulcerated nodule appeared at his right ankle joint. Subsequently, multiple reddish brown nodules appeared on both feet and the left thigh. Results of dermatohistopathological analysis confirmed the diagnosis of KS. Topical therapies including cryotherapy, carbon-dioxide laser, and photodynamic therapy could not prevent new recurrences and further cutaneous dissemination. Therefore, a novel antiangiogenic systemic therapy was started that was previously shown to be effective in angiosarcomas other than KS. The regimen consists of the biomodulators pioglitazone hydrochloride and rofecoxib combined with a metronomic (daily) low-dose chemotherapy with trofosfamide. We observed a partial remission, which has been stable for 18 months. No significant toxic effects were observed. CONCLUSION: The suggested antiangiogenic strategy has the potential to become a cheap, practical, feasible alternative treatment for endemic KS, particularly suitable for the outpatient setting.

Adult↗
PubMed2004

[The "red melanoma"--a rare form of amelanotic malignant melanoma].

The two major variants of amelanotic malignant melanoma are the verrucous and the polypoid forms. A further--albeit rare--red eczematous variety has also been described. We report two female patients with reddish, non-pigmented, scaly lesions on the upper arm and the shoulder that had developed 2 to 3 years previously. One biopsy showed the diagnosis of a melanoma growing in situ while the second revealed a highly atypical melanocytic tumour. However, the histopathological examination of the entire tumour showed a superficial spreading amelanotic malignant melanoma. Therefore, in non-healing erythematous lesions, even without pigmentation or ulceration, the rare differential diagnosis of amelanotic malignant melanoma should be taken in consideration and a biopsy should be performed prior to therapy without histological control.

Aged↗
PubMed2003

Treatment of oral lichen planus with the 308-nm UVB excimer laser--early preliminary results in eight patients.

BACKGROUND AND OBJECTIVES: Oral lichen planus (OLP) is a chronic disease of uncertain origin. Many patients with OLP are refractory to all available therapies. The 308-nm excimer laser was used as a possible additional method in the treatment of OLP. STUDY DESIGN/MATERIALS AND METHODS: Eight patients with OLP were treated using the 308-nm UVB excimer laser. RESULTS: Clinical improvement was achieved in six patients. Two patients showed complete remission, of which one patient showed recurrence of the lesions after 4 weeks. CONCLUSION: The preliminary results in our opinion warrant further studies of this treatment.

Adult↗
PubMed2003

[Porokeratotic eccrine ostial and dermal duct naevus (PEODDN)].

The porokeratotic eccrine ostial and dermal duct naevus or PEODDN represents a very rare hamartoma of the eccrine sweat glands. A 16-year old boy had developed subtle hyperkeratotic skin lesions on his right hallux at six months of age. When he was eight years old, he developed similar lesions on his right palm. Clinically the lesions were coniform hyperkeratoses. The histopathological examination confirmed the diagnosis of a PEODDN showing typical cornoid lamella where the eccrine secretory ducts penetrated the epidermis. Although porokeratotic eccrine ostial and dermal duct naevi are generally considered as unresponsive to conservative treatment, in our patient topical treatment with tazarotene gel 0.1% resulted in a significant improvement within three weeks.

Administration, Topical↗
PubMed2003

Bullous malignant melanoma: an unusual differential diagnosis of a hemorrhagic friction blister.

BACKGROUND: A 66-year-old woman presented to our outpatient clinic with a 3 x 2.5-cm tense, hemorrhagic-appearing bulla on her forefoot. Histopathology and immunohistochemistry confirmed a transtumoral-transepidermal blister formation within an advanced acrolentiginous malignant melanoma (MM). OBJECTIVE: To study bullous malignant melanoma. METHODS: Blistering in MMs represents a rare but clinically important pitfall in clinical differential diagnosis. The blisters are typically due to the disruption of the cohesion between neoplastic cells and keratinocytes, but physical friction may also contribute. RESULTS: Hemorrhagic blistering is, in many cases, a relatively insignificant finding in which frictional forces are imposed. CONCLUSION: The case reported here underscores that in rare cases MMs, particularly if acrally located, can be complicated by hemorrhagic blistering. Because of the life-threatening consequences, one should be aware of this rare differential diagnosis.

Aged↗
PubMed2003

Spindle cell hemangioma.

BACKGROUND: Spindle cell hemangioma (SCH) is an uncommon benign vascular tumor. OBJECTIVE: To report and discuss a case of SCH in an 11-year-old boy. METHODS: A case report and discussion of the rare entity of SCH are given. RESULTS: The excision of a vascular tumor showed a vascular connection to the great saphenous vein. Histologic examination was consistent with SCH. CONCLUSION: The diagnosis of SCH is supported by typical histologic and immunohistochemical features and by the intraoperative finding of an association with a large vessel.

Child↗
PubMed2003

Variable pulse frequency-doubled Nd:YAG laser versus flashlamp-pumped pulsed dye laser in the treatment of port wine stains.

The flashlamp-pumped pulsed dye laser (FPDL) is regarded as the gold standard in the treatment of port wine stains. The purpose of this prospective, intra-individual, comparative clinical study was to investigate whether a frequency-doubled variable pulsed Nd:YAG laser (frequency-doubled Nd:YAG) is equally as safe and effective as established lasers. Forty-three patients with port wine stains were included in the study. Test treatments were performed using the frequency-doubled Nd:YAG laser (532 nm; 4 mm psi; 5-50 ms; 5.5 to 15 J/cm2) versus the FPDL (585 nm; 450 micros; 7 mm psi; 6 J/cm2). After 6 weeks, a full lesional treatment was performed using the device and the parameters showing the best clearance and the fewest side effects. The clearance of the lesions was generally good to fair. With the exception of poor results at 5 ms and 5.5 J/cm2 with the frequency-doubled Nd:YAG laser, there were no significant differences between the two laser devices. Scar formation, nevertheless, occurred in only 3% of the FPDL-treated sites versus up to 18% of the frequency-doubled Nd:YAG sites, increasing with pulse duration. In port wine stains, the FPDL remains the therapy of choice because of the somewhat better results and a lower frequency of side effects, especially scarring.

Adolescent↗